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The Difference Between an Addiction and a Compulsion

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Updated July 15, 2011

Some Simple Definitions

Addiction is a broad term, which is used to describe an entire process by which people (or animals) become dependent on a particular substance or behavior in order to cope with life. This dependence becomes so important to the individual that they will persist in using the substance, or engaging in the behavior, even when it is harmful to themself, their family, and other important areas of their life.

In contrast, compulsion is a quite narrow term, which is used to describe the intense urge to do something. Compulsions are a small but important part of the addictive process, and are also a major part of obsessive-compulsive disorder.

So you can see that an addiction involves the compulsion to take an addictive substance (such as alcohol or heroin) or to carry out an addictive behavior (such as gambling or sex), but it also involves other processes.

Key Differences

Pleasure

One major distinction between an addiction and a compulsion (as it is experienced in obsessive-compulsive disorder) is the experience of pleasure. While people who have addictions suffer all manner of discomforts, the desire to use the substance or engage in the behavior is based on the expectation that it will be pleasurable.

In contrast, someone who experiences a compulsion as part of obsessive-compulsive disorder may not get any pleasure from the behavior he carries out. Often, it is a way of dealing with the obsessive part of the disorder, resulting in a feeling of relief.

This can get a little confusing because there often comes a point for people with addictions where they don’t really enjoy the addictive behavior, and they are just seeking relief from the urge to use or engage in the behavior. This is compounded by the experience of withdrawal that often happens when they stop taking the substance or engaging in the behavior. Although this can look like obsessive-compulsive behavior because the pleasure is gone, the original motivation to engage in the behavior was to feel good.

Reality

Another major distinction between an addiction and a compulsion has to do with the individual’s awareness of reality. When people have obsessive-compulsive disorder, they are usually aware that their obsession is not real. They are often disturbed by feeling the need to carry out a behavior that defies logic, yet they do it anyway to relieve their anxiety.

In contrast, people with addictions are often quite detached from the senselessness of their actions, feeling that they are just having a good time, and that other concerns aren’t that important. This is often known as denial because the addicted person denies that his use or behavior is a problem. Often it is not until a major consequence such as a spouse leavin a drunk-driving accident, or a job loss, that they are faced with the reality of their addiction.

Why All the Confusion?

Addiction and compulsion are both terms that have entered our everyday language. And like many words that are in common use, they may be misused and misunderstood. This causes confusion for everyone, especially those suffering from addictions and compulsions, but also for professionals trying to help. Often, people use these terms interchangeably without thinking about the distinctions between them.

There are several reasons that the word “compulsion” started to be used in relation to addictive behaviors. Originally, the term compulsion stemmed from the idea of addicts accessing the erotic pleasure centers of the brain. Later, the term “compulsion” was used in place of “addiction” in the hope that it would add legitimacy to the treatment of addiction, and make it more likely that treatment would be covered by insurers.

These days, the biggest controversy in the field of addictions is whether behavioral addictions are legitimate addictions like substance addictions. Another term, dependence, is used in the Diagnostic and Statistical Manual of Mental Disorders (DSM) to refer to alcohol and drug addictions, and compulsive gambling is the only behavioral addiction specifically included in the manual. As we near the publication of the next edition, expected in May 2012, work is being done to consider inclusion and unification of the various addictions.

Sources:

American Psychiatric Association. "Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision" 2000 Washington, DC: APA.

Carnes, P. "Addiction or Compulsion? Politics or Illness?" Sexual Addiction & Compulsivity 3:127-150. 1996.

Kelly, O. "Symptoms of OCD? OCD is an Anxiety Disorder." About.com 19 Jan 2009.

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