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Book Review – “Can’t. Just. Stop. An Investigation of Compulsions”

I had such a good time reading Sharon Begley’s new book, Can’t. Just. Stop. An Investigation of Compulsions (Simon & Schuster, 2017), that I was sorry when it ended. For a serious science writer, Begley can be surprisingly funny, which is rather fortunate when dealing with the painful topic of why we simply can’t stop doing things that we hate doing and hate ourselves for doing. Like mindless, emotional, compulsive, binge or over-eating, for example.
If you’re looking for easy answers on how to stop compulsions or addictions, you won’t find them in this book. However, if you’re looking for a greater understanding of why you’re driven to do whatever it is you do (while not wanting to do it), you’ll learn a lot. First off, Begley describes the difference between compulsions and addictions, which are often used interchangeably though they do not mean the same thing. Throw in the term “poor impulse control” and things get really confusing.
Begley straightens us out. In addictions, we crave the pleasure we experience, especially initially. We get a buzz, a high, a rush—until we don’t. Then, yearning for that initial kick, we relentlessly keep seeking it via greater and greater levels of whatever brought it on in the first place. Plus, as any ex-smoker or drinker knows, giving up addictions causes serious emotional distress. Hence, “the Big Three of Addiction” are “pleasure, tolerance and withdrawal.” (page 21)
“Impulsive behaviors involve acting without planning or even thought, driven by pleasure seeking and an urge for immediate gratification…As a result, impulsivity can be the first step toward a behavioral or substance addiction.” Alternately, compulsive behaviors “are all about avoiding unpleasant outcomes. They are born in anxiety and remain strangers to joy. They are repetitive behaviors we engage in over and over and over again to alleviate the angst brought on by the possibility of negative consequences.” (pages 21-22) Like bingeing or licking candy wrappers plucked out of the garbage can.
So, in terms of eating, what’s going on for you? When you reach for that slice of cheesecake, is it because you’re being impulsive and haven’t considered how eating it will drive up your blood sugar? Are you carving yourself a slice in anticipation of how good you’re going to feel while eating it, which would lead us to think about the process as being addictive? Or do you eat it because it’s the last piece on the plate and the thought of not eating it makes you cringe with horror, qualifying it as a compulsion?
Words matter. You want to be careful about telling yourself that you’re addicted to a food when you’re really in the throes of compulsion. With compulsions, you already don’t want to be doing what you’re doing (running out to the 24-hour market in the middle of the night for a pint of Ben and Jerry’s). All you need to do is to tolerate the anxiety of not doing the hated (but also desired) behavior, and you can kick the compulsion. Although this is not a book specifically about how to end compulsions, it universalizes them, lays them out in a light more humane than pathological, and will help you understand what drives your behaviors, perhaps enough to enable you to Just. Stop.
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