Multiple addictions interacting with one another.
Dr. Patrick Carnes was the first to describe the way multiple addictions interact with one another as more than pure coexistence. Therapists have long observed that compulsive behaviors come in multiples. The alcoholic was often a “womanizer” as well. The gambler may have spending and debting issues. The codependent might have an eating disorder. Rarely do we find a client with a single problem area. We now know that these behaviors interact in quite complicated ways such that the whole is much more than the sum of the parts.
Historically therapists have believed that patients should focus on one addiction at a time. They would not ask the alcoholic to stop smoking or the eating disordered patient to stop acting out sexually. The rate of relapse in these patients was great. It is now known that even though they may have remained abstinent from their “main” addiction, these patients actually were never sober. Unless the multiply addicted individual abstains from all addictive processes, the likelihood of relapse will remain high.
By abstaining from all addictive processes simultaneously, the multiply addicted individual is offered the opportunity to enter recovery with a sober brain that now has a chance to heal. Pain and other hard to experience emotions are known drivers of addiction and must be experienced in the treatment process. As long as the recovering addict has a parallel addiction to fall back on, those difficult feelings will be medicated rather than processed. Unless the therapist addresses the way various compulsive behaviors interact and the patient commit to complete abstinence, sobriety will prove to be elusive.