In my last blog, I talked about the “Biological” or disease model for understanding how addictions develop. In today’s blog, I want to discuss the “Psychological” model for understanding the development and maintenance of addictions. In discussing this, it’s important to keep in mind that there are many psychological theories for explaining human behaviour. I’ll probably end up summarizing some of these different theories in other blogs. For today, though, my goal is to discuss addiction from the perspectives of psychodynamic and object-relations theories of human behaviour.
According to psychodynamic and object-relations theories, people tend to use alcohol and drugs as a way of coping with traumatic experiences or negative relationships, many of which originated in childhood and adolescence. In fact, it has been psychological research on our early life experiences (lifespan development) from which the term self-medication hypothesis originated. So, what are people trying to self-medicate?
1) The expression of emotions. Some people cannot connect the feelings that they are experiencing with the traumatic stories behind them. Therefore, they turn to alcohol and drugs in order to block the need to express their emotions.
2) Difficulty in self-care. Many people are drug dependent because they are unable to soothe or calm themselves appropriately.
3) Low self-esteem. Many individuals have low self-worth and low self-esteem. Alcohol and drug use hides this reality from the user.
4) Troubled relationships. Many users have difficulty forming healthy relationships. This theory says that if someone is dependent on a drug, they are re-creating the dependency relationship between the primary caregiver and child. It suggests that the drug (or behaviour) the person is addicted to comes to represent a relationship that the individual is trying to heal from, resolve, or replicate.
In my next blog, I’ll discuss the “Social” portion of the bio-psycho-social-spiritual approach to understanding addictions.
Dr. Richard Amaral
www.TorontoPsychotherapyCentre.com
Note: One of the texts that has been helpful in my reflections, writings, and work in this field comes from Robert Margolis’ and Joan Zweben’s book, “Treating Patients with Alcohol and Other Drug Problems: An Integrated Approach” (1998).