Craving (25 page)

Chocolate

Craving chocolate is more complex than a sugar craving. Research suggests that it’s a very specific craving, more common in women, and not entirely explained by its sweetness or sugar content. But as a base, the sugar suggestions in the previous section will help with chocolate cravings. Below are some additional suggestions:

• Plan for your premenstrual period.
  Obviously, this only applies to women. Women crave chocolate at a much higher rate than men, and some research suggests that chocolate cravings tend to peak in the immediate premenstrual period and for a few days into your period.
  ¹²²
  Get the chocolate out of the house and office, and stay full with healthier foods.
  
• Remember that, biologically, your craving for chocolate is more a craving for the sensation of eating chocolate than for any biological effect.
  Research has shown that the sensory effect of chocolate (taste, texture, smell) is what you primarily crave, and only to a lesser extent the effects of the chemicals in chocolate, like xanthines. That means if the cravings are particularly bad, you can satisfy them with the other suggestions listed in this book, plus a small amount of sugar-free
  dark
  chocolate. This should be a last resort.
  
• As with all cravings, wait it out.
  Chocolate cravings tend to only last a few minutes, although they can feel like a lifetime. Distract yourself, call someone, eat a healthier snack, and follow the other suggestions in this book rather than give in.
  
• Address your stress.
  Stress and cravings are tightly linked, and chocolate cravings are no different. Get a handle on your stress before it gets a handle on you.
  
• Take magnesium.
  Ask your doctor if magnesium is safe for you, but some research suggests that chocolate cravings during a woman’s premenstrual timeframe may be linked to magnesium deficiency. Chelated magnesium supplementation may help. See your doctor for the dose that’s right for you. Similarly, what doctors call “unopposed estrogen” may worsen chocolate cravings. Check with your doctor about the possible role of progesterone in addressing your chocolate cravings.
  
• Chocolate cravings won’t hurt you.
  This means that giving in to a chocolate craving, if you are not prone to binge eating, can be an acceptable option for many, as long as you can do so in a way that doesn’t undermine your health and fitness goals.
  

Gambling

For those who are having a problem with excessive gambling, the following tips can help you quit and deal with the cravings.

• Quit smoking.
  Surprised? The research shows that gambling cravings and smoking go hand in hand. But studies have also shown that nicotine replacement therapies like lozenges and patches are safe—they don’t seem to worsen gambling cravings.
  ¹²³
  
• Avoid cues and triggers.
  Obviously, as I’ve shown elsewhere in this book, you can’t avoid everything that reminds you of your craving. But especially in early recovery, it’s important to stay away from triggers. New research in gambling addiction shows that your eyes and your attention point very strongly toward anything gambling-related, and that those automatic (and unconscious) responses increase your cravings and the chances that you will give in.
  
• Consider medications.
  Although naltrexone and acamprosate (medications used for drug and alcohol addiction) are not FDA-approved for compulsive gambling, a growing body of research is showing benefit, especially for naltrexone. Ask your doctor if it’s a good choice for you.
  
• Use the power of the group.
  As we explored in
  chapter 7
  , groups can really help when it comes to cravings. Gamblers Anonymous (GA) is a Twelve Step group that has helped many people recover from compulsive gambling. I always recommend that people who are concerned about gambling answer GA’s twenty questions to learn more about the impact gambling may be having in their life. This list of twenty questions can be found on their website:
  www.gamblersanonymous.org
  . GA has a specialized system called “pressure relief” that can help you deal with gambling debts in a sane, recovery-supportive manner.
  
• Let your spouse and loved ones know about Gam-Anon,
  which is a Twelve Step group specifically for loved ones of gambling addicts. See
  www.gam-anon.org
  for more information.
  
• Change your environment.
  As with most cravings, gambling addicts are often subtly affected by their environments in ways that are hard to explain until later. If you are in a situation where you are craving to gamble, consider leaving the situation and connecting with a support person.
  
• Carry only the amount of money you need for daily essentials, and don’t carry checks or credit cards.
  Adding barriers to accessing funds can help when the cravings hit.
  
• Be accountable.
  For some people with gambling addiction, temporarily having someone you absolutely trust manage your finances, and also giving a spouse or loved one access to your transactions, can be a way to remain accountable. If you ask for money or make a withdrawal without a good explanation, it can let them know you may be in trouble.
  
• Address your stress.
  The suggestions in the previous lists are helpful for gambling cravings as well. Sleep, stress, and mood all affect gambling cravings. Get help for them if they are a problem.
  
• Set up safeguards.
  Have an accountability partner block gaming sites on your computer and help you close your gaming accounts. Set up email filters to block gambling establishments and websites from contacting you, or, better yet, change your email address. If you gamble with a partner, let him know you are no longer available for gambling. If the person pressures you, he is not your real friend. Close your credit cards and put a fraud alert on your credit file, which adds an extra step you must go through to obtain credit.
  
• Postpone gambling.
  Remember that all cravings are short-lived. If you can distract yourself, call a friend, do something healthy and interesting, or do something that cheers you up, that can make the difference between success and relapse.
  

Internet Compulsions

The Internet is a wonderful thing, and most people use it without major problems. However, if you find yourself lying about your Internet use, using the Internet in secret, compromising your values when surfing online, feeling shame about your online activities, or finding yourself in a “bubble” where you stay online for hours and avoid eating, drinking, or engaging anyone else, you likely have an Internet addiction. In particular, if your relationships or work or school performance are suffering because of your Internet use, you most likely have an Internet addiction. Internet addictions can have tolerance, withdrawal, cravings, and all the major features found in other addictions.

Although not a formal diagnosis (yet), I’ve seen many such cases and they can be very serious. Sometimes, just as with drug addiction or alcoholism, you may need to detox completely first. Once you’ve been offline, it may be safe and appropriate to re-introduce Internet use by following these tips. But if you find yourself out of control again, you may need even more time off and more support. In some cases, you may need to remain completely offline; in others, not using a particular application, device, or website may be the answer. The only way to know is to try it with an accountability partner, and then see whether you need moderation or abstinence.

College students are particularly at risk, as they leave home and have large blocks of unsupervised and unstructured time and nearly unlimited access to the Internet. College counseling programs are beginning to offer support for these students. Here are some tips that can help if you think you have a problem. If moderating your use of the Internet is unsuccessful, you may need to skip these steps, get help, and stop completely.

• Get accountable.
  Allowing someone you trust to access your computer and see what you’re up to can help you avoid the temptation to be swallowed up in the numb world of Internet addiction. A trusting partner who will rotate the Wi-Fi password in the home can help too. I know one mom who furnishes the daily Wi-Fi password to her kids
  after
  their chores and homework are done.
  
• Get really accountable.
  If Internet compulsion is a serious problem for you, ask your partner to hold your computer or password, and only go online with him or her present.
  
• Let your laptop battery die.
  Not plugging in your laptop means that the battery itself can serve as a stopwatch for the duration of your online activities.
  
• Avoid cues and triggers.
  Obviously, as I’ve shown elsewhere in this book, you can’t avoid everything that reminds you of your craving. But putting your computer away is a good start.
  
• Ditch the smartphone.
  These days it can be hard to find a simple cell phone—but trust me, they do still exist. You’ll be forced to limit the amount of time you spend online.
  
• Focus on some offline relationships.
  As with most compulsions, recovery from cravings is mostly about what you
  start
  doing and less about what you
  stop
  doing. Focus on doing things with a few friends in real life. Get coffee, go for a walk, get outside, or even just talk on the phone. Connect with people without using the computer as a medium, so that your brain can begin to unpair the connection between relating and being online.
  
• Reconnect with your hobbies.
  If you don’t have any, ask your friends or family members what they like to do.
  
• Try the other suggestions in this book.
  For example, attend a mutual-help group for people with similar problems. Focus on helping others. Get physically active. Talk to others about your problem. Document your behaviors. You’ll quickly see that the suggestions found throughout this book will apply very well to your Internet compulsions.
  

An additional point: most Internet and computer-related compulsions fall into one of a few categories, which I have listed here. Each type of compulsion is different and requires a specialized approach to treatment. For example, online gaming addicts may benefit from therapy for gambling addiction. Compulsive online shoppers may need to hand over their credit cards. Gamers may need to deactivate their profiles. The categories of Internet/computer-related compulsions include:

• Pornography, online dating, sexting/online flirting, chatrooms/webcams, and other forms of pseudointimacy, which may or may not be sexualized
  
• Gambling such as poker, sports betting, and day trading
  
• Shopping compulsions, eBay,
  etc.
  
• Obsessive searching/surfing, or workaholic tendencies online
  
• Facebook, Twitter, Pinterest, and social media-related compulsions
  
• Games (ranging from the immersive massive multiplayer online role-playing games such as World of Warcraft, to multiplayer games like Call of Duty, to somewhat social games such as Words with Friends and Farmville, to solo games such as Solitaire and Minesweeper)
  

…

Appendix

A Field Polarized

The Uncomfortable Gap between Cognitive Therapies and Twelve Step Programs

The cognitive view of addiction mostly derives from a classic paper by Albert Bandura (required reading for anyone studying addictions) who, in 1977, proposed that a person’s expectation of self-efficacy predicts whether coping strategies will be initiated, how much effort will be expended on coping, and how resilient those efforts will be to stress and other challenges.
¹²⁴
Of course, this makes sense, as you would expect that how likely you are to do something depends on how well you think it will work.

The late Alan Marlatt, considered by many to be the father of craving research, spent his career further developing and testing this idea. Marlatt proposed that whether or not an alcoholic will drink in a high-risk situation is determined by what the person believes the consequences of drinking will be. Various distortions in the alcoholic’s thinking cause the person to draw erroneous conclusions about the relationship between their choices and their results. Therapies can then be targeted to address the behaviors that can land alcoholics in high-risk situations with a particular focus on the false conclusions that people draw about the relationship between certain decisions and the results. These therapies can also focus on analyzing the drinker’s responses to high-risk situations and then help the alcoholic develop strategies to more effectively deal with these stressors. This increases the person’s confidence that they will be successful, so that they will be more likely to expend the effort to do what’s needed to stay sober in the future. Marlatt emphasized concepts such as the “covert antecedents” and “immediate determinants” of relapse, and noted that many of the decisions alcoholics make that seem irrelevant or unrelated to their drinking at the time are often directly responsible for relapse. And research does confirm that his approach can help many people with alcoholism, especially in the short term, to avoid self-destructive behaviors by interrupting and correcting the decision cycle.