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The Addiction Model of Personality Disorder

What makes something an addiction?

For example, I’ve heard some commentators claim that conditions like sex addiction are a joke because all men are sex addicts at heart but just lack the means and opportunity. Other observers feel that the term “addiction” should only apply to alcohol and drugs and that the application of the term to phenomena such as shopping, gambling, sex, and food is overdone. One of the biggest complaints about modern psychology is its apparent need to label everything an addiction.

My take is the opposite. I think we don’t apply the label addiction to enough things. I do believe sex, shopping, gambling, and food addictions are real things, and I believe that the addiction model can be applied to a lot more areas too and that understanding the mechanisms and psychodynamics of addiction go a long way toward demystifying much of human behavior.

Returning to the sex addiction example: are all men sex addicts? They actually aren’t. Liking and wanting something a lot isn’t enough to make someone an addict.

So what does make someone an addict as opposed to, say, an avid enthusiast? There are three main components that warp an interest into an addiction.

  1. Compulsion. This means that the person’s use or indulgence in the object has a compulsive nature. It’s an urge that feels irresistible, often irrational and contrary to one’s conscious will, defies reason, and displays an extreme disregard for risk and consequences. For example I may like food and occasionally overeat, but if I am regularly binging to the point where I am almost vomiting or can’t move for hours afterward and have developed diabetes, that’s compulsive behavior. Another example: many men may like sex, but if a specific opportunity to engage in a quickie is so risky that it may destroy his family and career, he may pass up that opportunity. This ability to properly assess risk and responsibly decide to resist the impulse is a sign that his love of sex isn’t compulsive.
  2. Tolerance. This is when you have used and abused an object so much that you now need much stronger and more frequent doses of the object in order to feel relief. Instead of just needing the desired object to feel grandiose and high, you start needing the object just to feel normal. It becomes less about chasing a larger than life feeling and more about keeping emotional sensations of worthlessness at bay in order to just get through the day.
  3. Withdrawal. This is when you feel extreme emotional distress and intense cravings whenever deprived of the object. The longer one fails to procure the desired object, the more the feelings of worthlessness creep in and the more desperate one gets in what they’ll do to get their fix. To return to the sex addiction example, the reason most men aren’t sex addicts is because even though most men really like sex, they don’t feel despondent and wracked with self-loathing if they go out partying one night without getting laid.

In previous posts, I explained the concept of narcissistic supply. I also discussed  the similarities between narcissists and drug addicts:

I will tell you the easiest, fastest way to understand narcissists and other Cluster Bs like borderlines and histrionics. All you have to do is grasp the following sentence.

The types of things drug addicts and alcoholics are driven to do for their substance of choice (lie, steal, betray, etc.), are the exact things a narcissist will do to get narcissistic supply.

Then I discussed how different types of Cluster Bs have different preferred forms of narcissistic supply, just like most drug addicts have their preferred drug of choice:

I think Cluster Bs go from borderline to narcissistic to histrionic to sociopathic based on which type of narcissistic supply, if any, they are craving at any given time, for whatever reason. The preferred forms of narcissistic supply for each type is as follows:

  • Histrionic Personality Disorder: Anything that makes them feel like the center of attention. Flattering attention (especially sexual), flirtation, conquests, sexual teasing and withholding, romance, bodybuilding, loud obnoxious vocal displays and bright sports attire while watching sports games, drooling and double takes from others when wearing sexy or slutty outfits, obsession with abs, plastic surgery and cosmetic procedures, demanding grooming (lots of “mani/pedis” and hair appointments) or physical regimen (like Gym, Tanning, Laundry), making lovers jealous, making scenes in public, bravado and machismo, being fought over
  • Narcissistic Personality Disorder: Anything that makes them feel flawless and omnipotent. Admiration, being envied, being feared, being idolized, being asked for advice and treated like an expert, compliments, whether earned or unearned,
  • Borderline Personality Disorder: Anything that makes them feel like they have a committed partner dedicated to taking care of them. The presence of their mate, any indication that will reinforce the feeling that their lovers are devoted and won’t abandon them, making lovers jump through hoops, grand gestures from lovers, anything that indicates their lover is well-trained, like passing “shit tests,” getting lovers to forgive them and stay with them when the relationship is looking rocky

As with any other addiction, it isn’t the fact that a person enjoys the object of addiction, in this case narcissistic supply, that makes them an addict. It’s the fact that they have a specific type of toxic relationship to their enjoyed object that involves cycles of increased compulsion, tolerance, and withdrawal that makes it an addiction.

Just about everyone enjoys food, sex, shopping, alcohol, and the feeling of being high. That doesn’t mean everyone is addicted to those things. Likewise, all the forms of narcissistic supply I listed above that histrionics, narcissists, and borderlines obsess over are things that all of us enjoy to a degree. Who doesn’t like flattering attention or feeling flawless and idolized or having a devoted mate who won’t abandon them? Yet most of us though don’t compulsively chase these things in irrational, self-sabotaging ways. Most of us haven’t habitually chased ego boosts and relationship commitments to the point where we have a high tolerance to them and need insane amounts just to feel normal. Most of us don’t feel waves of self-loathing, distress, and anxiety if we don’t receive ego boosts or aren’t in a romantic relationship.

I’d also like to offer another way to think about this. One way to look at it is the way I’ve already described. That narcissism is a form of addiction, where the drug being abused is narcissistic supply instead of a substance like alcohol or drugs. But another way to look at it is that drug addiction is a form of chemically-induced narcissism/emotional vampirism, and the drug addict is a narcissist who prefers his narcissistic supply in a chemical form and prefers his grandiosity feelings in the form of an alcohol or drug high. The Cluster B emotional vampire needs narcissistic supply in order to fight off shaky self-esteem and induce feelings his grandiosity. Likewise, the alcoholic or drug addict uses a chemical form of narcissistic supply to fight off self-esteem and chemically induce feelings of being high. A drug high is grandiosity that one induces and amplifies chemically.

So is narcissism a type of drug addiction where the drug in question is narcissistic supply and the “high” achieved is grandiosity or is drug addiction a form of narcissism where the narcissistic supply comes in the physical form of drugs and the grandiosity achieved is the drug high? Or put even more simply and directly: is narcissism an expression of addiction, is addiction an expression of narcissism, or are both addiction and narcissism expressions of some bigger disorder? It’s a subtle, maybe meaningless, distinction, but one that we’ll be exploring in future posts.

17 Responses to “The Addiction Model of Personality Disorder”


  1. Just about everyone enjoys food, sex, shopping, alcohol, and the feeling of being high. That doesn’t mean everyone is addicted to those things. Likewise, all the forms of narcissistic supply I listed above that histrionics, narcissists, and borderlines obsess over are things that all of us enjoy to a degree. Who doesn’t like flattering attention or feeling flawless and idolized or having a devoted mate who won’t abandon them? Most of us though don’t compulsively chase these things in irrational, self-sabotaging ways. Most of us haven’t habitually chased ego boosts and relationship commitments to the point where we have a high tolerance to them and need insane amounts just to feel normal. Most of us don’t feel waves of self-loathing, distress, and anxiety if we don’t receive ego boosts or aren’t in a romantic relationship.

    Great post. Way to put it all perfectly.

    Was it a couple years ago, we had a bit of a disagreement about whether it was healthy to want outside validation? I do think it is healthy, up to a point. If you’re an neglected writer who has been trying to get your book published for 10 years or someone who can’t seem to get a boyfriend or girlfriend, it is ok to be a bit frustrated and depressed at times, even if you know yourself you’re a good writer or that you’d make a good partner for someone. But that is a lot different than being addicted to attention and ego boosts for their own sake.

    I think you’ve put things better than I could.


  2. I suspect the argument against classifying something as an addiction often stems from the fact that individuals will use the addiction argument as a way to duck culpability for transgressions. Rather than arguing that certain individuals don’t have a problem and are just making an excuse, we seek to discredit their excuse. It’s a less confrontational way of assigning blame.


  3. I guess I’m addicted to having people validate my opinions, because seeing this in print made me insanely happy. GG. I’ve been trying to inject this viewpoint for quite a few years, but I think you’ll get better resonance than I did. It seems that, in the end, it all boils down to the dopamine/opioid cycles.

    I’m looking forward to any future posts on the same subject matter. Why I hadn’t discovered this blog sooner is beyond me.


  4. Thursday:

    Was it a couple years ago, we had a bit of a disagreement about whether it was healthy to want outside validation?

    I would have to search it out, but I’m pretty sure the disagreement wasn’t about whether it’s healthy to want outside validation at all but rather whether it’s healthy to be primarily motivated by outside validation over internal validation. I think outside validation should be the icing on the cake, not the actual cake itself.

    But that is a lot different than being addicted to attention and ego boosts for their own sake.

    Why did you feel the need to make that distinction? I’m pretty sure no one would claim they were similar?

    Eric Stratton:

    I suspect the argument against classifying something as an addiction often stems from the fact that individuals will use the addiction argument as a way to duck culpability for transgressions. Rather than arguing that certain individuals don’t have a problem and are just making an excuse, we seek to discredit their excuse. It’s a less confrontational way of assigning blame.

    I can see that. I think both certain addicts and certain critics of addicts believe that allowing people to label a problem as an addiction somehow relinquishes the person of all responsibility and accountability. People think that if they can say they have an addiction, it’s no longer their fault because they were in the grip of a “condition.” Which is why many critics of psychology hate the trend of labeling so many things addictions. But labeling something an addiction doesn’t mean the addict should no longer be held accountable for his or her actions or shouldn’t be required to do penance or make restitution or pay consequences for what they’ve done.

    I think the addict does have a problem, but that that problem should not be used as an excuse for bad behavior or a way to duck accountability. Both the addicts and the nonaddict need to understand that calling someone in addict does not in any way let the person off the hook for things they do wrong. It just provides a useful established framework for understanding the behavior and thought processes.

    Angulimala:

    I’ve been trying to inject this viewpoint for quite a few years, but I think you’ll get better resonance than I did. It seems that, in the end, it all boils down to the dopamine/opioid cycles.

    You’ve nailed the direction I’m headed in. This is eventually going to discuss dopamine. You can see a preview of where my thought process currently is by reading the Charles Lyell’s dopamine project blog: http://dopamineproject.org/

    It’s a direction I had independently arrived at myself last year, but he turned out to be way ahead of me in figuring it out and crystallized my thoughts on the matter much better.


  5. Could you fix the RSS-feed so that it shows the complete post? I like reading blogs in google reader.


  6. Excellent and insightful analysis as usual Ricky. Thanks!


  7. It’s good to see you back ricky raw.
    Best compliments from brazil.


  8. “You’ve nailed the direction I’m headed in. This is eventually going to discuss dopamine.”

    Sounds like continuing the theme of the primacy of emotions (or internal states, or now the reward system of the brain). This blog could likely be retitled “101 Ways to Overcome Your Objections to Eastern Mysticism.”


  9. When struggling with narcissistic or addictive behaviors, it is easy to get frustrated and its tempting to give up while using the disguise of taking a break, have that one “last” cigarette, text that person one “last time”.

    It does get easier when you come to understand where it is coming from, but really requires constant vigilance and awareness. I think this is where developing positive habits becomes critical.

    I agree with Eric Stratton (great blog btw) in that doing bad things is what makes you a bad person, everything else is excuses, so the solution is to stop doing those things. This of course applies to your run of the mill douchey behavior as much as to people struggling with more serious and destructive issues.

    Anyway, thank you. Reading you over the years made me understand myself and others much better.


  10. Woooooooo Ricky is back!!!!
    Ok now i´ll start to read your post hahaha!


  11. Jim:

    Could you fix the RSS-feed so that it shows the complete post? I like reading blogs in google reader.

    Thanks for pointing that out. I don’t like the RSS feed appearing like that either. I’ve changed it back to showing complete posts.

    Appolion, heltersk:

    Thanks for reading and commenting.

    Different T:

    Sounds like continuing the theme of the primacy of emotions (or internal states, or now the reward system of the brain). This blog could likely be retitled “101 Ways to Overcome Your Objections to Eastern Mysticism.”

    It’s also been incorporating a lot of Western psychology and will start incorporating a lot of neuroscience as well, especially neurotransmitters, so I think of it more as a synthesis of Eastern and Western insights, which aren’t as different in my opinion as people make them out to be. It’s just that in the West we’ve reached a place thanks to technological progress where we can’t trust an insight unless it’s provable by scientific experiments and studies. Now that neuroscience and fMRI scans are starting to provide scientific evidence of a lot of the things that Western psychology and Eastern mysticism have been saying about personality and the brain, a lot of divergent schools of thought are starting to come together in bigger ways.

    s:

    I agree with Eric Stratton (great blog btw) in that doing bad things is what makes you a bad person, everything else is excuses, so the solution is to stop doing those things. This of course applies to your run of the mill douchey behavior as much as to people struggling with more serious and destructive issues.

    I totally agree. I think both people with personality issues who are eager to label themselves and “normal” people who are against the use of labels on personality disordered people need to realize that labels shouldn’t be used as an excuse or an escape from accountability, they’re just a diagnostic tool, that’s all. As long as you are sane enough to know right from wrong, and you still do wrong, you need to be held accountable at the end of the day, no matter what labels you fall under.

  12. Matthew Rappaport on November 12th, 2012 at 4:14 PM

    HE’S BACK.

    Nice way to make a return, my dude.


  13. I guess my point is that there isn’t anything necessarily wrong with sometimes pursuing external validation, even purely for its own sake; it is more about your relationship to that validation.


  14. “the alcoholic or drug addict uses a chemical form of narcissistic supply”

    Awesome.


  15. As a self-diagnosed narcissist I wonder how can I experience a non-narcissistic perception of the world even for a short time. Any tips?


  16. @Jurko

    can you please,explain what kind of person you are…like

    -what other people say about you?
    -what do you think about yourself?
    -what do you do when you feel bad,when you fail at something,when
    someone critics you?

    thank you very much


  17. I think i fall into this category a lot. Is there any way to talk to people online about all this? I suppose Im basically looking for a cheaper way of getting to a better understanding of it. 60 pound an hour to an expert hurts my bottom line a bit too much.

    Living in a fantasy world at times, seems like everything im doing these days is designed to avoid myself. Whether its PS3, tv, porn, alcohol etc etc. I can easily see me just gradually dropping out, outside world hurts lol. Lots of crazy stuff going through my head.

    I feel like Ive got to go through a period of feeling like an utter loser, perhaps Ive got that bit wrong! The article on shame nails me I think, dont want to face people without drink.