Chemical and Process Addictions

May 4, 2012

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By Terence. T. Gorski

Addictions can be organized around different triggers that activate the Core Addiction Syndrome. These activating triggers have one  thing in common – they activate an addictive brain response. This means that the brain is flooded the brain with pleasure chemicals that create a unique sense of euphoria while being inhibiting from producing warning chemicals which cause the feelings of stress, anxiety, fear, and panic.: As a result when people expose themselves to addictive triggers, their brain responds with an addictive brain response which positively reinforces them to keep hitting the addictive trigger. When people stop hitting the addictive trigger they experience dysphoria,  The triggers for the addictive brain response can be classified into two major groups:

  • Chemical Addictions to mind/brain altering substances (which include alcohol, illegal/illicit drugs, prescription medications, and over-the-counter medication)
  • Process Addictions to mind/brain altering behaviors (which includes food, sex, gambling, work, and money).

A large number of people switch from one addiction to another. This often goes unnoticed because of problems with language. Most people, even most professionals, think only of chemical addictions when they hear or read the word addiction. Many people describe process addictions as compulsions or else describe them in the context of DSM using words like sexual disorders, eating disorders, etc. The idea of a process addiction doesn’t even come into mind.

Most people have an addiction of choice. In other words, they receive treatment for a chemical addiction, and then in sobriety, they crossover or migrate to another addiction, often a process addiction. The negative consequences of the process addiction causes pain and problems in “sobriety” that can lead back to the use mind/brain altering chemicals. This progression of pain and problems in sobriety are often called Early Relapse Warning Signs.

The switching of addiction –from chemical to process and then back to chemical –is a common but not universal phenomena. This raises the questions of whether chemical dependent people with a process addiction have independent and co-existing disorders, or if there is an underlying core addiction syndrome that drives them both. This is, of course, black-and-white thinking, which is not always helpful. Perhaps chemical addictions and process addiction share some things in common yet have significant difference.  This is a reasonable position, especially in light of a long history in the addiction field of defining different types of addiction.

In the next blog we will look at the simalarities between chemical and process addictions.

Terence T. (Terry) Gorski

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The Core Addiction Syndrome

May 4, 2012

By Terence. T. Gorski

I recently found an article on the internet by Floyd P. Garrett, MD, who presented the following definition of the term Addictive Process

“The addictive process is a recognizable psychological and behavioral syndrome that expresses itself in a particular individual in regard to specific substances or processes but which exhibits a striking similarity and commonality among addicted individuals regardless of their specific circumstances and particular addictions.”
~ Floyd P. Garrett, MD

To understand this definition and put it together with my previous understand I hade to take this definition apart. Here is how I thought it through:

1.      The addictive process is recognizable. I agreed with this statement and it matched with my experience. Patients have many disorders that have a great deal of similarity to the original symptoms of alcohols as presented Jellinek and other models of drug addiction. I also see that there are critical differences that set them apart.

2.      The addictive process is composed of recognizable psychological and social system. I agree with this statement as far as it goes. In my opinion, however, it is incomplete. In my experience, there are also neuropsychological problems based in abnormal brain chemistry that are a critical part of the addictive process. On a physiological level The use of certain mind-altering chemicals (often referred to as a drug of choice) and the use of certain mind-altering behaviors activate an addictive brain response in predisposed individuals.  When the addictive brain response is activated by use of an addictive drug or behavior the brain has an automatic addictive response. This automatic addictive brain stimulates the brain to over-produce pleasure chemicals and inhibit the production of warning chemicals that reduce stress anxiety and fear. As a result, when the addictive brain response is activated people feel a strong and pleasant sense of euphoria and do not feel stress, anxiety or fear. Reference: Straight Talk About Addiction by Terence T. (Terry) Gorski

3.      There are many similarities among all conditions related to this addictive process, whether if focus is chemical or behavioral.  I agree, but again I believe that this definition is incomplete there are also critical differences among the different manifestation of the addictive process. In my opinion both the similarities and the differences need to be recognized in order for effective treatment and recovery plans can be developed and implemented.

The term used by Garret, the Core Addictive Process is a good one, especially because it highlights that the response caused by addiction to addictive chemicals and behaviors are both processes that share a core of similarities. I believe, however, that the term Core Addictive Syndrome is more useful in the context of a total lexicon or system of language. A Syndrome is a group of identifying signs and symptoms; a group of signs and symptoms that together are characteristic or indicative of a specific disease or other disorder; a group of things that form a pattern that can be recognized and distinguished from other patterns.

The term Core Addiction Syndrome will establish both chemical and behavioral addictions firmly into the lexicon of medical terminology which will be required for its acceptance into the community of behavioral health providers.

My next blog will focus upon taking the concept of the Core Addiction Syndrome and examining the common mind altering chemical and behaviors that can activate the syndrome.

FOCUS HealthcareTerence T. (Terry) Gorski

introduction to The GORSKI-CENAPS Model of Addiction, Recovery, and Relapse

August 6, 2010

This blog will give a brief and easy to understand description of addiction, recovery, and relapse prevention for addiction and related problems.

Addiction is a biopsychosocial disease with profound spiritual consequences.

  • BIO means “biological” or pertaining to the physical actions of the body.
  • PSYCHO means psychological and pertains to the actions of both the brain (the hardware of thinking, feeling, and acting) and the mind (the nonphysical software that programs the actions of the brain).
  • SOCIAL pertains to the complex interactions that we have with other people, things, and systems. The social dimension also includes culture which is the basis for deep feelings of either belonging or alienation – feelings of being a part of or apart from.

Added to this mix is the complex interaction between addiction and spirituality. For the purpose of this blog, SPIRITUALITY pertains to our search for a meaning and purpose in life that is larger than ourselves. It is, in Twelve Step language, the search for a power greater than ourselves that will give us the courage, strength, and hope to go on in spite of hardship and adversity. Spirituality is the power that gives us the ability to go on even in the face of our inevitable death.

As you can see we will be covering a lot of territory – so keep coming back.

You can review my published materials and inorfmation on training and consultation at

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