Group therapy for behavioral addictions
Group therapy for behavioral addictions is a therapeutic approach that assists individuals in overcoming compulsive behaviors similar to substance abuse. This type of therapy often employs support group models, such as twelve-step programs, and cognitive-behavioral therapies that emphasize changing thought patterns to alter actions. Participants in group therapy benefit from shared experiences, which can help diminish feelings of isolation and denial, crucial barriers in recognizing and addressing their addictions.
Behavioral addictions, which include compulsions related to gambling, eating, gaming, work, and codependency, manifest through destructive patterns that disrupt personal and social relationships. Unlike substance addiction, individuals can often cease harmful behaviors without physical withdrawal, although they may experience psychological symptoms like anxiety and restlessness.
Various support groups, such as Gamblers Anonymous and Overeaters Anonymous, provide frameworks for recovery, fostering community and understanding. Through these collective experiences, individuals can cultivate healthier coping strategies and rebuild trust within their relationships. Current research suggests behavioral addictions may involve similar brain mechanisms as substance addictions, highlighting the need for further exploration in this area. Overall, group therapy offers a respectful and supportive environment for individuals struggling with behavioral addictions, encouraging recovery and personal growth.
Group therapy for behavioral addictions
DEFINITION: As the medical community debates whether behavioral addictions are true addictions, research has proven that support groups (group therapy) that are similar to those for substance abusers can help people overcome the compulsion for certain unhealthy behaviors. Many of these groups are twelve-step programs. Other behavioral addiction groups focus on cognitive-behavioral therapies, which stress that thoughts precede actions.
Overcoming Behavioral Addictions
All support groups help a person addicted to a harmful behavior to become aware of the problem, find solace in the company of other people with similar issues, and develop new ways of coping with stress. Behavioral addictions are destructive patterns of behavior that mimic substance abuse. They begin when a person experiences pleasure in association with a behavior and then later engages in that behavior to reduce stress.
Eventually, through frequent and ritualized indulgence, the behavior becomes part of the person’s daily routine. A person addicted to behaviors such as gambling, eating, sex, video games, exercise, shopping, or work or affection from another person (codependency) has a strong urge to engage in the behavior to experience relief and euphoria, despite persistent negative consequences.
Whether caused by substances or undesirable behaviors, all addictions have three things in common: physical and mental cravings, a habit, and denial of both craving and habit. Denial is a key factor in behavioral addictions, and it must be overcome if the person is to recover. Group therapy is successful in such cases because sitting in a room and listening to others describe situations and feelings that one has experienced in painful isolation tends to turn denial into identification. People who have recovered from the same affliction can also offer compassion, which is needed to offset feelings of self-loathing common in individuals with addictions.
Evidence suggests that behavioral addictions involve the same brain mechanisms as substance addictions, although more research is needed to clarify and confirm this. For now, it is clear that behavioral addictions present problems with relationships similar to substance abuse by undermining trust and by putting pressure on family members to compensate for difficulties caused by the addiction.
Unlike treatment for most types of substance abuse, behavioral addiction treatment does not require a detoxification period. A person with a behavioral addiction can stop doing it suddenly without experiencing physical withdrawal symptoms. Psychological withdrawal symptoms are common, however, and include feeling restless or anxious and having a strong desire to engage in the harmful behavior.
Pathological Gambling and Gamblers Anonymous
Pathological gambling (PG) was the first recognized behavioral addiction included in the 1980 version of the American Psychological Association’s diagnostic manual, classified as an impulse control disorder. The next behavioral disorder included was internet gaming disorder, included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) published in 2022. However, it was listed as a condition that required further study rather than a research-based diagnosis with criteria to determine the extent of the condition in patients. PG was later renamed gambling disorder and categorized in the manual's substance-related and addictive disorders section.
Gambling disorder is a serious problem not only for the individual with the addiction but also for their family and for society at large. The disorder produces financial insecurity, family dysfunction, domestic abuse, legal problems, employment difficulties, psychological distress, and higher rates of suicide. The problem is likely to become more prevalent as state governments derive significant revenue from and thus promote gambling-related activities, such as lotteries. Also, Internet gambling increases access and anonymity.
Gamblers Anonymous (GA) was founded in Los Angeles in 1957 by two men who focused on fostering a character change within themselves in order to stop gambling. This fellowship of men and women has since grown to thousands of groups in the United States, Australia, Brazil, Israel, Japan, Kenya, Korea, the United Kingdom, and Spain. GA’s website offers a questionnaire to help people determine if they need the program.
Family members of compulsive gamblers can attend Gam-Anon, another twelve-step program founded in 1958. Through Gam-Anon, members come from understand their problems and learn how to give emotional support to the troubled person without enabling them in the illness. Children can attend Gam-A-Teen, part of the Gam-Anon program.
Overeating, Codependence, and Sex Addictions
The idea for Overeaters Anonymous (OA) came to a woman who attended a GA meeting in 1958 and “heard her story,” though she related the speaker’s turmoil to her eating compulsion instead of a gambling problem. Not until 1960, though, did she find another person willing to recover from the addiction. OA offers recovery from compulsive eating through a worldwide fellowship of about seven thousand groups in more than eighty countries.
The organization’s website includes a fifteen-item questionnaire to help people determine if they have an eating problem. Compulsive eating is a threefold illness, affecting physical condition, mental state, and spirit. In the mental dimension, a compulsive eater is not “eating down” feelings but is expressing an inner hunger that leads to a loss of spiritual values.
Co-Dependents Anonymous, which was founded in 1986, is a fellowship of men and women whose common purpose is to develop healthy relationships. Rather than a questionnaire, its website offers a list of patterns and characteristics of codependence in five categories.
Under the category of denial, for example, co-dependent behaviors include minimizing one’s feelings or expressing negativity in passive-aggressive ways. Low self-esteem behavior patterns include difficulty making decisions and constantly seeking recognition. Compliance patterns emerge when compromising one’s integrity to avoid rejection or anger and being hypervigilant about other people’s feelings. Control patterns include freely offering advice and direction to others without being asked and needing to be needed. Avoidance patterns show up in pulling people close and then pushing them away.
Sex and Love Addicts Anonymous (SLAA) offers help to anyone with a sex addiction, love addiction, or both, and who wants to recover from that addiction. The fellowship was founded in 1976 by an Alcoholics Anonymous member who was serially unfaithful to his wife. SLAA recognizes that an obsessive-compulsive pattern exists when relationships or sexual activities become destructive to one’s career, family, and self-esteem. Advances in computer technology have made it easier for people to access sex-related websites with great anonymity, leading to a problem called Internet-enabled sexual behavior, which affects family relationships, work productivity, and academic success.
Internet Addiction
Internet addiction disorder (IAD) is a behavioral problem affecting a growing number of people who use the web, according to the American Psychiatric Association. People who lose track of time while using the Internet become more socially isolated, depressed, and challenged by family discord, divorce, academic failure, financial failure, and job loss. While IAD is not listed in the DSM-5-TR as a clinical diagnosis, addictions to technology and the internet exist. Some practitioners categorize it as a process addiction.
In the United States, one-on-one cognitive-behavioral therapy (CBT) has been shown to reduce the amount of time a person spends online. A study in Shanghai found that group therapy using CBT techniques, which emphasize that thoughts precede actions, was successful in treating teenagers addicted to the Internet.
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