Addiction with Dr Vanessa Moulton

March 15, 2022

Please click here to listen

Michael Coates: Vanessa, what is addiction?

Vanessa Moulton: Probably the easiest way to kind of define it is effec3vely something that you have effec3vely lost control over doing or using or taking, and to the point where it has become unhealthy or harmful for you. As you would imagine, there's some common things that are associated with it, and that includes gambling, drugs, alcohol, smoking, and also things like food actually is actually something that you can become addicted to in the way that you use it.

Michael Coates: With that, is the addic3on purely psychological or can it be a physical addic3on?

Vanessa Moulton: 100% it can become a physical addic3on. That's one of the reasons why, especially with something like with drugs or something with smoking that has something in it like nico3ne, it affects your physiology to the point where you crave it or it feels like you need it. So 100% it affects the physiology of your body, as well as your mind.

Michael Coates: Then if we look at how you become addicted, obviously there's a plethora of ways I'm sure, but can you talk about some of the most common ways of how we physically and psychologically become addicted?

Vanessa Moulton: Yeah, as I say, there are a number of different reasons why you might become addicted to something. Let's take, I don't know, the first one being it makes you feel good. So obviously in certain situa3ons for certain people where they struggle to get to a place where they're feeling good about something, they might use drugs or alcohol or some other form of something that they do or they use to make them feel

They experience that feeling and or a feeling of, for example, feeling mentally psychologically high, and
they therefore get the urge to use that thing again, because they quite enjoy that feeling. Then if you
keep using it and it's something that will physiologically cause a craving, then it becomes even harder to
stop. Then that's where people start taking more of that thing or using more of that thing that is leaving
them feeling good, or also maybe perhaps it can be used to block feelings out. So if someone is
struggling with high anxiety, stress, or just really tough emo3ons, people use things to block out those

Michael Coates: Then with regard to learning it, you've men3oned, and we'll go into why you would become addicted in a second, but could you learn it? Can you see someone doing it and think that was acceptable, and then you go that way? Or is that just an entry level? I'm thinking watching your granddad going to a
bookmakers when you was liSle. Could you then learn that? Is that an acceptable behaviour?

Vanessa Moulton: Definitely. As I say, it's either something that you kind of poten3ally even just try yourself or it can be something that you've seen somebody else do. Now we all, and especially when we're younger, we learn different coping strategies, primarily from our caregivers or the people that are around us.

So if we don't have access to people who let's say help us deal with when we're upset about something
in a healthy way, and they deal with it, for example, by drinking, that's something that you kind of go, "Oh, well, that's how you learn to deal with your emotions, or that's how you learn to deal with a certain situation, or that's how someone learns to feel relaxed and good." Therefore, it becomes an accepted kind of behaviour.

So definitely what you're exposed to throughout your life, but especially actually when you're younger
can impact kind of the choices that you make around how you cope with things or what you deem to be
is acceptable.

Michael Coates: Is that because the brain's developing when you're younger and is that with the childhood?

Vanessa Moulton: Yeah, so the developmental stages of the brain that we go through, we know that's why it's so key when you're young and you're a child that you learn the healthy skills around how you look after yourself and look after your mind, because your brain is literally like a sponge when you're younger. The things that
you are exposed to, your brain starts forming patterns and beliefs and rules about how you do things,
how things are responded to, how you cope with things.

Actually, you can learn those ways of being as a child, and you can take them all the way through your
adulthood, unless someone gives you the opportunity to recognise that's not a healthy way of
responding to something or behaving towards something. So, your childhood and what you're exposed
to in your childhood is just so fundamental about how you are as an adult around either kind of coping
or responding to just different aspects of your life.

Michael Coates: If we look at then, and I'll give you one specific, so if we look at why you would become addicted and we have touched on it there, but I want to give you an example too. We talked about children and
developing and how your early life impacts you later on.

You experience trauma as a child, you experience maybe bullying by your stepdad or an abuse from a
family member, later on in life you may have blocked that out, and then later on you develop a way of
self-medicating, or these traumas start surfacing for whatever reason. The brain's relaxed, you're in a
safer place, whatever, and then you need to start self-medica3ng to do what you just said, like block out. I don't know if I answered it there, but...

Vanessa Moulton: I think you have.

Michael Coates: Yeah, could you elaborate a little bit more on how past traumas can, I suppose, implement self-medication?

Dr. Vanessa Moulton: Yeah, I mean, there are different aspects that come to the fore and different things that we experience if we are experiencing feeling re-trauma3sed by something. Generally, it usually is coupled with quite strong emotions that a lot of people can feel really uncomfortable having to deal with. So as you kind of
suggested, using alcohol, using drugs, can for some people feel like kind of the easiest way and the quickest way to either bury some of those emotions, not have to experience some of those emotions.

We also know, a lot of the military work that I've done where people are struggling with something like PTSD, they have nightmares, and a lot of people will, for example, use alcohol, because it's the only way that they can actually get themselves to fall asleep. We know that drinking alcohol will mean that you
won't have a good night's sleep, but it perhaps enables people to fall asleep, which they will really
struggle with if they're scared about having nightmares when they fall asleep.

So, it can be used for different kind of reasons if someone has been re-traumatised for numbing the
emo3ons and dealing with the emotions, or actually certain aspects, which is simply like, I can't get to
sleep without smoking marijuana, or I can't fall to sleep without having a certain amount of alcohol,
which I've heard pretty regularly.

Michael Coates: Also as well, things like, and as you were saying, that guys who have literally physically finessed themselves to sleep, where you just go OTT on physical fitness to exhaust yourself to the point where
you have to fall asleep. So, my point being there is it's not just these typical heroin, marijuana, alcohol, there's a lot of other factors around this. A lot of the behaviours, that if you become, like we said at the start, obsessed with something, if it becomes unhealthy, it can bubble over, I suppose, into an addiction.

Dr. Vanessa Moulton: Yeah, and it's kind of like this no3on of it can to a certain degree. It doesn't necessarily have to be drugs and alcohol, as you say, it can be anything. It's about when you use a behaviour or you use something to the extent where it's actually not good for you.

So again, I will always advocate being fit and healthy. Doing exercise is fantastic for your psychological health, but if you are beating yourself to do two or three sessions a day, or you're going for a run at 11:00 at night, it's not good for you, it's not healthy, but you are using exercise in an unhealthy way to be able to cope with something that you're going through.

Michael Coates: If we look at gambling, and again, this is a three hour podcast, gambling, but if we look at that and one of the things I was really interested hearing someone recently, and I thought, do they hate themselves and are they trying to lose to make themselves feel bad?

Dr. Vanessa Moulton: That's a multi-layered complex, but there will be some people that will do it for that. It's all about understanding what someone gains from doing the thing that they are doing.

So we talk about a secondary gain, for example. So, you'll be talking to somebody or I'll be talking to
somebody who doesn't want to use what they are using, be that spending too much money, gambling,
whatever, but actually they get some sort of gain from it. So it might be that that individual has such a
high-level of shame about something, that it's almost like a form of self-flagellation, where they are
trying to cause harm towards themselves, because they think that they deserve it.

Equally, gambling can quite simply be used, because from a physiological point of view, if you win, you
get a massive dump of the hormone dopamine. It makes you feel great, it gives you a high, very similar
to taking a drug, and you want to do that thing again, you want to feel that experience again, that high.
So, it's what the person is needing. It might be that they're lacking that aspect in their life.

It might also be we see regularly people who are potentially, and I can't help but thinking about kind of
the ex-military group, whereby perhaps they've led a life where there has been a lot of risk-taking, and
actually they've become to enjoy risk-taking, it's kind of part of who they are. They leave the forces and
that element to life is not there anymore, so they look for things that are risky behaviours, driving fast,
gambling. It's a risky behaviour, but what it does is it provides that person with a sense of high, which is
lacking in their life at that point.

Michael Coates: Can it remove joy in other things? Can it remove joy in going for a walk, spending time with your family? These simple pleasures that are so meaningful, can it remove, yeah, what we'd call joy?

Dr. Vanessa Moulton: I would say so, definitely, because when something is addictive, it tends to take over. When things take over, it tends to be something that's on your mind a lot. Generally speaking, if we're spending time with our friends, our family, going for a nice walk, if our mind is elsewhere and we're thinking about the next time we can go gambling or the next time we can use the thing that we're addicted to, we're not able to
fully immerse ourselves in the moment that we're in.

So it's quite hard to experience joy, A, because you're not present, but, B, because you've been getting a
high or your experience of what joy is has been translated into gambling, for example, and nothing else
will kind of meet that level that you're looking for.

Michael Coates: This is the final thing. Could you give us some possible solutions or some possible next steps if someone who is listening, either themselves or someone who they know has an addiction, has a problem?

Dr. Vanessa Moulton: Yeah, I mean, I will all always say, and it's really important that your first call should always be your GP, because they really are the central point of all of us getting the support that we need. There are of course other services, charities and websites out there that provide quite a lot of information around it,
but I would always suggest that you contact your GP. You will have a local mental health team.

It doesn't necessarily mean that you need go to a crisis response at all, but the first step is just actually
being open and saying to someone, "Do you know what? I think I'm struggling." Because then the care
pathways and the different care pathways that are right for you as an individual will be given to you.
That's the key point, is there isn't one care pathway that's right for everybody, so actually your GP or a
healthcare professional will be able to point you in the right direction to ensure that you get the right
level of support that you need.

Michael Coates: Thanks so much, Vanessa. We'll leave it there

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