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Introduction
ОглавлениеI suggest an experiment.
Before you read this book, put away your phone and laptop, and see how long you can last without a mobile device and the internet.
If you managed to go for more than twenty-four hours without a mobile device and the World Wide Web, and you had no desire to pick up your phone to check social networks and messaging apps – you are fine.
If you thought about your phone and social networks a few times, you may have some degree of addiction to social media and the internet, but you can overcome it on your own.
If you put away your phone and are experiencing irritability, aggression, and are trying to switch to alcohol, drugs, exercise, or if you are stress-eating with sweets – you are addicted, and you need to seek professional help.
If you cannot put your phone away and are certain that there is no life outside the internet, or that it is dull and dreary, congratulations: you have truly serious issues with a behavioral addiction, and you must take action because you will not overcome it on your own.
One of the paradoxical aspects of behavioral addictions is that they are often perceived by individuals as an expression of their personal freedom. A person believes that they themselves choose how much time to spend on the computer, what purchases to make, or how intensively to work. However, in reality, these actions become compulsive and uncontrollable, leading to a loss of true freedom of choice.
Furthermore, behavioral addictions can create a false sense of control over one's life. For example, a person suffering from compulsive shopping may think that buying a new item will help them cope with stress or improve their mood. In reality, this provides only temporary relief, after which the problem returns with renewed intensity.
Behavioral addictions pose a serious threat to an individual's mental and physical health. They create an illusion of freedom, which is in fact a form of enslavement. Addressing this problem requires comprehensive measures, including both individual work with psychologists and changes in the social environment. Only in this way can genuine freedom and control over one's life be restored.
The concept of behavioral addiction is one of the most pressing issues in modern psychology and sociology. In the context of rapid technological development and the expansion of the information environment, behavioral addictions are becoming increasingly widespread.
The purpose of this book is to analyze the phenomenon of modern behavioral addictions. A behavioral addiction, much like a substance use disorder, is associated with a loss of self-control. This addiction consists of irresistible cravings and the motivation to experience intense positive emotions. And who among us does not enjoy positive emotions?
People are dependent on many things that seem natural to them. For instance, we enjoy scrolling through pictures and short entertaining videos on our gadgets, chatting in messengers, engaging in sports for pleasure, eating sweets or oranges, or watching several episodes of a favorite series in a row. It is difficult for modern individuals to give up various harmful, or not-so-harmful, habits. Any addiction is driven by the goal of obtaining immediate pleasure, a short-term reward. But we all know that for such a short-term reward, a person ultimately incurs long-term costs and negative consequences.
Addiction is a destructive form of behavior that develops when a person attempts to escape reality, striving to avoid interaction with an unpleasant situation or period in life by altering their mental state.
The Russian psychiatrist A. O. Bukhanovsky defines addictive behavior as a chronic mental disorder, representing a deformation and pathological development of the personality. At the same time, Bukhanovsky notes that the motives for committing the actions are not amenable to rational analysis in the moment, often causing pain and harm to the addicted individual and their family. The harm resulting from the addiction can be of various kinds: medical, psychological, material, and often even legal.
V. D. Mendelevich, an author of scientific works in the field of clinical psychology and psychiatry, believes that classical Russian addiction medicine is based on an erroneous paradigm of the psychological pathologization of substance use disorders. Meanwhile, the definition of "addictive craving" is currently considered acceptable from a scientific standpoint for both chemical and non-chemical dependencies.
V. D. Mendelevich notes that the primary diagnostic criterion for a dependency, whether chemical or non-chemical in nature, is the presence of an altered state of consciousness. It is well known that chemical dependency is based on the use of psychoactive substances. However, a non-chemical dependency is defined as one based not on the use of a psychoactive substance, but on a specific behavioral pattern – a particular stereotype of behavior that negatively affects the quality of life. Although non-chemical dependencies are outside the focus of attention for psychiatrists and addiction specialists in our country, they not only exist theoretically in textbooks but are also frequently encountered in the practice of clinical psychologists.
A behavioral addiction may be less severe in its consequences for physical health, but financially, socially, and psychologically, an individual can suffer greatly from it. Such dependencies often occur within family dynamics. The family is one of the primary factors in the development of behavioral addictions, which is why family psychotherapy is often the optimal choice in practice for working with such disorders.
In 2015, T. Robins and L. Clark wrote in their research that chemical and behavioral addictions share common biological mechanisms. Such a statement implies that some behavioral addictions may respond to therapeutic interventions used in the treatment of chemical dependencies.
A behavioral addiction is characterized by a rapid reward, long-term physical costs, and substantial risks of various kinds. For example, an individual may resort to watching a specific type of video content to reduce feelings of anxiety, irritation, or melancholy, thereby providing themselves with short-term euphoria. A crucial role in behavioral addictions is played by a lack of emotional regulation skills, which could otherwise correct a person's behavior and direct their actions into more beneficial channels for themselves. People suffering from gambling disorder, compulsive shopping, or eating addictions notice that their level of positive emotions diminishes over time. When they repeat the same pleasure-inducing action, the novelty effect disappears.
Due to the diminishing intensity of positive emotions, a person with an addiction requires not just a repetition of the same actions, but also an increase in energy expenditure to achieve the desired emotional effect. For instance, when viewing a specific type of video content, men notice that after some time, they cease to derive pleasure from the same video. The absence of a positive effect not only prompts them to endless internet surfing but also drives them to seek out content that is socially unacceptable.
How is normality distinguished from abnormality today?
Imagine you are observing a colony of emperor penguins. They are all large, sleek, black, and beautiful, with yellow feathers above their eyes that you would call "fabulous eyebrows" if penguins were human. Then, among this uniform colony, a small, completely white, awkward albino penguin comes into focus, and you catch yourself thinking: "Oh, this shouldn't be. This is completely unacceptable from the standpoint of the standard beauty of emperor penguins!"
Well, today's norm is the standard accepted by the majority of people, by the entire society. Pornography addiction, for example, is not entirely normal today. An individual can have many other addictive behavioral conditions; however, the problem of pornography addiction is currently addressed by very few. Men suffering from this behavioral addiction, while attempting to rid themselves of systematically viewing pornography during the psychotherapeutic process, note that if they are forced to abstain from viewing such content under the principle of "quitting cold turkey and never watching those terrible videos again," they subsequently describe experiencing a state resembling withdrawal syndrome after discontinuing the use of psychoactive substances. However, this kind of withdrawal does not have serious medical consequences.
During the withdrawal syndrome in a behavioral addiction, symptoms of a hypertensive crisis are entirely absent, and, incidentally, there are no significant physiological changes. However, if one abruptly decides to quit video games, internet surfing, or excessive gadget use, they experience not only a depressed state but also aggression, rage, and irritability, which can be difficult to control.
The formation of any addiction involves the neurotransmitter systems of our body. I will mention them very briefly so as not to weary the reader. The leading roles here are played by serotonin, which is responsible for behavioral inhibition, and dopamine, responsible for the reward system, motivation, learning, and assessing the significance of a stimulus. The dopaminergic system plays a key role in the formation of a behavioral addiction.
Neurobiological studies have identified impaired functioning of the prefrontal cortex in individuals prone to both chemical and behavioral addictions. The prefrontal cortex determines the impulsivity of actions and is responsible for inhibition. In addition to the prefrontal cortex, the amygdala and the mesocorticolimbic system become activated during engagement in activities such as gambling, buying lottery tickets, internet surfing, and playing computer games. The constant activation of these brain areas and the suppression of the prefrontal cortex firmly reinforce specific addictive behavioral patterns in an individual; this is how a behavioral addiction is formed.
The use of psychoactive substances or involvement in a behavioral addiction can be the consequence of the same underlying process that provokes such behavior. For example, constant family conflicts, arguments, problems at work, and being in a stressful situation – coupled with a lack of self-regulation skills and stress resilience – create fertile ground for the development of both alcoholism and drug addiction, as well as for the formation of behavioral addictions. Certainly, hereditary factors also play a role here. Thus, if first – degree relatives (parents) had a dependency on drugs or alcohol, then under certain conditions their offspring may also have a propensity for drug or alcohol use, or a propensity for gambling disorder, kleptomania, internet addiction, or pornography addiction.
V. D. Mendelevich classifies religious and political fanaticism, as well as sports fanaticism, as forms of addictive behavior. He emphasizes that any aspect of human activity, when pursued with excessive passion, ultimately causes harm to the individual and their loved ones.
Today, researchers have developed several classifications of behavioral addictions. Let us present one of them. A. V. Kotlyarov proposes that the following phenomena be considered addictions:
– appearance addiction (a fanatical desire to frequently visit cosmetologists, a striving for the ideal appearance promoted by social media trends);
– ideology addiction (religious fanaticism, sects, astrology, palmistry, esoteric movements);
– existential addiction: a constant search for the meaning of life and a tendency towards exaggerated philosophizing about the meaning of existence, coupled with neglect of other life spheres (addiction to psychotherapy with metaphysical intoxication);
– sexual addiction (frequent change of sexual partners, promiscuity, nymphomania, pornography addiction, and addiction to being in love);
– addiction to solitude and a constant need for loneliness, which has a negative impact on a person's quality of life;
– codependent relationships;
– computer addictions: gaming addiction, internet surfing, criminal programming (an urge for hacking);
– addiction to mass media, to watching television, viewing advertisements and social media videos, and binge-watching series;
– economic dependency (addiction to money and its social hierarchy, an overvaluation of material and financial means);
– gambling addiction (gambling);
– workaholism and work as a fixed idea;
– shopping addiction and compulsive buying on marketplaces and online;
– gadget dependency (excessive use of smart gadgets in daily life, such as phones);
– victimhood dependency: masochism, Stockholm syndrome, aggressive behavior such as sadism, a perpetual war syndrome, constant blackmail;
– other dependencies: scribomania, urgency addiction (expressed as a constant feeling of time shortage), binge reading, Merry Driving Syndrome, sports addiction.
Not all behavioral addictions are listed in this book, but some of them are included in the multiaxial classification of diseases and accompany more severe mental disorders, such as schizophrenia.
The formation of behavioral addictions results from a specific set of factors: these include not only family upbringing and social environment but also the broader cultural and national milieu, encompassing the mentality of the individual and the entire ethnic group to which the person belongs. Theoretical and empirical data revealing the nature of behavioral addictions remain limited to this day, a fact which prevents the inclusion of all forms of these dependencies in modern classifications of mental disorders. The lack of substantial research fuels debate in medicine, biology, and psychology: should behavioral addiction even be considered a disorder, rather than an individual's lifestyle choice?
The question of medical support in treating behavioral addictions, unfortunately, remains open in domestic psychiatry due to insufficient study of the phenomenon. Equally relevant today is the issue of behavioral addiction among children and adolescents. There is no shortage of means that can lead to behavioral addictions, ranging from gadgets, messengers, and computer games to internet surfing.
An analysis of research on adolescent and child behavior in the practice of psychotherapy and clinical psychology establishes the significance of computer games as a dominant activity for primary school children and teenagers. At a certain point in a child's or adolescent's life, educational activities, hobbies, peer communication, literature, and ordinary outdoor activities are imperceptibly displaced by computer games.
The personality of an adolescent who "lives" in the world of computer games exhibits a high degree of emotional and mental immaturity. Because of this infantilism, such a teenager lacks independence in everyday situations, has weak friendship bonds in the real world, and seldom goes outside. Internet technologies are constantly evolving, and modern society cannot eliminate them from daily life. Strict restrictions and manipulative behavior from adults based on the principle, "If you don't do your homework, I will take away your phone," are ineffective. Modern information technologies play an important role in our lives, having secured a firm place in commercial, communicative, industrial, and cultural spheres of activity.
Through immersion in the world of information technology, sports, or work, people try to escape their difficulties. For a modern teenager – shy, fragile, unable to defend their point of view among friends and classmates, and suffering from a lack of attention at home – "escaping" into a computer game or watching online video content is a way to mitigate negative emotions and sensations from real life. Choosing a positive, highly "leveled-up" computer hero can also be a form of compensation for the adolescent's own self-rejection. The reward system in computer games also works in a treacherous manner; what a child cannot achieve in real life – the ability to "earn bonuses" in studies, relationships, or other hobbies – is obtained within the computer game.
This is a way to feel significant, like a superhero. While for a child or adolescent the method of "escaping" into an unreal world may be linked to compensating for something important, for an adult, immersion in a behavioral addiction is also a way to shirk responsibility for events in real life.
Most modern online computer games give a person the opportunity to feel competitive. L. O. Perezhogin and N. V. Vostroknutov suggest that gaming among adolescents is the most widespread form of behavioral addiction today.
M. G. Chukhrova notes that the prevalence of addiction can vary significantly across different geographical regions. For example, internet addiction affects approximately 0.8% of the population in Italy, whereas in Hong Kong, it is observed in 26.7% of the population. The emergence of addiction is influenced not only by demographic and socio-economic factors and the internal dynamics of a person's social environment but also by a genetic predisposition. However, not everything can be attributed to genes. The development of both chemical and behavioral addictions involves not only "bad genes" but also pathophysiological processes and comorbid disorders in children and adults.
Today, shopaholism, preoccupation with video games and social media, workaholism, excessive engagement in physical exercise, eating disorders, promiscuous sex, and other manifestations of addictive behavior have negative social consequences. All these phenomena present a contradiction; some of them, such as workaholism and sports addictions, are socially acceptable in modern society.
The debate among psychiatrists, clinical psychologists, neuroscientists, and behavioral therapists on whether to classify behavioral addiction as a disorder or merely an extreme manifestation of behavior continues unabated in the scientific world.