Smoking and other addictions
(cannabis, tea, coffee, chocolate, chewing gum)

  • It is my thesis that, contrary to popular belief, smoking is also a psychological symptom, akin to bulimia.
  • This page will show the mechanisms involved.
  • If you are ready to do some work on yourself, you can be cured.
  • Sometimes there is a very quick change but usually you need 6-9 months if you are a heavy and longstanding smoker.
  • During this Covid pandemic we work mostly by teleconsultations. But if you are in Paris you can come and see me in my office.
  • I used to hold clinics in Goa in India during certain months. But the situation for travel is uncertain for the next few months.
  • Wherever you are in the world, we can make an appointment taking into account the time difference.
  • My fees are not so expensive. My normal rate is 100€ per session.
  • I reserve some time for my Indian patients. My fee for them is 4000 Rupees per session.
  • The first consultation is free.
  • Read on, or book mark this page and come back another time, when you have more time.
  • You will need about 30 minutes to read this page slowly.
[Click on each section for more information.]

Smoking has a similar mechanism at origin to bulimia. The difference is that the substance involved is pharmacologically active and so adds a complication. Nicotine gives its own chemical relief and relaxation. Food relieves by an indirect effect, acting on the stretch receptors of the stomach and the secondary secretion of many hormones and neurotransmitters responsible for the sensation of satiety. Nicotine acts directly on the brain. But the strength and physical effect of nicotine makes us forget that the need for the substance is triggered by a psychological cause.

The craving of nicotine and psychology.

The craving for food of a bulimic is every bit as imperious as the smoker’s need for a cigarette.This simple fact is worth remembering. So the craving for nicotine in a smoker is not simply due to its chemical properties. There is an initial psychological need.In bulimia most people see the psychological nature of the problem and don’t blame the food for the craving. In smoking, we are so blinded by the chemical nature of the substance involved that we think it is the nicotine that is the cause of the problem. It is not! Once again it is this psychological collapse that starts the craving for the cigarette. “I don’t care! I need a cigarette!”

This comes on and off due to the psychological state of the subject, not the nicotine level in the blood. Few people smoke their first cigarette early in the morning, when the level of nicotine might be the lowest. It is not nicotine withdrawal that produces the craving for a cigarette, but when put under some stress, when the subject has to generate the words to face the world around him, he breaks down, gives in, needs his cigarette, hopes for some help from the cigarette for his psychological incompleteness. So chronologically, the chemical craving is triggered by an initial psychological process, and then the craving becomes overwhelming. The strength and physical nature of this craving makes us forget that it is triggered by a psychological cause, a psychological weakness, a psychological inability to generate the necessary words.

In medicine, there are many such examples of psychological causes producing somatic symptoms: migraine, eczema, asthma, irritable bowel syndrome, menstrual and sexual dysfunction…In all these somatic conditions there is often a psychological cause. It is our working hypothesis that the very physical craving for tobacco is triggered by a similar psychological process. Exactly as in the other psychosomatic conditions mentioned above, and as in our friend, bulimia. So our thesis is that if we cure the initial psychological cause, we will heal the physical need for nicotine. The many cases of smoking cessation demonstrate this.

A psychological dependence, not a physical dependence.

So there is first of all a psychological weakness that triggers the nicotine craving (just as there is in the craving for food in bulimia). It is this psychological breakdown that has to be conquered on its own. And when it is, those who stop smoking do not feel any serious side effects of nicotine withdrawal (about 5% of smokers every year stop smoking successfully and 85 to 90 % report no withdrawal symptoms). In a day or two they have no craving for nicotine. The most significant side effect of withdrawal is a little constipation. So it is not a physical dependence on nicotine that is at the root of tobacco addiction, but, as in overeating, an initial psychological deficit: an inner incompleteness, an inner unsatisfaction. And if the smoker can close the psychological deficit that opens up inside him that makes him crave for his cigarette, he does not need nicotine, he does not feel any craving. He has successfully made a psychological shift inside himself that frees him from this dependence.

Yes, you can stop smoking in 2020!

Every year some 5% of smokers give up smoking spontaneously. Most do so after a second or third attempt. They do so because they have slowly done some work on themselves; they have changed inside, away from a dependent, “asking” position, to a new, more self-reliant position. And the fact that the change is often sudden, implies that there is a switch in the psychological software, which changes the positioning of the subject. We will discuss below our explanation of this.

Not medication, will power or coaching, but a psychological work.

What is sure is that to give up smoking, the person has to make a change inside himself or herself and if he is willing to do this work, he will be able to stop, without will power or the craving of nicotine. If he does not, he will be like the 95% who try but fail to give up the habit every year. Psychotherapy greatly increases the chances of a successful outcome. Because it treats the cause of the habit: the psychological incompleteness, the psychological “giving in”. Unless this is cured it will continue to trigger the craving. Just like the need for food in the bulimic. And once triggered the craving is irresistible and only satisfied by the nicotine.

A hankering for a pacifier in the mouth against separation anxiety.

At the root of these two phenomena, of bulimia and smoking, there is something we can all understand. At the age of 4 or 5 years, after a long period of attachment to the mother, the child slowly gives up his pacifier, stops sucking his thumb and can sleep without his security blanket. Slowly, he becomes more and more independent of his mother's presence. From this age, he develops the ability to generate the words necessary to cope with his own little life and loneliness. But this software is fragile and when the child is in a difficult situation, for example if he is lost, or hurt or frightened, he starts to cry, asks for his mother and still needs his pacifier in his mouth, to calm his trembling body. In our opinion, this hankering for something in the mouth in moments of anxiety, reminiscent of a pacifier and the presence of the mother, is at stake in these oral addictions of bulimia and smoking. The anxiety of separation, firstly from the mother and then any other separation anxiety, can provoke in us this very primitive reflex to want something in the mouth to relieve us.

The psychological mechanism at play in smoking: our hypothesis.

Later, if a child is abruptly separated, without adequate explanation, from other important attachments: other parents, home, school, objects, friends, animals, they also leave a trace, an injury, a hole in the psyche. We all carry in us many disturbances of this kind. If it is not well understood and repaired with words, an incident like this leaves the subject with a lack of words around certain subjects, with a tension, an anguish in his voice and his chest. These wounds are in the same place in our psychological software as the first separation from mother. And for this reason they also have a relationship with the mouth and sucking.

The mild, intoxicating relief provided by nicotine.

So, if our psychological software is damaged in this way by other separations, or it is overloaded, with a lot of things to do at the same time (stress), we can continue our tasks, but the machine drags, slows down. We find ourselves in some discomfort, with a background anxiety. And we are on the lookout for help, (just like the lost boy or girl, without mom). In this state, the nostalgia for something in the mouth resurfaces. And we look for food, tea, coffee, a cigarette ... to fill us. The mild intoxication of nicotine offers a welcome relief. Like a half glass of wine, the chemical effect of nicotine reduces the accumulated psychological tension, frees the words a little, allows the subject to relax, and relieves the accumulated pain for a few minutes. For the subject (the anxious child in him) this relaxation recalls the soothing presence of the mother. In addition, the act of sucking on a cigarette to receive its contents is reminiscent of sucking at the breast or on a pacifier.

The unconscious painful subjects which cause the need to smoke must be deciphered.

So, in the act of smoking, just as in bulimia, the subject feels a relief by a certain return to the "mother". The smoker's psychological pain, his anguish, produces in him a babyish connection to the mother, a need for the comfort of her presence. And just as a child without his pacifier who starts to become unhappy, the smoker, when pushed, stressed, needs his pacifier, his security blanket, his cigarette, his "mother". This is an image, a way of talking about a more complex phenomenon. But we are talking about something very concrete, that everyone can check for himself: the memory of the love of one's mother is highly comforting. Nicotine brings a welcome chemical relaxation effect, with the secretion of many neurotransmitters like endorphins, opioids and cannabinoids. But this chemical phenomenon follows an initial precipitating psychological need. The real problem is the psychological need or needs that lead the smoker to his cigarette. These causes must be deciphered, resolved, dispersed, for the subject to stop smoking.

There are certain thoughts, incidents, unconscious memories, which are at the origin of the desire to smoke.

So, behind the urge to smoke, there are certain incidents, thoughts, topics that have damaged the subject's unconscious psychological software. This produces a small almost constant anxiety in the subject. He is never completely calm. Most often these incidents or accidents are related (as in bulimia) to his relationship with his mother. The separation may have passed off more or less well. There may be unfulfilled requests, misunderstandings, injuries. But there can also be things that have happened with other people (father, grandmother, brother, sister), or places (moving house, schools) or painful episodes in the subject's life (loss of friends, lovers, objects, beliefs, money ...). The difficulty comes from the fact that the marks of these wounds are mostly unconscious and not available to the subject. They are buried inside him, leaving him with only a hole, without words, just this blind need to smoke. The conscious subject does not know why he smokes. And he is powerless to overcome it because the causes, and even this explanation, are not available to him.

Allen Carr’s method to stop smoking: a critique.

Allen Carr was a hundred cigarettes a day smoker and then one day, at the age of 48, his son told him to stop smoking, and that it was not so difficult to stop. After this conversation, he stopped smoking from one moment to the next: no will power, no craving, no side effects to speak of. He was so surprised by his own experience that he campaigned all his life to help others to stop smoking through books and clinics bearing his name. He thought the secret of his cure was the rational advice of his son: it’s not so hard to stop.

His book (The Easy Way to Stop Smoking) is rather repetitive but his advice boils down to making the decision to stop, that it is not so difficult if you have a positive outlook and realize you aren't losing anything other than a bad habit. And for many people his book and his method seem to work.

Our reading of his method and this experience is that it proves the following three important points:

1. When you are psychologically ready to quit, it is easy to stop.

2. There is no craving, no frustration and the physical side effects are mild and short lived.

3. For those who are not ready, self convincing does not work.

Allen Carr does not address how to be psychologically ready to stop. His method boils down to convincing yourself rationally that smoking is an awful thing …something we all know a hundred times. It is surely not a lack of knowledge of the harmfulness of tobacco that prevents most smokers from stopping. There is surely something deeper inside each smoker that is preventing him from stopping. And those who stop are making a psychological change inside themselves.

In particular he seems not to have understood the real reason for his own cure. His son told him to stop smoking and that it was not so hard to stop. This conversation cured him and he thought it was the rationality of the advice that cured him.

My reading of this encounter is that it was not the rational advice from his son that did the trick. It was the emotional content of the remarks, which could be put in this way: “Dad, you don’t need to smoke. Stop begging something of those stupid cigarettes. Come away from there. It’s not so hard. Talk to me. Here I am”.

In our vocabulary, his son’s words and affection, at the exact psychological place, helped him to detach himself from an internal, asking, begging position, from a babyish attachment to “mother”. A switch was thrown, which allowed him to come into the present, to his son who was waiting for him with intelligent words. He did not need to ask anything of those 100 cigarettes per day anymore. He had a son to talk to.

A psychoanalytical psychotherapy works something along these lines.

Cannabis, tea, coffee, chocolate, chewing gum.

In addictions to these substances, the same mechanisms are at stake. Of course, their consumption is a matter of degree, from the normal, controlled and reasonable, to the unreasonable and uncontrolled. (The factors that allow the subject to resist the temptation to ingest these substances without limit are the second part of the phenomenon of addiction.)

With cannabis, the immediate flow of words produced by the drug gives immediate relief to the subject's psychological pain. So, it is an intoxicant drug, just like alcohol. With cannabis you escape all the anxieties and demands of external and internal life, all the internal and external worries. It's easy to get lost in its effects and want to stay there. To break a real addiction you have to do a real psychotherapy, to alleviate the psychological pain that you are trying to escape, through the delirium produced by the drug.

Tea and coffee are lightly stimulating drinks, less strong than nicotine. Addiction to these substances works just like nicotine and bulimia. As with nicotine, the subject seeks a stimulation against mental slowness. As in bulimia, the subject drinks cup after cup, without being satiated. All this with a background of an inexplicable dissatisfaction at the mouth (think pacifier, think unrepaired losses).

Behind the ceaseless chewing of gum are a few words, a few sentences, that are seeking to express themselves.

Addiction to chocolate and other sweets is a little different from other substances because chocolate has no direct or indirect pharmacological action. Its attraction is its delicious taste. It is an addiction close to bulimia. The demand is to receive delicious things: a lot, a lot of chocolate - of very, very delicious chocolate. It is easy to see here the need for mother's affection, just like a child who asks for sweets. It is fairly easily treatable, by visiting, talking to the mother inside.

Psychotherapy changes the balance of elements in the personality of the subject.

As we have said, the factors that enable the subject to resist the temptation of these substances are the second part of this story. Certain factors (role of the father vis-à-vis the attachment to the mother, other people who replace the mother, sublimating beliefs, discipline, ....) allow the subject to avoid or to repair the injuries that push him towards uncontrolled consumption. These factors and the work of psychotherapy allow you to close the hole at the mouth, to finish the unfinished conversations with mother or other people, and to repair the wounds of other separations with important people or places .... By this work, psychotherapy changes the balance of the elements in the subject's personality and allows him to fill the hole or holes at the origin of the need for cigarettes. Sometimes this process is very rapid, and the subject stops smoking immediately. This indicates that there is a switch in the software, which moves the inner positioning of the subject (the explanation is complex but crudely, there is a shift inside the subject - from the silent and babyish attachment to Mother to conversations with Father. In other words, take the pacifier out of your mouth and speak with your name.)

Smoking and the writing cure. You can work from home.

To really make a psychological change, what is needed is a change in the psychological software. Exhortation, advice, will power, drugs, nicotine patches and electronic cigarettes do not change anything in the psychological structure of the subject. A psychological change can only be effected by a competent therapist who knows where to go and what to change: a few pages, even a few sentences, here and there, said or missing, in the concrete history of your life..

With my writing cure, I can help you stop smoking if you are ready to do some work on yourself for a few months. I have had some cases of very fast cures. Just starting this work can quickly stop the habit. Remember the switch we met!

The addictions to cannabis, tea, coffee, chewing gum and chocolate are also treatable by my method. You do not always need to do a long psychotherapy in my office. After a few sessions, the rest can be done remotely, by email through my writing cure, with consultations in my office or by telphone or video conference from time to time.

Do come and talk to me if you find my ideas convincing and you want to stop smoking or using the other substances mentioned.

If you have quit smoking, by any method, or you have had an interesting experience that reminds you of my ideas, I would be delighted to hear from you:

  • Doctor's office, Paris 13th
  • Consultations over the Internet, by phone, e-mail, or video.
  • Free initial consultation
  • Reimbursed by insurance companies

To make an appointment
Telephone: + 33 1 47 07 55 28
If you are not in Paris, treatment can also be done by telephone, e-mail and video conference (Whatsapp, Zoom, Skype, FaceTime).
65 rue Pascal – 75013 Paris
In the courtyard, between numbers 63 and 65.
Bus 47, 83, 91, 21 or 27
Metro Gobelins line 7 and Glacière line 6.
Enter by the iron gate.

First teleconsultation free. During this pandemic due to Covid-19, all of the appointments in my Doctolib calendar are for teleconsultations, only, not office consultations. The times given in the calendar are for the time zone of France, European Central Time. You can also email me for an appointment. I will confirm your appointment, taking into account the time difference between your city and Paris. I have patients in India and America, with no problems. We will start the teleconsultation by phone. I will come towards you first. We can then continue on Facetime, Whatsapp, Zoom or Skype. This first teleconsultation is free, unless you cancel at the last moment (less than 24h). In that case the consultation will be owed. Doctor Nagpal.