Behavioral Addictions: Understanding Abstinence

Behavioral Addictions: Understanding Abstinence

BETH FISHMAN, PHD, PROGRAM MANAGER, ADDICTION SERVICES

In a previous blog post we met Lauren, a 16 year-old junior in high school who was having trouble with online activities. Because of her time online, she was losing sleep, seeing her grades slip and having less time and more conflict with her family. Covid restrictions seemed to make it all worse, and she found that screen time distracted her from increasingly anxious and depressed thoughts and feelings. Lauren’s online activities in her free time are considered a behavioral addiction because she has lost control and has many negative consequences from it. At the same time, Lauren’s school had been fully remote and therefore required her to be online for hours a day. How can Lauren develop a non-destructive relationship with online activities? What does abstinence look like in a situation like this?

Abstinence can seem pretty straightforward when one is misusing alcohol or other drugs. In these cases, abstinence is defined as complete removal of the substance from one’s life. Most folks aren’t required, by medical advice or otherwise, to ingest alcohol or recreational drugs. So, abstinence can be defined here as removing alcohol and recreational drugs from one’s life.

The same definition of abstinence can be applied to some behavioral addictions, things we do that become out of control and cause problems in our lives. When the problematic activity can be completely removed from one’s life, for example gambling, then abstinence is achieved by living a gambling-free life.

But with some behavioral addictions, abstinence is trickier because the problem behavior can’t be completely removed from one’s life. This is the case with Lauren’s internet use. She can’t get offline completely because her academic classes are online. If the problematic behavior involves food, one still has to eat. What if one is engaged in compulsive sexual behavior? Most folks wouldn’t need to stop all sexual activity. In these cases and others, one can “slice and dice” the problematic activity in order to create an abstinence plan, in which abstinence is not defined as the cessation of all related activity, but only the problematic activity. What might this look like?

Often only some items or activities are causing a problem. Lauren looked more closely at her internet use and identified Instagram as the app she couldn’t control. She had no trouble controlling her time for school research projects. For her, removing Instagram from her devices was the start of her internet abstinence plan. The same is true for compulsive eating, as most individuals who experience compulsive eating focus on certain foods like simple carbohydrates. An individualized abstinence eating plan would remove simple carbs while complex carbs stay in the diet. Abstinence from many behavioral addictions can include this process of identifying and removing specific items or activities. From there, the approaches to maintaining abstinence are similar to substance misuse: managing cravings, learning new coping skills, finding community support, accessing therapies, and more.

Treatment programs for behavioral addictions are available locally and nationally. If you or someone you care about is struggling with any kind of addictive behavior, JCFS Chicago addiction services is here to help. Please contact us for information about addiction and recovery, a brief phone screening, and/or information on local and national treatment and support resources. Email Beth Fishman, Program Manager, or Nina Henry, Addiction Specialist. We are here for you.