I guess I will chime in here. I work with people who are trying to overcome addictions (alchoholics, smoking, cutting, sex addicts, eating disorders, obsessive compulsives, and a host of other stuff). I don't really think you can understand the extent of addiction until you see someone be completely destroyed by it.
To most psychologists classify an addiction as being a destructive activity or behavior repeated over time that severely restricts the individuals agency. It may not be entirely true to say thay an addict has no choice, but for most part this is the case.
When treating an addiction, I have never seen a therapist tell an addict to just stop the addictive behavior. It just doesn't work that way for a real addiction.
Every therapist I have worked with attacks an addiction by focusing on underlying problems that have led to the addiction. Mostly this means focusing on thoughts and feelings that have led to the addiction. Oftens it means resolving other issues that face the client that he or she may or may not having any control over.
To tie into the other thread a little, I will use sex addiction as an example. Sex addiction is a rapidly growing problem throughout the world, but largely in North America and Europe. It is characterized by using sexual activity to numb oneself to everyday problems. Often sex addicts face health risks and physical abuse. Most prostitutes, porn stars, and sex offenders are considered to be sex addicts by the mental health profession.
Now treating sexual addictions has several problems. The first being that sex addicts just can't leave behind sex forever. Sex is suppose to be part of a healthy adult life, however it can also be easily misused. So the treatment involves the client learning to have healthy relationships. This can be very challenging in that many of the individuals have never had a healthy relationship. The vast majority of these people were abused as children, which is how they learned to have unhealthy relationships.
The initial steps are almost identical to the steps taken in the recovery of other addictions. That is, the understanding and control of one's own thoughts and feelings. Addicts have something that they misunderstand about themselves or the world around them that is causing them to engage in hurtful behavior. So it is the job of the therapist to help the client see things as they really are, or at least how they could be.
So it comes done to taking control of one thoughts and feelings, then taking actions to reverse the hurtful behavior. Some manage to do this and some do not. The deeper involved the individual is in their addiction, the harder it is to help them and for them to help themself. When you hear a a cutting addict talk about how it's perfectly harmless and normal to slash open one's wrist and that everyone should try it, then you kind of understand how bad it gets.
Unfortunately, the mental health system in developed countries are swamped. And many addicts won't seek help or even see that they have a problem, and often surround themselves with similar people who encourage their negative behavior.
