Addictions and impulse control

Addiction as an extreme form of experiential avoidance

From the viewpoint of this model, addictive behaviors (whether to substances such as alcohol or to processes such as pathological gambling or pornography) are not seen simply as a search for pleasure, but fundamentally as an escape from pain.

Addiction is the desperate attempt to regulate unbearable emotions in the short term, at the cost of destroying life in the long term.

Alcohol is not used just for fun, but to silence self-criticism or social anxiety.

Gambling is not just for money, but to anesthetize boredom or a sense of emptiness.

Treatment begins by helping the client connect with the function of his or her consumption. "What do you get to avoid when you drink, what feelings go away?".

Once it is identified that addiction is a failed emotional control strategy, work is done on developing acceptance as an alternative.

If the person drinks to avoid feeling lonely, treatment involves learning to sit with the loneliness, to breathe through it, and to discover that it is a painful but not lethal emotion.

Recovery is not just about physical abstinence, but about the ability to feel everything that the substance was covering up without the need for anesthesia.

Impulse management: the technique of surfing the wave (Urge Surfing)

Craving or the urge to engage in compulsive behavior is often experienced as a compelling command that grows in intensity until it becomes unbearable.

Patients often believe that if they do not give in to the urge, it will explode or last forever.

ACT introduces the "Surfing the Wave" technique to disprove this belief through direct experience.

The client is taught to visualize the impulse as a wave in the ocean: it starts small, grows, reaches a maximum crest, and finally breaks and dissipates on the shore.

The instruction is to observe the physical impulse (tension in the jaw, salivation, restlessness in the hands) with scientific curiosity, without trying to suppress it or give in to it. "Notice how the wave of desire rises.

You don't have to fight the water, just keep your balance on the board of your breath and watch the wave change."

The client learns that no momentum is permanent; they all go up and down. By not acting on the momentum, the wave passes.

With repeated pra