FAQ: Can you talk about the definition of addiction. Is any behavior that we lose control over considered an addiction, in your mind? Or have we gone "addiction crazy" in the last few years, tagging all vices as addictive?

Gaetane: We have gone a little addiction crazy. We use the term very sloppily and inaccurately. One of the most common definitions used in the addiction field is the following; It usually has 3 components to it:

1 - it's a biological disorder (a disease)  with a genetic basis.

2 - its hallmark is progressive use in the face of adverse consequence (effects on school or work, health, finance, legal, & relationships).

3 - there is also a component of denial.

FAQ: Is addiction a result of an unresolved issue or fear? How do your emotions play a part in addictions?

Gaetane: Addiction is a biological switch having been thrown in the deep regions of the brain. For the most part emotional disregulation is why people  turn to alcohol, drugs, or addictive behaviors in the first place: Difficulty regulating feelings, trying to feel better, seeking solutions to emotional states, and inadvertently throwing that switch.

FAQ: What are symptoms of a sexual addiction?

Gaetane:  Sexual Addiction is a model of any other addiction. You need to see a family history of alcoholism or addiction. And again, the hallmark will be ongoing sexual acting out in the face of adverse consequence. And denial will often be present.

FAQ: Can a person with alcohol addiction pass the gene to their offspring to be an alcoholic or will the offspring have a addiction to something else such as sex, drugs etc.?

Gaetane: The same gene or genes are responsible for all forms of addiction. Regardless of your manifestation of the addiction gene, you will have about a 50% probability of passing that on to your children. But remember, genes are not destiny, and what you are passing is the predisposition.

FAQ: Is there any way to be tested for these genes?

Gaetane: Not yet. I expect there will be within 10 years.

FAQ: My ex is worried I am overdoing my sex stuff, from cyber to masturbation to sex with others. I tell her it's my life. What is normal or not? Who is right/wrong?

Gaetane: I think to apply terms like right or wrong will only serve to confuse these matters. Clearly there is a problem when behaviors progress in the face of consequences. When a normal person has an adverse affect from a behavior they will curtail the behavior. An addict will not. If you are able to have stable relationships, you are not putting your health in harm's way, or creating financial or legal liabilities, then you are probably in the normal range.

There is, of course, the more subtle issue of being able to be empathic with the people with whom you are having these flings. And if you are not, and you are being exploitative, that is another reason to look at things.

FAQ: I know that it's not as big as being addicted to alcohol or drugs, but I am unable to stop overeating and I don't know where to turn. My mom is overweight, actually almost everyone in my family is struggling with weight issues. My doctor thinks Weight Watchers is the answer, but as I try, I fail and am nearing 300 pounds (at 5'3''). The problem is binge eating. Is there somewhere else I can turn?

Gaetane: This is an amazingly common problem. Food can be an addiction and is poorly addressed by our culture. Our culture would have you believe that you merely haven't found the right diet, when the reality is this may be a food addiction. Think about it: One, there is an obvious manifestation of an extraordinary biological disorder with a genetic basis. Two: you are unable to stop in the face of adverse consequence.

FAQ: I have smoked pot for a number of years as an anti-stressor. Currently I'm feeling depressed. I am very tired and in a lot of discomfort? I am getting older, so I want to quit the smoke altogether.

Gaetane: You no longer use marijuana as a stress reducer. You are an addict and this addiction will not stop without treatment. I would suggest you look into Marijuana Anonymous. You need careful supervision when you stop this drug. There is an extraordinarily high incident of suicide in the first six months of marijuana abstinence.

The syndrome of marijuana addiction is always the same: A profound euphoria is experienced, usually after the second or third exposure to it, and from that moment on the addict pursues, preoccupies, or uses that drug every day. Somewhere down the line, exactly what you are experiencing develops; the addict gets depressed, has trouble sleeping and being motivated. Of course, the addict's response is to smoke more or better pot to deal with "the stress," which only accelerates the decline into depression.

FAQ: What's your take on online support for addicts ?

Gaetane: Any form of support is useful for people with compulsive or addictive behaviors. Twelve-step models definitely work. Whether the support is merely to help with the feelings of having to contend with this condition or in an attempt to intervene therapeutically, it is helpful, but it is never a substitute for face-to-face interaction.

FAQ: My husband had an addiction to painkillers. He stopped taking them about seven months ago without any treatment. Does an addict need treatment or can he actually conquer the addiction on his own? This addiction was enough for him to lose everything.

Gaetane: I have never seen somebody with advanced forms of addiction successfully stay stopped without treatment. There is something referred to as "natural recovery," which basically is the spontaneous remission of addictive behaviors. I am of the opinion that this only occurs in earlier, less-progressed manifestation of the disease, and I believe most of these people will return to substances eventually.

FAQ: How do you support a sister addicted to drugs that lives 2,400 miles away, and only calls when she needs something?

Gaetane: You go to Al-Anon. Your participation in a co-dependency 12-step process with a sponsor will have a positive affect on her disease. Try it and you will be amazed.

FAQ: Are there such things as positive addictions? Can people become addicted to things that are actually good for them?

Gaetane: I get that question all the time, and so far I haven't found one. I guess the closest thing would be a selfless workaholism, but remember this is a disease defined by the consequences, and consequences mean negative results. Therefore, even a positive behavior would have to have escalated to the point that it becomes destructive in order to be considered an addiction.

FAQ: What if you are addicted to something such as self-injury?

Gaetane: Cutting can become part of an addictive syndrome. It does activate thrill mechanisms and cause a powerful surge of central nervous system endorphins. But it is not the initial manifestation of an addiction. It can be a compulsion, and it is a sign of very serious psychiatric disturbances, but if it becomes an addictive behavior there almost always was first an addiction to a pharmacological agent.

FAQ: What about recidivism from people who are children of alcoholics and who had a flirt with 15 years of cocaine abuse, but haven't used it in 12 years after a rehab program? Do they revert when put into stressful situations? What causes them to lose it? Can they become "normal,"" conventional folks?

Gaetane: Once the switch has been thrown on this disease, it is forever active. It is a chronic disease marked by relapse. Unless they remain connected to a treatment process chronically, they are at risk for future relapse. Whether triggered by life stressors or the result of re-exposure to an addictive chemical, there is once again a need for treatment.