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Updated January 24, 2025
Addiction is a complex disease that impacts all aspects of your life. It affects you physically, emotionally, spiritually and psychologically, causing you to change how you think, feel and act.
When you’re struggling with addiction to a particular substance like heroin, alcohol, opiates, or a combination of different drugs, chances are good that your addiction likely seemed to be safe and nondestructive at first. After all, those few drinks after work or that extra dose of hydromorphone may have given you the relief you needed after a stressful day at the office or helped you deal with yet another conflict with your kids or spouse.
It’s only over time that your behavior changed to the point where your pursuit of alcohol and drugs started to feel uncomfortable for you, leaving you with a sense of guilt, failure, and anxiety. You knew that the amount of energy, time and money you were pouring into the pursuit of your next “fix” was having a negative impact on your life, yet you found yourself unable to change your behavior on your own.
This shift from engaging in behaviors that fit with your personal values, beliefs, and goals towards acting in a way that felt uncomfortable and conflicted with how you saw yourself is a common experience among people who struggle with addictions. In psychological terms, this shift is referred to as moving from eco-syntonic behaviors to ego-dystonic behaviors.
What Are Ego-Syntonic Behaviors?
In psychotherapy, the term “ego” refers to one’s self, namely, the part of a person’s mind that serves as a virtual bridge between conscious and unconscious thoughts. It’s a sort of invisible safety mechanism that helps people control their behavior in a way consistent with what they believe in, their personal value system and their future goals and ambitions.
It’s the ego that helps people resist the urge to engage in behaviors that could be in conflict with how a person thinks or feels. This internal control is what helps you “do the right thing,” especially in situations where it can be tempting to take actions that go against your personal values. Some refer to the ego as the internal voice of reason — it’s what helps motivate you to ensure your behavior is congruent with how you see yourself.
Ego-syntonic behaviors are behaviors that are aligned with your values and self-image. If you’re a dedicated athlete, working out daily could be considered an ego-syntonic behavior because it aligns with your goals and how you perceive yourself.
What are Ego-Dystonic Behaviors?
While ego-syntonic behaviors are actions that align with your personal goals, values, and beliefs, as you might expect, ego-dystonic behaviors are actions that are inconsistent with your ego. These behaviors tend to gradually develop over time, and it can take days, weeks or even years to shift your actions from being congruent with your ego to being largely in conflict with how you see yourself.
On the extreme end of the spectrum, a person who is suffering from obsessive-compulsive disorder (OCD) engages in a number of behaviors that are ego-dystonic — they feel powerless to control actions they know are unhealthy and interfering with their life.
With regards to substance abuse, ego-dystonic behaviors can include stealing money to buy drugs, lying to a physician in order to get a prescription for painkillers and engaging in actions that simply don’t fit with your values and beliefs.
The Cycle of Ego-Dystonic Behavior in Addiction
Not only do ego-dystonic behaviors feel uncomfortable, but the guilt and shame associated with acting in ways that conflict with your ego tends to create a vicious cycle of addictive behaviors. You start engaging in ego-dystonic behaviors in order to enjoy the satisfaction, relief, and gratification you get from “scratching your itch.” But shortly afterward, you’re overcome with a sense of failure and internal conflict.
To relieve those negative feelings, you once again engage in behaviors that are ego-dystonic to find relief from the intense tension you are experiencing, and in the process, the addiction cycle continues.
Treatment can begin quickly and discreetly, get started now One of the things that are exceptionally difficult for people to understand about addictions is how a person can change from being an upstanding father, mother, professional, student or sibling to becoming an addict. After all, no child ever dreams of becoming addicted when they grow up—addiction isn’t something that anyone strives for, desires or wants to be impacted by. Unfortunately, addiction is an exceptionally complex and persistent disease that can impact even those with the strongest, most well-defined egos. A person who is addicted doesn’t suddenly shift their behaviors from being largely ego-syntonic to being mostly ego-dystonic — this is a change that happens over time. With regard to substance abuse, many addicts start out using in a way that is socially acceptable and completely consistent with their ego. A person who is addicted to alcohol may start drinking in a social setting to connect with prospective clients, maintain friendships or enjoy a relaxing evening with their spouse. The act of drinking alcohol initially gives them a feeling of gratification or pleasure without causing any negative impacts in any other areas of their life. Over time, simply drinking on an occasional basis may no longer give them the same gratification or pleasure that it once did; they find they need to drink more often and in larger quantities to achieve the same feelings. Their ego tells them they shouldn’t drink more, but as the addiction takes hold and the urge to engage in ego-dystonic behaviors becomes difficult to suppress, they ignore the internal messages from their ego. It’s this experience that leads to ego-dystonic behaviors taking over, and eventually, the conflict created leads the addict to seek treatment. Psychiatric professionals frequently refer to egodystonic and egosyntonic behaviors in the context of addiction. (Again, many people with substance use disorders shift from behaving in ways that align with or represent their values to behaviors that are at odds with their values.) Some classic egodystonic behaviors associated with drug and alcohol addiction include: Egodystonic behaviors can have a disastrous impact on family and friends. Although the individual is aware that their behaviors no longer align with their morals and values, they continue to feel compelled to use drugs and engage in the behaviors that feed their drug abuse. As the substance abuse continues, the individual loses track of their egosyntonic impulses and forgets their former identity. Eventually, they may no longer experience guilt over their egodystonic behaviors like stealing or trading sex for drugs. The terms egosyntonic and egodystonic refer to the teachings of Freud. Many psychiatric professionals have abandoned these terms in favor of other paradigms in order to help clients achieve recovery from substance use disorders or to manage other mental health and behavioral health conditions like OCD and eating disorders. For example, one of the key problems with using the egosyntonic/egodystonic paradigm is that many people see nothing wrong with behaviors that would typically be regarded as egodystonic. For instance, not all clients view lying about their drug use as intrinsically bad or at odds with their self-perceptions. While these terms can continue to enhance the way many practitioners treat clients, the behavioral health profession now has a wide range of therapeutic paradigms it can use to support the recovery process. Treatments like cognitive behavioral therapy, for instance, have become more central in the treatment of substance abuse and addiction, as well as other mental health conditions.Need Help?
How Do Ego-Syntonic Behaviors Shift Towards Ego-Dystonic Behaviors?
Egodystonic vs. Egosyntonic and Substance Use Disorders
Treating Substance Use Disorders with Reference to Egosyntonic and Egodystonic Behaviors
About Chris Foy
