Addiction is generally defined as a chronic, brain disease where an individual is physically and psychologically reliant on an agent or behavior—whether it be alcohol, narcotics or gambling.
Yet, even with such a refined definition, there is still much disagreement and a lack of consensus about what constitutes an addiction and how, why, when and to whom it occurs.
Perhaps, part of the problem for experts and professionals is an emphasis on the substance and behavior. There is a focus on the agent or behavior—the alcohol, narcotics, and gambling—which plays only a partial role in the onset and longevity of an addiction.
We tend to isolate and analyze the substance and/or behavior rigorously.
For example, in examining alcohol use disorder, we examine alcohol’s organic effects on a microscopic and cellular level. We investigate its impact on the brain and other bodily systems. We measure its effects on perception, co-ordination and memory which are consequently expressed in ways such as blood alcohol content.
The disorder is focused around the alcohol and how it affects the being on a physiological level. We become alcohol specialists—instead of broadening our thinking in transforming and empowering people to overcome addiction’s grip.
We are a society of specialists—particularly in the West.
Emile Durkheim—an early sociologist—coined the term “organic solidarity” to describe a phenomenon that characterized modern societies. Organic solidarity referred to the interdependence of people on one another and the specialization of work. We see that in several disciplines from healthcare and psychology to dance and music.
One instance is the care of patients in a hospital. You may have a team of doctors who work in different specialties and depend on each other’s knowledge to nurse and heal the patient. You may have a cardiologist, neurologist and radiologist working together—all with their own specialized knowledge and unique perspective.
Specializing is practical in that it allows for the accumulation of in-depth knowledge, skill and experience.
Conversely, specialization has the potential to keep us fixated on a particular framework. In the case of the doctors, each doctor plays his/her individual role to contribute towards overall patient health, without having to tend to the entire person or tend to other problems that lie in the domain of another specialist.
One doctor with one framework may not heal a patient with a complex problem—or heal them well.
In the field of addictions, there is a specialization and focus on the drug or behavior when trying to uncover the etiology of addiction, which results in a failure to survey and see the whole person.
By focusing on the ingested agent or repeated behavior, we are thinking small and are limiting our knowledge of addiction and knowledge of the entire being.
I propose we turn to the humanistic paradigm in psychology—more specifically the Rogerian tradition—by stressing the importance of the whole being.
This approach would constitute a significant step towards not only understanding how addiction is incorporated and situated in the context of the entire being, but also understanding how personal history, experience and trauma lead to addiction.
Carl Rogers—a twentieth century psychologist and therapist—championed the person centered approach that focuses on individual roles, personal agency and a subjective framework in nurturing human growth.
Rogers postulated that people are motivated and strive to achieve their full potential in life. People have a desire to reach a state of self-actualization. People want fulfillment in their lives. Thus, instead of deploying a more objective approach to addiction, which focuses on how the substance changes the person physiologically and hinders his or her ability to function as a social member, Rogers takes a more subject approach.
As observers, the reality is objective: people are addicted to the substance and it is causing great harm in their lives. However, employing Roger’s idea of subjectivity, the true reality emanates from those labelled by society as addicts. Their perception of reality is what should be emphasized.
Thus, from this perspective, why are some people addicted to specific substances or behaviors? Why don’t they stop? Typical answers might include looking at genetic makeup, family history, peer pressure, availability of drugs and alcohol and lack of laws.
Yet, to achieve a better understanding of addiction, we must look at the whole person which means looking at what makes us really human—from a humanistic perspective. These characteristics may be abstract, but they are a litmus test of how we are living and why we are living.
According to Rogers, they include self-esteem, self-image, self-concept—how we essentially view ourselves—feelings, emotions and motivations.
Truly analyzing an addiction problem is not simply about identifying and isolating the substance or behavior, but instead about deeply examining the interconnectedness of one’s own self-image within a complex web of personal, sociohistorical realities.
Although Roger’s theory was a reaction to the psychodynamic paradigm, I think that Roger’s approach can lead to gaining insight—borrowing from Freud’s psychoanalytical theory— and making “conscious” the “unconscious,” hidden, internal, mesh of intricate dramas, traumas, triumphs, joys, failures and experiences.
How can we help those in the grip of addiction bring their sociohistorical realities to consciousness? According to Rogers, if we want to really pursue healing (and sobriety in the case of addictions), self-worth must be built within an environment of unconditional positive regard—a term used by Rogers to refer to complete acceptance by others without judgment.
Not only do people have to feel accepted, but they have to be able to participate in open dialogue. It must be an open dialogue based on trust and sympathy. Only then, can the potential to spark the process of healing, recovery and personal growth be realized.
If dialogue and understanding is based on deception, then there is no true healing and no true acceptance by either party. By confining our understanding of addiction to physiological and cellular roots, we rob people of the opportunity to truly heal. Our understanding has to incorporate an understanding of people’s self-image and how their lived realities have gotten them to the point of addiction. If not, then we are deceiving ourselves as experts and professionals.