There are times in our profession where we must shift our focus away from substance abuse, but rather on behaviors that are both repetitive and often times pathological. With our attention diverted away from these harmful substances, we can then turn our focus to similar behaviors as they relate in the realm of addiction. Namely, this involves looking at what is typically referred to as compulsive behaviors, and their similarities with substance abuse.

One aspect when considering different compulsive behaviors is to understand that there are various types which can be confused easily. For instance, several people often times confuse impulse-control disorders with obsessive-compulsive disorders. The defining characteristic of an impulse control is the inability to resist a harmful behavior, while an obsessive-compulsive disorder involves participating in a repetitive action to simply reduce anxiety or frustration, not for enjoyment.

While these compulsive behaviors themselves may not directly involve the use of drugs or alcohol, the reasons that most would engage in compulsive behaviors is the same reason why they would engage in the use of harmful substances. One may harness the use of a compulsive behavior (such as over-eating or compulsive gambling) to overcome boredom, take their mind off of their problems, manage their depression and/or anxiety, or even try to alter their state of consciousness.  Furthermore, from examinations of the human brain through functional MRI scans, we can see that “the same areas of the brain activated by abusing drugs are also activated while gambling or anticipating the desired food.” (Cohen/Inaba) This particular finding was from a radiology test done at Massachusetts General Hospital. For instance, the portion of a gambling addict’s brain which would respond to a potential “big win” as well as losing a bet were the same portions of the brain of a cocaine addict which responded with a rush of endorphins when the offer of cocaine was on the table.

 When we consider these behaviors with the classic disease model primarily associated with substance abuse, we can then correlate compulsive behaviors as merely a symptom, while the addiction is still viewed as the sickness.

There lies the crux of our solution towards helping those maintain and treat their compulsive behaviors. It has often been a common observation, relating to the old saying “once an addict, always an addict,” that people who have struggled with drug and alcohol addiction, primarily can see their disease manifest itself into other behaviors, both compulsive and obsessive.

So, what is left to be done when these behaviors come up with one of our clients? The answer is to walk them through it. Help them to realize the harmful attributes of their behaviors and how backed by evidence-based research, we can show them that their disease manifests itself in many ways. This, in turn, can allow us to approach a solution based on love, healing, and support; which proves to them that just as they overcome the desire to drink and use on a daily basis, so too can they overcome their compulsive behaviors.


-J. Dalton Williams






Inaba, Darryl S. Cohen, William E. Uppers, Downers, All Arounders: Physical and Mental Effects of Psychoactive Drugs. 8th ed. CNS Productions, INC. 2014.