need more food or more sex to get the burst of mood-altering dopamine back. Certain foods affect dopamine levels, and when we overuse them we’re taking that first step toward a process addiction. Sugar and the taste of sweets, for example, stimulate the brain by activating beta-endorphin receptor sites (ibid). These are the same chemicals activated by heroin and morphine. This is thought to be one of the drivers of compulsive overeating.
How Moments of Panic Lead to Self-Medication
Why does a gambler, in just a few minutes’ time, burn through his child’s college fund or lose the family home? Why does a compulsive eater drive through the night to find an open deli where she can load up on sugar and white flour and then try to throw it all up an hour later? What drives a sex addict to humiliate himself and his family and put all that he loves and has worked for at risk? What factors contribute to this mind-boggling loss of impulse control?
We all have a mind/body chemistry designed to nourish, sustain, and keep us safe. When that body chemistry gets thrown out of balance through trauma we have suffered or trauma we’ve brought onto ourselves, it can drive the kinds of behaviors that get us into trouble.
Engaging in risky behaviors can cause us to go into a fear/panic state. Here’s how that cycle kicks in:
When our panic button gets pushed, our emergency systems engage; they go into fight/flight.
Then, our thinking mind (pre-frontal cortex), which is the part of us that perceives future consequences, goes off-line. We freeze in our tracks.
But our emotional (limbic) mind swings into high gear. In that moment of panic, we become all feeling with little or no thought. Oftentimes, in the case of process addictions, it’s our own risky, acting-out behavior that scares us, behavior that may be fueled not only by old pain and a wish to get rid of it, but by fear of our actions of the moment. The food we don’t want anyone to know we crave and have to have now! The sex we don’t want anyone to know about because it could get us into huge trouble with our spouse. The spending that will leave us without money left to pay bills. These ‘’crazy” high-risk behaviors can, and probably should, send us into a panic/shame spiral. That fear presses our panic button; we get flooded with awful feelings of shame and pain (what did I just do?) along with prickly, anxiety-provoking body sensations that make us all jumpy inside. Then there we are, in need of something to make us feel better fast. And we know what that is because we just did it. So we’ll just do it again, this one last time. And it isn’t all that bad anyway, it’s just food, or sex, or one drink, or a little something we’d just love to take home, or one last win. And it’s only just this once.
Emotional Eating: Feeding Our Feelings
It is estimated that fourteen million people are affected by an obsessive, compulsive, or disordered relationship with food. Jenni Schaeffer, author of Life Without Ed: How One Woman Declared Her Independence from Her Eating Disorder, wrote a gripping piece that offers an unobstructed window into the mind of someone with disordered eating patterns. Jennie’s words illustrate how chasing her own dopamine high to avoid feeling her depression led her down a desperate path toward a compulsive relationship with food.
After restricting food for days, I really needed energy. I dared to try an apple. I knew this would lead to eating more and more. Of course, it did. I started baking and bingeing. . . . I drove to a vending machine at my apartment complex, and it was empty. So I drove my car to a nearby convenience store at 2:00 am. Would it still be open? How much money would I have to spend? Realizing I did not have enough money or my cell phone, I went back to my apartment to get both. Then I drove twenty minutes to a fast-food restaurant that is open twenty-four hours. I ordered lots of food at the drive-through and ate it in less than thirty seconds. A guy came running out of the store yelling something at me. Did he know what I was doing? . . . I know it’s not safe driving in my car at 2:30 am with a missing a headlight and a bad engine. But I drove to another fast-food restaurant to get more food. What is wrong with me? I wouldn’t even eat dinner with Amy earlier today. But now, all I can do is eat. I have no control. I still need more food, but I can’t go back to the same drive-through. They will recognize me. So I drive—now at 3:30 am—forty-five minutes to a twenty-four hour grocery store. I buy lots of food that I had avoided eating earlier in the week. (I bought the exact candy that my boyfriend had offered to me and that I had refused.) My binges always equal everything I normally won’t let myself touch at all.
Finally, I am satisfied. That anxious feeling is gone. I drive home. I try to throw up twice. (I’m never very successful at this.) I am depressed.
I feel isolated from my mom and dad, Amy, my boyfriend, and everyone. I don’t want anyone to ask me about my eating. I have to avoid everyone so that they won’t ask. How did it get like this? I feel fat. I don’t want to eat again. My life is unmanageable because of food. But what do I do? I feel helpless and fat. I can’t break the cycle. I just want to break the cycle.
I know what I can do. I won’t eat tomorrow (Schaeffer 2012).
A study from Scripps Research Institute headquartered in La Jolla, California, and published in Nature Neuroscience on March 28, 2010, found that junk food, or foods high in white sugar, white flour, and unsaturated fats, can be as addictive to the brain as cocaine, as it causes similar changes in the brain and sets up cravings for more junk food. In lab tests, rats given unlimited access to high-calorie foods like candy bars and cheesecake not only became obese very quickly, they continued gorging even when this binging behavior led to an electric shock. Obese rats that had their junk food replaced with a healthy diet actually stopped eating completely because the reward system in the rats’ brains changed when they became compulsive eaters. “What we’re seeing in our animals is very similar to what you’d see in humans who overindulge,” says lead researcher Paul J. Kenny, an associate professor of molecular therapeutics at the institute. “It seemed that it was okay, from what we could tell, to enjoy snack foods, but if you repeatedly overindulge, that’s where the problem comes in” (Johnson and Kenny 2010). Repeated indulgence in junk food changes the brain chemistry to want that soothing, oblivious high, or what amounts to self-medicating, so that the brain and body actually become locked into an addictive cycle that is similar to that of a cocaine addict.
Compulsive Combos: Invisible Addictions
One bad choice leads to another. Sugary foods can become a gateway to self-sabotaging food choices that can lead us straight into compulsive eating. ACoAs who don’t want to think of themselves as alcoholics or drug addicts may be unwittingly manipulating their own body chemistry. Foods that contain sugar and white flour that the body immediately converts into sugar, along with a couple of drinks of alcohol that add to and potentate the sugar effect, constitute a “compulsive combo” that can become extremely addictive.
Holistic nutrition counselor Meredith Watkins writes about how food sets up cravings and increases anxiety levels that lead to self-medicating. “The recovering alcoholic who keeps a daily cocktail of caffeine and nicotine coursing through his veins and keeps white pasta and bagels on regular rotation in his diet . . . not surprisingly has alcohol cravings going through the roof. . . . In this case, the sugar from the white flour products acts in his body in the exact same way alcohol does.” And the caffeine he is drinking with the bagel or muffin “is blocking the production of natural serotonin,” his body’s natural mood stabilizer (2012).
In her book The Mood Cure, Julia Ross talks about the chemical action of sugar and alcohol in an alcoholic’s body: “Alcohol acts just like sugar biochemically, only more so. It contains more calories per gram, and it gets into your bloodstream faster. For people whose blood sugar levels tend to be low (of which research states that 95% of alcoholics are hypoglycemic), this can be irresistible” (2002). “This is why those bagels should be verboten to a recovering alcoholic” (Watkins 2012).
Sex Addiction: Li
ving a Double Life
Mina,
I’m joy that I have a chance to get closer with u.
Friends call me Ira. I like sport, music, and Internet.
I’ve got shiny smile and attractive body.
Write me.
I saw your photos, and I wanna meet you.
Bye!
This was on fourteen-year-old Mina’s computer when she logged on—some weird, Google-translated solicitation that no young girl should have to deal with, along with countless ads using pornographic language to advertise for Viagra, Cialis, and other similar meds.
Mina’s parents are divorced. Her mother works long hours, and her father lives a long distance from her. Feeling lonely, she has gotten into the habit of visiting chat rooms. She met a “boy” online. They got close. Mina felt Don understood her, and he always seemed to ask the right questions. She got into the habit of spending hours each evening chatting with Don. His voice was warm and made her feel secure and cared about. After weeks of becoming closer than she had ever felt to anyone in her life, they decided to meet. When Mina met Don she was taken aback—he seemed much older than he said he was. She felt like a girl and like he was a much older man. Still, she was meeting her best friend. She felt scared, she felt confused, she felt betrayed. But she checked into a motel with him because they were so “close.” After one visit, she told her mother.
A statistic from the Society for the Advancement of Sexual Health estimates that 3 percent to 5 percent of the U.S. population suffers from sexual compulsion disorders; however, this estimate only includes those actively seeking treatment for sexual addiction. There may be millions who are affected, living in the shadows, and not getting help.
Pornography, addiction, and cybersex are forms of sex addiction that have inexpensive and available gateways. Some indication of the extent of the problem is the amount of pornography available and used on the Internet. As of 2003, there were 1.3 million pornographic websites—260 million pages. Cybersex involves a noncontact sexual episode through private chats, either with or without a video connection. Seventy-six percent of victims in Internet-initiated sexual exploitation cases were 13 to 15 years old, and 75 percent were girls. “Most cases progressed to sexual encounters,” according to the Journal of Adolescent Health (Dube et al. 2006), and 93 percent of the face-to-face meetings involved illegal or underage sex.
The difference between old-fashioned porn and Internet porn is a bit like the difference between wine and spirits. After hundreds of years as a mild intoxicant, erotica has undergone a sudden distillation. Digital porn is the equivalent of cheap gin in Georgian England: a reliable if unhygienic hit that relieves misery and boredom. And, unlike the old “dirty mags,” it is available in limitless quantities” (Thompson 2012).
And cybersex appears to affect relationships. At a 2003 meeting of the American Academy of Matrimonial Lawyers, two-thirds of the 350 divorce lawyers who attended said that excessive interest in online porn played a significant role in the divorces of that year, where previously it had almost no role (Hagedorn 2009).
Sex Addiction that Begins in Childhood
Raymond’s father is an alcoholic. His parents ran a funeral home and the family lived above it. Raymond was very much afraid of his father, who raged at him, and his mother and brother didn’t offer much companionship, protection, or solace. An employee at the home, Caruso, took a shine to Raymond and spent time with him. He was big, gregarious, and paid attention to Raymond. Caruso often took Raymond to the basement to “train” him in the family business. His father approved. While initially this felt like much longed-for special attention, it eventually became an experience that sowed the seeds for a life-long pattern of sexual acting-out behaviors. In the course of “training,” Caruso terrified Raymond by showing him dead bodies and body parts. He also exposed himself to Raymond and “he got me to do things to him.” He told Raymond that if he told his parents what was going on, he would kill him. And Raymond, being a child and a frightened child at that, believed him. In Raymond’s young mind, sex became fused with terror and abuse, a hand, a body, an erect penis. Sexual pleasure and sexual fear all became conflated in Raymond’s mind.
It is no wonder that as an adult, Raymond himself became a womanizer and turned to alcohol and drugs to deal with the freaky imagery that he lived with and the state of anxiety his past left him with. He has had a string of careers; in his using days he was the owner of a strip club.
The longer the origins of Raymond’s behavior went unaddressed, coupled with his use of drugs and alcohol as his “go to” for managing his pain, the more his sexual acting out escalated. Though some of the details of Raymond’s story are unusual, the gist of this story I find all too common. There are many children in many basements “playing” or “being taken care of.” The Raymond character carries terrible feelings of guilt and complicity. Though these victims were often very young at the time, say eight or so, the sexual liaison may have persisted over time, and they may have both feared and taken pleasure in it. They are left with the feeling that because they did not say no, they are somehow at fault. But trauma bonds make saying no extremely difficult, and the relationship described here between Raymond and Caruso is based on fear and subjugation; Caruso had the authority of age. He terrified Raymond and cut off any access to outside support that Raymond may have had by telling him that he would kill Raymond if he told; the more afraid Raymond was, the more he needed Caroso’s “protection.”
These same features can be part of a less obviously frightening situation if there is a power (age) imbalance, secrecy, and fear of being “found out” and a sense of one person being subjugated by the needs of the other. They are a recipe for a trauma bond.
Sex and Self-Soothing
We use sex for much more than reproduction. Orgasm releases dopamine into our bodies that makes us feel soothed, cared for, and alive. It is one of nature’s great mood menders and bonders. But intense sexual stimulation, such as Internet pornography, can trigger a neurochemical high followed by a hangover or a withdrawal period. As dopamine drops, a sexual satiation neurochemical rises, and testosterone receptors decrease—all of which can radically affect mood for the worse or even bring on withdrawal symptoms. Some of this drop is natural, and if couples are lying in each other’s arms, it can be a soothing and bonding time in which they can enjoy each other and affirm their affectionate feelings. If the drop is severe and a person is left feeling alone and perhaps disconnected, this withdrawal can feel like a letdown where emotions of shame or loneliness can make one want to do something to get rid of uncomfortable feelings, something that can spiral him or her further toward compulsivity.
Spending and Debting
We are a nation of consumers; buying is what keeps our economy afloat. Spending and debting are part of our landscape. Between 6 to 9 million people are estimated as affected by pathological gambling, which is now included in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Indeed, this seesawing between financial extremes has come back to haunt all of us from megacorporations to small households. Behaviors around money can fly out of balance through overspending, underspending, or a combination of the two. We can binge and purge with money just as with food; we can be financially sober, financially inebriated, or financially anorexic.
The Adrenaline-Endorphin High
Adrenaline, which the body releases when it is in a state of hyperarousal—the fight-or-flight response—rewards the body with a rush of exquisite pleasure and pain relief. When secreted into the bloodstream, it rapidly prepares the body for action. While some people get their adrenaline “fix” from driving too fast or skydiving, others get theirs from gambling, compulsive spending, overworking, or obsessive activity—all of which reflect problems with self-regulation and impulse control. Endorphins resemble opiates in their ability to produce a sense of well-being and are
a natural pain killer. Both adrenaline and endorphins are part of the self-medicating cycle.
◊◊◊◊
Sandra and Dick came to a session with me as a couple; they were beginning to have some relationship issues. They had fallen madly in love at a conference and were married within three months. Dick was Sandra’s fifth husband, and Sandra was Dick’s third wife. As we explored what brought them to see me, it became obvious that Dick was very concerned about the way that Sandra spent money.
“About how much money did you spend, would you say?” I asked.
“Well, not that much really, around well, maybe thirty-five or forty-five thousand,” Sandra answered sweetly.
“Which is it, do you think?” I asked, beginning to get a picture of her reluctance to acknowledge the amount.
“Well,” said Sandra, without as much guilt as I might have expected, “maybe closer to forty-five thousand.”
“How long did it take you to spend that amount?”
“I’m not sure, fifteen minutes maybe . . . maybe thirty,” Sandra said sheepishly and with the look of a little girl who’d just eaten the first piece of someone else’s birthday cake. She was acting like she had simply overspent a bit but that it was somehow not that big a deal.
“What did you buy that you spent that much so quickly?” I asked, imagining that it might be a piece of jewelry she’d been wanting.
“Oh, lots of things. I don’t quite remember. A bracelet, I think, a lizard-skin jacket, some other stuff, some lingerie.” She winked at her husband, who was now shifting his weight back and forth in his chair. The picture was beginning to take shape: a woman running frantically around a store, grabbing breathlessly at items she not only didn’t particularly need, but ones she didn’t even remember buying.
The ACOA Trauma Syndrome Page 12