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Theories of Addiction

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As the semester gets underway, we would like to remind you about a resource
available to MCC students with personal counseling needs. Free individual
counseling is available through a partnership with Tarleton State
University. Graduate students who are enrolled in practicum courses in the
counseling psychology program will be available to counsel MCC students under the
supervision of a clinical supervisor.
Counseling will be available for issues such as
anxiety, depression, anger, loneliness, guilt, low selfesteem, grief, stress, relationship issues, roommate problems, family
crisis, divorce, identity concerns, and academic concerns. Referrals to community
resources will be available for students needing services beyond the above list.
This service will be located in rooms 313 and 314 of the Student Services Center
(SSC) during the first half of this semester; the offices will move to their new location
in Wellness & Fitness once the renovations there are completed. Counseling will be
available from 10am-6pm Monday-Thursday, and from 8am-12pm on Fridays.
If you have a student with personal counseling needs, please have them call
Counseling Services at 299-8210. Students with immediate counseling needs may
also be referred directly to SSC 313/314, although calling for an appointment is
recommended.
1
Week 1
2

A car accident occurred when the car skidded
off a wet road and smashed into a tree. The
driver was ejected from the vehicle and killed.
What is the perspective of:
Physician?
Highway Safety Expert?
Meteorologist?
Police Officer?
3

A. The Physician
pronounced the driver, “Dead from Massive Head Trauma”.
4

The Highway Safety Expert
reported that the cause of death was, “Unsafe Road Design
combined with the fact that the tree was allowed to grow in a
dangerous position at the side of the road.”
5
 The
Meteorologist
blamed the death on “weather
conditions at the time of the
crash.”
6
 The
Police Officer
upon seeing empty beer cans in back of
the car, blamed the death on the driver’s
use of alcohol and the driver not wearing
a seatbelt.
7
Illustration points out how one event can be
viewed differently by various professionals.
The same holds true for Addictions and
Chemical Dependency!
8



Eclectic
To pick and choose individual aspects that
you like rather than accepting the “whole
package”
Addiction
A relationship with a substance or activity,
which replaces Healthy Relationships with
People (develops tolerance & leads to
uncontrollable use)
Tolerance
Need for more & more
to produce the desired
effects
9

Neurotransmitter
Chemicals in the brain which are responsible
for processing information
(synapse = opening)

Addictive Logic
The way families/addicts learn to reason (as a
coping mechanism) creating fallacies; also
known as Cognitive Distortions
10

Jekyll/Hyde
“normal”/”addict”; addictive personality
Homeostasis
The tendency of a system to be stable and
resist change; examples: human body regulation of body temperature, control of blood
glucose levels, the regulation of salt and water
balance; cruise control on a car
11

•
•

Defense Mechanisms
Protect the EGO from overwhelming
situations
(Review Freud: 3 parts of personality)
Examples: Denial, Displacement,
Rationalization, etc.
Endorphins
◦ Naturally occurring chemicals with opiate-like
properties which serve as neurotransmitters
12
As the semester gets underway, we would like to remind you about a resource
available to MCC students with personal counseling needs. Free individual
counseling is available through a partnership with Tarleton State
University. Graduate students who are enrolled in practicum courses in the
counseling psychology program will be available to counsel MCC students under the
supervision of a clinical supervisor.
Counseling will be available for issues such as anxiety, depression, anger, loneliness,
guilt, low self-esteem, grief, stress, relationship issues, roommate problems, family
crisis, divorce, identity concerns, and academic concerns. Referrals to community
resources will be available for students needing services beyond the above list.
This service will be located in rooms 313 and 314 of the Student Services Center
(SSC) during the first half of this semester; the offices will move to their new location
in Wellness & Fitness once the renovations there are completed. Counseling will be
available from 10am-6pm Monday-Thursday, and from 8am-12pm on Fridays.
If you have a student with personal counseling needs, please have them call
Counseling Services at 299-8210. Students with immediate counseling needs may
also be referred directly to SSC 313/314, although calling for an appointment is
recommended.
13

We will be looking at 11 Models of Addiction
in a general Chronological Order:
Earliest
Latest
14











My
T eacher
A ssigned
E ach
C hild
C upcakes
B ecause
S he
G ets
S uch
P leasure!
15

A. Emphasize personal choice as the cause of
alcohol problems
16


B. Drunkeness viewed as sinful; spiritual
deficit
C. Willful violations of societal rules/norms
17

1988 Supreme Court case dealt with issue of
“disease”
◦ Is the behavior beyond person’s control?
◦ Or is it “willful misconduct” for which the person is
accountable
Individuals are seen to be capable of making choices
& decisions and ARE HELD ACCOUNTABLE BY LAW
18
US Courts do not excuse behavior because of
“alcoholic” label
19


A. Emphasized Moderation or “Temperance”
B. 1919 - 18th Amendment banning the
manufacture, sale, transportation or
importation of alcohol (abstinence)
20


C. Use and related problems of alcohol were
the lowest in History, but it was unpopular &
very difficult to enforce
D. 1933 - 21st Amendment repealed
Prohibition (18th Amend.)
21

E. Cause of Alcohol problems is the
Alcohol itself (Pharmacologic Properties)
22

A. 1935 - Alcoholics Anonymous (AA) came into
being, introducing the “disease concept”
23

B. Alcoholics viewed as substantially different
than non-alcoholics - making them incapable
of drinking in moderation
24

C. Likened to an “allergy to alcohol” arising
from
◦ Physical,
◦ Psychological &
◦ Spiritual Causes
25
“1 Drink, 1 Drunk”
26


E. Disease is seen as irreversible; incapable of
being cured; but possible to be controlled
through abstinence
F. View has limited acceptance outside of US
27
◦ 1. Alcoholics - removes responsibility & justifies
humane treatment instead of punishment
28

2. Other Drinkers - alcohol doesn’t
affect them, only “alcoholics”
29

3. Medical Community - requires
medical treatment
30

4. Manufacturers of
Alcohol - removes
blame from them and
places it on an
abnormality in certain
individuals. The
implication is that
“Alcoholism is not
caused by alcohol”
(some alcoholics have
never had a drink)
31

H. Intervention - the “Quest for the
Test” to determine who is alcoholic
32

The assumption is that
alcohol/drug problems
evolve from a knowledge
deficit and lack of
information about use &
abuse.
Drug Abuse
Resistance
Education
33

A. Emphasize the roots of Alcoholism in
abnormalities of personality
34

B. Represents an early fixation of normal
psychological development involving
unresolved conflicts regarding Dependence
(Freud);
arrested at Oral Stage of development, person
is literally “sucking the bottle”
35

C. Also may arise from low self-esteem, sexrole conflicts, drive for power or control by
persons who feel powerless (abusive when
drinking/using)
36

D. Assumption is that alcoholics are people
with particular personality types & the
resolution requires a restructuring of the
personality
37

E. Assumes that the Alcoholic displays an
unusually high level of defense mechanisms
(such as Denial)
38

A. Pavlovian conditioning (Stimulus-Response
Theory) emphasizes role of learning in
shaping drinking behavior & craving for
alcohol
39

B. Skinner’s work in Operant Conditioning
indicates that if drinking alcohol leads to
rewarding consequences, it is likely to
continue or increase
40

C. Other incentives:
◦
◦
◦
◦
Tension reduction
“Time out” from societal rules
Positive social reinforcement from companions
Enabling behaviors from family
41

A. Emerged in 1970’s; Gives emphasis to
Genetic & Physiological processes as the
causes of alcoholism
42

B. Predisposition due to things like
Heredity, Abnormal Alcohol
Metabolism, Unique Brain Sensitivity, etc.
43

C. Pharmacologic Addiction is represented in
this model
44

D. THIQ Theory
THIQs* are a cause of alcoholism. This is an old
theory, which was very attractive in the early
1970s. It suggested that alcoholics, when they
drink, form opiate-like THIQs (abbreviation for
several artificially-formed chemicals) in the
brain, to which they become dependent. Later
research was not able to consistently find THIQs
in the tissues of alcoholics compared to those of
non-alcoholics. Thus, the “THIQ theory” is no
longer popular among most scientists.
*tetrahydroisoquinolines
45

A. Focus on Interactions between the individual
and the environment in shaping patterns of
alcohol use
46

B. Emphasizes modeling, peer pressure & also
the importance of coping skills.
(Reliance on Drug Use for Coping Purposes =
Psychological Dependence)
47


C. Cognitive Processes - Expectations (Beliefs
that Alcohol causes Beneficial & Desirable
Effects)
D. Treatment includes Cognitive
Restructuring
48

A. View Individual behavior as an inherent
part of a larger social system (which tends to
maintain an overall status quo, & will resist
change)
49

B. Individual’s problem is the malfunctioning
or “dysfunction” of a larger system
50

C. Usually the larger system is thought of as
the Family (members take on Roles to play
interactive “games”)
51

D. Co-Dependents:
The Dysfunctional Family has an abnormal set
of needs & traits, which make the person
uniquely vulnerable to Addictive Behaviors or
Pathological Relationships
Some say it even passes on to grandchildren
of Alcoholics (making it generational)
52

A. Assumption that the Higher the Level per
Capita of Alcohol Consumption, the Higher
the Level of Alcohol Problems that they will
Experience
53

B. This is influenced by
◦
◦
◦
◦
Availability of alcohol
Costs
Convenience of access
Legal regulation
54


C. Key consideration is Social Control of
Availability
D. Legal Trends:
◦ Increased liability of those serving if harm is
inflicted by the drinker who was served
◦ Acknowledges the responsibility of the larger
environment for the actions of the individual
55

F. Cultural Factors:
◦
◦
◦
◦
Level of societal stress or alienation
Encouragement or punishment for drunkenness
Attitudes about alcohol
Symbolic or functional importance of alcohol within
the society
56

G. Availability restricted by
◦ Increasing cost (by taxation)
◦ Regulation of the number, location & hours of
places that sell
◦ Prohibition of advertising
57


A. No One Model is likely to be adequate in
intervening with & preventing alcohol
problems
B. Proposes an integration of the 3 types of
causal factors:
◦ Agent (alcohol or drug)
◦ Host (user)
◦ Environment (family, society, culture)
58

This translates into our “BioPsychoSocial” Theory:
Bio = Physical
Psycho = Psychological
Social = Environment
And Also into the “Agent/Host/Environment” Theory:
Bio = Physical = AGENT (alcohol)
Psycho = Psychological = HOST (user)
Social = Environment = ENVIRONMENT
59
Put the 10 Models into the
Corresponding Category:
1.
2.
3.
4.
5.
Moral
Temperance
American Disease
Educational
Characterological
6. Conditioning
7. Biological
8. Social Learning
9. General Systems
10. Sociocultural
11. Public Health Model
Agent
Host
Environment
Temperance
Moral
Conditioning
American Disease
Social Learning
Educational
General Systems
Characterological
Sociocultural
Biological
Public Health Model
Public Health Model
Public Health Model
60
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