For a very long time, much of the medical community has lumped addictions and compulsions together, as professionals tried to get their hands around how to best treat these confounding issues. Doctors and therapists oftentimes tried using similar techniques, under the assumption that these two were separate displays of the very same brain disease. However, continued research indicates there are very clear distinctions between them. These distinctions can make a big difference in your personal diagnosis and the kind of treatment that may help in achieving recovery.
Part of the problem is that the two terms are frequently used interchangeably. How often have you heard someone addicted to gambling called a compulsive gambler? In addition, the range of compulsion can add to the confusion. For example, most of us associate Obsessive Compulsive Disorder (OCD) with germaphobes and people who need order to the extreme, like the lead character from the TV show “Monk”. Addiction involves a flash of pleasure with a hint of danger. It’s fun to gamble, drink and even overeat, but it also puts you at risk. You ring up unsafe amounts of debt, make poor decisions and ruin your health, among other things. Addiction brings pleasure in the moment but leaves you holding the bag of negative consequences. You also build up a tolerance causing you to need MORE just to get to the same level of excitement.
Compulsion on the other hand, pushes you to avoid unpleasant outcomes. Someone who insists things must be done in a certain way is likely to have been raised in a hurricane of inconsistency and disorganization. Order was developed as a defense mechanism. Interestingly enough, a hoarder could develop her characteristics for that very same reason (among many others), but because of some type of ‘loss’ during that disorganization they fear parting with objects. Hoarding is what gives her a sense of security. Repetitive behaviors also relieve anxiety. A message loop replays in the person’s brain, over and over again, about re-checking something. The action itself relieves the stress of that loop. Compulsion primarily stems from seeking relief, not pleasure. This distinction between compulsion and addiction becomes a bit murky on this final point though, because certain addictive behaviors are done to relieve anxiety (but are still not compulsions), like drinking or doing drugs at the end of a bad day. However, the addict will also drink for numerous other pleasure seeking reasons, so it’s important not to confuse that point in reflecting on your own personal behavior. Adding further to the discussion, people can, of course, have both compulsions and addictions at the same time.
Now what? Recognition of the issue is the first key step, but it’s only one step. If you’ve come to the conclusion that you’re in the grips of addiction or compulsion, it’s time to do something about it. The type of treatment you require depends on the severity of your disease. As with all diseases, the earlier you take note of it, the easier it is to treat.