The Line Between Discipline and Addiction

But the diagnosis of addiction is really based on behaviors and can be briefly summarized as the four C's. Control, compulsion, craving, and consequences, especially continued use despite consequences. So like what if you're a, like I have friends that are addicted to golf and they just can't wait to go play golf. What's the consequences? Well, it might be that their spouse says, gee whiz, why are you playing golf all the time? Maybe they just need a new spouse. Well, okay. Okay. So this actually comes up a lot in clinical care. Like to what extent is it my problem? To what extent do I have to change my life? And I always say to patients, you know, that is a great question and not one that I can answer for you, but maybe together we can find the answer because the truth is sometimes it is a question of needing to change your life. Right. And I wouldn't presume to necessarily know, especially with cases on the border. Now there are certainly on the border, I mean on the border of like, um, consequence, pathological. Yeah. I mean, there are some cases where like, okay, you don't need to be a psychiatrist to diagnose that this person has addiction. It seems open to interpretation in the world of what you would call extreme winners, like the Michael Jordans of the world, the people that are just absolutely completely obsessed with winning. That seems like you could kind of call that an addiction, but then they are the most celebrated people in all of the world. Right. Right. So you're tapping into something that is really important to talk about, which is that our society rewards certain types of addictions and not others. We certainly reward professional athletes who have become obsessively focused on their sport. We certainly reward workaholics of all types. And again, it's not to say that we, we should pathologize all types of intensity or all types of commitment to a behavior. That's not what it's about. But what I think is important is to recognize that the same mental machinery that approach and avoid behavior mediated by dopamine that is at play when we become addicted to something can be at play really in all different aspects of our lives, not just drugs and alcohol. So you're essentially looking at this very objectively. You're not making a judgment call. You're just saying the same mechanism is in place, whether it is extremely beneficial like you are Michael Jordan, or whether extremely detrimental like you're a person who's addicted to crack or you're a gambling addict who keeps blowing all their family's money. That's kind of, you're on the same human neurological pathway. That's exactly right. It's the same mental machinery that's being applied. And again, there are certain types of addictive behaviors that our society rewards. But even in those cases, I think it's important for people to really closely evaluate potential hidden consequences. And I feel like that's happening. I mean, just using the example, again, of athletes, I feel like there are more and more there are athletes who are in different ways kind of questioning their lifestyle or the things that they have to do, which I think is good. I think it's always good to look at the pros and cons. Basically there's never the light without the dark. It's really that dialectic that comes into play really in all aspects of our lives, which I think we need to talk about and think about. We celebrate the people that are extreme winners. We celebrate the people that are absolutely completely obsessed with performance and they have everything dialed in, including their calories, their macronutrients, the amount of sleep they have, the amount of recovery that they seek out, how they do it. But they have a massive reward for that. The massive reward is the glory of being a Michael Jordan or being a Mike Tyson or being a Sugar Ray Leonard or whoever it is at the peak of their performance when they're on top of the world. There's a great deal of benefit to having what many would just call extreme discipline. So what's wrong with that? What we hear very little about is when that road comes to an end and that escalating glory and reward dries up and what those people's lives are like after that. My sense is that unless they've worked very hard to cultivate other aspects of their personality, when that dopamine trail dries up because they get injured or they just age, then they have to contend with the come down, the dopamine deficit state, not to mention all of the other aspects related to loss of identity. Who am I if I'm not this person who's winning? Of course, that's an old trope. We know that, but we don't hear about those athletes after that. The other thing I would say that you point out in that description, which I think is also key to the process of becoming addicted, is the ways in which addiction is also about controlling and changing the way we feel in the moment rather than tolerating the feelings or the uncertainty of what's next and just letting it wash over us. So a really key important aspect of what you call discipline, but which I think in some contexts might be addiction, is wanting to control what we're feeling when we feel it. I think this is also deeply embedded into modern life and modern culture. Explain that, wanting to control what we're feeling and when we feel it. That's what separates discipline from addiction. No, I think there's overlap there, so let me go back. Part of what drives the phenomenon of addiction is that people control what they feel when they feel it. For example, in this moment, let's say I'm struggling, but I feel like, oh, I can get through this because when this is over, I'm not saying I'm struggling, but if I were, because when this is over, I'm going to reward myself with X, Y, and Z. If you go running and then afterwards, you can have a slice of pizza. That's right, exactly. So it's the way that we bracket our endeavors with rewards, and this is just deeply embedded into our culture. And the control aspect is a big part of the addictive aspect because I'm now going to control the way I feel when I feel it, which is a very different way of living if you were to eliminate rewards as a way to shape time. If you were to think, I'm not going to do anything to reward myself today, I'm just going to get through the day. It totally changes the arc of our experience in the moment. Watch the entire episode for free only on Spotify.