Ask a Therapist: Facing Our Addictions with Richard Kneip

Last Editorial Review: 10/23/2003

WebMD Live Events Transcript

The definition of an addiction is the act of devoting or giving oneself habitually or compulsively or to become physiologically dependent on a habit- forming substance or action. This can include gambling, alcohol, drugs, sex, food, etc. When a habit interferes with your daily life, it is then considered an addiction. Join Richard Kneip, PhD, as he talks about how to recognize addictions and what can be done to overcome them.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

Moderator: Welcome everyone! Today's guest is Richard Kneip, PhD. He will be answering your questions about addictions.

mulconrey: I'm 18 and I think I'm an alcoholic. How can I know?

Richard Kneip, PhD: Strictly speaking, there is no widely accepted definition of what constitutes an "alcoholic." However, when deciding whether alcohol or drug use is problematic for someone, we evaluate whether the drug or alcohol use is creating problems in the major functional areas of the individual's life, such as school, work, and relationships. I am concerned just knowing that you are wondering if you might be an alcoholic, suggesting to me that you are thinking that your use of alcohol may be obsessive. We do know through research that the younger someone is when they start to use alcohol, the more likely it is that their substance use will escalate into a major problem in later years. I would strongly encourage you to speak with a school counselor, your doctor, or any other adult trained in the evaluation of substance abuse problems. Lots of help is available, and you should take full advantage of it. You can get more information about the signs and symptoms of alcohol and other drug dependencies at

johncandylookalike: If I have addictions to the Internet, overeating, and masturbation, will an overeaters anonymous group help me with all of them? I mean each topic is different, but the concepts for overcoming them are similar right?

Richard Kneip, PhD: You are absolutely right that the concepts and methods used to promote recovery from addictions are similar across different problems. The reason for this is that the methodologies have been adapted from the 12-step program developed by alcoholics anonymous. The specific content related to particular addictions may be important for you as it relates to your situation, but making progress in any one of the areas you mentioned by participating in the 12-step program may help you in the other areas.

satoshiokamoto_98: Do you recommend any therapy for sex addiction?

Richard Kneip, PhD: Recently, there have been a number of books written, and specific treatment programs are being introduced for so-called " sexual addiction." These programs, as mentioned in the previous question, are based largely on the 12-step program developed by alcoholics anonymous. Individual counseling or psychotherapy may also be helpful for you to understand the roots or causes of your behavior, as well as to help you explore alternative behaviors. As with any addiction recovery program, group therapy has also been shown to be highly effective.

the_reverend_al_sharpton: Is there such a thing as food addiction?

Richard Kneip, PhD: Traditionally, the word addiction was used to describe the body's physical dependence upon a chemical substance, such as alcohol or heroine. More recently, the word has been generalized to many behaviors that are prone to behavioral excess. When defined this broadly, addiction can be applied to virtually any behavior in which an individual might engage for their own gratification or pleasure. Obviously, eating is something that many people do to excess if you look at the World Health Organization statistics on the rate of obesity in the US and other affluent countries.

Jim_nc_99: Is the same person likely to be addicted to several things? In other words, is there such a thing as an addictive personality?

Richard Kneip, PhD: That is a very good question. Behavioral therapists have debated and conducted substantial research into the so-called "addictive personality," but the results to date have been equivocal at best. Certainly, it is common in clinical practice to see individuals that are using a wide variety of substances, such as alcohol, marijuana and cocaine, but this can easily be explained by the individual's socio-cultural peer group and lifestyle. Much less common would be individuals who show "addictive" behavior across disparate behavioral areas, such as sex and gambling. To further complicate matters, we must recognize that in some cases, addictive behaviors might represent an individual's attempt to overcome or deal with a mental health problem, such as depression or anxiety. You can find more information on a wide variety of "addictive" behavioral disorders at

tdauble: Is it possible to get addicted to the Internet (computer), and what are some signs?

Richard Kneip, PhD: Again, we would define "addiction" to the Internet in terms of its effects on the functioning of the individual. For instance, a student that skips school or neglects their studies in order to spend more time on the Internet could probably be thought of as addicted. Common signs of addiction include preoccupation or obsession with the addictive behavior, much time spent planning and anticipating upcoming opportunities to engage in the addictive behavior, poor performance in other functional life areas such as school, work, or relationships, and possibly withdrawal, which in this case would be marked psychological distress when blocked from engaging in the addictive behavior. Another significant sign of addiction is persistent desire or unsuccessful efforts to cut down or stop the addictive behavior.

Pimpdaplanet: I have a problem. I wash my hands at least 100 times a day. Please help me.

Richard Kneip, PhD: The hand-washing behavior you describe is a manifestation of what we call obsessive/compulsive disorder. While not an addiction per say, it does share certain characteristics with the addictive behavior in that it persists when the person tries to stop the behavior. Treatments are available and would include individual counseling, behavioral counseling or psychotherapy and medication. You should talk to your family doctor and seek a referral to a qualified mental health professional right away. You can find more information on obsessive/compulsive disorder at

twilight_52: I am an Rx addict that just relapsed. I deal with a lot of stress and physical pain. How can I deal successfully with my addiction and still find relief?

Richard Kneip, PhD: Addiction to pain medication can be quite complicated, as you point out, when the patient depends upon the pain medication to manage chronic or intractable pain. Without knowing more about your particular problem, it is hard to say, but we most likely would recommend that you receive simultaneous treatment for your medication addiction and your physical pain. Physiatrists are medical doctors that specialize in the management of pain and very often can recommend exercises and relaxation techniques that may help you to greatly reduce your pain without the use of medication.

marina_s2: What about image disorder? Is that an addiction?

Richard Kneip, PhD: I am not familiar with image disorder, but if you are referring to a body image disorder, then the answer would be no. By definition, addictive disorders involve either appetitive (meaning consumption) or behavioral (such as sex or gambling). A body image disorder is a disorder of perception, in which an individual might have distorted, inaccurate, or even bizarre perceptions of themselves.

LuckyStar_02: Is it possible to inherit addiction?

Richard Kneip, PhD: Good question. There is strong scientific evidence that addiction is at least in part heritable. For instance, some individuals lack a particular enzyme that is important in the metabolism of alcohol, making them much more susceptible to addiction to alcohol. This trait can be passed on from parents to children. Also, studies have shown that identical twins reared apart are more likely to demonstrate addictive behavior more so than unrelated individuals in the general population. These types of studies show, therefore, that genetics is at least partly responsible, as is the individuals social environment and psychological makeup. You can find more information about addictive disorders and treatment at

adampmp: I have a friend who is addicted. How do I make him realize the truth? He is addicted to acid and pot.

Richard Kneip, PhD: One of the cardinal signs of addiction is denial. Denial is the psychological defense mechanism that individuals use to blind themselves to the consequences of their addiction. It never ceases to amaze me when I see a patient that has lost their family, job, home, and continues to flatly deny that any of their problems are due to their addiction. Unfortunately, there is probably very little that you can do that will break through your friend's denial system. Of course, you shouldn't hold back from expressing your concern, but don't expect much. Sometimes we use what we call an intervention, where a large group of friends and loved ones assemble to confront the addict with the negative consequences of their addiction. When effective, such interventions might motivate the individual to seek out treatment. More information can be found about denial and recovery from addiction at

Tinklemizer: I've dealt with the active part of my addiction, but now I'm having spiritual problems. What do I do?

Richard Kneip, PhD: Good for you. Changing your behavior and dealing with your active substance abuse represents a significant milestone in your recovery. Although I am not quite sure what you mean by spiritual problems, many individuals in recovery find that without drugs or alcohol in their lives they are unable to find meaning in their lives. Recovering from addiction usually involves breaking old friendships, learning new behaviors and pastimes and finding new areas of interest and personal expression. At this point in your recovery, you might find that a support group such as AA or some other 12-step group might be very helpful. As I'm sure you know, these groups have a spiritual component.

TheBard2000: Do you think an addict can break his/her addiction without any outside help?

Richard Kneip, PhD: Absolutely. In fact, we know that more individuals recover from addiction of all types (alcohol, cigarettes, drugs) without help than with help.

Thank you all for joining me today. For those of you struggling with recovery from addiction, take it one day at a time and stick with your program. Also, for further information on addictions, please visit

Moderator: Thank you, Dr. Kneip, for joining us today. We had so many great questions, and I know you would have liked to answer more, but unfortunately time has run out. Sorry we couldn't get to all of your questions, but hopefully you were able to get some information.


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