October 26th, 2022
This post will serve as the second of two blog posts about six different models of addiction: moral, spiritual, disease, psychodynamic, social learning, and biopsychosocial. Last week, we discussed the moral, spiritual, and disease models of addiction, so let’s take a look at the other three this week.
Remember: many of these models have different names. For example, the social learning model is sometimes referred to as the environmental model, and the biopsychosocial model is sometimes referred to as the heterogeneity model. Let’s begin with the psychodynamic model.
The psychodynamic model of addiction views substance use through a psychodynamic lens whereby past experiences, thoughts, and circumstances are believed to shape a person’s present behaviors. This particular model is especially helpful when working with clients with a severe or extensive history of traumatic events.
The most practical application of this model of addiction has to do with the strong positive correlation between adverse childhood experiences (ACEs) and substance-related behaviors. As the number of ACEs increases, individuals are shown to have:
The effects of ACEs on future substance-related problems are substantial. For example, for every additional ACE score, there is a correlated 62% increase in the rate of the number of prescription drugs used. Furthermore, a two- to four-fold increase in the likelihood of early initiation into illicit drug use is observed each time an ACE of childhood abuse, neglect, or household dysfunction is introduced.
Psychodynamic therapy—whereby a clinician helps an individual process and heal from their pain, become more aware of their unconscious thoughts, and analyze deep feelings about their past experiences—can be incredibly beneficial when working with a person with a history of trauma. Many people who use substances do so to cope with uncomfortable memories of past traumatic events, so it is critical to help these individuals develop alternative, more adaptive coping mechanisms to utilize when they are in need of support.
Social learning is the most common way that people learn. It refers to the process of observing and imitating others, thereby resulting in the acquisition of new behaviors.
The social learning model, therefore, describes addiction as resulting from “differential reinforcement from other individuals, from the environment, from thoughts and feelings, and from the direct consequences of drug or alcohol use.”
Below are some examples of how substance use may be socially learned by an individual:
Generally speaking, as the addiction progresses, the addicted individual will decreasingly interact with individuals who do not use substances, and increasingly interact with those who do. At this point, it is not uncommon for close friends or family members to distance themselves from the individual struggling with their substance use until eventually, the individual’s entire social network consists of other people who use and/or are addicted to substances.
If you’ve ever received substance use services, or if you’ve ever worked in a treatment setting, you are likely well aware of the emphasis that is placed on forming new relationships with new people who do not use substances. For many, this is the biggest benefit of mutual support groups such as Alcoholics Anonymous. In fact, AA considers itself to be “a fellowship, a community of like-minded sufferers who have found a way out of a hopeless condition.” The first step for many on the road to recovery is terminating old, maladaptive relationships, and replacing them with new, more adaptive ones.
For what it’s worth, the biopsychosocial model is my preferred theoretical framework to approach the issue of addiction from. It incorporates elements from many different models of addiction to take a more holistic view of substance use and addiction. While this model does emphasize some universal aspects of addiction—such as the reward system of the brain being activated by substances—it also acknowledges the many idiosyncrasies and intricacies of addiction.
This model posits that a combination of biological, psychological, and social factors all interact to result in an individual becoming addicted to one or multiple substances. Counselors and therapists should, therefore, explore any family history of addiction (biological/genetic component), past experiences that may have made an individual more susceptible to developing an addiction (psychological component), and the social context in which that addiction developed and progressed (social component).
My hope is that, through reading this blog series, you have gained a deeper understanding of some of the many theoretical models of addiction, and how different factors may contribute to the development of addiction in individuals. The mere fact that there are so many potential explanations for how addiction does (and does not) develop should tell you that addiction and recovery are intensely personal processes for the individual struggling with it.
Our role as counselors is to meet the individual where they are, treat them as unique individuals with unique goals, listen to them and their goals, and help them achieve those goals by eliciting the motivation to change that already lies within them.
Written by: Ryan Watters, LSW, CADC.
At Clarity Clinic, we have highly trained staff who specialize in therapy and psychiatry services. To learn more about how we can support your mental health, call Clarity Clinic at (312) 815-9660 or schedule an appointment today.
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