Approaches To Behavioral Addiction
Approaches To Behavioral Addiction
Marc Kern (Addiction Expert, Director of Addiction Alternatives) gives expert video advice on: What is the "disease model" approach to behavioral addiction?; What is the cognitive-behavioral approach to behavioral addiction?; What is the "psychodynamic perspective" of behavioral addiction? and more...
What is the "disease model" approach to behavioral addiction?
There are many reasons that people think addiction is a disease; a lot of really actually good reasons that we think addiction is a disease. Modern technology has given us the opportunity to look inside the brain and see that when people involve themselves with certain substances and certain behaviours, certain parts of their brain light up and are to central to not only the formation, but the continuation of the behaviour. The medical community has, in my estimation, an investment in keeping it a disease, because it keeps it in the paradigm that they were educated in and it keeps the insurance companies in the position of having a legitimate obligation of to reimburse for a formal biological disease. From the outside, it may look very much like a disease in the sense that it makes no rational sense; it's not logical. These addictions are not logical. It's confusing, and it's easy to assign a label called disease on these mysterious phenomenon. The twelve-step community, the twelve-step program, has integrated the disease model and it is sometimes easier to say to myself "Well, I have a disease, and therefore I'm not at fault", rather than blame myself, moralise myself, or shame myself. It's a way of removing the guilt, removing the shame, and actually being given the opportunity to reach out for assistance in whatever shape or form it takes.
What is the cognitive-behavioral approach to behavioral addiction?
People call addictions habits because, unlike the disease model, they see addiction as an evolutionary process. It is like, you know, brushing your teeth in the morning. They just kind of do it; they don't really think about it. They get dressed, they wash their face; it's sort of automatic. It doesn't appear from the inside that there is an organic or biological process going on, but rather it comes through repetition and practice that they engage in this particular behaviour. Another part of why people see addictions as a habit is because it has the same sort of muscle memory of other habits. There's also a powerlessness. A powerlessness is central to the disease model, 'twelve-step', and to call it a disease is to call myself powerless. I'm doomed and destined. So, there's often a complete resistance of people to own such a powerless position and they actually want to feel empowered, and calling it a habit puts their mind at ease. It eases their mind to think that there is something they can do and something they can think about; that they can intervene, that they are not victims and they can change without it being some sort of organically fixed phenomenon that they were born with.
What is the "psychodynamic perspective" of behavioral addiction?
The psychodynamic perspective of addiction comes out of the famous Dr. Freud. It originated approximately 100 years ago and it's based on the assumption, and there are some parallels within the cognitive behavioral world, that if the unconscious forces within us are part and parcel of why we engage in addictive behavior. There are beliefs that through means of interpretation of early life trauma, developmental difficulties, that the child becomes to have certain meanings and associations with particular elixirs, particular people and particular activities, and their recovery is about the understanding, the unraveling and the unearthing of these unconscious forces, and beliefs and meanings.
What is the "biopsychosocial perspective" of behavioral addiction?
In reality is that most current, most contemporary addiction professionals believe in the biopsychosocial model. You could have a disease model or a popular behavioral model, we all buy into a little bit of the biopsychosocial model. All biopsychosocial model means is there's a biological component, a psychological component, and a social component. It isn't just one of those three. It is, what I believe, as well that, there are those three components involved in everyone's addiction and it's a matter of, sort of degree of how much the biology, how much the psychology, and how much the sociology plays in the actual formation and maintenance of addiction.
What is the "holistic approach" to behavioral addiction?
The holistic approach to addiction is, again, very much a bio-psychosocial approach, but the emphasis is more on recovery. Recovery is expanded and the tools that are brought to a recovery program or person are quite a bit broader. They include alternative medicine methods, Eastern philosophies, and literally anything that'll work for behavioural addiction. There is not an emphasis on Western approaches or particular theories of psychology, but more of an Eastern, maybe even a sort of a little bit of Buddhist sort of thinking about mind, body, spirit, and things like that.
What is the cognitive-behavioral perspective of behavioral addiction?
The cognitive behavioral approach to addiction really is a broad range of tools, psychological tools, that have research behind them, that have been studied and repeated over and over again. They all seem to involve an emphasis on focusing on the thinking as it leads to behavior or the thinking as it leads to feelings. And, the techniques may be quite broad and quite different, but as long as their focus is on the space between the two ears, that's the place where professionals intervene. It's basically about talking, it's about reorganizing the beliefs, again, that lead to certain other beliefs or certain other feelings or certain behaviors and the thrust of most of the interventions is thought, language and correction of irrational, destructive thoughts and beliefs.