Re: Addiction : a definition
Dear Bernard,
Defining addiction - now this is a meaty topic. While researching my book Sob
riety Demystified I ran across a number of references to the fact that the
competition for funding of addiction research and treatment has had a
significant influence on the confounding number of definitions of addiction
we find in the field today. Funds go to the organizations which best
represent the current generally accepted point of view. For example, at
various times the psychoanalytic or cognitive or medical models have been in
the forefront, so funding has gone into the establishments espousing the
particular point of view popular at the moment. As they publish the results
of their research or publicize their treatment methodologies, the definition
of addiction changes based on their particular point of view. As a result we
have the Minnesota Model, the genetic model, the American Disease Model, the
TIQ Hypothesis, various psychoanalytic definitions, the rational behavioral
model, etc.
It seems the recent trend has focused more on a combination of cognitive
processes and biochemical descriptions of the disorder. For myself, the most
useful definition of addiction comes from the field of medicine. Likening
addiction to other chronic medical disorders such as diabetes or coronary
heart disease, addiction can best be defined as a biopsychosocial disease.
The appeal of this definition is its flexible application to the disorder.
If you are intent on describing the origins of the problem, you can draw
from research which demonstrates the biological nature of addiction, such as
the "twin studies" or the TIQ-genetic description (see Blum and Payne's
wonderful book, Alcohol and the Addictive Brain). You may also emphasize psyc
hological origins (both Ellis-RET and Maultsby-RBT describe faulty cognitive
processes linked to substance abuse) and/or the effects of social background
(familial, peer, cultural, etc. - see the works of Bandura) of the client.
On the other hand, if you are treating a client for the problem, you can
focus on biological interventions (i.e. abstention is a biological
intervention), psychological interventions (being a cognitive-behavioral
NLPer, I'm biased about what is most effective), and/or social interventions
(family therapy, for example).
Finally, as I point out in my book, Robert Dilts' work on the logical levels
of change (based on Bateson's stuff) also provides additional structure to a
discussion on addiction. Not only does his model address change at all levels
of the organism (environment, behavior, capability, values & beliefs and
identity--or biopsychosocial change), it includes the potential for work at a
higher level as well: the spiritual level of existence. For a client caught
in the throes of addiction, that is a level of work which cannot be
overlooked.
Any compulsively repeated behavior, whether drinking, using, gambling,
eat-purging, certain sexual activities, etc. which negatively impact an
individual biologically, psychologically, socially, or spiritually is an
addiction.
Sorry to be so long-winded; this is a very important topic.
Warmly,
--Byron Lewis