August 6, 2021 • 16 mins
If you have a habit you just can’t break, it may not be a true addiction—but it can definitely interfere with your life. Dr. Saltz tells how to get control of compulsions like needless shopping, overeating and spending way too much time on social media.
Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
See omnystudio.com/listener for privacy information.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:05):
Bees are challenging times, but you don't have to navigate
them alone. Welcome to how can I help? I'm Dr
Gail Saltz. I'm a clinical Associate Professor of Psychiatry at
the New York Presbyterian Hospital, a psychoanalyst, and best selling author,
and I'm here every week to answer your most pressing questions,
(00:27):
hopefully with understanding, insight and advice. I hear it every day.
I'm addicted to chocolate or I'm addicted to watching Real Housewives?
Is that real? Am I really addicted? While overeating can
be a compulsive behavior, chocolate and Real Housewives do not
(00:51):
an addiction. Make this patient of mine. Susan was a
lovely woman in her mid forties who spoke often about
her in Tract A shoe addiction. She had many more
pairs than she could use or afford, and yet she
found it nearly impossible to pass up a pair that
caught her eye when something was stressing her out. She
(01:14):
bought shoes when she felt sad. She bought shoes when
she was happy and wanted to celebrate something. Yes, she
bought shoes, So she surmised this must be an addiction.
The definition of an addiction has changed over the years. Historically,
an addiction required both a physical and a psychological dependence
(01:38):
on a chemical which directly affected the brain. This meant
a substance such as alcohol or tobacco drugs, and not
a behavior. Today, many people use the term addiction to
refer not only to substance dependence, but also the psychological
(02:00):
dependence a person can feel about a behavior they're doing,
like gambling or eating, having sex, exercising, working, shopping, watching pornography,
for being on a computer. But is the mechanism of
addiction the same for a behavior as it is for
(02:21):
a drug. The answer is no. Substances change body and
brain chemistry and cause of physiologic withdrawal when the addictive
person stops using them. Arise in blood pressure, feeling nauseous, sweaty,
having tremors. Those are all signs of physiological addiction withdrawal.
(02:47):
On the other hand, behaviors that you need to repeat
over and over again despite not always wanting to do it,
and then feeling discomfort if you don't do it is
really called a compulsive behavior. If the earlier patient I
mentioned forced herself not to buy shoes for a week
(03:09):
or two, she did not get the shakes, But what
she did find is that she easily lost the willpower
to avoid the purchase, despite the fact that she was
risking her marriage because her husband was furious, and her
family's financial well being because in fact they could not
afford all these shoes, and her husband really was completely
(03:33):
fed up. Actually, I've seen many patients who are dealing
with some compulsive behavior or another. People who can't stop
checking their phone and internet such that they waste huge
amounts of time that they don't have, and the anger,
spouses and children who can't seem to keep their attention,
(03:54):
men and women who exercise every day for hours at
a time, even though their body or their family is
screaming enough. The interesting thing is that usually someone with
a compulsive behavior does not come to see me for
that problem because they don't want to see those behaviors
as a problem, and they don't really want to stop.
(04:16):
They're often already my patient because they're struggling with depression
or anxiety or relationship problems. But then when we look
at what's going on, we find that someone is also
suffering from repeating an act over and over again that's
seriously compromising their life. I had another patient, a woman
(04:37):
I'll call Meg, who saw me as her last stop
before getting gastric bypass surgery. She felt it was her
only hope given her level of unhealthy obesity, and yet
she also knew that she had secretly and compulsively been
eating bags of candies and cookies for years. She ate
in the corners where no one could see. She ate
(04:59):
till she felt sick, and she could barely remember everything
she had crammed in when the moment was over, following
which she was racked with guilt. She suffered from compulsive
eating and it was actually slowly killing her, but she
couldn't stop. Interestingly, during the treatment, she told me that
(05:19):
she was increasingly concerned about her fifteen year old child,
who was playing video games night and day. His grades
were slipping, He stayed up late night playing. He only
wanted to hang out with friends who would play video
games with him, and it was causing many arguments at home.
Playing video games can also become an obsession, and impulsive
(05:43):
behaviors run in families. The exact cause of compulsive behaviors
is not completely understood and can vary from person to person.
A number of different issues seemed to contribute and imbalance
in chemicals in the brain called neurotransmitters may be a
cause in certain compulsive behaviors, such as having sex, gambling, shopping,
(06:08):
and eating. Sexual compulsions are sometimes seen in diseases that
damage the brain, like multiple scrossis and Huntington's disease. Genetics
can play some role as compulsions, as I mentioned, do
run in families. The environment you grow up in can
influence compulsive behavior by either learning a habit you've seen,
(06:30):
or by reacting to adversity by relieving the tension with
this behavior. Compulsions are often linked to psychological distress, so
anxiety and depression can lead to compulsive sex or gambling, shopping, eating,
and contribute to just about any compulsive behavior you can
(06:50):
think of. The mind tries to deal with feeling anxious
by acting something out that temporarily relieves nervousness. So the
excitement of gambling, or the comfort of eating, or the
thrill of sex, the high of the purchase all tend
to for that moment, drown out the sadness or the worry.
(07:15):
But of course, as soon as the moment is over,
the bad feeling is still there. And hence the need
to repeat the behavior over and over again. It's also
believed that in some cases, the brain circuitry that is
stimulated with compulsive behaviors is close to that involved in
addiction to some drugs, hence the feeling of a high
(07:38):
produced when the behavior is done. And unfortunately, the more
you use that neural circuitry, the stronger it becomes, making
it extremely difficult to just quit. Because behaviors we are
talking about when done in moderation are normal behaviors and
often enjoyable parts of life, it can be different goal
(08:00):
to tell or admit when you across the line, so
I advise ask yourself these questions. Are you preoccupied with
planning and doing the behavior much of the time. Is
doing the behavior negatively affecting one or more areas of
your life, such as relationships or work or finances? Are
(08:23):
you secretive about the behavior much of the time? And
have you tried to stop the behavior but unsuccessfully or
for a little while, only to restart again. If you
answer yes to any of these questions, you may be
struggling with a compulsive behavior and needs some help. So
(08:46):
today I have a question from a listener who thinks
she has an addiction, So let's take a listen and
see how can I help? How can I help with
Dr Gail Salts will be back after the short break.
(09:10):
Dear Doctor Salts. I find myself looking at my Instagram
a lot. At first, I thought, well, it's a great
way to stay connected to people I like and show
them what I'm up to. And I do find it
fun deciding what to post and looking at other posts.
But over time I find I'm looking all the time.
(09:33):
I find myself thinking about looking, even if I just
looked ten minutes ago. I think if I added it up.
I spend a lot of time on Instagram, and truthfully,
I don't really have a lot of extra time. It's
made me think about not doing it so often, but
I find it really hard to stop, and I just
(09:55):
seemed to keep doing it anyway. Is this an addiction?
Am I addicted to Instagram? And if I am, how
do I stop? If you are spending so much time
either on Instagram, thinking about going on Instagram, trying not
to go on Instagram, that it is interfering with some
(10:16):
aspect of your life, your relationships, because other people get
annoyed that you're always on the phone even while you're
with them, that you don't have time to see them
in person, or your work is being compromised because you're
on your phone and you're not going to bed at
a reasonable hour because you're on your Instagram. Then, while
social media cannot cause you to be physiologically addicted, it
(10:41):
can cause you to feel psychologically addicted because you feel
such a rewarding feeling doing it that you can't cut
back easily and it's interfering with your life. This would
actually be called a compulsive behavior. It does sound like
this is the issue year. If cutting back has proved
(11:03):
unsuccessful for you, I'd suggest a full stop for two
weeks and a reset. This will not be easy initially,
but by taking a full stop holiday as in remove
the app from your phone, you will be uncomfortable for
(11:23):
the first few days you'll be thinking about it, but
then over time that feeling will dissipate and you'll spend
some time feeling good, encumbered by the needy feeling of
having to check I have to look. So once you've
been clean, so to speak, for a few weeks, you
(11:46):
can consider returning, but I would really advise that you
make a strict time limit rule for yourself, like I
look once for ten minutes in the morning, and then
I don't look again until the evening, where I look
once where again ten minutes. Follow your own rules rather
(12:07):
than letting it creep up again. If over time you
aren't able to do this, it may be that Instagram
or social media is a real achilles heel for you,
and you might be better off without it. I hope
that was helpful. When you're struggling with a compulsive behavior
(12:28):
of any kind, there are some things you can try
on your own. Most important is to admit to yourself
that you have a problem. Without being honest with yourself,
you can't really address quitting in the same vein. It
can be very helpful to tell someone else you realize
you have a problem. They can help you to be
(12:50):
honest with yourself. Understand what is driving this behavior. Is
there some for example, sexual trauma you suffer in the
past that makes sex compulsive for you. Are you terrified
of looking heavy like your mother as you age and
this is making you stay in the gym night and day.
(13:11):
Are you feeling depressed every time you have nothing to do,
and so you keep trolling the Internet just to be
distracted by something. Examine what's behind the behavior, because doing
the behavior is so reinforcing. One tactic is to interrupt
the behavior. For example, try postponing the behavior when you
(13:33):
go to check that email again, tell yourself in one
hour and wait, rather than just postponing longer and longer,
be erratic about it. Delayed by two hours, then by
ten minutes, then a full day. The point is to
remind yourself that you are actually in charge, not your
(13:56):
compulsive behavior. Another technique is to change the way you
do it rather than for example, shoveling in sweets, substitute
other foods, or do your exercise routine out of order again.
This can help shake up the ritualistic nature of compulsive behavior.
(14:19):
The goal, of course, is to work towards just not
doing the behavior compulsively, which means cutting way down, not
necessarily never doing it at all. This is hard because
the trigger is often doing the behavior at all, and
obviously you cannot and should not, for example, avoid eating
(14:41):
or having sex. But some problems like gambling, shopping, and
internet pornography may require you to stop completely in order
to end the compulsion, because even a taste will throw
you back into a pattern, so it depends what type
of compulsive behavior we're discussing. Psychotherapy can be very helpful.
(15:04):
A combination of psychodynamic psychotherapy to understand the roots of
the behavior with a cognitive behavioral training to change the
actual behavior is very helpful. Sometimes medication is used to
treat some compulsive behaviors. For example, antidepressants, which affect the
chemical serotonin and R benephrin in the brain, are used
(15:26):
in some serious cases of compulsive shopping, sexual behavior, and
even eating. This is because it is believed these chemicals
are involved in the desire to act. Antidepressants or anti
anxiety medications may be used. However, in any compulsive behavior
problem when it is felt that depression or anxiety are
(15:50):
present and driving the compulsion. Do you have a problem
I can help with? If so, email me yet how
can I help? At Seneca Women dot Com. All centers
remain anonymous and listen every Friday to how can I
help with me? Doctor Gail's Salts
Bees are challenging times, but you don't have to navigate
them alone. Welcome to how can I help? I'm Dr
Gail Saltz. I'm a clinical Associate Professor of Psychiatry at
the New York Presbyterian Hospital, a psychoanalyst, and best selling author,
and I'm here every week to answer your most pressing questions,
(00:27):
hopefully with understanding, insight and advice. I hear it every day.
I'm addicted to chocolate or I'm addicted to watching Real Housewives?
Is that real? Am I really addicted? While overeating can
be a compulsive behavior, chocolate and Real Housewives do not
(00:51):
an addiction. Make this patient of mine. Susan was a
lovely woman in her mid forties who spoke often about
her in Tract A shoe addiction. She had many more
pairs than she could use or afford, and yet she
found it nearly impossible to pass up a pair that
caught her eye when something was stressing her out. She
(01:14):
bought shoes when she felt sad. She bought shoes when
she was happy and wanted to celebrate something. Yes, she
bought shoes, So she surmised this must be an addiction.
The definition of an addiction has changed over the years. Historically,
an addiction required both a physical and a psychological dependence
(01:38):
on a chemical which directly affected the brain. This meant
a substance such as alcohol or tobacco drugs, and not
a behavior. Today, many people use the term addiction to
refer not only to substance dependence, but also the psychological
(02:00):
dependence a person can feel about a behavior they're doing,
like gambling or eating, having sex, exercising, working, shopping, watching pornography,
for being on a computer. But is the mechanism of
addiction the same for a behavior as it is for
(02:21):
a drug. The answer is no. Substances change body and
brain chemistry and cause of physiologic withdrawal when the addictive
person stops using them. Arise in blood pressure, feeling nauseous, sweaty,
having tremors. Those are all signs of physiological addiction withdrawal.
(02:47):
On the other hand, behaviors that you need to repeat
over and over again despite not always wanting to do it,
and then feeling discomfort if you don't do it is
really called a compulsive behavior. If the earlier patient I
mentioned forced herself not to buy shoes for a week
(03:09):
or two, she did not get the shakes, But what
she did find is that she easily lost the willpower
to avoid the purchase, despite the fact that she was
risking her marriage because her husband was furious, and her
family's financial well being because in fact they could not
afford all these shoes, and her husband really was completely
(03:33):
fed up. Actually, I've seen many patients who are dealing
with some compulsive behavior or another. People who can't stop
checking their phone and internet such that they waste huge
amounts of time that they don't have, and the anger,
spouses and children who can't seem to keep their attention,
(03:54):
men and women who exercise every day for hours at
a time, even though their body or their family is
screaming enough. The interesting thing is that usually someone with
a compulsive behavior does not come to see me for
that problem because they don't want to see those behaviors
as a problem, and they don't really want to stop.
(04:16):
They're often already my patient because they're struggling with depression
or anxiety or relationship problems. But then when we look
at what's going on, we find that someone is also
suffering from repeating an act over and over again that's
seriously compromising their life. I had another patient, a woman
(04:37):
I'll call Meg, who saw me as her last stop
before getting gastric bypass surgery. She felt it was her
only hope given her level of unhealthy obesity, and yet
she also knew that she had secretly and compulsively been
eating bags of candies and cookies for years. She ate
in the corners where no one could see. She ate
(04:59):
till she felt sick, and she could barely remember everything
she had crammed in when the moment was over, following
which she was racked with guilt. She suffered from compulsive
eating and it was actually slowly killing her, but she
couldn't stop. Interestingly, during the treatment, she told me that
(05:19):
she was increasingly concerned about her fifteen year old child,
who was playing video games night and day. His grades
were slipping, He stayed up late night playing. He only
wanted to hang out with friends who would play video
games with him, and it was causing many arguments at home.
Playing video games can also become an obsession, and impulsive
(05:43):
behaviors run in families. The exact cause of compulsive behaviors
is not completely understood and can vary from person to person.
A number of different issues seemed to contribute and imbalance
in chemicals in the brain called neurotransmitters may be a
cause in certain compulsive behaviors, such as having sex, gambling, shopping,
(06:08):
and eating. Sexual compulsions are sometimes seen in diseases that
damage the brain, like multiple scrossis and Huntington's disease. Genetics
can play some role as compulsions, as I mentioned, do
run in families. The environment you grow up in can
influence compulsive behavior by either learning a habit you've seen,
(06:30):
or by reacting to adversity by relieving the tension with
this behavior. Compulsions are often linked to psychological distress, so
anxiety and depression can lead to compulsive sex or gambling, shopping, eating,
and contribute to just about any compulsive behavior you can
(06:50):
think of. The mind tries to deal with feeling anxious
by acting something out that temporarily relieves nervousness. So the
excitement of gambling, or the comfort of eating, or the
thrill of sex, the high of the purchase all tend
to for that moment, drown out the sadness or the worry.
(07:15):
But of course, as soon as the moment is over,
the bad feeling is still there. And hence the need
to repeat the behavior over and over again. It's also
believed that in some cases, the brain circuitry that is
stimulated with compulsive behaviors is close to that involved in
addiction to some drugs, hence the feeling of a high
(07:38):
produced when the behavior is done. And unfortunately, the more
you use that neural circuitry, the stronger it becomes, making
it extremely difficult to just quit. Because behaviors we are
talking about when done in moderation are normal behaviors and
often enjoyable parts of life, it can be different goal
(08:00):
to tell or admit when you across the line, so
I advise ask yourself these questions. Are you preoccupied with
planning and doing the behavior much of the time. Is
doing the behavior negatively affecting one or more areas of
your life, such as relationships or work or finances? Are
(08:23):
you secretive about the behavior much of the time? And
have you tried to stop the behavior but unsuccessfully or
for a little while, only to restart again. If you
answer yes to any of these questions, you may be
struggling with a compulsive behavior and needs some help. So
(08:46):
today I have a question from a listener who thinks
she has an addiction, So let's take a listen and
see how can I help? How can I help with
Dr Gail Salts will be back after the short break.
(09:10):
Dear Doctor Salts. I find myself looking at my Instagram
a lot. At first, I thought, well, it's a great
way to stay connected to people I like and show
them what I'm up to. And I do find it
fun deciding what to post and looking at other posts.
But over time I find I'm looking all the time.
(09:33):
I find myself thinking about looking, even if I just
looked ten minutes ago. I think if I added it up.
I spend a lot of time on Instagram, and truthfully,
I don't really have a lot of extra time. It's
made me think about not doing it so often, but
I find it really hard to stop, and I just
(09:55):
seemed to keep doing it anyway. Is this an addiction?
Am I addicted to Instagram? And if I am, how
do I stop? If you are spending so much time
either on Instagram, thinking about going on Instagram, trying not
to go on Instagram, that it is interfering with some
(10:16):
aspect of your life, your relationships, because other people get
annoyed that you're always on the phone even while you're
with them, that you don't have time to see them
in person, or your work is being compromised because you're
on your phone and you're not going to bed at
a reasonable hour because you're on your Instagram. Then, while
social media cannot cause you to be physiologically addicted, it
(10:41):
can cause you to feel psychologically addicted because you feel
such a rewarding feeling doing it that you can't cut
back easily and it's interfering with your life. This would
actually be called a compulsive behavior. It does sound like
this is the issue year. If cutting back has proved
(11:03):
unsuccessful for you, I'd suggest a full stop for two
weeks and a reset. This will not be easy initially,
but by taking a full stop holiday as in remove
the app from your phone, you will be uncomfortable for
(11:23):
the first few days you'll be thinking about it, but
then over time that feeling will dissipate and you'll spend
some time feeling good, encumbered by the needy feeling of
having to check I have to look. So once you've
been clean, so to speak, for a few weeks, you
(11:46):
can consider returning, but I would really advise that you
make a strict time limit rule for yourself, like I
look once for ten minutes in the morning, and then
I don't look again until the evening, where I look
once where again ten minutes. Follow your own rules rather
(12:07):
than letting it creep up again. If over time you
aren't able to do this, it may be that Instagram
or social media is a real achilles heel for you,
and you might be better off without it. I hope
that was helpful. When you're struggling with a compulsive behavior
(12:28):
of any kind, there are some things you can try
on your own. Most important is to admit to yourself
that you have a problem. Without being honest with yourself,
you can't really address quitting in the same vein. It
can be very helpful to tell someone else you realize
you have a problem. They can help you to be
(12:50):
honest with yourself. Understand what is driving this behavior. Is
there some for example, sexual trauma you suffer in the
past that makes sex compulsive for you. Are you terrified
of looking heavy like your mother as you age and
this is making you stay in the gym night and day.
(13:11):
Are you feeling depressed every time you have nothing to do,
and so you keep trolling the Internet just to be
distracted by something. Examine what's behind the behavior, because doing
the behavior is so reinforcing. One tactic is to interrupt
the behavior. For example, try postponing the behavior when you
(13:33):
go to check that email again, tell yourself in one
hour and wait, rather than just postponing longer and longer,
be erratic about it. Delayed by two hours, then by
ten minutes, then a full day. The point is to
remind yourself that you are actually in charge, not your
(13:56):
compulsive behavior. Another technique is to change the way you
do it rather than for example, shoveling in sweets, substitute
other foods, or do your exercise routine out of order again.
This can help shake up the ritualistic nature of compulsive behavior.
(14:19):
The goal, of course, is to work towards just not
doing the behavior compulsively, which means cutting way down, not
necessarily never doing it at all. This is hard because
the trigger is often doing the behavior at all, and
obviously you cannot and should not, for example, avoid eating
(14:41):
or having sex. But some problems like gambling, shopping, and
internet pornography may require you to stop completely in order
to end the compulsion, because even a taste will throw
you back into a pattern, so it depends what type
of compulsive behavior we're discussing. Psychotherapy can be very helpful.
(15:04):
A combination of psychodynamic psychotherapy to understand the roots of
the behavior with a cognitive behavioral training to change the
actual behavior is very helpful. Sometimes medication is used to
treat some compulsive behaviors. For example, antidepressants, which affect the
chemical serotonin and R benephrin in the brain, are used
(15:26):
in some serious cases of compulsive shopping, sexual behavior, and
even eating. This is because it is believed these chemicals
are involved in the desire to act. Antidepressants or anti
anxiety medications may be used. However, in any compulsive behavior
problem when it is felt that depression or anxiety are
(15:50):
present and driving the compulsion. Do you have a problem
I can help with? If so, email me yet how
can I help? At Seneca Women dot Com. All centers
remain anonymous and listen every Friday to how can I
help with me? Doctor Gail's Salts
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.