Transcript Addiction Interaction Disorder New Concepts in

Addiction Interaction Disorder:
New Concepts in Understanding Addiction
and The Dance of the Addictions
Alan M. Yorker, LMFT
August 26, 2014
GSAS Conference
Cross Addiction
• Old definition - having two or more addictions
• New definition – observation of how separate
addictions interact or interrelate –
STAY TUNED!
• Part 1 – Understanding Addiction Interaction
Disorder as a new model for addiction
• A true addiction is a compulsion to do
something repeatedly that proves to be
harmful to oneself and/or others.
• True addictions are progressive (i.e.
strengthen/worsen over time).
• True addiction involves repeated cycles of
toxic behavior.
• True addiction has harmful impacts on family,
friends and society.
Four Modalities of Addiction
• Substances (e.g. alcohol, street drugs, food,
tobacco/nicotine, pharmaceuticals, etc.)
• Activities (e.g. work, sex, gambling, exercise,
worship, cleaning, etc.)
• Relationships (i.e. codependency)
• Mind/body states (e.g. anger, arousal,
histrionics, etc.)
Part 2 – The Dance of the Addictions
• 1985 Orford, “The triad of drink, sex and
gambling share many features; each has given
rise to fascinating and similar logical and
semantic problems.”
• Early 90’s - Carnes reports less than 13% of all
addicts have only one addiction.
• 1993 Huebner – In Eating Disorders,
Endorphines, and other Addictive Behaviors
finds similar neurochemical reactions with
compulsions and deprivations.
• 1994 Carnes - Addiction Interaction model
conceptualized.
• 2001 – Leshner, “Addiction is a disease that
manifests as compulsive behavior.”
• 2001 - van der Kolk - Discovers traumatic
reactivity and alteration in the brain leading to
excessive behaviors, i. e.addiction.
• A model was needed to integrate the
addictions.
• Addictions have meta-patterns that are
important and are discernable clinically. This
is the basis of “Addictive Interaction Disorder.”
• Addictions don’t just coexist. They interact,
reinforce and become part of one another.
• They become packages which can be
unbundled and examined separately as is
done currently. However, they need to be
examined as a whole to get to the heart of the
problem.
• Eleven (11) Addiction Interaction Dimensions
have been identified.
• Cross Tolerance: When two addictions coexist
and reinforce each other (e.g. workaholism
and sexual addiction)
• Withdrawal mediation: When one addiction
mediates another, (e.g. caffeine, nicotine)
• Replacement: When one addiction replaces
another (e.g. Bill W.)
• Alternating Addiction Cycles: When addiction
shifts focus (thin and sexually hyperactive vs.
obese and sexually aversive)
• Masking: Blaming one addiction for another
(e.g. “I did it because I was so drunk”)
• Ritualizing: Set behavioral patterns of dress,
place, routine.
• Intensification: Two or more addictions fused
or partially fused together or infused.
• Numbing: Using one addiction to soothe
oneself or calm oneself after another (e.g.
drinking to relax after sex, watching TV for
hours after amphetamine abuse. Drug binge)
• Disinhibiting: Using one addiction to lower
one’s inhibition to another (e.g. drinking to
“get up the courage”, using drugs to engage in
risky behavior)
• Combining: Using multiple addictions to
create a wave of “high” (drinking followed by
drug use, followed by risky sex, followed by
gambling)
• Inhibiting: Using an addiction to limit or
control another (using MJ to avoid using
cocaine, gambling online to avoid accessing
child porn)