One of the hardest parts of battling an addiction of any form (in this case, drugs and alcohol) is the cessation of rituals, habits and compulsions to do something in a set order or the same way every single time.
Certain things trigger the urge to use or drink, even things such as getting up in the morning, getting into the car, coming home from work, seeing certain people, doing certain activities and many, many others. As people living with an addiction, we build our lives around our illness. It is the centerpiece of our existence when our world becomes totally insular.
But I’m betting that you’re asking yourself, what exactly do these things mean? What is a ritual, and why do compulsive habits drive me to use or drink? well, keep reading and we will look at each term independently and how they all link together.
Definitions Relative To This Article
Below are some short descriptions of the most common terms we will look at in greater detail as we go down through the article.
Ritual – Doing something in the same set/prescribed order every time you do it.
Example: When you brush your teeth, you brush them a set number of times on the top, the same number of times at the bottom and you brush your tongue in a certain way that you don’t use anywhere else in your mouth.
Habit – A tendency to practice something that is often hard to give up.
Example: You smoke 30 cigarettes a day and have done so for the past 20 years.
Compulsion – An irresistible urge to do something, go somewhere or repeat a process in a set order each time the compulsions arise.
Example: Just before you have a hit (inject), you must always have three new, clean syringes and three new, clean needles lined up in a row before you finish cooking up your drugs. If you don’t, you’ll feel uneasy and get the feeling that somethings wrong or incorrect, even though in reality there isn’t.
What’s The Difference Between An Addiction Versus A Compulsion?
Addiction is a broad term used to describe the process by which someone becomes dependent on a particular substance or behaviour. This dependence becomes so important that they will persist in using the substance or engaging in the behaviour, even when it is harmful to themselves, their family, friends and the other important areas of their life.
In contrast, compulsion is a narrow term used to describe the intense urge to do something, which can sometimes lead to a behaviour. Compulsions do play a role in the addiction process. As an addiction develops, it will involve a feeling of compulsion to take an addictive substance, such as alcohol or heroin, or to carry out an addictive behavior, such as gambling or sex.
Compulsions are also a symptom of obsessive-compulsive disorder (OCD). Someone with OCD may have a compulsion to engage in a behaviour like washing their hands, tying their shoes, or checking the stove as a way of trying to alleviate anxiety. Compulsions in OCD are often directly related to obsessions, which are repeated thoughts that generate distress.
Compulsions are one of the two primary symptoms of obsessive-compulsive disorder, a psychiatric disorder that affects approximately 1.2% of adults in the United Kingdom in a given year.
A compulsion is a repetitive behaviour or mental act that a person with OCD is driven to perform in response to an obsession or according to rigidly applied rules (which are often used to help manage feelings of anxiety or distress).
Compulsions Versus Habits
Not all repeated behaviours and routines are compulsions. Many people follow a familiar pattern or routine when getting ready for bed at night, for example, or they may perform other self-care tasks, such as showering and getting ready in the morning, in a specific order.
These tendencies, or habits, can occur subconsciously, and habits can serve a positive purpose in daily functioning. Habits are considered to be within the range of “normal” human behaviour.
Similarly, just because someone is particularly orderly and feels good about keeping their living environment tidy does not mean they “are OCD” or have OCD.
With OCD, compulsions are time-consuming and accompanied by significant emotional distress.3 The behaviors are typically carried out for two reasons:
- To neutralise or reduce the anxiety, disgust, or distress
- To minimise or prevent the perceived risk/feared outcome associated with an obsession
The Rituals & Habits Of An Addict
One of the harder parts of battling any addiction is the cessation of the rituals that happen before, during and after using drugs or drinking alcohol. Certain things can trigger the urge or thought to use or drink. Even just doing simple things like getting up in the morning, getting into the car, coming home from work, or even something as simple as holding, having or possessing a certain object can trigger an urge. Those who live with an addiction or are a direct friend or family member of an addict, you will know that addicts build their lives around their illness, in this case, their addiction.
It is the centerpiece of an addicts existence and the thought of no longer having or using drugs and alcohol seem totally unthinkable and impossible. It isn’t until the addict enters recovery via abstinence or sobriety that they see things are possible and achievable.
The rituals of an addiction supersede everything. People do them without thinking. Maybe, at the end of the day, they always stop at a certain bar or pub for a drink, or a certain road or house to buy their substance of choice.
Maybe they visit their dealer on a certain day at a certain time, for example on a benefit or wage payday. Bodies and minds know what they want and how to get it, despite the logical part of our brain that might be telling us to stop, to wait or to say no. When it’s over, we might stop for a moment and ask ourselves why we drank or used. By then it’s too late, the first step’s been taken.
Rituals themselves are not a bad thing- they simply exist so that we can complete a task from beginning to end in the correct order. They provide structure, give comfort and purpose. Rituals can also be a way to cope with stress. People seek the familiar, they want to know the rules of the situation.
They get up at the same time for work, eat certain things, on certain days of the week. In fact, rituals can help in recovery, that is if we can turn those moments of unconscious negative, harmful habits and rituals away from the illness of addiction and into a positive reinforcement for their sobriety/abstinence and recovery, they can be powerful tools when “the rough edges are smoothed out” and we fine tune what the new, acceptable normality is and what’s no longer.
Rather than eliminating the ritual, replace it with a more positive one. They don’t have to be massive changes, just something small is a perfect starting point you can build upon. For example, instead of stopping at the bar after work, try stopping by your local gym, explain your situation and see what’s on offer. Many gyms have special offers and programs that are sometimes funded by the NHS.
You can also try changing your routine. Instead of stopping at the dealers house or meeting point on the way home, go to a fellowship meeting. There are other types of meeting that you can attend if a fellowship style meeting doesn’t work for you.
Find something supportive in your recovery to do. It’s important to interrupt the negative processes and replace them with other positive ones. Start small and try just changing one thing at a time and don’t take on too much.
Making sweeping changes creates stress and when stress happens, people look for what they know, in this case, drugs and alcohol. This is not to say that even small changes won’t be stressful, but it is a matter of level and how influential the changes you decide to make have on your daily life and routine. Big changes tend to create bigger amounts of stress, and choosing to recover is one of the biggest changes someone can make. That is why it is important to break it down into manageable pieces that can be tackled on a daily basis, with small changes ultimately shaping the way toward your desired goals and outcomes. If you’re new to this, try to make your changes, SMART proof.
Understanding Obsessive Compulsive Disorder (OCD)
Obsessive-compulsive disorder (OCD) is a disorder involving recurrent, unwanted thoughts and/or actions.
Obsessive compulsive thoughts and actions take up time and energy. A person suffering from OCD may not be able to maintain a healthy, daily routine while trying to manage these distractions. Just as addictions do for addicts.
Signs & Symptoms Of OCD
If you have OCD or OCD tendencies, you’ll usually experience frequent obsessive thoughts and compulsive behaviours.
- An obsession is an unwanted and unpleasant thought, image or urge that repeatedly enters your mind, causing feelings of anxiety, disgust or unease.
- A compulsion is a repetitive behaviour or mental act that you feel you need to do to temporarily relieve the unpleasant feelings brought on by the obsessive thought.
For example, someone with an obsessive fear of being burgled may feel they need to check all the windows and doors are locked several times before they can leave their house.
Women can sometimes have OCD during pregnancy or after their baby is born. Obsessions may include worrying about harming the baby or not sterilising feeding bottles properly. Compulsions could be things such as repeatedly checking the baby is breathing.
OCD can cause anxiety, depression and even suicidal thoughts when left untreated.
Like many anxiety disorders and depression, alcohol and drug addiction often co-occur with OCD. This pairing can cause serious mental and physical damage. In these dual diagnosis situations of substance addiction and OCD or other mental health conditions, it’s crucial to get the right treatment for both disorders simultaneously as one can worsen the other if only one aspect is treated and the other untreated.
Co-Occurring OCD & Addiction
The mental and emotional pain OCD inflicts can lead sufferers to self-medicate with drugs and alcohol.
Substance use disorders (drug and alcohol addictions) affect more than one-quarter of those who seek treatment for OCD.
Many movies and television shows portray those with OCD as nervous and hyper-organised but overall healthy people. OCD is actually a serious mental illness disrupting people’s home, work and family lives.
Coping with OCD obsessions can be exhausting. Self-medicating with drugs and alcohol only provide a short relief, yet still leave the worries and problems that led you to use or drink, still waiting for you when you “sober up”, and are most often worse than they would have otherwise been had you dealt with it in the first place. This leads to repeated substance use whenever unwanted thoughts or urges arise. Then, with enough time and repeated use, a drug or alcohol addiction can form. This then provides a rapidly downward spiral of increasing debt, criminality, housing and relationship problems, job loss and many others besides.
Social Isolation, OCD & Addiction
The social isolation that OCD can provide, combined with the insular world that addiction creates can also lead to further, worsening drug and alcohol misuse and dependency. Those suffering from OCD understand that their obsessions and compulsions don’t make logical sense. OCD sufferers — and addicts — often feel shame, guilt and embarrassment for thinking and acting the way they do. Why do I think and feel the way I do when logically I know I shouldn’t, and if I were giving someone else the same advice or help, you wouldn’t punish, mock or belittle them as you do to yourself.
Like drug addiction, an obsessive-compulsive disorder can leave people feeling isolated from the outside world. Someone suffering from OCD might avoid important people and social settings to keep their obsessions and compulsions private. This shame, loneliness and physical isolation easily leads to substance use in an attempt to escape the way that this isolation and loneliness makes us feel.
Symptoms & Effects Of OCD
OCD often emerges in someone’s late teens and early twenties, but it can also start in the early teens or at any other time of life. Since many teens begin experimenting with drugs and alcohol during this same window, the potential for co-occurring OCD and substance misuse grows.
According to the U.S. National Library of Medicine, teens with OCD may be especially vulnerable to misusing drugs and alcohol.
Obsessive compulsive disorder is marked by having “obsessions” and/or “compulsions.” Those self-medicating OCD with drugs or alcohol might be trying to manage these symptoms.
Remember: Obsessive compulsive disorder is marked by having “obsessions” and/or “compulsions.” Those self-medicating OCD with drugs or alcohol might be trying to manage a mixture of these symptoms, thoughts and feelings.
Obsessions are frequent and forceful images, urges or thoughts that cause the sufferer great distress or anxiety. The individual tries to ignore these obsessions or get rid of them with another thought or action. This is called performing a compulsion.
Distress from OCD obsessions can cause sufferers to withdraw from friends and family. OCD obsessions can also make forming new relationships difficult. Both situations can lead to depression and then begin to self-medicate with drugs and alcohol or worsen any current substance dependency issues that they may already have.
Common OCD obsessions can include:
- Fear of germs, viruses, bacteria or “getting sick”
- Obsessions over “good” or “bad” numbers
- Intrusive thoughts of harm toward others or self-harm
- Obsessions with religious topics or “blasphemous” thoughts
- Intrusive images or thoughts of sexual acts with others, or with those that sexual acts would be inappropriate with
- Fear of losing a loved one to injury or illness
- Obsessions with having certain equipment or items to use or drink with or fears over not having these items
- Extreme, overwhelming fear of withdrawal (all addicts fear withdrawal to some extent, but when it dominates your thoughts, you need to seek professional help)
- Catching or passing on blood borne viruses or sexually transmitted infections
- And many others
Compulsions are repeated behaviours or mental rituals those with OCD believe will deflect these unwanted thoughts or urges. These rituals have no real connection to the OCD obsessions they’re meant to get rid of. Those with OCD feel “compelled” to perform these rituals regardless of the logic in doing so.
Common OCD compulsions include but aren’t limited to:
- Excessive washing and cleaning
- Excessively “double-checking” things like light switches, appliances and locks
- Counting, repeating words or tapping to soothe anxiety
- Breathing in a certain rhythms or number of patterns
- Excessive praying out of religious fear
- Repeatedly “checking in” on loved ones’ safety or to ensure that they’re still alive
- Hoarding useless items or trash
- Collating various injecting equipment like needles, syringes or others to ensure that they have a set amount of each still available
- Cleaning pipes or bongs out in a certain way or a certain number of times
- Ensuring that drinking glasses are clean and undamaged or that the individual has the right amount of associated items like ice, fruit or mixers
- And many others
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), both obsessions and compulsions are time-consuming, taking up more than an hour a day. They also significantly disrupt sufferers’ daily routines, commitments, appointments or prearranged events.
For example, someone with OCD might spend thirty minutes washing their hands after having an intrusive thought. He or she will complete this ritual despite being an hour late to work. The stress of OCD obsessions and compulsions on daily life can allow co-occurring drug addiction to take root.
Treating OCD & Addiction
The key to effectively beating co-occurring conditions such as addiction and OCD is treating the disorders at the same time.
Cognitive behavioural therapy (CBT) is often an effective treatment for substance addiction and OCD. This form of mental health counselling teaches addicted people with OCD to cope with unwanted thoughts and feelings that can lead to drug and alcohol use. Particular medications can also help to treat OCD symptoms. Speak to your GP or Doctor about this if you feel that this may benefit you.
Our highly trained and experienced therapists specialising in addictions, chronic pain and mental health crises are highly skilled at helping addicts overcome those tight shackles that bind you to your addiction, provide you with the tools and techniques you need to shape your own key to freedom from addiction and into a happy, prosperous and productive life. For more information, check out how you can change your life, starting from today by clicking here!
Common medicines for treating OCD symptoms can include but not limited to:
- Fluvoxamine (Luvox CR)
- Paroxetine (Paxil, Pexeva)
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
- Clomipramine (Anafranil).
It’s important to remember that addiction is a chronic illness. OCD’s symptoms can be treated with medication, but overcoming addiction requires constant, lifelong maintenance to avoid a lapse or full relapse. It’s important to also remember that medications aren’t right for everyone and every situation. We highly recommend that you first try holistic, alternative or mindfulness based approaches before seeking help from medications that come with side effects and other unintended pitfalls, one of which can be developing yet another addiction to the medications you could be prescribed.
Finding A Healthy Balance Again
Obsessive-compulsive disorders and addictions can leave you feeling helpless, alone, isolated and like a lost cause, unworthy of help or redemption. But it doesn’t have to be that way. Medical professionals are there to help you overcome OCD and addiction with a mixture of treatment methods, recovery programs and coping strategies. Contact us to find out more if you’re fed up living the same day, over and over again, never changing and growing, then we are the ones to help you!
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