Addiction and Dissociation: The Pleasure-Pain Loop That Keeps You Hooked

Written by Roland Bal

From birth, if not earlier, we are forced to learn how to deal with and find ways of soothing pain.

When we are hungry or distressed as babies, we cry to get our mother's attention so that she will care for us, help us regulate ourselves, and fulfil our needs. When we are stressed on a neurochemical level, our body releases nor-adrenaline, adrenaline, and cortisol into our bloodstream. When these levels rise too much — in other words, if the level ruptures our emotional threshold — we overflow.

When we are not able to contain our emotions, we look for ways to pacify ourselves. In healthy attunement, our parents or primary carers help us to regulate our emotional imbalance when we are babies, then through childhood. Through healthy attunement and care, we become more independent, resilient, and able to self-regulate our internal environment, thereby giving ourselves the capacity to face the challenges of life.

The Pleasure-Pain Cycle: What Dopamine Has to Do with Addiction

The release of dopamine hormones into our bloodstream and on our nerve-receptors takes the edge off our internal suffering and helps us to regain a sense of containment. Through attunement and social interaction, we learn what healthy boundaries and containment are.

Unfortunately, for many of us, a picture-perfect life of attunement just doesn't happen. Misattunement caused by our carers is extremely prevalent in our current demanding society. Furthermore, there is a need to mention abuse and neglect and what it does to our developing nervous system and our internal regulating mechanisms of pain and pleasure.

When care is not provided at critical moments, and when the lack thereof continues, we look for ways of coping. By the time we are adults, we will have put into place patterns that will give us some sense of control. What these patterns do is to help us release dopamine in our system in an unnatural way or, when we use substances, replace our natural dopamine hormones by opiates. These are necessary survival strategies that we have put in place in times of need, but when we continue to rely on them, they become destructive.

How Dissociation Drives the Craving Loop

Addictive behaviour, or addiction to substances, alters our relation to our pain-pleasure centres in the brain and creates the additional problem of craving. It masks and perpetuates the underlying trauma which is often at the root of all this.

In my model of dissociation, there are layers. At the furthest extreme you have the shutdown response. Just below that sits addiction and excessive thoughts. Then you have a core or coping emotion — usually one that you are more comfortable or habitual in acting out. And then at the base you have your core overwhelming trauma or emotion.

Each layer protects you from the one below it. Addiction protects you from the anxiety. The anxiety protects you from the anger. The anger protects you from the core hurt. The deeper the layer that you address, the more what is built on top of it starts to lessen in intensity.

When we are not able to contain our emotions, we look for ways to pacify ourselves. Addictive behaviour alters our relation to our pain-pleasure centres in the brain and creates the additional problem of craving.

Shame as a Driver of Addiction

One of the most underrecognised drivers of addiction is shame. With addictions — particularly if you have had a pretty intense one or one of those periods with a lot of stories you would rather forget — there is a lot of shame sitting underneath.

The problem is that shame itself becomes fuel for the cycle. You feel ashamed of the addiction. You beat yourself up. The self-reproach creates such a painful thought spiral that you reach for the substance or behaviour again, just to escape the shame. And then there is more shame on top of that.

This is why responding to addiction with more shame — "you shouldn't be doing that" — only makes it worse. It adds more fuel to the fire. Working with the shame directly, learning to feel it and hold it without drowning in it, takes away one of the most powerful drivers of the addictive cycle. Understanding why addiction is a coping mechanism rather than a moral failing is part of that shift.

Tuning Into the Craving Itself: A Somatic Exercise

If, for the time being, you would stop making an issue out of your particular addiction, in the knowledge that it serves only one purpose — as a coping mechanism — and you would look at it afresh, being interested in finding a resolution to this complex issue:

Could you tune into — not the object of your addiction — but to the very energy and feeling of addiction itself? The craving, the desire, the groping, the wanting. And to sense that feeling in the body, in the mind. Observing that without making it into a problem. Without giving it any further, separative movement through judgement.

Now ask yourself: what is the underlying factor in that need, the craving that expresses itself as a form of addiction?

Listen to that question and let the answer come to you. Keep the energy and attention in the body rather than analysing it. It might be obvious that when you tune into what is fundamental to the wanting — the craving, the desire — there is some form of hurt, deep anger, or sadness. Or it might be less defined for you, by revealing itself as stress, tension, or anxiety.

See if you can stay with what reveals itself as it is. You might notice that from here on there is that pull to dissociate, losing focus, going numb, or you move back into thoughts that relate to the hurt. Slow it down and bring your attention back to the hurt or stress as it is felt in the body. Breathe into it, allowing it space.

As you are staying with it, you are giving containment to it. You are building up sufficient resilience to stay with what is. And once your hurt is fully contained, through the scope of your attention, your emotional residue can actually start to be processed. You are actively reversing the process of dissociation that flows from feeling emotionally overwhelmed. To take this further, the three conditions for trauma-informed recovery — cognitive framework, somatic work, and containment — provide the structure for lasting change.