Addictive behaviours

“The chains of habit are generally too small to be felt until they are too strong to be broken”, Samuel Johnson 

Dr Samuel Johnson (1709 to 1784) is one of the towering figures of  English literature. Grub Street journalist, poet, novelist, moralist and  lexicographer, he published his greatest work, A Dictionary of the English Language in 1759. He has been described as “arguably the most distinguished man of letters in English history”.Thanks to his biographer James Boswell, we have a wonderful picture  of this larger than life figure. He was witty, gregarious, yet subject  to depression and numerous injurious habits. He was also subject to many  involuntary mannerisms and prone to fidget and make nervous noises. He  himself was aware of them, but quite incapable of stopping them. 

Boswell described his many tics and twitches:“While talking or even musing as he sat in his chair, he commonly  held his head to one side towards his right shoulder, and shook it in a  tremulous manner, moving his body backwards and forwards, and rubbing  his left knee in the same direction, with the palm of his hand. In the  intervals of articulating he made various sounds with his mouth;  sometimes giving a half whistle, some­times making his tongue play  backwards from the roof of his mouth, as if cluck­ing like a hen, and  sometimes protrud­ing it against his upper gums in front, as if  pronouncing quickly under his breath, ‘Too, too, too’. All this  accom­panied sometimes with a thoughtful look, but more frequently with a  smile. Generally when he had concluded a period, in the course of a  dispute, by which time he was a good deal exhausted by violence and  vociferation, he used to blow out his breath like a whale.”

Johnson was also said to “perform his gesticulations” upon  entering a room or a building. A small girl once asked him why he made  these strange noises and movements, to which he replied that they were  just “a bad habit”.Medical historians are now quite convinced that he was, in fact, a  sufferer from Tourette’s syndrome. This was, of course, unknown in  Johnson’s day. It is likely that he was much distressed by it, for he  declared that he was of a most melancholic nature. And in “performing  his gesticulations” before entering a room it is likely that he was  trying to control these tics and “get them out of the way” before he had  to see and talk to people.The full name for this condition is Gilles de la Tourette’s syndrome,  after the doctor who first described it in 1825. It is characterised by  making movements and sounds that you cannot control. And it is often  also accompanied by various emotions, such as anxiety, depression and by  the development of obsessive compulsive behaviour and various habits.Nowadays it is estimated that as many as one in 200 people can be  affected. There are various orthodox medicines that can help, as can  behav­ioural therapy and homeopathy.

Habits 

All habits are a form of learned behav­iour. We talk about some  being good, in that they serve some useful purpose. For example,  brushing your teeth after a meal, putting on your safety belt as soon as  you get in the car are both good habits to get into. On the other hand  we talk about bad habits when they are aesthetically unpleasant,  hazardous to health or liable to lead to other problems.Many habits start off fairly simply and seem quite innocuous. Parents  of a thumb­sucking baby may initially regard the habit as a friend, in  that it stops the baby crying, acts as a com­fort and may even allow  them some extra sleep. When it persists into late childhood or even into  the teens, it can be another matter. Trying to get the youngster to  stop can cause all sorts of problems and tensions.Habits can be a sort of coping mech­anism. From the child who sucks  his thumb for comfort, to the adult smoking his or her cigarette on the  pavement outside the office, the habit helps to relieve tension.  Removing that habit, that coping mechanism, very often causes a sudden  surge of tension and an explosion in stress.When a weak coping mechanism like a habit has been in operation for a  long time it induces stress of its own. The term “breaking the habit”  is often not as simple as it is intended to sound. Rather than breaking  the anchoring link with the individual, there is a risk of breaking the  individual and leaving them to face a whole host of emotions until the  healing process is complete.Many people advocate the “cold turkey” approach, whereby the  indi­vidual is suddenly deprived of the object of their habit or their  addiction. The result is an unpleasant physical and psychological  reaction. Others favour a graded reduction in the habit in order to  allow the body to reduce its physi­cal craving, minimise the extent of  the physical withdrawal reaction and maximise the confidence needed to  finally lose the habit.In general I favour the latter approach, which seems the least  distressing. Having said that, there are some people who can only handle  things if they throw themselves in at the deep end and “get it over  quickly”. Again, it all reflects the individuality of people and their  different needs. And of course, this is at the very heart of homeopathy.

Modifying behaviour 

As I said at the beginning, a habit is a form of learned behaviour.  As such, it is not likely to disappear suddenly just by taking a  medicine, whether that is an orthodox drug or a homeopathic medicine.  Some form of behavioural modification is going to be necessary.I mentioned earlier that I favour a graded reduction of the habit.  Thus, in trying to stop or curb some activity or another I usually  advise a period of observation of how often the activity is done. This  can be quite informative to the individual, because they may hardly be  aware of the extent that the habit has taken over their life. For  example, how many cigarettes are consumed, how often the nose is picked,  the nails are nibbled, or how often the hair is twirled? A small  notebook is useful to record whenever the person feels the urge to carry  out whatever activity or move­ment is causing the concern. It is this  urge at the start that is so important and, if the individual can get a  handle on it, then you may have something to aim your treatment at.With some habits, after the obser­vation period comes an agreed,  realistic reduction programme. With cigarettes, for example, you decide  on a definite stop smoking day. Then, leading up to this day, you agree a  schedule of reduc­tion. Splitting the day into three hour sessions, for  example, from waking up until going to bed. Then allocate a max­imum  number over each segment, but without being able to borrow from one  segment or store up for later. And over the period of reduction up until  the stopping day, schedule the reduction. This way you will reduce the  physical dependence, so that by stopping day it will only be the  psychological depend­ence that has to be dealt with.It is a good idea to have habit sub­stitutes. In the case of smoking I  advise cutting carrots, celery sticks or liquorice roots to cigarette  length and chewing them whenever the craving comes on.

Changing habitat 

I like this concept and stress it to people trying to break a habit.  Rather than thinking of a habitat as the place that one lives one’s  life, think of it as the places that you indulge the habit.Smokers have had their habitat severely restricted and many people  will have given up just by virtue of having been forced out onto the  street corner to indulge their habit.With problems drinking or gambling on casino apps,  then avoiding the places where temptation lurks is obviously sensible.  With other nuisance habits such as nail­biting, or nose­picking,  changing habitat may not be so easy. But if the habit is something that  the person does locked away in their room, then get out of the comfort  zone and change the habitat in favour of the limelight where there are  people and therefore less tendency to indulge.Finally, taking up new interests may help. Do something outrageous.  Choose something that you have never managed to get round to, or which  may seem out of character. If you want to change habits, you are  changing yourself, so these sorts of changes become symbolic of how you  can make it happen.

Habit reversal 

This is a behavioural technique that was first devised in the 1970s  by psycholo­gists Nathan Azrin and Gregory Nunn to treat stammering,  various tics and habit disorders, like skin picking and hair twirling.The first thing is to develop habit awareness, which obviously comes  during the period of observation that I mentioned before. Having focused  on the unpleasant urge that sets the whole thing off, you can then try  to replace it with another, less harmful or distressing habit. This is  referred to as a compet­ing response.For example, with someone who picks their nose, as soon as the  impulse is there, try clenching one fist and count­ing to five, thinking  at the same time of suddenly releasing the urge on the count of five.And, of course, you back this up with other techniques like  meditation, progressive muscle relaxation and homeo­pathic treatment.

What sort of medicine? 

The thing about homeopathy is that its effectiveness depends upon  taking the remedy that is right for you. Some homeopaths would suggest  that taking the constitutional remedy is all that one needs to do. I  would say that a consti­tutional remedy might be helpful, but only if  some indication of the habit is identifiable as part of the over­all  remedy profile.Generally, I find that with these habit problems, if you focus on the  habit itself you can usually select a remedy that covers the habit and  the way that the individual responds.With regard to potency, I find that the 30c is the most useful here,  because you are almost certainly going to repeat it. My own approach is  to prescribe the 30c potency twice a day for three days and repeat at  intervals of two weeks. During this time I will advise the fore­going  behavioural modifications.

Tics and twitches 

Nervous mannerisms, facial tics, grunts and moans are all difficult  to master. They can be part of the Tourette spec­trum or be quite  isolated. A tic may occur several times a minute, every minute of every  waking hour. I would certainly always try to use habit rever­sal with a  remedy to help to alleviate the urge.Aconite is a superb medicine to try if  this problem has come on following a shock. Argentum nitricum is  invalu­able if the tic is worsened at times of stress, so that as some  dreaded event approaches, the tic worsens. Zincum metallicum seems to  work well in slow, ponderous, melancholic people, espe­cially if they  repeat things that are said to them.

Hair twirling 

This condition is known as trichotillo­mania. People get the impulse to  twirl and pull out hair, often resulting in hair loss. They can do it on  the head, on eye­brows or, if embarrassed but unable to stop, they  secretly do it to normally covered body hair.Jimmy was a nervy seven year­old who was brought along to see me. He  was forever on the move, forever in conflict with his younger brother  and seemed addicted to twirling and pulling out his eyebrow hair and the  hair from an area on the back of his head. He was on the move as soon  as he came into my consulting room. He had an extremely fast and  effective response to Tarentula hispanica over three months.Belladonna and Cuprum metallicum are two other highly effective medicines.

Nose­picking 

I find that Arum triphyllum is almost a specific for this problem and  can bring great relief to youngsters, and their parents, since this is  an unpleasant habit for other people to witness.Gus was a youngster with a very short temper who used to bore his  fingers into his nostrils, even making them bleed. Cina cured his habit.

Thumb­sucking 

Baryta carbonica is the first medicine that I think of here. It is  useful in slight, nervous children who struggle to advance. On the other  hand Pulsatilla helps those children who always want to be outside and  who can get in a real strop with people. I have also found that  Phosphorus works well when the urge is described as being like having a  hot, itchy thumb, which is eased by sucking.

Nail­biting 

Biting your fingernails to the quick is a common cartoon image. Yet it  is not funny to be afflicted with this problem. I usually combine habit  reversal technique with simple taping over of the nails that are least  bitten. Usually these are the little and ring fingernails. For the  observation period I permit the individual to nibble at the others. Each  evening the taped nails are looked at and compared, then immediately  re­taped. After two weeks the nails should look quite normal and it will  induce a desire to achieve this on all of them. We then use a remedy.Alison had been a nail­biter all of her life. Secure in a good,  well­paid job, the habit was an embarrassment to her. I have to admit  that she and I almost gave up, for my initial choices made no  difference. Then we focused on the urge to bite and why she did it. It  seemed that it was due to intense irritation around the nailbed, which  only biting would help. This led to a prescription of Ammonium bromatum.  This eased the itch quite amazingly, and the above tech­nique helped to  clear up the problem.Argentum nitricum and Lycopodium are two other medicines that I find  are often indicated. People needing these tend to suffer from  anticipatory anxiety, when any stress­relieving habit may be  intensified. Those who need Argentum nitricum tend to crave cold sweet  drinks, while Lycopodium likes warm sweet drinks.

The big three 

Alcohol, tobacco and drug dependence are all huge problems and I  have touched upon smoking already. All three of these need behavioural  treatment, but the foll­owing remedies have all performed well in  treating people with these problems.Caladium is a keynote remedy for tobacco addiction, especially in men  who have noticed that they have become impotent or have erectile  problems. These problems are probably due to the toxicity of nicotine.Capsicum is a good remedy for peo­ple who crave drugs, tobacco or  alcohol and who tend towards being overweight, of a peppery temperament,  and who easily feel homesick.Finally, Nux vomica is never far from one’s mind for fiery, irritable  types who are always in a hurry and who are impatient with everyone.  “Give me the remedy now,” they almost demand.
Obviously it is a good idea to seek professional help when tackling these.

A last word 

I started with Dr Samuel Johnson so I will finish with him. Although  medical historians have attempted to analyse his health and his psyche  and retrospectively diagnosed Tourette’s syndrome and  obsessive­compulsive disorder, it has to be mentioned that his  gargantuan work, his great dictionary, would probably never have come to  fruition if he had not been driven by his “habits”. Was he content with  his lot? Let us look at his own definition of his chosen profession: Lexicographer — A writer of diction­aries, a harmless drudge.

Keith Souter MB ChB FRCGP MFHom  MIPsiMed DepMedAc has a private holistic medicine practice and is a  newspaper columnist as well as the author of Homeopathy for the Third Age and Homeopathy: Heart & Soul.