Compulsions and addictions both involve urges, but compulsions are fueled by anxiety or fear whereas addictions are driven by pleasure or escapism.
Compulsions and addictions often get confused, and while these behaviors have a lot of similarities, there are key ways to tell them apart. Both compulsions and addictions are driven by an overwhelming urge to engage in the behavior; the key difference is what’s driving this urge.
When you engage in an addiction, like an overwhelming desire to smoke a cigarette, you hope to gain a sense of pleasure, or to escape from what’s troubling you. A compulsion, on the other hand, is performed as a response to anxiety or fear. For example, you may compulsively wash your hands if you experience frequent, intrusive thoughts about getting sick.
Read on to gain a better understanding of compulsions, addictions, what differentiates these behaviors, and how you can seek help for each.
What does it mean to have an addiction?
An addiction is usually defined as a pattern of substance use or behavior that is disruptive to your life and overall health. “Addictive behaviors—like disordered substance use, gambling, kleptomania—tend to provide the person with a rush of excitement and/or pleasure,” says Taylor Newendorp, MA, LCPC, Network Clinical Training Director at NOCD. “People enjoy the feeling they get from engaging, so they seek out more and more.”
Addictions are split into two categories: substance addictions and behavioral addictions. When you hear the word ‘addiction,’ your mind may gravitate toward substance use disorder, which refers to an addiction to alcohol, drugs, or other substances like caffeine. While you can technically become addicted to anything that stimulates your brain’s reward system, common behavioral addictions include:
- Food (as in binge-eating disorder)
- Porn
- Sex
- Gambling
- Internet or social media use
- Shopping
- Gaming
- Exercise
- Work
Signs of an addiction include:
- Inability to quit the substance or stop engaging in the behavior.
- Heightened tolerance to the substance or behavior you’re engaging in. In other words, you need more and more to feel the same rush.
- Cravings for the addictive substance or behavior. The addiction is at the center of your life and is all you think about.
- Personal problems with finances, health, or your social life due to the addiction.
- Withdrawal when you try to stop. If you can’t obtain the substance or engage in the behavior, you experience mood changes like anxiety or irritability—or even physical symptoms like vomiting and sweating.
What are compulsions?
Compulsions—one of the defining symptoms of obsessive-compulsive disorder—are repetitive mental or physical actions done to prevent a feared event from happening, or relieve distress. Compulsions are a direct response to obsessions, which are intrusive thoughts, sensations, images, feelings, or urges.
Compulsions give you a sense of temporary relief, but they ultimately pull you back into a cycle of symptoms. “The more people seek short-term relief from their obsessions by doing compulsions, the more they build up the false belief that obsessions pose some sort of risk or danger,” Newendorp explains. “So, their anxiety just gets worse in the long run.”
Common OCD compulsions include:
- Checking stoves, doors, locks, etc.
- Seeking reassurance from others.
- Excessive handwashing and cleaning.
- Ordering or arranging items in a certain way until they feel “just right.”
- Performing rituals, such as repeating certain words or phrases
- Excessively researching to find answers to your doubts.
- Hoarding possessions.
- Counting steps, objects, or other things in a particular way.
- Avoiding particular people, places, objects, or situations.
- Excessive prayer and/or confession.
- Mentally reviewing or replaying past events over and over again to try to find clarity.
- Rumination or overthinking.
- Mental checking.
- Memory hoarding.
- Thought suppression.
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The difference between addictions and compulsions
The key difference between addictions and compulsions is what drives the behaviors. “Addictive behaviors (in the absence of OCD) are not done in direct response to obsessive fears or to prevent bad things from happening,” explains Newendorp.
Instead, addictions give you a sense of pleasure—even if they can have deeply harmful repercussions. Addictions may also feel like an escape from boring or stressful situations. For example, you might drink too much after a long day at work, or spend too much time and money shopping instead of tending to your responsibilities. Newendorp describes these behaviors as “impulsive, not compulsive,” explaining that people dealing with addictions are often unaware about the severity of their addiction.
In contrast, people with OCD usually express more understanding that their behaviors are harmful—but feel incapable of stopping themselves from engaging. If you have OCD, you may know your compulsions don’t really make sense, but you keep going back to them to achieve that fleeting moment of relief. “With OCD, you literally feel compelled to engage in a compulsion—that’s where the word comes from. You don’t want to do it, but you feel you need to in the moment.”
Addiction, on the other hand, is often accompanied by a sense of denial which is connected to the feelings of pleasure that engaging in the addiction can bring. “It ‘feels fun,’ so you may not see how it has become problematic,” explains Newendorp. “Or, you simply deny that it has become problematic, because you don’t want to give up those rushes of excitement.”
Treating addictions and compulsions
Addiction treatment
Sometimes, it’s necessary to seek support for the physical impacts of addiction before addressing the root cause of your problem. This might involve being monitored by a medical team at a hospital or other medical facility while you navigate the initial symptoms of withdrawal. Once you’ve stabilized, your healthcare provider may recommend medications that reduce cravings and help with other withdrawal symptoms. Some people opt for rehabilitation at this stage, which is when you enter a residential treatment center (either inpatient or outpatient) to navigate the next stages of recovery.
Whether or not you decide to go to rehab, the next step is counseling. Various types of therapy have shown success at treating addiction, including cognitive behavioral therapy (CBT) and group therapy. Support groups, like Alcoholics Anonymous, are a long-term option to connect with others experiencing similar situations and gain a support system.
ERP therapy for OCD
The most effective treatment for OCD is exposure and response-prevention (ERP) therapy, a specialized and highly effective form of CBT designed for OCD. ERP therapy addresses compulsions by purposefully triggering an obsession, and helping you learn new ways to respond without resorting to compulsions.
Let’s say your obsessions center on fears of death. In response, you ruminate for hours about how your own life might end. Your ERP therapist might help you learn to resist this mental compulsion, by practicing accepting uncertainty. This might involve journaling phrases like, “maybe I’ll die tomorrow, maybe I won’t,” or simply taking a moment to sit with your thoughts, rather than trying to overanalyze or solve them.
With time, ERP therapy can help you learn to accept the low-level risks inherent to living a full and vibrant life—without resorting to compulsions.
Bottom line
Addictions and compulsions may look similar, but understanding their distinct qualities is key to knowing what you’re dealing with and getting help. Reaching out to a therapist can help you get diagnosed, and allow you to access the right treatment plan for your condition.
Key Takeaways
- Addictions differ from compulsions in that they provide pleasure or allow for escapism.
- Compulsions are done in response to obsessions, and are meant to relieve or neutralize distress.
- Addictions and compulsions are both marked by a strong urge to engage in maladaptive behaviors.
- Both addictions and compulsions can be treated with specific therapeutic interventions, like ERP therapy and group counseling.