Firefighters and Behavioral Addictions

Beth Flaherty, LMFT

Whenever I mentioned the phrase “pornography addiction” to a classroom of firefighters, there were snickers of laughter followed by pointing at one particular guy in the room, nodding their heads in agreement.  However, as I continued with my presentation, listing multiple other common behavioral addictions, things grew silent. It was clear some of these firefighters could also see these less-than-healthy behaviors in themselves.

Taking Care of Those Who Take Care of Others

Behavioral addictions (BAs), also known as process addictions, are compulsive-like behaviors that interfere with normal living and cause significant negative consequences in a person’s family, finances, health, work, and relationships.  A person may experience a psychological reward or feel a “high” while engaging in the behavior. But as with most addictions, they may feel guilt, shame, and remorse from the consequences of their acts, and an inability to control or stop the behavior. This often reinforces already existing mental health issues such as depression, anxiety, low self-esteem, and isolation from their family and social supports.

 Common behavioral addictions are:

• Gambling
• Internet/smartphone
• Shopping/buying
• Sex/porn
• Food
• Exercise
• Gaming

Research supports that co-occurrence of BAs with substance-use disorders and other mental health concerns is common. The neurological changes in the brains of people who engaged in gambling, binge eating, and compulsive sex were similar to the brains of people who abused substances¹.

Some Examples

I dealt with a paramedic who had such a problem. Several years prior, his wife had discovered him “sexting” another woman and compulsively watching porn. Understandably, the wife was distraught and threatened marital separation if he didn’t stop all communication with the woman. She also insisted on having full access to his phone and laptop.  He complied with her requests and promised he would never “be so stupid again.”

By the time he reached out to me, he explained that, since the initial incident, he had continued these behaviors but became much savvier at hiding them from his wife. Most of his indiscretions were brief and “didn’t meant anything,” and he admitted his porn watching was increasing.  He matter-of-factly stated: “I love my wife and have no intention of not being married to her. I don’t really know why I do this, and I hate that I can’t stop. I guess I need help. I don’t want her to find out and leave me.”

What are some characteristics of these BAs?:

• Gambling: The compulsive urge to gamble includes online gambling, sports betting, card playing, casino games, and lotteries. Gambling means a person is repeatedly willing to risk something they value, usually money, in the hope of gaining something of greater value, in spite of the toll it takes on finances, relationships, or one’s life.
• Internet/smartphone: This means excessive time spent using non-work-related technology. It also includes preoccupation with digital and social media, withdrawal symptoms when not engaged, constantly checking notifications, reassurance seeking, and a fear of missing out. Research suggests that smartphone addiction is associated with physical and mental health problems, including depression, anxiety, and poor sleep.
• Shopping/buying: Compulsive shopping, also known as oniomania, is characterized by an uncontrollable urge to buy even when the person knows they don’t have the money to afford it and will likely end up in debt. Some professionals believe it falls in the category of impulse control or obsessive-compulsive disorders.
• Sex/pornography:  This involves continued engagement in sexual activities despite negative consequences. There is a wide range of activities that could be problematic, such as compulsive masturbation, cybersex, compulsive viewing of porn, or seeking and engaging in extreme amounts of consensual sex.
• Food: This includes the compulsive urge to eat food, especially unhealthy food, going beyond hunger or deriving pleasure from the act of eating.
• Exercise: Those suffering from this affliction may need to increase the amount of exercise to feel the desired effect. It also means giving up other activities to exercise, continuing to exercise in spite of physical, psychological, or relationship consequences, and feeling anxiety if one has to miss a workout.
• Gaming: This includes severely reduced control over gaming activity despite the negative consequences, such as diminished self-care and hygiene, damaged relationships, and neglect of work or school.

As one person suffering from this BA said: “My first day off shift I would usually come home, nap, then get on and play some video games. It helped me chill and just decompress. We (my wife) would have fights about how much time I spent gaming, but I told her at least I was at home and not in some bar drinking.  It wasn’t until I completely missed my daughter’s game one day, barely realizing the family was gone, that I realized, yeah, maybe I have a problem.”

Do I Have a Problem?

Questions to ask yourself if you suspect you have a problem are:

• Is the activity causing you to disconnect from your family, spouse, or partner?
• Are you lying to cover up your activity or the amount of time you spend on it?
• Do you have “secret” technology (phones, laptops, accounts) to hide your acts?
• Have you tried to control, cut back, or stop your behavior without success or for periods of time only to relapse?
• Have others told you that you have a problem and need to get help?

There can be many reasons why we develop addictions of any type, and usually there are a number of contributing factors, including one’s childhood experiences, our environment, changes in brain activity, and interpersonal issues. However, we believe that behavioral addictions frequently are associated with a history of trauma, sexual abuse or early exposure to pornography, lack of social supports, and a family history of substance abuse or mental illness. Often, they are distractions from our feelings of emotional pain or loneliness.

Like other mental illnesses or substance abuse, there is still a lot of stigma for firefighters to admit and then ask for help with an addiction.

Common fears and reactions are:

• “What will my crew think of me? They will think I’m some kind of freak.”
• “Will I lose my job?”
• “There’s no way I’m going into some kind of rehab place!”

Getting help and treatment should address the underlying issues, like feelings of inadequacy, anxiety and shame from early life experiences or things that trigger us and make us more likely to engage in harmful or excessive behaviors. It is important to understand the impact your addiction has on your relationships, as well.

Treatment may include:

• Cognitive behavioral therapy
• Individual therapy
• Couples counseling
• 12-step programs
• Medication management

If you believe you may have a problem with a behavioral addiction, speak with a therapist who specializes in addiction or a member of your peer-support team to point you in the direction of a fire service, culturally competent clinician. This is the first step in treatment and assessing what level of care is recommended.

Source

1. Grant J.E.  Impulse Control Disorders: A Clinician’s Guide to Understanding and Treating Behavioral Addictions. New York, NY: Norton Press, 2008

Beth Flaherty is a licensed clinical marriage and family therapist in Virginia and Maryland. She is the clinical director of the Virginia Professional Fire Fighters Peer Support Team as well as Prince George’s County (MD) Professional Fire Fighters and Paramedics, Local 1619.