September 21, 2012
Humanistic Perspective and Addiction
There are several theories of addiction. All of them are imperfect. All are partial explanations. It is for this reason that it is important to be aware of and question addiction theories. One contemporary psychoanalytical view of substance abuse is that it is a defense against anxiety (Thombs D 2006). Addicts often abuse alcohol and other substances to guard against anxiety and other painful feelings like shame, guilt, loneliness and depression. Psychological problems including substance abuse disorders are viewed as a result of inhibited ability to make authentic, meaningful, and self directed choices about how to live. The Humanistic Perspective views the human nature as basically good, with a natural potential to maintain healthy, meaningful relationships and to make choices that are in the best interest of self and others. Humanistic and existential psychotherapies use a wide range of approaches to case conceptualization, therapeutic goals, intervention strategies, and research methodologies. Consequently, interventions are aimed at increasingly client self-awareness and self-understanding. Humanistic and existential therapies delve to a much deeper level, to issues related to substance abuse disorders and addiction, often serving as a catalyst for finding alternatives to fill the emptiness that the addict may be feeling. In the 1970s, there was a breakthrough in receiving insurance reimbursement for treatment of addictive disorders-an agreement between Smithers Rehabilitation Program and Blue Cross/Blue Shield of New York designating the 28-day rehab benefit. Addictive behavior was now considered a primary illness, a symptomatic expression of an underlying mental disorder. Axis II disorders were not considered "serious" mental illnesses whose treatment could be underwritten by insurance companies and, later, by managed-care policy makers. Fragmenting symptoms as if they derived from separate illnesses led to a misuse of the concept of so called "dual diagnosis," flying in the face of Jellinek's original ideas and enabling patients to minimize the severity of their core ego deficits by splitting them into disparate and unconnected parts serving their delusions of denial and the maintenance of dependency.
All interested parties are aware that the most frequent outcome of treatment is relapse. Although patients are held responsible, in fact, for their own behavior, the public perceives such behaviors as a failure of the treatment environment. Therefore, grasping the humanistic perspective and aspects of addiction and its treatment can only work to advance the knowledge and technology of effective treatments of addiction.
There are many different kinds of addictions, from drugs to interpersonal relationships. Although these diverse addictions vary in many ways there are common threads that bind them together. There are several theories that model addiction: genetic theories, exposure theories (both biological and conditioning), and adaptation theories. To be successful, an addiction model must blend the multidimensional aspects of addiction. It must account for regional and cultural variation, interpersonal preferences as well as hold true for the variety of addictions. In addition, a good model will describe a cycle that exists that encourages increasing use until the addiction is overwhelming and leaves the host lame. Lastly, theories must be able to describe addiction as it occurs through human experience. Although animal studies can aid in understanding behavior, results need to be carefully interpreted before they are applied to the much more complex nature of a human being.
Though a genetic component seems likely, exactly what the gene codes for has not been elucidated. Questions arise as to whether or not it is the addictive behavior that is encoded or a biological mechanism that drives the...