Process Addiction Treatment and Recovery

May 27th, 2024

By P. Casey Arrillaga, LCSW, LCDC

Process addictions are dangerous illnesses that are slowly but surely being acknowledged by mental health professionals. Rather than focusing on a substance such as alcohol or other drugs, process addictions are centered around behaviors. There is still controversy about such conditions, yet people who suffer from them have benefited greatly from focused support groups and increasing professional attention. This post will look at what is known so far and what can be done to help.

What We Know So Far

Process addictions, also known as “behavioral addictions,” are a type of addiction that a repetitive and destructive behavior other than using alcohol or another drug. Examples include gambling addiction, sex and love addiction, food addiction, food restriction, binging and purging, shopping addiction, exercise addiction, work addiction, self-harm addiction, and many more. This list has grown over time in part because more people are aware of and willing to acknowledge their mental health problems, professionals are more willing to view such conditions as addictions, and brain research has shown the commonalities between drug addictions and process addictions.

While some of the process addictions listed above may look very different at first glance, there are common features that help define them as addictions. First, each one involves a repetitive behavior that becomes compulsive, causes harm to the individual (and often those around them), and there are withdrawal effects if they try to stop or even slow the behavior. The person in the grip of the addiction often cannot keep promises to themselves or others around the behavior, and they may not be able to accurately predict how a given behavioral episode will end. In many cases, the behaviors increase over time, crossing boundaries set by the individual for themselves, by family and others close to the individual, and often by society in terms of what is considered acceptable and proper. This can lead to another common symptom of any addiction: guilt and shame, which often leads in turn to hiding, denial, living a “double life,” dishonesty, anger if the behavior is challenged, and turning to the behavior to avoid the difficult feelings that come as a result of the behavior itself. In other words, these addictions can result in an all-too-familiar downward spiral unless the person gets help. This spiral often ends in serious harm and even death from either the behaviors themselves or from suicide.

Process addictions have been recognized from the 1950’s on by those who suffer from them, as evidenced by the mutual self-help groups that have emerged one by one to address these addictions. Process addictions began to gain increasing professional attention in the 1980’s and started to appear more and more in research papers in the early 1990’s. As of this writing, only Gambling Disorder is recognized in the DSM 5, which is the most widely-used standard for diagnosing mental health conditions. The World Health Organization acknowledges addiction as including sexual behavior, gambling, and shopping, but does not include food addictions. In other words, the mental health helping professions still have a long way to go around recognizing and thus helping these serious life-threatening conditions.

Why There Is Controversy

From the beginning, there has been professional and social controversy about process addictions. Some of this has been based in familiar arguments that were heard earlier around addiction to alcohol and other drugs: that calling it an addiction or disease is just an excuse for bad behavior, that some people just need to exercise their willpower, or they just need to make better choices. Some professionals have also argued that the idea of process addictions follows a broader trend of making everything into a disease that needs treatment, or that we are pathologizing normal human behavior.

On the other side of the debate are all the people who suffer from these addictions. They have not waited for professionals to acknowledge their distress in order to treat it. They have started numerous self-help groups decades before professionals would help them, because they recognized that they needed to do something about their behaviors whether anyone else agreed or not. These groups have mostly been 12 Step fellowships based on the model pioneered by Alcoholics Anonymous [AA]. This is no coincidence. Such groups have almost all been started by AA members who saw the similarities between their alcohol use and their process addictions, and they found that the same tools could help.

As such people have sought professional therapy and treatment, more and more professionals have also seen the similarities and have increasingly recognized that these are addictions that can and should be treated. Another major contributor to professional acceptance of process addictions is the increasing body of research, especially brain research, that shows the similarities between process and drug addictions.

What Can Be Done

If you think you or someone you love may be suffering from a process addiction, you should take the same steps you would for a drug addiction. First and foremost, seek help as soon as possible. Addictions often get worse over time and can result in serious harm or even death. There are many self-help groups out there, and these make an excellent starting point. It’s also a good idea to seek professional help, but because of the controversy mentioned above, you should interview the professional to make sure they not only acknowledge process addictions but have experience in helping people with them.

Treatment centers increasingly say they help process addictions. Be sure they offer more in the way of help than just adding a few paragraphs to their website. Before admitting to a center, ask for details about how they actually help people who suffer and how much experience they have doing it.

For instance, at Windmill, we offer specialized groups such as our Sex and Love Addicts Anonymous focused process group, we get our clients involved in individualized outside recovery meetings including Gamblers Anonymous, Sex and Love Addicts Anonymous, Overeaters Anonymous, Workaholics Anonymous, etc. so they meet others in recovery and build a recovery community they can carry with them after they leave. We teach our clients how to use the tools of both 12 Step and SMART Recovery to address process addictions. We help our clients find sponsors and mentors from the larger recovery community who are recovering from these issues. We work in individual therapy and as a team to help any client with a process addiction to heal and grow. Many of our staff members can speak to their personal recovery from such issues, thus offering living examples of recovery around process addictions. Our on-campus bookstore carries the basic texts from many process addiction recovery groups. In other words, we offer a broad range of support for process addictions. Whether it is the issue that inspired the client to seek treatment in the first place or it is something they realized they need to deal with after they joined our community, we can help.

The Bottom Line

Process addictions are a type of addiction that has been increasingly recognized and treated over the past few decades. While there is still some public and professional disagreement about such conditions, there is a range of help available through anything from self-help groups to residential treatment. If you or someone you know may be struggling with such an addiction, seek help now.

About The Author

P. Casey Arrillaga is the Team Leader for Education at Windmill Wellness Ranch, and he is the author of books including “Realistic Hope: The Family Survival Guide for Facing Alcoholism and Other Addictions”.

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