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”.