Understanding Addiction

By David Hennessy, Clinical Psychologist, Varsity Lakes, Gold Coast, QLD.

Addiction is a common human difficulty, but it is often misunderstood. Many people think of addiction only as alcohol or drug dependence. In practice, addiction can also involve repeated behaviours such as gambling, gaming, pornography use, internet use, shopping, or other compulsive patterns that become difficult to control.

Addiction is not simply a lack of willpower. It is usually better understood as a pattern that involves learning, reward, habit, emotional relief, stress, environment, relationships, mental health, and repeated attempts to cope [1,2]. This does not remove personal responsibility, but it does make change more realistic and compassionate.

Most people who struggle with addiction have already tried to stop, cut down, hide the behaviour, or “just be stronger”. Therapy often begins by slowing the pattern down enough to understand what is happening, what the behaviour is doing for the person in the short term, and what it is costing in the longer term.

What Addiction Can Mean

Addiction usually refers to a repeated pattern of substance use or behaviour that continues despite harm, distress, or unwanted consequences [1]. The person may genuinely want to stop, but still find themselves returning to the behaviour.

This can involve:

• Strong urges or cravings
• Difficulty cutting down or stopping
• Repeated promises to change, followed by relapse
• Using more than intended, or for longer than intended
• Spending significant time planning, doing, hiding, recovering from, or thinking about the behaviour
• Continuing despite relationship, work, financial, legal, health, or emotional consequences
• Feeling shame, secrecy, guilt, or hopelessness

In diagnostic systems, substance use disorders are described using patterns such as impaired control, social impairment, risky use, craving, tolerance, and withdrawal [1,3]. Gambling disorder is also recognised as an addictive disorder [1]. Other behavioural patterns may still be clinically important, even when they do not fit neatly into a single diagnostic label.

Why Addiction Can Become So Entrenched

Addictive behaviours often work in the short term. This is part of why they become so difficult to change. A drink, drug, bet, screen, sexual behaviour, binge, or compulsive routine may temporarily reduce anxiety, numb pain, create excitement, ease loneliness, provide escape, or give a sense of control.

The difficulty is that short-term relief can strengthen the pattern. Over time, the brain and body may learn: “When I feel this, do that.” The behaviour can become more automatic, especially when the person is tired, stressed, ashamed, lonely, bored, angry, or overwhelmed [2,4].

This is not unlike learning in ordinary life. A tradesperson repeats a task until the movement becomes automatic. A driver can arrive somewhere with little memory of each turn. A person under stress can also fall into well-worn coping tracks. Therapy helps people notice those tracks and practise new responses until different choices become more available.

Addiction And Emotional Pain

Many addictive patterns are linked with emotional regulation. This means the behaviour may be used to manage feelings that seem too intense, empty, confusing, or hard to sit with [5].

People may use substances or behaviours to manage:

• Anxiety
• Depression
• Shame
• Grief
• Trauma reminders
• Loneliness
• Boredom
• Anger
• Restlessness
• Low self-worth

This does not mean the addiction is “really just emotion”. Addiction is more complex than that. It does mean that treatment often needs to include emotional skills, not only rules about stopping.

You may find it useful to read more about Emotion Regulation and Behaviour Change, especially if urges are strongest during stress, conflict, loneliness, or emotional overwhelm.

Substance Addiction And Behavioural Addiction

Substance addiction can involve alcohol, cannabis, stimulants, opioids, sedatives, nicotine, or other drugs. Behavioural addiction can involve repeated actions that activate reward, relief, anticipation, or escape. Gambling disorder is the clearest formally recognised behavioural addiction [1]. Research and clinical practice also pay close attention to problematic gaming, internet use, pornography use, compulsive sexual behaviour, and other repetitive patterns.

For some people, the substance or behaviour is the visible part of the problem. Underneath it may be stress, trauma, neurodevelopmental differences, depression, anxiety, social isolation, grief, relationship pain, or a life that has become too narrow.

Good therapy does not simply ask, “How do we stop this?” It also asks, “What is this doing for you, what is it costing you, and what would need to be built in its place?”

The Cycle Of Addiction

The addiction cycle is not the same for everyone, but a common pattern looks like this:

• A trigger occurs, such as stress, conflict, boredom, pain, shame, or an opportunity to use.
• The person experiences thoughts, feelings, body sensations, memories, or urges.
• The mind offers permission-giving thoughts, such as “just once”, “I have already failed”, or “I deserve this”.
• The behaviour provides short-term relief, pleasure, escape, numbness, or distraction.
• Later, the person may feel guilt, shame, secrecy, exhaustion, financial stress, relationship strain, or self-criticism.
• Those painful feelings can become new triggers, and the cycle continues.

Therapy often works by identifying the cycle early, creating space before action, and building alternative responses that are practical enough to use in real life.

Why Shame Often Makes Addiction Worse

Shame is common in addiction. Many people feel they have failed morally, spiritually, personally, or relationally. Shame can sometimes motivate a short burst of change, but it often becomes part of the problem. When a person feels worthless, hopeless, or exposed, the urge to escape can become stronger.

A respectful therapy approach separates the person from the pattern. The behaviour may be harmful and may need firm limits. The person still deserves dignity, honesty, safety, and a workable path forward.

This distinction matters. People tend to change more effectively when they can look clearly at consequences without being crushed by self-hatred.

What Helps Addiction Recovery?

Recovery is rarely one single decision. It is usually a process of repeated decisions, practical planning, emotional learning, support, and repair. Evidence-based approaches for addiction often include motivational interviewing, cognitive behavioural therapy, relapse prevention, mindfulness-based strategies, values-based work, and, where appropriate, medication-assisted treatment or specialist alcohol and other drug services [6,7,8].

Psychology may help people:

• Understand their triggers and warning signs
• Notice permission-giving thoughts
• Manage cravings without automatically acting on them
• Develop emotional regulation skills
• Practise urge surfing, delay, distraction, grounding, and choice points
• Reduce secrecy and shame
• Repair relationships where possible
• Build routines that reduce risk
• Reconnect with values, identity, health, work, study, family, and community
• Prepare for lapses without turning them into full relapse

For some people, recovery means abstinence. For others, especially in early stages, the first goal may be harm reduction, safer behaviour, reduced frequency, reduced intensity, or more honest monitoring. Australian alcohol and other drug guidance recognises that treatment should be person-centred, evidence-informed, culturally responsive, and flexible across goals such as harm reduction and abstinence [9].

How CBT Can Help Addiction

Cognitive Behavioural Therapy, or CBT, can help people understand the connection between situations, thoughts, emotions, body sensations, and actions. In addiction treatment, CBT often focuses on identifying triggers, challenging permission-giving thoughts, building coping skills, and developing relapse prevention plans [6,7].

For example, the thought “I have already ruined the day, so I may as well keep going” can be examined and replaced with a more useful response: “A lapse is a warning sign. The next choice still matters.”

You can read more about this approach in What Is Cognitive Behavioural Therapy (CBT)?.

How ACT Can Help Addiction

Acceptance and Commitment Therapy, or ACT, can help people make room for difficult urges, thoughts, and feelings while taking action guided by values [10]. ACT does not require a person to feel perfectly confident before changing. It helps people notice the urge, name it, allow discomfort to be present, and choose the next workable step.

This can be especially useful when urges are tied to avoidance. A person may learn to say, “I am having the urge to escape this feeling”, rather than “I have to use”.

You can read more in What Is Acceptance and Commitment Therapy (ACT)?.

When Addiction Co-Occurs With Other Mental Health Difficulties

Addiction commonly overlaps with anxiety, depression, trauma, sleep problems, grief, stress, and other mental health concerns. The relationship can go both ways. A person may use alcohol, drugs, gambling, pornography, gaming, or other behaviours to cope with distress. The addiction may then worsen distress through consequences, secrecy, sleep disruption, withdrawal, conflict, or loss of confidence [11].

Useful related articles include Understanding Grief and Loss, Psychology to Improve Sleep, and What Is Mindfulness-Based Therapy?.

When To Seek Professional Support

Professional support may be helpful when the pattern is affecting health, relationships, finances, work, study, legal safety, mood, sleep, self-respect, or daily functioning.

It may also be worth seeking support if:

• You feel unable to stop once you start
• You hide the behaviour from others
• You repeatedly break your own rules
• You feel trapped between craving and shame
• You are spending more time, money, or energy than intended
• You have tried to change but keep returning to the same pattern
• Other people are concerned
• You are worried about future consequences

If withdrawal from alcohol, benzodiazepines, opioids, or other substances may be medically risky, it is important to seek medical advice before suddenly stopping. A GP, addiction medicine service, emergency department, or local alcohol and other drug service may be needed depending on risk.

Psychology Support For Addiction

Hennessy Clinical Psychology provides psychology support for adolescents and adults experiencing addiction-related difficulties, including substance use and behavioural patterns. Support is available in Varsity Lakes on the Gold Coast and by telehealth where appropriate.

Therapy aims to help people understand the pattern, reduce harm, build skills, improve emotional regulation, strengthen motivation, and move towards a life that is more consistent with their values.

For local service information, visit Psychology Support for Addiction in Varsity Lakes, Gold Coast QLD.

Internal Links

• Psychology Support for Addiction in Varsity Lakes, Gold Coast QLD
• Emotion Regulation and Behaviour Change
• What Is Cognitive Behavioural Therapy (CBT)?
• What Is Acceptance and Commitment Therapy (ACT)?
• What Is Mindfulness-Based Therapy?
• Psychology to Improve Sleep
• Understanding Grief and Loss
• Articles
• Contact and Online Booking

Frequently Asked Questions

Is Addiction A Disease, A Habit, Or A Choice?

Addiction can include aspects of all three, depending on the person and the situation. It involves brain and body processes, learned habits, emotional coping, environment, and repeated choices. A helpful approach recognises the complexity without removing responsibility or increasing shame.

Can Someone Have An Addiction Without Using Drugs Or Alcohol?

Yes. Gambling disorder is formally recognised as an addictive disorder. Other behavioural patterns, such as problematic gaming, pornography use, internet use, or compulsive behaviours, may also cause serious distress and impairment even when they do not fit neatly into one diagnostic category.

Why Do People Keep Going Back To Something That Is Hurting Them?

Many addictive behaviours provide short-term relief, pleasure, escape, numbness, or distraction. The longer-term consequences may be painful, but the immediate effect can strongly reinforce the pattern.

Does A Lapse Mean Recovery Has Failed?

No. A lapse is important information, not proof that change is impossible. Therapy can help people understand what happened, reduce shame, repair where needed, and strengthen the plan for next time.

Can Psychology Help If I Am Not Ready To Stop Completely?

Yes. Many people begin by exploring ambivalence, reducing harm, improving honesty, tracking patterns, and building motivation. Some people move towards abstinence. Others begin with smaller safety-focused goals.

When Is Medical Support Needed?

Medical support is important when withdrawal may be risky, when there is heavy alcohol or drug use, when medication may assist recovery, or when there are safety concerns. A GP, addiction medicine specialist, or alcohol and other drug service may be needed alongside psychology.

References

[1] American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.). American Psychiatric Association Publishing.

[2] Volkow, N. D., Koob, G. F., & McLellan, A. T. (2016). Neurobiologic advances from the brain disease model of addiction. New England Journal of Medicine, 374(4), 363–371. https://doi.org/10.1056/NEJMra1511480

[3] Hasin, D. S., O’Brien, C. P., Auriacombe, M., Borges, G., Bucholz, K., Budney, A., Compton, W. M., Crowley, T., Ling, W., Petry, N. M., Schuckit, M., & Grant, B. F. (2013). DSM-5 criteria for substance use disorders: Recommendations and rationale. American Journal of Psychiatry, 170(8), 834–851. https://doi.org/10.1176/appi.ajp.2013.12060782

[4] Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harvard Review of Psychiatry, 4(5), 231–244. https://doi.org/10.3109/10673229709030550

[5] Sloan, E., Hall, K., Moulding, R., Bryce, S., Mildred, H., & Staiger, P. K. (2017). Emotion regulation as a transdiagnostic treatment construct across anxiety, depression, substance, eating and borderline personality disorders: A systematic review. Clinical Psychology Review, 57, 141–163. https://doi.org/10.1016/j.cpr.2017.09.002

[6] McHugh, R. K., Hearon, B. A., & Otto, M. W. (2010). Cognitive-behavioral therapy for substance use disorders. Psychiatric Clinics of North America, 33(3), 511–525. https://doi.org/10.1016/j.psc.2010.04.012

[7] Boness, C. L., Votaw, V. R., Schwebel, F. J., Moniz-Lewis, D. I. K., McHugh, R. K., Witkiewitz, K., & Pearson, M. R. (2023). An evaluation of cognitive behavioral therapy for substance use disorders: A systematic review and application of the Society of Clinical Psychology criteria for empirically supported treatments. Clinical Psychology: Science and Practice, 30(2), 129–142. https://doi.org/10.1037/cps0000131

[8] Ray, L. A., Meredith, L. R., Kiluk, B. D., Walthers, J., Carroll, K. M., & Magill, M. (2020). Combined pharmacotherapy and cognitive behavioral therapy for adults with alcohol or substance use disorders: A systematic review and meta-analysis. JAMA Network Open, 3(6), e208279. https://doi.org/10.1001/jamanetworkopen.2020.8279

[9] Australian Government Department of Health. (2017). National Drug Strategy 2017–2026. Commonwealth of Australia.
https://www.health.gov.au/resources/publications/national-drug-strategy-2017-2026

[10] Lee, E. B., An, W., Levin, M. E., & Twohig, M. P. (2015). An initial meta-analysis of Acceptance and Commitment Therapy for treating substance use disorders. Drug and Alcohol Dependence, 155, 1–7. https://doi.org/10.1016/j.drugalcdep.2015.08.004

[11] Alcohol and Drug Foundation. (2025). Alcohol and other drugs and mental health. https://adf.org.au/resources/health-professionals/aod-mental-health/