The ratio of dark to light rye bread changes depending on where you slice the loaf. The same is true for addiction—the ratio of biological to psychological factors is different for everyone, and that calls for individualized addiction treatment.
Actually, both sides are correct. Every addiction contains elements of the biological as well as the psychological. In my opinion, it’s not a matter of one or the other. Instead, we should be asking: how much of an individual’s addiction is biological, and how much is psychological? What genetic risk factors do they present with? Have they experienced in ACEs (adverse childhood experiences)? What are the bigger things that can motivate them to change? By asking these questions, we will be addressing all facets as we develop a plan of individualized addiction treatment for this person.
Everyone is different
I’ve worked with addicted individuals who have experienced trauma and psychological despair. In that case, the addiction was more psychological than biological in origin, and we worked on unpacking the trauma while developing healthier coping strategies. On the other hand, I’ve worked with clients suffering from ADHD and chemical imbalances. In this instance, the nature of the addiction was more biological than psychological, so they continued their prescribed medication while incorporating more neurofeedback training.
It’s important to realize addiction is never static. In many ways, it’s a moving target. No matter how an addiction begins, it becomes more biological with each passing day, as it rewires the physical structure of the brain in habit formation. However, if addiction were strictly biological, we’d have shots, pills, and surgical procedures that could “cure” it. While we have medications like Naltrexone which help disrupt both the biological and psychological mechanisms, there’s still no “magic bullet.” The fact that we need individualized addiction treatment reflects the reality that there is no one thing that does the trick for everyone. It doesn’t exist. Not even after hundreds of years.
The Alternatives approach to individualized addiction treatment
If we are to treat addiction successfully, we must understand that it is a complex problem that demands a sophisticated solution. Whether it’s by letting someone choose moderation as their treatment goal (link), training them on the Sinclair Method, or teaching them mindfulness and other DBT skills, our approach is personalized for every client’s unique mix of strengths, challenges, and preferences. Because addressing all the factors by creating individualized treatment plans improves someone’s odds of achieving long-lasting, sustained recovery. And that’s what it’s all about, isn’t it?