Their allure is all around us, but why do some people get addicted and others don’t. Dr. Joshua Grubbs studies addiction, specifically gambling and sex related addictions. We talk problem gambling, porn addictions, identifying and treating addictions and the most addictive things. Then, we countdown the Top 5 Things You Shouldn’t Buy Cheap.
Dr. Joshua Grubbs: 01:21ish
Pointless: 47:23ish
Top 5: 01:12:28ish
nickvinzant@gmail.com (Show Email)
316-530-7719 (Show voicemail)
https://www.joshuagrubbsphd.com/ (Dr. Grubbs’ Website)
https://twitter.com/JoshuaGrubbsPhD (Dr. Grubbs’ Twitter)
Interview with Dr. Joshua Grubbs: Gambling and Sex Addiction Researcher
0:12
Welcome to Profoundly Pointless. My name is Nick VinZant Coming up in this episode addiction, and the top five things you don't want to buy cheap,
0:22
people seem to be more attached not to the win. But to that moment, right before they know whether it's a win or a near miss. Some most people are like, Oh, I bet you people lie because they don't want to share about their sex line. It's actually not typically that it's the issue for getting the truth for people is that our own perceptions of our behaviors shape what we see about ourselves. So anything you do, that makes you safer, and more likely to wake up tomorrow, even in the midst of your addiction, that's breaking part of the cycle.
0:55
I want to thank you so much for joining us. If you get a chance, subscribe, leave us a rating or review. We really appreciate it. It helps out the show and more than anything, we just like hearing from people. So I want to get right to our first guest. He's an addiction researcher who specializes in gambling and sex addiction. This is Dr. Joshua Grubbs. What is addiction? Basically,
1:23
it's not an easy answer. This is one that if you ask them on the street, what is an addiction? I think they might actually be able to come up with a answer more quickly than most psychologists or specialists could because this is something that's still debated. Now, broadly speaking, when we say addiction, what we tend to mean is a pattern of excessive or compulsive behavior or behavior that's out of control, someone feels like they cannot stop, but they try to stop but they can't. Even though that behavior is getting in the way of their lives, it's causing problems. Normally, most professionals would also say that there's a chemical piece as well, right? There's this notion that there's things going on in your brain with neurotransmitters typically being altered via and the introduction of a chemical from outside the system. But the core of it is this inability to stop despite consequences. Despite wanting to stop.
2:17
Is this something that happens to us kind of over time? Or are people like born? And imagine you could look at the baby brain? And like, yep, that person is going to be addicted to something like, are we born this way? Or do we become this way?
2:31
So right, that's getting right at the core of nature versus nurture, which is at the heart of psychology, which we've been fighting about for as long as the field has existed? The answer is yes. Right. So genetics are a huge portion. If you are the child of people with addictions, you are more likely to develop that even if you were, you know, adopted at birth. But environment is a huge factor. So things happen along the way that make it more likely. And then personal decisions, as well as societal factors. You know, someone might have a predisposition developing an opioid addiction, but never really encountered opioids in daily life, because they never had an accident that left them needing pain medication. So yes, the genetic piece the being born with the piece is there for some people. But whether or not that leads to addiction is completely based on environment. And there's some people that come from families with no history of addiction whatsoever, that then due to life circumstances due to things that happen in them developing. So it's a little bit of both, and it varies from person to person.
3:32
So could it be like a situation for me, like I use myself as an example, I could be incredibly addicted to let's use something benign Nerds candy, but I've never had Nerds candy. And then one day, it's just, boom, I'm off the rails.
3:48
In theory, yes, certainly could happen there. There are, you know, documented cases of people that never had a problem with addiction in their life get prescribed an opioid. And then it seems like they can never come off of it, right. And so that that sort of thing. So they get prescribed oxy. And then it just never goes away. So that that happens, that's less likely more often than not, there's these complex factors. And it's not just one exposure. But there are cases that it is it seems like that one exposures and often sets it all off.
4:16
Do people usually know it? Like, did they know that they're addicted? Or the friends and family kind of spot it first
4:22
most in my clinical work? Most of the time? Yes, they get there tends to be in awareness. I mean, the consequences become severe enough that they have and they realize they can't stop even when they want to. Right. So often one of the criteria we look for in diagnosing addiction is well, having tried to stop and fail. If you've tried to stop you've typically acknowledged that something's wrong, right? And so there's an awareness that something's going right now what's interesting is we actually see with certain behaviors, they say viewing pornography, or sexual behavior, people will say they have an addiction even when they don't have one. And so there's actually an over reporting with some behaviors, and other behaviors are less likely to be report Like, traditionally, people with an alcohol problem, often take a little longer to realize the problem than say, maybe someone that was dealing with an illicit drug problem. There's just like social norms and awareness might lead someone to really I mean, the reality is that if you're using something like heroin that you're buying off the street, it doesn't take long to realize, like, maybe this isn't the best. And this is probably a sign that something's wrong. Whereas if you're, you know, having three drinks a day afterward, it evolves into four evolves into five evolves into six, it may take longer for you to realize, like, whoa, wait a minute, this is this is a lot, this is a problem.
5:39
Now, correct me if I'm wrong, but you specialize basically in gambling and sex addiction, those areas? Yeah. Is that are they fundamentally different than other types of addiction? Or is addiction addiction? It's just, instead of like, an apples, you like oranges?
5:55
So the answer you get to that question is going to vary by the research professional you talk to I'm definitely the one that says they are fundamentally different and functionally the same, which sounds like a weird distinction. And it is, in practice, with consequences in life with how it affects your relationships, how it affects your work, how it affects your day to day living, they are functionally the same as most other addictions, you know, at the end of the day, and out of control behavior pattern that leads your relationships to fall apart, that leads you to get fired from jobs that lead you to go into debt, that leads you to perform, I mean, to do things that are maybe not legal to support it, whether it's heroin, or sex, or gambling, they're all functionally looking the same. But fundamentally, I think when we really start parsing out what's going on underneath the surface, in the brain, and in in the complex psychological processes leading to it, I think there are some differences, I am of the opinion that there's maybe a difference between what we would call a compulsive behavior, which would be something like sex or gambling and a true addiction, which we would say maybe as a substance that you've developed and dependence on. But that that's very hotly debated. And so I would say this is my opinion, as a scientist and a professional that works in this space, and that you could find five other scientists and professionals that I strongly respect, they would absolutely disagree and say no, they're exactly the same.
7:26
How prevalent I guess, are gambling and sex addiction. Right? So
7:30
um, so if we're talking about prevalence, so I'll answer gambling first is super straightforward. somewhere between half a percent and 5% of the population has problems with that, I tend to think it's the number the best numbers I think are in that one to 2% range. So even 100 people, one of them probably has a gambling problem. That is more common than pressing B on your keyboard. But far less common than alcohol and nicotine, certainly less common than caffeine. Is it's, it's the type that again, if you think about your networks of people, you probably do know someone whether you know that you know or not, um, you probably do know, somewhat the game. Whereas if you think most of us we think about our networks of people, we know several people that have substance use issues somewhere along the way.
8:19
Yeah, sex is
8:21
is a lot more complicated. And the reason being is that it's hard to determine what is a dysregulated amount of sex and whether or not someone's self report is accurate? Here's what I mean by that. When we run nationally representative surveys, and I asked him, Do you think you're addicted to porn? A full 10% of American men will say, yes. That is an unbelievably high number. And I'm not trying to dismiss people's concerns. But if 10% of American men had a full blown addiction to true addiction to porn, we would expect there to be much larger societal consequences. I mean, the when we think about true addictions, we're talking about wages, lost work, missed relationships, falling apart, health problems, all of these things, none of those things are currently attached to porn use. So we actually see this phenomena with porn in particular, where people will overreported based on the fact that they're engaging in a behavior that makes them feel guilty and ashamed, but yet they still do it. And so there's the shame aspect with the SEC stuff. And that really complicates it if I guess I would say it's probably around that 1% mark, but I couldn't point to data that proved me right there.
9:30
That makes sense. I'll use like myself as an example right? Like I've certainly never missed work or anything like that. Or you know, like not spent time with family. But have I maybe looked at pictures when I probably should have been doing something else like yeah, so is that kind of
9:49
that like part of it? I mean, the big the lion's share of this shaming guilt phenomenon leading to someone thinking they're they have an addiction because They're, they're feeling guilty is in more conservative, more religious groups. And so if you look in conservative religious groups in the US and so I don't just so evangelical Christians are an obvious one here is but it's the same for the church, Jesus Christ of Latter Day Saints that the Mormon church. It's the same for Conservative Catholics. It's the same for several other denominations as well. It also occurs in the Orthodox Jewish community. There's an obsessive concern about how porn is ruining lives. And so there's a lot of messaging against pornography. So it's really heavily emphasized you should never look at more important is bad, it's evil. It's I mean, there's verses in the Bible that people quote saying, like, you know, this is literally committing adultery. So when you're viewing porn, you're you're committing adultery on your spouse, and you get this messaging in people's head. And so they think, Well, this is really bad. But yet, I'm still viewing it once a month, I must have an addiction. Because if, if it's this bad, and I can't stop doing it once a month, like, that means I'm addicted to it. And it's like, I've been up in porn for 30 minutes last month. And like, yeah, it created a lot of distress for you and probably created drama in your relationships. But that's just not the criteria typically associated with an addiction.
11:13
Yeah, that's kind of you and like I would, okay, so when what point would you say if you looked at like, Alright, now, this is a problem, somebody? Right? 30 minutes a day.
11:26
And so it's hugely variable, and it's going to vary on your your kind of life circumstances? And what's going on? What I would say is, are their objective consequences? So are you finding yourself you know, viewing porn, when you're at work, and it's creating problems. So I don't mean like, Okay, that one time, one year ago, I went to the bathroom with my phone, I mean, like, No, at my desk, I mean, every day. Or, or you find yourself spending multiple hours per day. So like, if you're in a situation where you're viewing porn for multiple hours a day, and it's getting in the way of work, or relationships or self care, like, Hey, you haven't showered six days, because spending eight hours a day viewing window, that's a that's a bad, like, that's not healthy, right? We are looking for those more extreme cases. And what the more common presentation is someone who might might go five or six days a week without viewing but then it's literally all weekend long, completely binge not engaged in any relationships whatsoever, just almost every waking moment. And again, these are extreme examples. But those are the types of examples that we see in therapy, that show up in some of the treatment studies as well of people that it's objectively ruining their life. I mean, and that sounds like a weird criteria to put out there. But I mean, that's what it is, is actually really creating major problems in your life, not your guilt about it, not your thoughts about it, but your actual behavior. Is that creating the problem? And if the answer is it's the actual behavior, then that's, that's a sign that something's going on that we probably want to work for with
13:08
sound. It reminds me kind of like, I went to journalism school. So it comes from that, right. Like the definition of obscenity is like, I can't tell you what it is. But I know it as soon as I see. Yeah,
13:18
there's a former Chief Justice of Supreme Court that actually said that about obscenities in forums recorded some bar papers of like defining porn is really hard. Defining obscenities are but you know, when you see addiction, I mean, there are right we use criteria like, you know, persistent patterns of dysregulation, but there's so much subjectivity in it about what impairment looks like. So if you told me, Well, you know, I'm an adult content creator, so I watch porn for three hours a day to get ideas, and I produce porn for two hours a day. Yeah, I actually enjoy that because that's who I am. I'm not going to tell that person that they have an addiction, even though they're spending five hours a day engaging with the art, right? Because it's a different context. But the person that says yeah, I'm, I'm spending, you know, couple minutes here or there, but then I go on these eight hour binges. And like, I got fired from me for doing that at work, or I don't spend time with any of my friends anymore. Because I have a free moment. I want to go to the porn. That's that's a more conservative and more It's easier with interpersonal sexual behaviors. If you tell me like, Yes, I'm constantly hooking up with strangers having unsafe sex, I cannot stop no matter what I try. I'm, I've had eight sexual partners last week. I don't remember who any of them were and it was all unsafe and unprotected. I'm going to be concerned. If you told me the same story and you're still being safe and protected. I'll be less concerned actually. But again, there's this when there's interpersonal sexual stuff, it's a little easier to pick up on them with safe Warren because we all have individual private sexual behaviors that getting norms were a little harder to establish.
14:54
I would imagine it's hard to get people to tell you the truth.
14:58
It is but not for the reason that you think So most people are like, Oh, I bet you people lie because they don't want to share about their sex life. And it's actually not typically that it's the issue for getting the truth from people is that our own perceptions of our behavior shape what we see about ourselves. So you'll have people we see this, it's actually pretty well documented with the people that game too much. So people that think they're addicted to games, if you actually measure how much time they're spending on games, and then ask them how much time they spend on games, they will over report they'll be they'll pick numbers that are sometimes twice three times as high as what they actually spent. So there's, there's this feeling something's wrong, so they inflated. And then the flip side people thinking, No, nothing's wrong, and so they downplay. And so our self perception, and this is actually true of all addictions. You know, there's this notion, sometimes in addiction therapy, that, Oh, you can't trust what your client says they're gonna lie to you. That's not what it is. Clients, people with addictions, people without addictions, we're not often very insightful about ourselves and our worldviews, our beliefs, our behaviors, our relationships, what we had for breakfast that morning, can all influence in that moment, what we recall of our own behaviors, and it changes what we say to the people. So yeah, it's hard to get honest reports, because I tell when I'm training new therapists that tell them you're not interested with therapy is not always about the objective truth. It's about their experience of their lives and getting to an experience of their life that's more positive, that's more that works for them. And so maybe that what they're telling you isn't entirely accurate, but it is what they think is accurate. So
16:36
is that is that because we I mean, are they in any way? Kind of? I don't know what the right phrase is self deflecting? Like they're not. They know what the truth is, but they won't admit it, or just that we as people are just bad at this.
16:49
Absolutely. Sometimes. That happens. Sometimes people are trying to hide and self deflecting and are being dishonest with themselves. I don't I don't I couldn't put a proportionate. But I would say I think it's probably more common that we just kind of lack insight. And so there are points in therapy as a therapist where I'm trying to push a client to say, Okay, if we really do an honest inventory of ourselves, right now, I think you're gonna come up with a different answer. But more often than not, it's you know, about reframing what's going on so that they can arrive. So it's not challenging them to be honest with themselves. It's, it's challenging them to think about it differently, which will then lead to different conclusion, which sounds like a small difference, but it is actually a pretty dramatic difference in in the room with how we're approaching things.
17:42
So when you look at like sex addiction, is it more prevalent amongst men, women,
17:48
undoubtedly, men, among people that self identify as having sex addiction that seek treatment from sex addiction, men are more common, and typically, it's heterosexual men. Despite the fact that bisexual gay men who have sex with men are actually typically much more sexually active and having more sexual encounters in their daily lives. It's typically heterosexual men that are identifying as having a sex addiction.
18:19
How come? Why do you? Why is that? Why would that? Why would it be?
18:23
So it's huge, huge, huge number of variables that go into play. One of the big ones is that same thing I was talking about was moral morality and shame and guilt and beliefs. Disproportionately the men who are dealing with conservative sexual values and feeling like they're violating are going to be men that identify as heterosexual right? If you're in a conservative religious group that says that viewing porn is evil, chances are you're also in a conservative religious group that says being anything other than heterosexual. So part of it is they're heterosexual by identification, because that's all they're allowed. So that's one factor. I mean, another factor is what's normative there. There are, you know, basic differences in sexual frequency desire drive, between men and women. I mean, it's very complex. And I don't want to get into like gender binary debates and all of that kind of stuff. Broadly speaking, on the whole, women are less likely to desire the frequency of sexual encounters as men. There's societal reasons for that. Whether or not they're biological is a separate debate. And so, heterosexual men are less likely to have partners that want sex as frequently as they are. And so there's a mismatch of desire. So one of the most common things you see in heterosexual marriages is desire mismatch, right? Where man wants more sex than woman. And instead of you know, working this throughout with compromise or therapy or conversations, man turns to porn and then he feels like he's using porn all the time. And It turns into this vicious cycle. Look, I'm not getting the sex I want. So I'm viewing porn, but I can't stop viewing porn. And when I tried to stop me when I couldn't, therefore having it, it just gets this this kind of spiral effect, where these, again, all of these things like it's hard to talk about it like, casually because there's so many different individual and then cultural variables that come into play. And I can imagine a counterpoint for everything that I'm saying. But on the whole, we see heterosexual men reporting it more. And it seems to be a combination of desire mismatch leading to other behaviors, and then the conservative sexual values
20:36
for gambling addictions, right, that gets it, I guess, what are they addicted to?
20:43
So it there's variability depending on the game of preference. In some case, some studies actually indicate it's an addiction to the ambiguity in the chance aspect of it. So what we actually have seen in repeated neurological studies in Curie activity size, they're just different paradigms that we use, people seem to be more attached not to the win. But to that moment, right before where they know whether it's a win or a near miss. So imagine on a traditional slot to really complicate matters on a more traditional slot setup, you've got your 347, whatever it is Rose, you know, spin, right. And they hit in order in whether it's a digital slot, or the old school traditional ones. They, you know, they they don't all stop at the same time, they stop one by one. So there's this build of like, Alright, I got this one. One logo showed up this one fruit to an old school slot machines. And the second one just hit the same. And there's this building anticipation, like, Ooh, what's going to be next. And then the third one hits this the same, and you're just waiting on that fourth one. And in that brief moment, there's this heightening of, I mean, everything inside like adrenaline kind of starts to pump. There's a lot of other kind of neuro chemicals getting involved bringing your attention into this moment really tying you into to what's about to hit next, what's going to be that last one. And what we find is that the arousal level actually hits the hardest. When you get you know, three, four, whatever it is in a row, and the last one misses, than when the last one hits. There's that near miss phenomena where there's this rush, and then the crushing disappointment, and that emotional roller coaster produces reactions and people that we crave, at a almost subconscious level. Now, yes, everyone loves winning. But if you won every time, it wouldn't be gambling, right? Like that's people aren't. So workaholism is not an actual addiction, right? You aren't addicted to going to work and making sure you get that paycheck every time. Like that's not a thing. It's the it's the uncertainty piece. That seems to activate something. Now there's there's theories about this a lot people will go back to evolutionary psychology and say that we're wired to seek uncertainty because uncertainty has the chance of better payoffs. I'm not entirely convinced by that argument. But there is something to be said said for humans like uncertainty. Even when we say that we don't we like a little bit ambiguity, we like surprises. And it seems to be that same process there. And that's for slot. I mean, it gets more complicated. We're talking about sports, and cards and things like that. But they all seem to be that same piece of that uncertainty, that moment of uncertainty. It's not when you when that hooks you, it's that uncertainty that you keep coming back for.
23:35
I would have never thought it that way. Right. Like I would have thought that they were addicted to the sensation of winning, but it sounds like they're really addicted to the sensation of almost winning and then losing
23:44
right. And if you talk to most gamblers boom, boom, you talk to most gamblers, they'll be like but no, it's the winning. And at a conscious level, it is the winning but when we look at what's happening underneath the surface, it is that bump bump roller coaster of that almost hitting it in the dropping, and then that makes the win even that much sweeter. Right? Because you've had you've gotten that ride, ride the roller coaster up and drop rides well, and then finally hits and it's like, yes. But again, it is that it's all built on on the losses like you have to have the losses for the winds to be appealing.
24:22
Does it matter the game like is somebody that is there a difference between the person who's addicted to blackjack versus craps versus poker versus slot machines?
24:32
So Blackjacks versus craps versus poker, actually, most often, there's not a whole lot of differences going on there. I joked that the difference between someone who has an addiction to poker, and the someone who's on the World Poker Tour is what how good they are right in there. It's not that that addiction isn't quite the same as what we're seeing with slots. In particular, and the reason being skill based games I has crafts is kind of watching it. So blackjack and poker have more skill pieces, poker being one of the most skill based games, with some chance interjected into it. And then everything gets progressively more chance based, those type of people that develop those problems. It's typically a complicated picture, based less on the inherently appealing nature of the game and more on what they're using the name for themselves. slots. i In practice, you see more people addicted to slots to sports, betting to Keno rare, more rare cases like extreme lottery ticket buying things like that. But for those people, there's often this clear use of the gambling as a detachment from something else going. So the very, we've documented this in a lot of our research, that people with PTSD, in particular are really drawn to slot machines to games that are very kind of zone out and just bring yourself into the game. So I mean, you could develop a slot machine problem without PTSD. But oftentimes, we see the slots functioning as a way of shutting out the rest of the world shutting off your internal world just being into with this one emotional roller coaster and not the rest of your life is chaos. Where that's a less common presentation for
26:29
poker like that. Are you ready for some harder slash listener submitted questions?
26:33
I'm always forced listener submitted questions.
26:36
Can people really break the cycle? Or do they just change one addiction for another,
26:41
people can absolutely break the cycle. And I would challenge people to think that breaking the cycle doesn't just mean total abstinence, you know, if someone in college was drinking, six, seven drinks a day living in a perpetual state of hungover to drunk and couldn't stop when they wanted, but then come to a point through either intervention or personal decision that they drink once or twice a month. That's breaking the cycle, right? That's breaking a cycle of what looks like an addictive behavior, even if they're not absence, even if they because they they've chosen to do things in a way that's safe. There's this notion in addiction treatment of harm reduction, anything you do that makes you safer, and more likely to wake up tomorrow, even in the midst of your addiction that's breaking part of the cycle. And so yes, absolutely. And I see people that go through recovery for one substance and never pick another one up. And yes, I see people the other way to that they just seem to change from one to the other. The person that had alcohol, the ghosts gambling, gambling goes to sex from sex, they go to hair, like yes, you see that. But more often than not, I see people that break the cycle or get to a safer place. And they don't they don't go back to that dark place again, and they move forward.
27:56
What's that? Like? I guess then what's the secret in the therapy? Or what's their secret? Like what did?
28:03
I mean, I don't think there's anything as far as I don't think it's a secret. I think it's a combination of, you know, getting getting the type of therapy you need. But a lot of people actually naturally remit which is it's hard for therapists to admit, but it's over half of people that have addictions, that recover, recover without therapists whatsoever. Like they just for some people, it is absolute, just white knuckling it through it. Other people, their lives change a relationship ends that was dragging them down for other people. It's a series of gradual changes, like I've met more than you know, I know lots of people that, you know, cold turkey their way quitting smoking, but I know a lot of other people that was like, Well, I used to smoke two packs a day. And then it came down to a half a pack a day. And then I switched to a vape. And I've been on a vape for three years now, but I only have eight, you know, twice a day. And yes, they're still, you know, dealing with the nicotine, but like, they're also their lung cancer risk went way down all of those types of so like it's, it's all sorts of different pictures that I see. And so it's not one size fits all. And one of the things if someone's listening to this and is really struggling with addiction, they don't feel like they can get through. My only advice is keep trying. If something's not working, don't just keep trying. Like if you've been trying to go to AAA meetings for 10 years, and it's never worked. Try something different. Like AAA doesn't work for everybody works for a lot of people doesn't work for everybody. So try something different.
29:31
Which does society demonize more gambling or sex addiction?
29:35
Sex? Yeah, sex. Undoubtedly, it's because of our society's got such a such a strong kind of Protestant background. And if you look, even politically, you know, one of the major political parties in the country's very strongly aligned with conservative Christian sexual values. So right now it's sex. Was it that way? 50 years ago, I don't know. Will it be that way? Two years from now, I don't know. Right now, though, I'd say it's X.
30:03
Are we more addicted now than you think that we were in the past?
30:08
No, no, this is actually pretty common idea like, oh, no, thanks to technology, and hyper palatable foods this we're all developing more addictions for I don't think there's any good evidence of that. I think, you know, I think addictions have have been here with us. The reason we think that there's more now is that we're more aware of what's happening. We just get better at measuring what's around us, the longer we go on. I think a good analogy is if you look at sports and sports statistics, and so you might sometimes listen to an old sports fan, like back in my day, we didn't have all these statistics. It's like, I mean, but they were there, like these metrics were still happening, right? Owen was measuring, right. So like, they, you know, you'll see, anytime you watch an NBA game, this is the first time someone's gone for this many minutes. This many scores this many thing while wearing shorts that were this long or whatever, right? Like, it seems absurd. But like it's its measurement, we're better at measuring things now than we used to be.
31:03
The thing this is completely aside, but the thing that I always wonder about is like, what did people in like the 1800s, they just look at clouds that look like a woman their history, or they do it?
31:16
History of porn is one of one of the really, I mean, I'm not a historian, but I've read some of this work. You know, there, there's certainly evidence that people were marketing erotic drawings, hundreds and hundreds of years ago, 1000s of years ago, it took less, it took only just a few short years for the from the invention of the camera to be selling of, you know, nudes. The reason that blu ray won out over what was it HD discs, or whatever it was,
31:46
was because though Yeah, heard that about? Yeah.
31:49
Yeah, Betamax. And this is consistent. Like, we have always used the technology at our disposal to produce images of sexuality, whether that was drawing on paper, to now with full blown virtual reality.
32:05
Are we all addicted to something?
32:08
So I think if you think of addiction in terms of functional impairment, like is this behavior creating problems in your ability to exist in life? The answer is no. If the if we're thinking about addiction in terms of is this something I can't stop? Even if I want it to, then yes, right. So like, Yes, I'm absolutely addicted to caffeine. Like, I traveled abroad a couple years ago, for COVID. To a country that did not have easy access to coffee, and I had withdrawal headaches for two days until I finally found a Starbucks. It was 16 blocks from my hotel, and I walked to it every single day, from there on out to get coffee. That absolutely sounds like an addiction when you describe it. Generally right now at home, three kids and wife at home, I get up in the morning, I make coffee. And I don't have problems. And so like, is that an addiction? A true addiction? Probably not. But in a different set of circumstances? Could it be conceived as one? Probably?
33:13
This one's a little lighthearted. Where on the scale of addiction studies, are you like, is the gambling and sex addiction person cooler than the person who studies like addiction to eating salt or addiction to something else? Right. So
33:30
I mean, depends on who you ask. Depends on how you define cool right now, if you want to talk about being able to get grant money, and who's able to get the money to do the work they want, and where the bottom of the totem pole but if you want to talk about the ones that people are the most excited to talk to and interested in. I think that we get a lot of public interest because the public is interested in these things, even if the funding agencies are
34:02
Yeah, they can't really fund it as much I guess.
34:06
Historically, not gambling, gambling is getting there. Eventually sex mind but sex they just get so wrapped up in the politics of it. All right. So
34:15
so that kind of a question that just jumps into my head is right, like so what do you think about gambling was hush hush, no gambling only in Vegas? Now you see fantasy advertisements for it left and right. Like I guess, what do you think about that? What's going on? Is this or new wave is coming or like what are you
34:37
so I don't so I see. You sometimes you see people that are very programming, saying there's not going to be any problems. It's just a new economic activity. And then sometimes you'll see people that are in the anti gambling, community sex. This is going to completely restructure society as we know it. And I think both are completely wrong. I think of it in terms of if you think about people being predisposed was to developing a problem with addiction. And then I mentioned really early on in this kind of podcast that well, sometimes you might be predisposed, but are never exposed to it, right? So you might be predisposed develop an alcohol problem, but for whatever reason, you just chose to never drink in your life even you never drank. So you never knew that you're predisposed, because you were never exposed to it. I think gambling is going to be like that I think more people that would have never developed a problem will but I don't think we're talking about some massive epidemic, I think we're talking. If the prevalence rate is 1%. Now maybe the prevalence rate goes to 2%. Now, that's an absolute doubling in the number of people that have gambling addictions, which is a very big deal. But it's also not like some rampant disease recognized all of society. So it's this kind of nuanced view. But I do think more people will develop problems that don't have it. And I think it won't be as bad as some people are afraid. You know, I am concerned, especially with the fact that a lot of states are legalizing the ability to gamble from your phone. The privacy aspect of it scares me a little bit. It's easier to be responsible with your bets, when you know people are watching you. But if nobody's watching you, and it's not real money, and there's not chips on the table, it's just numbers on the screen. I'm concerned, but it's a cautious concern, not a, I don't necessarily believe that it's definitely going to be a huge problem. I just I want to see what happened. And that's what a lot of our research now is is just documenting trends over time.
36:23
Most interesting gambling case most interesting sex addiction case you've had.
36:28
So I can't talk about specific line details publicly, right, because of HIPAA and various other protections. I think those some of my most gambling cases are the ones that have won big and I don't mean like, oh, they won 5000 or 10,000. Like I have cases that in one, one or 2 million, either via lottery or via some just insane cussing up AR, and then lost it all. Just, I mean, it says something to say I was up $2 million at one point. And now I'm in the hole 500,000. I mean, that speaks to what's going on. So that's that. And then sex addiction. What's not, it's not actually the sex addiction cases that are the most interesting to me. It's the ones that think they have a sex addiction with don't so like talking to someone that might say, I'm addicted to porn, and like, okay, so when was last time you for? Well, you know, three weeks ago, when I was in the supermarket, I was at the impulse counter. And I saw this very scantily clad woman on the magazine, and I thought of what she might look like naked. Like, yeah, but when was last time you looked at porn. And that's what they meant. And it's like this completely warped view of the world. Based on you just complete concerns about you know, not looking at a woman with lust in your eyes, which is, you know, a thing that comes up in Christian faith a lot. Like, so that's fascinates me again, not a true addiction. But fascinating worldview to kind of work with in the therapeutic room very hard, doesn't actually work out very well, sometimes, but very, very interesting.
37:55
Yeah. Like, what do you do in that kind of circumstances when you make maybe somebody thinks they have an addiction, but this isn't really an addiction,
38:03
right? Well, if someone is coming to me and asking for help, then I believe that they're a person that's in front of me that needs help. And so sometimes the help is addiction treatment, because you have addiction related kind of behaviors. But sometimes that's something like we the term we use is Acceptance and Commitment Therapy, it's kind of a school of thought is a type of therapy that's focused more on learning to not get so caught up in the struggles, basically, being able to say I fell short of my goals. That is in the past, I'm moving forward. And so I'm not saying I don't try to tell, you know, if my clients a conservative Christian, I'm not going to say, well, first, you should be an atheist, and then you should be okay to you in corn, like, I'm not going to say that, I'm going to say, okay, what are your values? How do we live up to those values without causing suffering in your life? And what does that mean for you? And so it looks a little different for everyone. But oftentimes, it's about learning not to hate yourself when you fall short of your values, and learning not to obsess about those values when you're living up. And so it's this balance of trying to just kind of even things out,
39:08
do people like when they maybe they cure the addiction, but can they ever get over a sense of shame? Like that? Oh, I was, I was a gambler, and I lost $10 million, or whatever, and I don't gamble anymore. But then do they ever get over that?
39:25
The aspect of times the negative emotion around it goes that the shame though, so they'll still be some regret, right? Feeling like I wish it hadn't been. But it doesn't carry the same pain. And a part of that is if you think about a lot of recovery groups, so whether it's a TA or GA or 12 Step groups, or there's lots of other groups that aren't 12 steps that that are different patterns. They're built on you telling your story pretty often and the more often you tell a story. It's the same thing for PTSD actually, the more often you tell that story that causes you pain, the less pain it costs. because you just get used to telling the story, it doesn't mean that you couldn't find the pain if you want it to it doesn't mean that there's not still some emotion there because of course there is. But it becomes less painful because it's it's just your story at that point. And the bigger thing we deal with is when somebody has a an incident where they slip back into something, there's often crushing shame. And then that crushing shame is like, well, what's the point in anything, might as well keep going. And it's like, no, a incident, you know, you've been sober for 10 years, and you've had one drink. That doesn't mean you need to give up and have 10 drinks a day for the rest of your life. It just means you had one drank and slept up to get back on.
40:37
I always wondered if John Daly was like a good example, or a bad example, somebody that was addicted and really had some trouble with it stopped for a long time, and then just seems to have become okay with it. Like in control, but still doing the thing that he was addicted to?
40:54
Yeah, I mean, it's tricky. I, I hesitate to point out like exemplars like if somebody is Yeah, right. But like, I do think, like I said earlier, whatever you're doing that makes it more likely that you wake up tomorrow morning, and that the people around you aren't getting harmed by what you're doing is a step in the right direction. And so if the thing is if you know, like, I'm going to end up using you, and I cannot stop it, but you learn a way to do that, that doesn't put your life in extreme risk and isn't actively hurting the people around you. I tend to think of that, as I mean, good versus bad is one way of thinking about I think of that as a better direction to go than just going full bore. You know,
41:39
is it always bad? Addiction, addiction, always bad?
41:43
Depends on how you define that, I think, I think of addiction, oftentimes as a reaction to what's life's got going on. So sometimes people will turn to addictions. Because what's going on in their life is so bad that they don't feel like they can face it without it. And I've worked with people with addictions that will say, Well, if I hadn't had that substance, I would have just committed suicide. And in that situation, it's a hard thing to say that that was bad, it may not have been the best thing for them. But it's hard to say it was bad at that they think that that kept them alive. I've heard that phrase before. And I think that that's one aspect. I mean, the other aspect of it is, as humans, we're always balancing, enjoying life and accomplishing the things that need to be accomplished. And it's not inherently bad that sometimes that balance gets out of whack, where we get a little too far on the enjoyment side of things, and we need to pull it back. We need to rake back. Yeah. Like I mean. So I again, I don't think I would say it's always bad. Yes, we want people to be safe. But sometimes people are going to engage in substances, they're going to engage in behaviors, sometimes they're going to get a little bit out of control. And it doesn't have to be
42:56
I would imagine that that's true in the sense that like, people don't get addicted to something for no reason. Like, are they usually kind of using it to compensate for something that might have been the worst option?
43:07
Oftentimes, that is the case. Yes. I mean, there are sure. Physiological addictions and there are these moments where people purely just develop a dependence on something and they can't stop because more often than not, yes, it is the addiction. The addiction develops, because the other options seemed worse. Now, we can debate on the outside whether it was or was not, but for the person living it, that's what that's what it felt like for them. And that's I mean, for me, that's part of being a non judgmental therapist is realizing that what led them to this point is not just some deranged, you know, desire to have an addiction or just a lack of self control or being weak know what led them to this point, it was a set of options that said, No, this is the option that makes no sense. And if we can understand that, some a lot of times addiction therapy is about making sure that there's better options there so that addiction is no longer the best option.
44:06
Yeah, kind of like I can confront my childhood field with abuse or I can drink alcohol. Yeah, and I drink alcohol is what I would do.
44:15
Right? And that that happens, and there may come a point with the right supports in place where confronting that abuse makes more sense. But where you are, for whatever reason right now, it just doesn't and so you choose to avoid it via substance.
44:31
Um, that's pretty much all the questions we got man. Is there anything that you think we missed? Or no, no, I think people kind of learn more about you. And
44:39
yeah, if you are interested, if you're ever interested in learning more about me, you can always find me I'm on Twitter at Josh Grubbs PhD. You My website is Joshua Grubbs phd.com. Both of those are probably the best place to catch up with me. But I'm always happy to hear from folks if people have questions. You know, I do get a lot of emails. I can't promise I'll respond to everything but I do try again. I'm pretty active on social.
45:04
What's the most addictive thing that you think like, oh, man, people get into that and it is just
45:13
I was gonna say caffeine. No, it's not caffeine. Right now I'm trying to decide if I think this is objectively true or if it's just because of where we kind of are societally. I mean, I tend to think of opioids is pretty pretty darn so like that. Heroin, fentanyl, car, fentanyl, that kind of isolated, which all have their purposes medically. But any human being if you gave them a daily dose of an opioid, for two weeks, they will be dependent on it at the end of the two weeks. Now, some people will fight through the withdrawal. But it's it's a very easy addiction to create. I think it's the easiest addiction to create that we've seen.