Addiction. It's an emotionally charged word that brings visions of darkened alleys, empty whiskey bottles strewn in a gutter, a desperate soul with his fingers wrapped tightly around a bundle of fine white powder. It brings to mind the alcoholic, the junkie—those who have lost control, surrendered to chemicals.

        Strictly speaking, scientific authorities haven't arrived at a concrete definition of addiction. As a word, it stems from the Latin addicere, meaning to bind a person over to one thing or another. One thing we do know for a certainty: it is not limited to the craving of alcohol or drugs. There are many kinds of addictions, and they manifest themselves in many kinds of behavior.

        Some people are addicted to food—or, more correctly, to eating. They eat to relieve boredom, frustration, anger, unhappiness, loneliness, jealousy, and hatred—or to reward themselves for some special achievement. They eat to console themselves in times of grief. They eat to inspire themselves. They reward themselves emotionally by eating.

        Other people are addicted to watching television. Instead of talking or reading or participating in athletics, they watch television. Television, in fact, becomes a way of escaping into a life they deem more pleasurable. It's easy to forget their worries and frustrations by identifying with a fleeting character who appears every Thursday or Friday night. Deprived of the experience, they become distracted, jittery, or hypnotic—unable, really, to function normally in the world around them.

        Still others are addicted to gambling—not to winning money, but to the thrill associated with the roll of the dice, the spin of the wheel, or the horses pounding down the home stretch, all the while knowing that their lives (or fortunes) are on the line. Gambling—taking a risk—becomes an exciting prospect that, much like eating or watching television, relieves boredom, soothes unhappiness, and allows an escape into another, more desirable world. The addiction to gambling, one of the fastest growing addictions in the nation, has recently been defined as a disease by a chain of self-help groups called "Gamblers Anonymous," fashioned after the popular Alcoholics Anonymous.

        A closely related addiction is the addiction to risk: not only gambling, but literally placing one's life in danger. A "risk addict" gains actual arousal or excitement from placing himself in danger—scaling a sheer rock cliff with a small pick hammer, catapulting from an airplane and waiting until the last second to release the parachute, heading into a hairpin curve at seventy miles an hour.

        Some become addicted to crime or violence, gaining arousal from the violation of other people or the destruction of other people's property. Some become addicted to sex, suffering an overwhelming obsession with pornography, sexual fantasizing, sexual paraphernalia, or promiscuous behavior. Still others become addicted to people: while they have difficulty with one-on-one relationships, they thrive on group socialization. Scarcely a night goes by without a visit to a bar, private club, or party.

        Some addictions don't appear to be harmful on the surface, but they are actually good habits gone awry. Consider exercise, for example a person may take the good habit of exercising three times a week to excess until it becomes a twice-daily ritual during which he avoids dealing with his problems. Deprived of his exercise for even a brief time, he becomes hostile and angry; he gradually but steadily loses the ability to view things in perspective.

        Similar is the "workaholic," the person who drives himself nearly to the point of extinction with his hard work. He may spend fifteen hours a day at the office, bring work home, stay up until the wee hours agonizing over a problem, and even creep into the office on weekends. He scarcely admits he has a family, or that his family may have problems that need his attention. He neglects home, friends, and personal life—but who can fault him? He's usually a success in business and is rewarded profusely for his dedication and loyalty to his job.

        Because addiction can take any of these—and many other—forms, it is critical to separate it from the most common manifestation of alcohol or drug abuse. It is essential to understand how addiction (regardless of its manifestation) occurs. It is critical that we be able to determine when addiction exists. And it is helpful to list the characteristics of addiction and of those who are addicted or who are most prone to become addicted. If we are to succeed in making a difference, we need to understand how to help people change addictions into healthy habits—and how to prevent addiction from occurring in the first place.

        The behavior is reinforced. Before an addiction can occur, the behavior must be reinforced in some way—usually by creating pleasure. The workaholic is reinforced because he gains honor and recognition from his superiors at the office. The person addicted to chocolate enjoys the taste. The Russian roulette player thrills to the arousal associated with the risk.

        The addiction is an attempt to meet basic needs. Human growth and developmental psychologist Abraham Maslow described human needs as a pyramid. At its base are the most basic needs the need for food and water in order to survive, for example. At its pinnacle is the highest level of human need, the need to become the best you possibly can (termed self-actualization by Maslow). Called "the hierarchy of human needs," Maslow's model describes five levels of need that must be met:

1. Basic physical needs—the need to survive, which includes the need for food, shelter, and water. Because these needs are the most basic, when they are not met, other needs become inconsequential. A person deprived of food or water will worry about little else: his primary efforts will center around getting what he needs to survive.

2. Safety needs. A person must feel secure. His life must have some sort of predictability. He must feel safe from outside forces that might destroy him. A person who does not feel safe or secure might retreat into a world where he does feel safe, even if that security is false. He may gain emotional comfort and a facade of safety from eating, sleeping, drinking, using drugs, or watching movies, for example.

3. Belonging needs—the need for love, affection, and a sense of being important to other people. A person who feels he doesn't belong, who feels he can't deal with the stress of developing close interpersonal relationships, may retreat into an addiction.

4. Esteem needs. Every person needs to feel important, to achieve something great, to feel worthwhile. Again, addictive behavior may seem to fill the emotional void for those who feel inadequate or unappreciated. Addictive behavior may also provide escape to those who feel unable to cope with the pressure to achieve.

5. Self-actualization needs. Even when all other four need levels are being filled, there is still the fifth, the need to be the best person we can possibly be. We all want to achieve our potential, develop our talents, and reach our goals. The woman who married and abandoned her plans for a career in medical technology during her sophomore year may feel resentful and imprisoned by her decision, especially when she contemplates a sinkful of crusted dishes, an overflowing diaper pail, or the demands of small children. She tries to escape these feelings of frustration and anger by retreating into the world of daytime soap operas. Suddenly she worries about whether Jenny will ever discover that Brad has been unfaithful; that consuming preoccupation saves her from worrying about whether she should have struggled to finish college.

        The Addiction relieves stress. Life without some kind of stress would be worthless, but when stress becomes overwhelming, it can be destructive. Some people are successful in dealing with stress; others try to escape by denying the problem or somehow running away from it. Addictive behavior is often a way to run from problems, to hide from problems, or to deny that problems exist. The workaholic whose teenage son is failing in school can blissfully escape the grueling problem of having to work with his son: after all, he's so busy at the office that he doesn't have time for family problems.

        The addiction results from peer pressure. At various stages in our lives, particularly during adolescence, we are especially vulnerable to peer pressure the subtle or overt influences exerted by people our own age, in similar circumstances, or simply close to us physically or emotionally. Peer pressure can not only influence the addiction to begin with, but it can help determine its extent.

        The addiction can exist within our value system. Our own value system, including the behaviors we consider acceptable, are typical sources of many addictions. We have beliefs about what is right or wrong. If our socioeconomic position, religious beliefs, education, traditions, and role expectations do not allow shooting heroin, then we will probably not develop such an addiction. However, we may become addicted to otherwise acceptable behaviors. Overeating, oversleeping, compulsive gambling, or obsessive television watching may become an addiction.

        Serious physical illness is present. Serious physical illness especially chronic or terminal illness can create for an individual a situation much like a steel trap: he envisions that he is going to be held prisoner forever, with no rational way out. To escape from the stress of the situation, he may turn to addiction. In some cases, the addiction may provide an escape from pain or disfigurement.

        There is pressure to perform or succeed. One of the most powerful factors leading to addiction may be the pressure to perform or succeed; the person who feels he just can't measure up might try to escape into an addiction. Within his own value system, he now has an excuse for his failure, which somehow makes it more acceptable.

        The person hates himself A person who actually comes to hate himself may seek an addiction as a subconscious way of punishing himself. The addiction may seriously hamper his ability to cope with life, but he reasons that he doesn't deserve any better anyway. With that rationalization, the addiction seems defensible.

        There may be a genetic link. At least a few prominent researchers believe there may be genetic determination of those who are susceptible to addiction, just as some believe that susceptibility to cancer may be genetically determined. This genetic makeup does not guarantee addiction, they say, but does determine whether a person will become addicted as a result of repeated reinforced behavior. Some even say that a true addict must have an abnormal chromosome- and without it, the person will never be truly addicted.

        Addiction may be due to varying brain activity. Closely related to the genetic theory is one that says a person is highly susceptible to an addiction if messages are transmitted in his brain with varying intensity. When nerve transmissions occur with unusual speed in certain parts of the brain, researchers say, the feeling linked to an addictive behavior may be much more intense than usual, leading to the important reinforcement required to establish addiction.

        Society allows addiction. While peers may pressure a person into addictive behavior, society contributes by allowing it—in other words, we have evolved into a society that has become much more lenient. Gone are the strictures that bound us even half a century ago; the byword is "do your own thing," and few people are persecuted for addictive behavior until it becomes clearly destructive (such as severe alcoholism). Medicine and psychiatry have become much more accepting; the media views addictions of all kinds as part of life.

1. The addictive behavior dominates the person's life; he begins to neglect other facets of his life (even basic ones, such as cleanliness).

2. The person's usual behavioral patterns or day-to-day patterns of living become seriously disrupted.

3. The abrupt discontinuation of the addictive behavior after continued or prolonged involvement results in a state of extreme anxiety, a hypnotic trance, or, in some cases, an actual physical "withdrawal" illness (such as that seen among drug or alcohol addicts).

4. The person cannot seem to get enough of the addictive behavior or substance—or, after getting "enough," he still can't stop.

5. The person shows no sign of the ability to make choices about the addictive behavior—he can't rationally determine whether it is an appropriate time or setting for the behavior. He does not act appropriately. In simple terms, he feels compelled into the behavior, regardless of his own feelings or circumstances at the time.

6. The person continues the addictive behavior even after it has lost some of its excitement or appeal to him; even though it isn't as pleasant as it once was, he continues regularly. A person who once got a real thrill out of betting on horses may continue to do so even when he is ridiculed or nagged, loses continually, or no longer feels the same thrill.

7. The person no longer does something because he wants to progress and improve; he does it because he wants to be left alone, because he fears he can't progress, or because he wishes to escape a stressful situation. He may not find any joy or pleasure in the addictive behavior, but it may be a way of erasing other things in his life that he dreads.

1. The person is readily satisfied by the behavior, and when that level of satisfaction is reached, the person can then stop and go on to something else.

2. The person derives pleasure from the behavior. That pleasure lasts not only while the behavior is taking place, but becomes part of a general sense of well-being and satisfaction that endures long past the behavior.

3. The behavior is spontaneous instead of being predictable. The person may seize the opportunity to watch television because something exceptionally interesting is on that evening—not simply because it is part of his routine to watch television every night.

4. The person welcomes the chance to do something else. A woman might have established a routine (or habit) of running two miles before she goes to work each morning. When a friend calls and suggests a tennis match instead, she eagerly accepts the tennis match as an equally good way of getting some exercise.

5. The person genuinely feels better about himself as a result of the behavior; over the long run, it contributes to his feelings of self-esteem and worth.

6. The person genuinely enjoys the activity or behavior—and when he stops enjoying it, he stops doing it.

7. The person feels exhilarated and expanded because of his behavior and uses it to build his confidence in himself. He eagerly looks for new challenges and behaviors that can take him a step further and readily abandons the old for something more challenging or rewarding.

8. The person becomes more aware, more educated, or more enlightened as a result of the behavior.

        Some of the signs of addictive behavior include:

1. The person can't seem to achieve satisfaction from the behavior; no matter how much he gets, it just isn't enough. He is constantly frustrated by the need to do more or get more. This frustration is negative, and it is much different from the motivation to do more out of challenge and determination.

2. The behavior is not pleasurable or does not contribute to an overall sense of well-being.

3. The behavior becomes predictable. A man knows that every morning he will arrive at work an hour early and that he will stay two hours after everyone else in the office goes home; the pattern never changes. A woman knows that no matter what, she will eat three chocolate bars before lunch.

4. The person becomes inflexible about the behavior. A woman who has established the pattern of running two miles before work each morning will balk at a friend's invitation to play tennis instead; if the friend won't join her in running, she'll run anyway—either before the tennis match or in place of it.

5. The person feels a lowered sense of self-worth or self-esteem because of the addictive behavior but feels unable to change.

6. The person does not necessarily enjoy the behavior but feels driven to do it anyway. A man may feel disgusted by his obsession to look at pornographic magazines and may feel that his is a "dirty" habit, but he can't seem to stop, regardless of those feelings. The behavior may even sicken the person, but still he feels incapable of changing it.

7. The person remains locked in the behavior as a means of escaping demands or stresses, not because the behavior is seen as an exhilarating challenge.

8. The behavior serves to dull the senses, provide an escape, or otherwise help the person get away from stress, unhappiness, boredom, or frustration. When the person gets the opportunity for challenge or reward, he resorts to the addictive behavior instead of abandoning it and accepting the challenges of some other behavior.

        By stubbornly clinging to addictive behavior, the person creates all kinds of problems for himself. His health may be compromised, as in an addiction to alcohol, drugs, or eating. He may no longer be able to function properly, and other aspects of his life fall into neglect, sometimes seriously compromising his status within the family or the community. His relationships with his spouse, other family members, and friends may be compromised. He may even experience serious social problems, such as involvement in criminal activity or problems with creditors.

        Healthy habits, on the other hand, enhance life. They increase the ability to function normally, and they usually promote health. As a result of healthy habits, a person is better able to communicate and relate to friends and members of his family; a person whose habits are healthy is not likely to experience serious social problems, because his awareness is acute and his priorities are not with the habit to the detriment of other things.

        One of the most common and overwhelming of these traits is the fact that the addicted person does not have the confidence to face life without the addictive behavior. He may simply feel as though he can't go on without the addictive behavior, or he may actually feel that life wouldn't be worth living if he were denied the chance to indulge himself with the addiction. A woman who was addicted to drinking cola drinks was told she had become diabetic and that she would need to severely limit her consumption of soft drinks. She literally decided that life was not worth living if she could not have the cola—and died at the age of twenty-five from complications of diabetes, still drinking twelve to fourteen cola drinks a day. Clearly, she may not have consciously wished to be dead, but her addictive behavior led to her death.

        The addicted person is generally negative. Instead of anticipating joy and pleasure, he fears pain, failure, and disappointment. A nonaddicted person looks forward to life's experiences for the joy and fulfillment they bring; an addicted person has convinced himself that life holds plenty to be anxious and unhappy about and little to look forward to.

        The addicted person suffers from all kinds of fear—fear of interaction with others, fear he may not perform well on the job, fear he may fail at school, fear he may not be a suitable husband or father. By constant fears and worries, he escapes into the addictive behavior, however falsely, to gain some reassurance that is never forthcoming.

        Some addicted persons believe they have no control over what happens to them. They think that their addictive behavior and the substances associated with it are more powerful than they are, and that they are mere victims with no ability to refuse or overcome.

        The addicted person regards life itself as a burden— something he can't cope with or handle. The nonaddicted person regards life as a pleasurable, fulfilling challenge and regards life's problems as temporary hurdles that can be overcome with work and effort. The only way the addicted person sees to overcome life's problems is to escape them.

        The addicted person feels extremely dependent—either on other people or on addictive substances or behaviors. He feels incapable of making an acceptable life-style for himself free of the addictive behavior. He views the addictive behavior as inevitable—something he can't (or won't) give up or escape.

        The addicted person often feels emotionally detached from other people, and, when other people stand in the way of the addictive behavior, he may view them as mere objects to be manipulated or exploited. He may even be able. to relate somewhat normally to others until it comes to the addictive behavior, and then he may lose the ability to view others with rationality. He may even seek out others who share his addiction.

        Finally, the addicted person welcomes the control that the addiction places over him; he feels some kind of safety and reassurance in submitting himself to it. If he is deprived of that chance to submit, he feels fearful and incapable of going on.

1. refuse to tackle life's problems head-on;

2. view success as a magic solution to life's ills;

3. don't set realistic, reasonable goals;

4. turn appropriate diversionary activities into obsessive activities;

5. worry about their own capabilities and express low self-esteem;

6. are often dependent, conforming, and compliant;

7. are frequently fearful of others and detached;

8. see problems as overwhelming burdens or obstacles that must be escaped;

9. often lack problem-solving skills;

10. don't cope well with stress;

11. often lack the spontaneity, creativity, and eagerness for life that others possess. Addiction-prone people are often bored with life.

        Latter-day Saint lay counselors should remember that all people have their agency to choose what they will do and be. That certain people have personality traits that match those listed above in no way determines their future behavior. The role of the lay counselor is to help an addicted person recognize that he has the freedom and the power to change his thoughts and his behavior.

        Those who are trying to break the habits of smoking, chewing tobacco, drinking alcoholic beverages, drinking coffee or tea, or abusing drugs should be encouraged to stay close to the Lord through prayer and regular Church activity. Probably they will feel unworthy, but they must learn to rely on the powers of heaven. Help them to remember the great blessings that can come from overcoming their addiction.

10. Help the addicted person realistically and vividly imagine the rewards that will come once the addictive behavior is conquered. Stress improvements in appearance, health, behavior, acceptance, or other areas that apply to the situation.

11. Help the person set realistic goals and map out a method of achieving them. A person needs commitment to a goal in order to reach it; help him identify goals that he can form a commitment to so that he can experience success and the confidence that come with responsible action.

12. Help the person develop new interests. They could be something as simple as needlepoint or gardening—but they should be things that the person is genuinely interested in. Help in the initial stages: if you decide to encourage her to start gardening, loan her a few books on gardening, go with her to buy seeds, visit another friend whose beautiful garden you've both admired, and get down on your knees in the warm soil with her. Watch her progress; praise her efforts. Take photographs of her garden and consider asking her to donate a basket of vegetables to an elderly neighbor or friend.

13. Help the person be realistic in his expectations. A person who decides to stop overeating because of the desire to be thin may hope to lose fifty pounds in a few months. When the weight does not come off quickly enough, he may become discouraged and return to his addictive behavior. Help him set realistic goals that anticipate what can reasonably be expected, and remember to acknowledge the progress he does make. You may need to help him consult a professional to determine what he can reasonably expect as he stops the addictive behavior and changes to new behavior patterns.

14. Examine your own relationship with the addicted person. To be of help, you should be warm, concerned, caring, and respectful; you should allow the person to examine his own alternatives, and you should provide support. If you do not acknowledge his importance to you, you may be withholding a basic truth that can invite his success. If he is under stress, do what you can to relieve it; if he is fearful or anxious, do what you can to relieve his fears. Help him make positive changes that will help him discover new ways he can meet his needs and free himself from his addiction.

15. Finally—and this is a difficult reality to accept—the person may have deep, destructive feelings associated with the addictive behavior. If this is the case, the person will require professional care by those qualified to help him resolve his destructive feelings.

About the Authors

Dr. Brent Q. Hafen, professor of health sciences at Brigham Young University, received his bachelor's and master's degrees from the University of Utah and his Ph.D. degree in health sciences from Southern Illinois University. A member of numerous professional associations, he has been a member of the advisory board of the Utah State Division of Alcoholism and Drugs.

A regular speaker at professional training seminars and workshops, Dr. Hafen is also the author, co-author, or editor of many books and manuals and as many articles and workbooks.

Dr. Hafen has served as a counselor in the Provo North Stake presidency. His previous Church callings include bishop, bishop's counselor, member of branch presidencies, member of a stake mission presidency, and high councilor.

He and his wife, Sylvia, are the parents of seven children.

Kathryn J. Frandsen, press secretary for Congressman Howard C. Nielson and writing colleague of Dr. Hafen, has studied at Brigham Young University. She has worked as an editor and editorial writer for four publications, including the Ensign and BYU Today, and she has co-authored a number of books. She is an active Church worker.

She and her husband, Cullen, are the parents of two children.