Experts Gather to Discuss Invisible Addictions

By Misty Harris, Canwest News ServiceSeptember 22, 2009

Chronic dependence on things such as shopping is being treated across North America, despite the fact that not one of these so-called “addictions” is officially recognized as a disorder.

Grandma collected one too many cookie jars? She may need rehab.

Chronic dependence on things such as hoarding, shopping, playing video games and even using Twitter is being treated in Betty Ford-style clinics across North America, despite the fact not one of these so-called “new addictions” is officially recognized as a disorder — at least, not yet.

On Oct. 1 and 2, mental health experts will gather at the Ontario Science Centre for one of the widest-ranging addictions symposiums ever held in Canada — an event that will see the proposal of clinical criteria defining where normal indulgence ends and disordered behaviour begins.

“In the past, you’d see people chasing the high with heroin or cocaine,” says Linda Bell, CEO of Bellwood Health Services in Toronto. “Now, they chase the high with gaming, they chase the high with sex, they chase the high with shopping.”

Although these modern-day maladies are frequently highlighted in the media — think Oprah’s episode on sex addicts or bestsellers such as Confessions of a Shopaholic — there remains little research on their treatment, along with lingering skepticism over adding them to the canon of addiction.

For instance, sexologists have long argued that what some call “sex addiction” is actually normal activity required for the survival of the species. Others believe it’s more likely a mental illness known as obsessive compulsive disorder.

But Bell, the first Canadian to be appointed a Fellow of the American College of Addiction Treatment Administrators, says not only are these addictions real, they’re being exacerbated by such things as Internet anonymity, ease of access and a stressful economy.

The challenge, according to Canadian addictions counsellor Anne McLaughlin, is that unlike chemical dependency, “process addiction” tends to have few detectable symptoms, with the behaviour either taking place in secret or being dismissed by family and friends as normal activity.

“It can be very isolating,” says McLaughlin, who treats both sex addicts and their partners. “If someone drinks or takes drugs, at least it’s visible.”

Coleen Moore, spokeswoman for the Illinois Institute for Addiction Recovery — one of a growing number of centres that treat process addictions — says Internet addiction is responsible for six to 10 per cent of annual patient intake, food addiction for one to three per cent, sex addiction for five per cent, shopping addiction for two to eight per cent and hoarding for one per cent.

Each of these behaviours is under review for inclusion in the 2012 edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), a psychiatry gospel whose list of recognized illnesses has tripled since 1952.

Proposed DSM criteria for Internet addiction in particular will be presented at the Canadian symposium.

“Pathological gambling is in the DSM . . . and it really sets up a precedent for these other behavioural addictions,” says Toronto psychotherapist Edith Townsend, pointing to diagnostic criteria such as preoccupation, unsuccessful efforts to cut back or stop, restlessness and irritability, using the behaviour to escape problems, lying and jeopardizing significant relationships. “It’s a total escape from reality.”

The clinical similarities, however, have not eased controversy around the impending recognition of such “addictions,” with critic Christopher Lane, author of Shyness: How Normal Behaviour Became a Sickness, writing: “Conceivably, we might by 2012 reach a point where the American Psychiatric Association is defining more than half the country as mentally ill.”
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