The difference between addiction and compulsion

Sometimes the words addiction and compulsion are used interchangeably. However, they are not actually the same thing. What is the difference between them?

Definitions

Addiction is a broad term, which is used to describe an entire process where someone becomes dependent on a particular substance or behaviour in order to help coping with life. This dependence becomes so important to the individual that they will keep on using the substance or engaging in the behaviour, even when it is harmful to themselves, 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, which can sometimes lead to a behaviour, but does not always. Compulsions are a small but important part of the addictive process and are also a major part of obsessive-compulsive disorder (OCD).

How are addiction and compulsion related?

As an addiction develops, it begins to involve the desire or compulsion to take an addictive substance, such as alcohol or heroin, or to carry out an addictive behaviour, such as gambling or sex, but it also involves other processes.

The Key Differences 

There are two main differences between addiction and compulsion:

1. Pleasure

A compulsion, at least as it is experienced in obsessive-compulsive disorder, does not include the experience of pleasure, whereas an addiction does. While people who have addictions suffer all manner of discomforts, the desire to use the substance or engage in the behaviour 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 behaviour he carries out. Often, it is just 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 behaviour, and they are just seeking relief from the urge to use or engage in the behaviour.

This is compounded by the experience of withdrawal that often happens when they stop taking the substance or engaging in the behaviour. Although this can look like obsessive-compulsive behaviour because the pleasure is gone, the original motivation to engage in the behaviour was to feel good.

2. Reality

Another major distinction between an addiction and a compulsion has to do with the person’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 behaviour that defies logic, yet they do it anyway to relieve their anxiety.

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

Why All the Confusion?

Like many words that are in common use, they may be misused and/or misunderstood. This causes confusion for everyone, not only 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 behaviours. Originally, the term compulsion stemmed from the idea of addicts accessing the erotic pleasure centres 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 medical insurance.

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