Is addiction a choice or an illness?

Is addiction a choice or an illness? I will present the elements involved and let you be the judge.

This questions has been debated by experts in the field for quiet some time and has created a divide in the recovery community. My research and experience tells me that the answer is not so black and white. I am a firm believer in the ability of human beings to make choices and to live with the consequences of those choices. At the same time, to make healthy choices, one must be equipped with a healthy mind.
There are multiple layers to addiction:
1. Biochemical dependence on the substance leading to cravings and urges. The brain is accustomed to the endorphins produced by the substance. This creates a dilemma for the brain: do I do the thing that I know works right now, or do I “make the choice” of not using, in hopes of some greater benefit sometime in the future? You see, the brain is motivated to take care of itself in the moment.
2. Behavioral dependence. The mind has been conditioned to use substances; in other words, a habit has been formed. The behavior has been reinforced over and over again, and the substance has been associated with various positive outcomes in the moment. We all know how difficult it is to change a behavior regardless of how many times we choose to change the behavior. We behave in the way we are conditioned to behave. Where does choice come into play?
3. Emotional dependence. Drugs and alcohol are effective ways to cope with emotional distress in the moment. The addicted person has learned to rely on his/her drug of choice for coping. Deficient coping skills, or lacking the habits of practicing healthy coping skills, prohibits the person from making choices in the moment of emotional distress, as the choices do not necessarily exist to cope properly in the moment.
4. Lowered levels of distress tolerance. The person who has been abusing drugs or alcohol has reduced tolerance for emotional and physical pain. Building distress tolerance is similar to developing muscle memory to ride a bicycle or to swim. If a person has relied on substances to cope, the person has diminished ability to cope than the average non-abuser.
As can be seen, there are a lot of factors to consider and the argument for either choice or illness is not so clear-cut. Many therapists rely on methods that align with one approach or the other. In my experience, a well-rounded approach must allow for both, and must incorporate methods to address both the choices that are made and the potentially underlying illness. Regardless of the position you take, there is a path to recovery. Read my next blog for suggestions.
About the author: Dr. Seda Gragossian is the Clinical Director at the Talk Therapy Psychology Center in San Diego, where she helps people work through mental health issues such as anxiety, depression, trauma, addiction, and many others.
Dr. Seda GragossianPhD, PSY 24901
(858) 205-2490
Clinical Director
Talk Therapy Psychology Center
5935 Cornerstone Ct W, Ste 125
San Diego, CA, 92121

Turning your fear into strength

At times, Talk Therapy Psychology Center hosts articles and important announcements from our partners and clients. Here is a meaningful post from one of our regular contributors:


“Don’t give in to your fears. If you do, you won’t be able to talk to your heart.”  ― Paulo Coelho, The Alchemist


Contrary to what our society often tells us, fear is not a character flaw or a sign of weakness. It is a natural human response to danger or discomfort that even the bravest of brave have felt. It is a healthy emotion that has served us throughout the evolution of humanity.


But as natural as fear is, it can also consume us in an unhealthy way and prevent us from growing. Fear can stop us dead in our tracks and hold us hostage in a state of inaction.


Personal development begins when we identify our fears, analyze them in a non-judgmental way, and proactively change our behavior as a result. True strength is not the absence of fear. True strength is the courage to face our fears head on, whatever they may be.


Changing behavior around drug or alcohol abuse typically involves dealing with a variety of fears. Fear of “fitting in,” fear of feeling pain, fear of losing friends, fear of digging up painful memories, and fear of our relationships changing with others are just a few of the fears that may surface throughout our recovery.


Another common fear is the fear of being “exposed” for having a substance abuse problem if we choose to get help. What will our loved ones or friends think of us if we decide to make a deliberate change in our behavior? These fears can keep us paralyzed and prevent us from getting help or making positive improvements in our lives.


Just remember these fears are normal, and they are O.K. These fears don’t make us weak; on the contrary, we become empowered the moment we are able to see these fears for what they are. They are only thoughts. Remember, personal development begins when we identify our fears, analyze them, and proactively change our behavior as a result.


The good news is that facing your fears gets easier with time, practice, and with the help of a solid support system and a structured lifestyle. Facing your fears is not always easy but ultimately it will be one of the most rewarding decisions you make in your lifetime.


About the Author:


Joseph Cervantes is an advocate for the de-stigmatizing of addiction and for the development of progressive treatment approaches. As a writer in the addiction treatment space and former community organizer he has had the opportunity to work with hundreds of individuals struggling with various addictions and mental health issues. Having completed several IOP and inpatient programs himself over the past 20 years, he offers a unique perspective into the treatment and recovery experience through both a “patient” and “practitioner” lens.


How do I persuade a loved one to get help?

It is very difficult to watch a loved one make destructive choices for themselves, whether it is by abusing drugs and alcohol, engaging in toxic relationships, or even by not taking care of themselves. Our loved ones may or may not be open to the idea that their behavior is causing harm. Even if they are open to the idea, they may not be ready to change their behavior. Here are some suggestions on how to approach such a delicate matter:
  • Make sure you are taking care of yourself first. It does not help anyone if you are letting go of your own health and self-care because you are so preoccupied by someone else’s health. If you do, you are ultimately doing just as your loved one is doing — not taking care of oneself.
  • Ask your loved one if he/she is open to seeking help. If not, ask whether he or she would be willing to attend a consulting session with you, as the situation is really affecting you.
  • Set firm and healthy boundaries with the person. One of the best ways to bring about change in others is by changing the way we interact with them. Let’s say you are financially supporting your son and your son is using part of the money to support his drinking habit. Devise a plan where the financial support is only going towards his healthy habits.
  • Search your heart for empathy and understanding. You will need to change many of your own behaviors if you are truly interested in bringing about change in your loved one. You will find that changing your own behavior will come at a cost and will most likely be challenging, because human beings are resistant to change. Use this to help build empathy and understanding for your loved one. Imagine how difficult it must be for them to make changes. Approaching the situation with empathy and understanding could drastically impact the outcome of what you are trying to achieve.
  • Consult with a professional.

About the author: Dr. Seda Gragossian is the Clinical Director at the Talk Therapy Psychology Center in San Diego, where she helps people work through mental health issues such as anxiety, depression, trauma, and addiction.

858 205-2490

What is the #1 addiction?

Take a guess. What do you think the most widespread addiction is? Do you think it’s alcohol, marijuana, meth, cocaine, sex, or chocolate? It is actually none of those. The most widespread addiction is the addiction to “thinking”. Yes, that’s right. Thinking is what most of us are addicted to.Do you remember the last time you had no thoughts? And by thought, I don’t mean just fearful or negative thoughts but any thought. Our mind is constantly busy thinking about anything that may appear benign to excruciatingly painful. If you stop and observe, you will see that your mind is constantly running one thought after another. Here are some categories of thoughts:
  • Planning and reviewing tasks and responsibilities, sometimes over and over. Sometimes, we are actually playing out the task in our heads as if we are performing it.
  • Going over interactions we have had with others, whether they were positive or negative, and all the things we should have, or not have said
  • Analyzing the choices that we have made in the past and all the things that we “should” have done differently
  • Predicting the future and all the things that could potentially go wrong.
  • Judging the present moment and all the things that are wrong with it, whether it has to do with the weather, people around us, what we have or don’t have, and on and on.
As you notice, we are either judging the past, judging the present, planning, or predicting the future.
No matter what thought the mind is thinking, there is no doubt that some kind of association, interpretation, or judgment is taking place. You may think that many of your thoughts are neutral but are they really? Reflect a bit on your thoughts and you will see that thoughts are not capable of being neutral. For example a thought might arise such as: “It is a sunny day.” Sounds pretty neutral, right? Not really! Think about all the associations that follow as soon as you think that thought. Think about everything that a sunny day has evolved to mean to you. If you are at work, you might be thinking “I wish I could go to the beach on a sunny day like this.” If you are at home, you might be thinking “I am not taking advantage of this sunny day.” Before you know it, one thought leads to another and you are caught up in your head.
The point of this article is to raise awareness. The incessant need for mind chatter is unhealthy and most people are not even aware of this taking place. This addictive thinking contributes to anxiety, and keeps you focused on past disfunctions and future fears. While the thinking cannot be stopped, it is best to slowly start creating peaceful times throughout your day. Here are some practices that can help:
  • Become aware that this is happening. Just by being aware that the mind is constantly analyzing the past and fearing the future, is a great start to creating some distance between where you are and what you fear.
  • Practice being present. Focusing on the present moment helps dissipate the power of the thinking mind. This can be done through mindfulness practices, like mindful walking or sitting.
  • Meditate. There are many meditation practices that can be learned and followed, Just 10 minutes a day can create a lasting benefit. During meditation, you can become aware of the thoughts as they come and go, but don’t feed them through. Pretend they are clouds going by in the sky.
  • Exercise. When doing something physically strenuous, the mind is not able to continue its thinking process. Instead, energy is diverted to carrying out a task.
  • Focus on your breathing. With eyes open or closed, focus your attention on the air going in through your nose, moving down into the body, and coming back out. This is a timeless practice that is very effective at slowing down the thinking mind.
  • Practice letting go. This can be a more advanced step than the others and, in fact, requires that you have some level of awareness and distance already created with the thinking process. When a thought arises that is problematic, such as an evaluation of something who has hurt you in the past, try letting the thought go without grasping it. Pretty soon, another thought will pop into the mind that may be less emotionally charged. It is actually easier to practice letting go with simple things. For instance, you are waiting for a parking spot at a busy store and someone comes and gets the available spot that you were in line for. That’s a simple matter. Let that thought go. Practice enough with the little stuff so that when you are dealing with a traumatic situation, you have some experience with what letting go feels like.
Over time, by introducing simple methods into your day, and doing so consistently, you will start to see some distance between who you are and the contents of your thought stream. In a sense, if thinking is an addiction, consider this a practice in moderation.
About the author: Dr. Seda Gragossian is the Clinical Director at the Talk Therapy Psychology Center in San Diego, where she helps people work through mental health issues such as anxiety, depression, trauma, addiction, and many others.
858 205-2490