Understanding Process Addiction

A process addiction is, in short, an addiction to a process rather than a substance. While not all process addictions are recognized by the medical profession, they all share similar traits with each other and, indeed, with substance addictions.

Essentially, an action or behavior creates a reward that develops into a compulsive behavior¹1.J. E. Grant, M. N. Potenza, A. Weinstein and D. A. Gorelick, Introduction to Behavioral Addictions – PMC, PubMed Central (PMC).; Retrieved September 23, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3164585/.

Process Addiction Definition

The traditional model of addiction was simplistic. An individual would use a drug, for example, and experience a positive effect and over time they would develop a tolerance and need more and more to achieve the same positive effect. This would result in dependence on the drug and become addiction.

While this model has the benefit of simplicity it does not explain behaviors that are recognized as addictive but involve no substance. Gambling, for example, is a recognized addiction, and it is estimated 1-3% of people have a severe gambling problem. But gambling is purely a process and there no physical dependence or withdrawal symptoms²2.S. S. Alavi, Behavioral Addiction versus Substance Addiction: Correspondence of Psychiatric and Psychological Views – PMC, PubMed Central (PMC).; Retrieved September 23, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354400/.

Modern understanding of addiction has developed, and now recognizes that it is the brain, and not the substance, that creates the addiction. While drugs can create a physical dependence, it’s actually the brain’s own neuroplasticity that is believed to create the addiction.

When the brain’s reward centers are activated, the brain started to create pathways to them. This happens with the gambler betting just as much as it does with a cocaine user taking a hit. The brain creates the addiction by creating a compulsion for the behavior that stimulates the reward centers, whether that’s a drug or process.

Getting a Diagnosis of Process Addiction

One of the problems of defining process addictions is that they involve behaviors that the majority of people exhibit without addiction. Not everyone gambles, everyone has to eat, most people will shop, use the internet, play video games or have a few drinks. But these are all behaviors that some people suggest can be addictive.

The discussion is further complicated by the cultural or moral judgements that some people might make. Someone who is culturally conservative might take a different view of what constitutes an addiction rather than someone who was culturally liberal.

While there are still discussions over which of these are truly addictions, scans, using technology like fMRI, have shown similar brain activity between process and substance addicts. But, without the resources to routinely scan people’s brains we have, instead, to look at the effect the addiction has on the individual and the need that the behavior satisfies for them.

Symptoms of Process Addiction

Like most mental health problems, many process addiction can be diagnosed using various questionnaires that have been developed. However, for almost all process addictions there are a series of symptoms that are fairly common to any type of addiction.

Behavior changes are a common effect of addiction. This will often relate to the addiction, so the addict might show irritability if they are not indulging in the addictive behavior or respond with anger when they are challenged about their addiction. They might take steps to hide their addiction, for example, avoiding being with people, so they can play video games.

In severe cases the behavior changes might start having an impact on other parts of their life. Compulsive gamblers, for example, might neglect work or family duties to spend time gambling³3.B. K. Thege, E. M. Woodin, D. C. Hodgins and R. J. Williams, Natural course of behavioral addictions: a 5-year longitudinal study – BMC Psychiatry, BioMed Central.; Retrieved September 23, 2022, from https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-015-0383-3. Those with an internet addiction might neglect relationships with real-life friends, preferring time online or connecting with people they only know through the computer.

Finally, addicts might also suffer from problems caused by their addiction in addition to those cause by neglect of other parts of their life. Debt problems are common with gamblers, for example, and in severe cases some resort to criminality to fund their bets.

Those with shopping compulsion may also have an issue with debt, or even hoarding as their unused purchases take up more and more space. And those with a love addiction might engage in risky sexual behavior, acquiring STIs.

Common Behavior Addictions

• Love addiction
• Shopping addiction
• Spending addiction
• Lying addiction
• Internet addiction
• Video game addiction
• Food addiction
• Gambling addiction
• Exercise addiction
• Adrenaline addiction

Although the label addiction is often applied to many negative behaviors, they are not all recognized by the medical profession as addictions. However, those commonly suggested as process addictions include things like love and relationships, shopping, video gaming and the internet, food, gambling, and even exercise. One of the difficulties in identifying addictions is that many of these behaviors are normal, some essential, and some usually seen as beneficial.

Where these become a problem it’s usually because the need it serves has become different to most peoples, or the way that need is fulfilled is different to most people. With food, for example, the addiction may be to specific types of food that provide a quick hit for the compulsive eater⁴4.A. Y. Hakami, Frontiers | Prevalence of Behavioral Addictions and Their Relationship With Stress and Anxiety Among Medical Students in Saudi Arabia: A Cross-Sectional Study, Frontiers.; Retrieved September 23, 2022, from https://www.frontiersin.org/articles/10.3389/fpsyt.2021.727798/full. Someone addicted to exercise will be doing it not to improve their fitness or train for a specific event or sport, but instead simply for the release of endorphins and dopamine, the effect commonly known as the runners’ high.

One current concern is that process addictions can act as a gateway and that by creating the neural pathways, it means that people might be more susceptible to other addictions. Many are particularly concerned because some of these processes are acceptable for children (it’s sometimes suggested that around 18% of children have a video gaming problem) and this might leave them susceptible to addictive behavior when they are older.

Process Addiction Treatment

Process addictions are highly treatable. However, in most cases, because the behavior is one that cannot be avoided the treatment will focus on developing a positive relationship instead, which can be particularly true when treating compulsive sexual disorder.

Inpatient treatment can be used as a last resort if the addition is particularly severe. This can be effective in ending the addictive behavior because the environment can be controlled⁵5.A. B. CEO Worlds Best Rehab Magazine, Worlds Best Rehab | Best Addiction Treatment Rehabs in the World, Worlds Best Rehab.; Retrieved September 23, 2022, from https://www.worldsbest.rehab. However, inpatient treatment will still need to focus on changing relationship and behaviors to prepare the individual for when they leave. Inpatients will need to have a strong support structure when they leave to help them.

The most common treatment for process addictions will be therapy. This might be individual CBT or group therapy, which can be very effective. There are also twelve-step programs for many process addictions where addicts can get the support of peers.

However, whatever treatment option is used, it is important to undertake treatment in a way that can handle other problems that might arise. Many process addictions may have developed as a way of coping with other problems, like depression or trauma, and these can resurface if the addictive behavior is removed.

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