What is Addiction?

Addiction is a chronic condition characterised by compulsive engagement with a substance or behaviour despite significant harmful consequences. It is not a failure of character. It is not something that willpower alone can resolve. And it is not a choice in the way that ordinary choices are choices.

What addiction does to the brain

Addictive substances and behaviours alter the brain’s reward system — specifically the dopamine pathways that regulate motivation, pleasure, and learning. Over time, the brain reorganises itself around the addiction. What began as a choice becomes a compulsion. The substance or behaviour is no longer pursued primarily for pleasure but to avoid the discomfort of its absence.

This is not a metaphor. It is a measurable neurological process.

The psychological function

Addiction almost always serves a psychological function — managing anxiety, numbing pain, creating a sense of control, filling an unbearable emptiness. The substance or behaviour is not the problem. It is the solution the person found to a problem that predates it.

“I always ask: what was the addiction doing for you? Because it was doing something. Nobody develops a serious addiction for no reason. It was solving something — badly, destructively, unsustainably — but solving something. That is where the work begins.” — Philippe Jacquet

Shame and secrecy

Addiction thrives in shame and secrecy. The person hides what they do not understand themselves, and the hiding deepens the isolation that feeding the addiction requires. This is one reason that the therapeutic relationship — a space in which the addiction can be spoken about without judgment — is so central to recovery.

Treatment

Effective treatment addresses the addiction itself, the underlying conditions that gave rise to it, and the patterns of relating and thinking that sustain it. Philippe Jacquet trained at the Hazelden Foundation and has over 25 years of clinical experience in addiction treatment, including clinical supervision of the teams at PROMIS Recovery Centre and Cardinal Clinic.

Book a consultation with Philippe Jacquet — addiction specialist and psychotherapist, London.