Non-Tangible Addictions

Sad woman“God grant me the SERENITY to accept the things I cannot change, the COURAGE to change the things I can, and the WISDOM to know the difference.” We recognize this quote as the serenity prayer, most typically used in alcoholics or narcotics anonymous communities. As a heuristic, individuals tend to view addiction associated with substances or activities that are tangible, such as alcohol, drugs, or gambling. This belief system is consistent with the specific definition of addiction is the fact or condition of being addicted to a particular substance, thing, or activity. In my clinical experiences as a psychologist for 20+ years, however, I have conceptualized addiction in a way that can apply to everyone and anyone, use of substances or not.

Let’s take the example of the client we will name Katie. She seeks therapy for the first time in her late 30’s because she is depressed, exhausted, and overwhelmed by her responsibilities in life. Her work performance is declining and she feels as if she could sleep all day. It is a struggle for her to engage in her assigned volunteer activities. She does not know what is happening to her. She has been married since 25 and has two school-aged children. She works part-time, volunteers at the kids’ schools, and hosts most of the family holidays. She avoids conflict since she does not like to fight with anyone nor does not want others to be upset with her. She expresses distress that she feels she is not appreciated by others even though she continues to help others.

Katie is a common example of a “people-pleaser.” She is afraid of others not liking her, does not like her husband or children to be upset with her, and does not want extended family members to talk about her in a negative manner. In other words, Katie has become “addicted” to pleasing others to the extent that it is significantly interfering with her psychological functioning. It is a power greater than herself and she needs help to overcome her anxiety with not pleasing others.

As a therapist, I explain to Katie that people-pleasing is analogous to craving cocaine and then using the drug. The process is as follows: 1) She seeks the drug (desperate desire for others to like her); 2) uses the drug (performs tasks to gain approval of others); 3) experiences the high of the drug (initially feels accepted); and 4) then crashes (again feels unappreciated if others do not “actively” voice their approval or reach out to her at a later point in time). She also feels taken advantage of when she realizes that some of her social network only contact her when they need something from her.

Katie’s story is a very common presenting issue. Other examples of interpersonal addiction is a desperate desire to feel heard or a desperate need to feel powerful to the extent that individuals lose friends or they become financially depleted. How did Katie become addicted to people-pleasing? Perhaps she had critical and controlling parents who conditioned her to work very hard to get others to like her, rather than learning that others can like her when she does not do things for them. She did not learn that others should like her just for being her and accept her for who she is.

To work toward this different frame of reference, Katie needs guidance and help to become assertive and create boundaries with others. She needs to learn to say ‘no’ to family members and people in her community and subsequently learn to tolerate the short-term distress and anxiety associated with saying no and be patient to experience the long-term peaceful benefit of not chasing others’ approval. Over time and with guidance, she can learn that she cannot change others, only herself. She needs to identify what she can change in life and what she cannot. She learns to let go of controlling others’ perceptions of her and solely be concerned with what makes her happy and what makes her feel good. There are many “Katies” out in this world who suffer from non-tangible addictions. Just because we can’t see what they are doing to be in pain, does not minimize the extent and devastation of their internal agony.