Approaching and treating addiction as a ritual

New insights into the treatment of addiction are needed. We therefore want to investigate whether an addiction in itself can be seen as a ritual. If that is the case, it could offer a new perspective for new approaches in the treatment of addiction. Rituals are actions that, just like the use of addictive substances, can become a daily habit. Addiction is therefore largely behavioral.

Purpose of the investigation

The aim of the research is to improve the treatment of addiction. The influence of the ritual on the individual and the community must first be examined. Religious communities, for example, make extensive use of rituals. Another fascinating aspect is the influence of rituals on our brains. Research has shown that psychoactive substances emit the same stimuli as the stimuli that cause a ritual. These are valuable starting points for further research into the function of the ritual in the treatment or prevention of addiction.

What is a ritual

When we think of a ritual, we quickly think of an action within a religious framework. There are different rituals. A ritual is an expression or behavior of a human or animal that is repeated during special or daily habits. This behavior can consist of a few elements but also of a whole series of different actions. A ritual is a daily recurring activity by one or more people. If the ritual is not performed, one gets an uneasy feeling which can lead to an urge for the ritual. The ritual can take place within a religious framework but also within non-religious frameworks. It is true that rituals are most common in religious communities and cultures. If the individual or community does not perform the ritual, a feeling of guilt may arise towards the deity offered by or in that ritual.

What does a ritual consist of?

The parts that a ritual can consist of are: posture, gestures, dance, singing, eating, drinking, offering, tattooing, painting, wearing one or more objects, dressing up, praying, meditation, lighting a candle, etc. What is very
important is part of a ritual is the established habit. A fixed habit can create the need to no longer be able to do without it. However, a fixed habit can also have the symptoms of obsessive-compulsive disorder . Expressing a wish plays an important role in a ritual. Satisfying a need.
Burning love letters from a ended relationship is also a ritual.

Rituals are indispensable

Rituals are very important. The familiar nature of the ritual is important, both for an individual person, who feels comfortable with it, and for a society, in which the (shared) rituals are a bond between people. A ritual provides a certain discharge and expression of emotions. Various meditation techniques show that this largely removes stress. Stress which in turn is a factor in developing an addiction.

What is addiction

The DSM-IV (Diagnostic and Statistical manual of mental disorders) distinguishes three classifications of substance use:

  • Abuse of the drug
  • Harmful use of the substance
  • Dependence or addiction on the substance

Diagnosis and treatment

The DSM does not speak of addiction, but of substance dependence. Despite this, one can still make a diagnosis based on the various criteria that corresponds to the term addiction. According to the DSM, a diagnosis of substance dependence is made when three or more of the following symptoms occur simultaneously within 12 months:

  • Tolerance occurs, which means that more and more of the addictive substance is needed to achieve the desired effect or that less and less effect occurs when using the same amount of the addictive substance
  • Withdrawal symptoms occur specific to that drug, or similar drugs are taken to cope with the withdrawal symptoms.
  • The drug is taken in increasingly larger quantities, over a longer period of time than was actually intended
  • There is the urge to stop taking the drug, several (unsuccessful) attempts have been made to stop or reduce
  • A lot of time is spent obtaining the drug and/or using the drug
  • Important social, work and/or leisure activities are given up or reduced due to substance use
  • Even though the person knows that the drug being taken is causing or worsening physical or psychological conditions, he or she continues to use it.

Distinction between physical and mental dependence

The DSM-IV also makes a distinction between whether the substance causes physical dependence or not. As we can see, there is no need for tolerance and withdrawal symptoms to occur. The point is that there must be at least three criteria to speak of an addiction or dependence. This is certainly the case with an addiction to actions. It is notable that the DSM-IV does not include habitual addictions. The DSM believes that a substance is always needed to create a dependency or addiction.

Neurological research for addiction treatment

There are therefore two types of addictions:

  • An addiction where one is dependent through the intake of a substance, such as smoking or alcohol.
  • An addiction on which one is dependent through habit or action, for example gambling or sex addiction.

However, both addictions have in common that the action or intake affects our reward system in our brain. We should note that the brain influences our actions and vice versa. Our behavior affects the brain.


The senses also play a major role in brain functioning and behavior. With an addiction, the senses are very sensitive to making connections. Someone who is addicted to alcohol may associate the smell of alcohol with drinking and the pleasant feeling. Even if the person was drunk the night before and felt ‘sick’ all day, experiencing the ritual can compel them to start drinking again. In other situations, hearing certain sounds associated with addictive behavior can lead to using. The senses in addicted people are super sensitive and have an ‘antenna’ for all matters related to behavior. The longer someone is addicted, the harder it is to quit the behavior.

Context and system of someone who has an addiction

When someone is treated for an addiction, it is beneficial not only to receive treatment as an individual. But the entire network, family, friends, etc. must also be involved. This is important because in this way the ‘ritual’ can be refuted more constructively. The network has often unconsciously become part of the ritual. This is often skipped and there is a fear of radically changing things. Sometimes relationships have to be broken. In more extreme cases, those around the addict must also undergo treatment because patterns can be very deeply ingrained.