Category Archives: Substance Use/ Addiction

The Psychological Meaning of Drug and Alcohol Addiction

An addiction to drugs and alcohol is not really an addiction to the drugs or to the alcohol. Rather we become addicted to a way of life. Our drug of choice, for better or for worse, helps us find our bearing in the world, and it is much more difficult to let go of a way of existing than it is to let go of a simple physiological enjoyment… 

My Own Sweet Addiction:

Recently I tried to break my own addiction to coffee. Over a period of time I felt that my daily dose of mocha served more to keep me afloat than to enhance my well-being. Instead of giving me a pleasant kick, coffee had started to become my daily crutch; a simple means to not feel utterly exhausted. After two years of gradually increasing my daily fix to simply stay alert, I finally found the resolve to kick my habit.

The first days after quitting, were horrible, of course. I felt quite down, my body started aching, and I had trouble staying awake during important meetings. Gradually, however, the withdrawal symptoms started wearing away, and life started to get back to a new normal. And just when I was feeling the wonderful clarity that comes with a sober mind, I started realizing that I am not the kind of person who wants to live a life without coffee.

Coffee for me is more than just a kick in the morning or a tool to stay awake. It is the enjoyment of sitting on my sun-bathed patio reading a book while treating myself to an aroma filled cappuccino. It is the satisfaction of sharing laughs with friends after a well-deserved meal that needs just that finishing touch which only coffee can provide. It is a reason to go out on a Sunday afternoon  and spend a couple of hours in a coffee shop for a slight change of ambience… It is not just a cup of coffee, but a lifestyle. Its effects go far beyond the simple physiological kick…

What this tells me is that: The addiction to coffee, just as the addiction to alcohol, cannabis, or any other drug or habit, is mainly a psychological addiction.

Addiction as a Love Affair with Life

It is easy (relatively speaking) to beat the physiological part of an addiction, but it is a monumental task to rid oneself of the addiction to life as we know it and enjoy it WITH our cherished addiction.

In the addiction literature, this psychological component of addiction is often minimized. It is referred to as the secondary gain or the reinforcement enhancing effect of addiction. And yet, it is this psychological, social, and contextual significance of the habits we form that is most likely to make us return time and time again to that cigarette, scotch on the rock, or sweet cup of Joe…

If there is any doubt in your mind about the power of our psychological needs in shaping our behavior, lets turn to an episode of the TV-show Frasier for support. In the episode “Where There’s Smoke There’s Fired”, Frasier agrees to use his psychiatric expertise to help his “manager” Bebe, break her smoking addiction. At one point, as Frasier and Bebe are sitting at the dinner table, Frasier asks her “What do you like so much about smoking?” Bebe’s answer, although fictional, is quite illuminating of the psychological impact a drug can have:

I like the way a fresh firm pack feels in my hand. I like peeling away that little piece of cellophane and seeing it twinkle in the light. I like coaxing that first sweet round cylinder out of its hiding place and bringing it slowly up to my lips, striking a match, watching it burst into a perfect little flame and knowing that soon that flame will be inside me. I love the first puff, bringing it into my lungs. Little fingers of smoke filling me, caressing me, feeling that warmth penetrate me deeper and deeper till I think I’m going to burst. Then whoosh!… watching it flow out of me in a lovely sinuous cloud, no two ever quite the same.

After hearing Bebe’s monologue, we are bound to wonder: Is this an addiction or a love affair with life? Surely giving up smoking will for Bebe not simply be about giving up on cigarettes, but about letting go of a very meaningful engagement with life…

Treatment of Drug Addiction is Treatment of a Lifestyle

The problem with many of our understandings of psychological phenomena, not least in the field of addiction, is that we are mired in a dualistic understanding of the world. What this means is that we separate objects in so-called objective reality, from our subjective experiences and the lives we live. This often creates a barrage of treatment approaches and techniques intended to target the physiological or brain-based components of our psychological experience, or that focus squarely on our behaviors and not the motivations, intentions, and meanings of our behaviors.

And yet, a cup of coffee, a cigarette, or a glass of wine never really exists outside of a life context of real people who fill their lives with experiences of a meaningful nature. An alcoholic beverage is never just that, but is always in some way a meaningful activity. It is a drink I have as a part of feeling included when I am out having a good time with my friends. It is a drink I need in order to deal with emotions or stress, which would otherwise eat me alive. It is a symbol of living the high life, a way to protest against lack of meaning in another area of life, or an enjoyable ritual in its own right. Regardless of whether or not the drink helps fulfill a healthy or unhealthy need, it is never just a drink, but a slice of life.

Coming to terms with addiction is therefore always about coming to terms with the psychological choices and meanings of the particular existence I live. Treatment of drug addiction is not the treatment of a drug, but the treatment of a life. Beating the physiological part of addiction is the easiest part. Creating a new life, and finding new ways to organize what one finds enjoyable and meaningful about life is by far the hardest.

At the end of the day, this is one of the reasons why the desire to change a habit, frequently requires a change in self or a new outlook on life. Therapy, of course, is one way to facilitate this process…

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Want more? To read more about my meaning-based take on the treatment of drug and alcohol addiction, download my article: The Value of Adopting a Human Science Approach in the Management and Treatment of AddictionYou can also read an interview with me on a Humanistic Approach to Addiction published by Sociedad Iberoamericana de Informacion Cientifica (SIIC) in both English and Spanish

About me: I am Rune Moelbak, a psychologist in Houston, TX, providing individual and couples therapy for people who want to get to the root of their problems. To read more, visit my website: www.bettertherapy.com