By MIKE GROPPERChess(photo credit: INGIMAGE)
Recently, I watched an interview with the syndicated columnist Charles Krauthammer. The host, Bret Baier, asked Krauthammer to tell him about the thing that he loved to do most. Krauthammer responded: “Playing chess.”Baier followed this response by asking Krauthammer if he still plays the game. Krauthammer stated that he does not.“Why?” asked Baier.Krauthammer emphatically stated that he would stay up all night long playing Internet speed chess and that his hobby had become his addiction. “I had to stop,” he told Baier.Krauthammer described what addiction experts call a behavioral addiction to the Internet; in his case, to speed chess. Krauthammer was aware enough to realize that he was indeed out of control and that he needed to quit. Previously, he had once publicly stated that for him, “chess: it’s like alcohol. It is a drug. I have to control it, or it could overwhelm me” (November 2, 2015, Chess.com).Historically, it has been quite common for people to think of alcoholics or heroin addicts when they hear the word “addiction.” In the past, most people, including addiction professionals, defined addiction as a substance abuse problem with the core feature of physical dependence.Two signs of physical dependence are “tolerance” and “withdrawal” symptoms. For example, tolerance in the case of alcoholism means that a person needs to consume increasing amounts of alcohol to achieve the desired effect. Withdrawal syndrome is a substance-specific set of very unpleasant psychological and bodily responses when the person no longer uses the substance – e.g., delirium tremens when an alcoholic is unable to get alcohol.However, during the 1980s, thinking about addiction began to change radically. Interestingly enough, it took a United States cocaine epidemic in the 1980s for us to understand that addiction does not have to include physical dependence. Experts realized that there were no physical withdrawal symptoms when stopping cocaine use but, rather, a strong psychological craving to use more of the drug.The way this works is that cocaine use stimulates the brain’s pleasure chemicals, dopamine, and the same neurochemicals that are released when having sex or eating. When a user snorts or smokes cocaine (called crack), very large amounts of dopamine are released in the brain, providing him with powerful stimulation, a sense of psychological well-being, energy and intense euphoric feelings.The process that leads people to get addicted to cocaine is based on two conditioning models.The first is a Skinnerian type of operant conditioning where the behavior of using the drug (the stimulus) leads to reward, which is the drug’s powerful psychoactive effects (e.g., the response), therefore reinforcing the individual to go back and repeat using cocaine.The second conditioning model is Pavlovian, also called classical, conditioning. Cocaine users consume the drug in specific places or locations, with specific people and under certain emotional conditions, albeit feeling sad or anxious, bored, or for some even happy. What happens with this type of classical conditioning is that the things or cues that are associated with prior cocaine use become conditioned stimuli that independently trigger strong cravings to get some cocaine and use it.As a professional who worked in a cocaine rehab clinic in the 1980s, I witnessed the power of the addictive nature of cocaine. One man I treated had repeatedly snorted cocaine when he drove home from work through the Lincoln Tunnel connecting New York City to New Jersey. He called it a “tunnel toot.” Going home, driving in his car, and approaching the tunnel were all conditioned stimuli that triggered him to crave and use cocaine. He had no control over this behavior.The two conditioning theories described above gave treatment professionals in the 1980s a major new perspective about addiction: People can get addicted to a drug like cocaine, even when physical dependence is not present. From the lessons learned about cocaine addiction, experts began to understand that certain non-drug behaviors could also make some people vulnerable to developing a full-blown addiction. The same chemicals in the brain that reinforce and condition cocaine use are triggered by behavioral addictions.Some examples of behavioral addictions include pathological gambling, addictions to food (binge eating), addiction to sex, Internet addiction (e.g., repeated visiting of porn sites, video games), smartphone addiction, and shopping.People are not equally vulnerable to developing drug, alcohol and/or behavioral addictions. Some individuals may have lower levels of self-control, which may be either genetically based or emotionally based, that make them more vulnerable to developing an addiction.Here are the five primary indicators of a behavioral addiction. All five must be present to determine if, in fact, there is an addiction.1. Compulsive behavior; does it repeatedly.2. Failure to cut back or limit the behavior.3. Continued use of the behavior, in spite of hurting yourself psychologically, socially, legally, financially, physically, or hurting your family or friends.4. At the core of addiction is the need to deny that you are addicted.5. Addiction is a relapsing condition.Krauthammer, who in fact is also a board certified psychiatrist, understood these processes very well, and he was ready and motivated to quit his online chess addiction.The good news for anyone with a behavioral addiction is that treatment models utilized today to treat all types of addictions are very successful, if the individual is motivated to get help.The writer is a marital, child and adult cognitive-behavioral psychotherapist, with offices in Jerusalem and Ra’anana. www.drmikegropper.weebly.com, drmikegropper@gmail.com
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