1
A Star Is Born: A Rockstar’s Battle with Addiction
Applying the Bio-Psycho-Social Plus (B P S +) Model
Steven Kopelevich
215552474
SOWK 2020 – B
Professor Sue Gallagher
October 11, 2020
2
Developed by Wayne Skinner and Marilyn Herie, the Bio-Psycho-Social Plus (BPS+)
model was designed to aid medical practitioners with being able to structure health and illness
beyond biological terms, incorporating psychological, social, cultural, and spiritual insights as
well. This model highlights that these dimensions are not distinct vectors but rather are
intertwined and work synergistically. They assert that in identifying and resolving addictive
behaviours, a holistic approach that encompasses all five dimensions provides an accurate
representation of addiction. Additionally, this model provides a basis for an integrated approach
relating to prevention, care, and rehabilitation of addiction. The BPS+ model will be utilized in
this paper to examine Rockstar Jackson Maine’s addiction to drugs and alcohol in the Academy
Award winning movie, A Star Is Born.
This critically acclaimed American romantic musical drama follows Rockstar Jackson
Maine’s journey as he falls in love with a young singer while his vices continue to trigger a
downwards spiral. The opening scene is when the audience is first introduced to Jack and his
substance abuse. Ready to hit the stage in front of a sold-out crowd, Maine is shown putting a
handful of pills into his mouth, gulping it down with a glass of alcohol. Directly after his show,
Jackson is seen in the back of his driver’s car finishing an entire bottle of alcohol, en route to
find the nearest bar. Drinking the night away, Jack is caught off guard by the amazing voice of a
performer on stage at the bar, Ally. Moved by her performance, Jack seeks to conversate with
Ally and is able to convince her to grab drinks with him. Before Ally is able to finish her first,
Jack is already onto his third and fourth drinks. After dropping Ally off at home, Jack tells his
driver to turn back around and shows up at her door where he invites her to his next show. As
she declines, her father is in disbelief as he knows what kind of an opportunity this can be for his
daughter, who has just about given up on her dream to make it big as a singer. Ally explains to
3
her dad that she does not want to get involved with Jackson, referring to him as a ‘drunk’. As
Jackson is at his next gig, he tells his driver to not come back unless it is with Ally, who finally
agrees and ends up backstage later that night. With Jackson’s encouragement, Ally sings on stage
with him and takes the world by storm. Jack invites Ally to go on tour with him and the two form
a romantic relationship while rising to the top of the music industry. As the film progresses,
Jackson’s substance abuse continuous to worsen to the point of admittance into a rehabilitation
centre. After being in rehab for two months, Jackson returns home. Promising to meet Ally at her
final show, Jackson never shows up. When help arrives, Jack is found hanging in his garage.
Biological Dimension
The biological component of the BPS+ model illustrates the affects of substance use and
other addictive habits on the brain and how it functions, as well as the rest of the body (Skinner,
2016). The affects of Jackson’s drug and alcohol use on his brain and body become evident
throughout a multitude of events within the film. As the audience becomes acquainted with
Jackson, it becomes clear that he rarely goes a day without drinking, which according to the
American Addictions Centres for Alcohol, would be classify him as a “high-functioning
alcoholic,” as he is able to “maintain a semblance of normal life by continuing to perform and
succeed in his career and other tasks” and is also “able to maintain relationships and physical
health” (Mosel, 2020). However, there are also instances when Jackson faces immediate
repercussions due to his heavy drinking and drug use. Backstage at a private venue, Jack is
shown sniffing cocaine and has a bottle of pills and alcohol on the table in front of him. As he
hits the stage, Jack zones in and out of reality and seems to be disoriented and dizzy, resulting in
him being found passed out on the grass the next morning by one of his drivers. Alcohol is as a
depressant and cocaine is a stimulant which classifies both of these substances as psychoactive
4
drugs (Hartney, 2020). When consuming such drugs “potent chemicals cross the blood-brain
barrier and produce dramatic neurobiological effects within the brain” (Skinner, 2016). This
explains Jackson’s inhibited cognitive abilities as “alcohol affects the cerebellum in the brain
which controls balance and coordination. Therefore, high alcohol consumption can disrupt the
brain’s judgement and cause dizziness” (BBC Health, 2001). Another display of the negative
affect alcohol has on Jack’s brain is during his argument with Ally in the washroom. At this
point, Jack is already intoxicated, and she taunts him by saying “why don’t we just get drunk till
we disappear” and “do you have those pills in your pocket?” Angered by this, Jack responds
“you’re just ugly, that’s all.” Ally is referring to the fact that drinking to escape reality is a
common form of self-medication, which is quite understandable since “alcohol is a mild
anesthetic” (Beck, 2018). Jack’s rude remarks are a direct result of being inebriated as “when
anyone drinks, there is neurological and psychological regression, and the higher the blood
alcohol level, the more primitive and hostile the response comes out” (Malone, 2006). One of the
most controversial scenes in the movie is Ally’s Grammy award acceptance. Leading up to this,
Jackson was sober for some time, but then relapses right before the event with cocaine and
alcohol. He is completely unaware of what is going on and where he is and this causes him to
urinate himself on stage and then pass out. This can be explained by the fact that “drinking
alcohol supresses ADH production, so your body produces more urine than it normally would”
(Cleveland Clinic, 2020) and that “alcohol boosts extracellular levels of adenosine, which in turn
induces sleep by blocking the wake-promoting cells of the basal forebrain” (Paddock, 2014).
When Jackson returns from rehab, he apologizes to Ally for embarrassing her on stage, to which
she replies, “it’s okay, it’s a disease.” Ally’s response is truthful and has scientific validity as “it
is now widely accepted that addiction is a brain disease” (Leschner, 1997). This is because “an
5
addicted person’s impaired ability to stop using drugs or alcohol has to do with deficits in the
function of the prefrontal cortex – the part of the brain involved in executive function” (Bierer,
2016). The director’s meticulous choice of Ally’s wording in this scene also aids in reinforcing
Jackson that it is not his fault and “can go far in helping reducing stigma” (Saitz, 2015), as this
film reaches millions of viewers from around the world. Thus, the biological dimension aids in
demonstrating the effects of drug and alcohol use on Jackson Maine’s brain and body throughout
a variety of events within the film.
Psychological Dimension
For an effective understanding of addiction, the psychological dimension of the BPS+
model is used to explore the impulses and drives that incline or disincline an individual to certain
actions, as well as the ways in which motivation and cognitive influences, along with external
rewards and punishments, form behaviours. Additionally, psychological factors contribute
greatly in understanding how and under what conditions individuals initiate and sustain change
over time (Skinner, 2016). It becomes quite clear that Jackson Maine’s childhood was far from
perfect; his mother passed away during his birth and his father passed when he was only thirteen.
When Jackson learns that Bobby, his brother, sells the ranch where their father was buried, the
two get into a very heated argument. Jack idolizes his father during this disagreement, which
makes it appear as though the two had a very strong bond. However, Bobby retaliates claiming
that “all dad ever did for you was make you his drinking buddy,” which provides insight as to
what kind of relationship the two really had. Not only does this scene provide context for Jack’s
troubled upbringing, but it also describes his early introduction to alcohol. “Traumatic
experiences linked to an elevated vulnerability to addiction include the loss of a parent. Those
who had experienced such things during childhood have shown an increased tendency to become
6
dependent on alcohol and drugs” (O’Leary, 2018). According to the National Institute on
Alcohol Abuse and Alcoholism, “those who began drinking in their early teens were not only at
greater risk of developing alcohol dependence at some point in their lives, they were also at
greater risk of developing dependence more quickly and at younger ages, and of developing
chronic, relapsing dependence” (NIH, 2006). Jackson’s intense substance abuse eventually led
him to a rehabilitation clinic. Although the film did not clarify as to whether Jack decided to go
to rehab himself or someone else made him do it, it does suggest that he was looking for a
change in his life and that he had hope in overcoming a lifelong addiction that was consuming
him. Soon after returning home from rehab, Jackson relapses. “In many instances, it is not the
particular circumstances or events but entire living arrangements that leave recovering alcoholics
and drug addicts vulnerable to relapse. Dysfunctional home or working environments are often
associated with substance abuse and recovering alcoholics who return to troubled circumstances
may lose their resolve and gradually drift back into their old habits” (The Right Step, 2017).
Jackson’s home is where a fair share of his substance abuse took place and it is impossible for
him to forget all those memories when he came back. Furthermore, he had his bottle of pills
readily accessible, stashed in the glove box of his truck. After taking the pills, in an incoherent
state, Jack stumbles to the garage and ultimately commits suicide. The BPS+ model’s
psychological component can be utilized effectively to understand the desires and drives that
motivated Jackson’s substance use as well as his inability to successfully maintain change over
time.
Social Dimension
Social factors have been taken to mean the proximal influences of people close to the
person on their resilience or susceptibility to addiction. The ways in which behaviours are
7
indorsed or discouraged, and the ways in which they are held to be ordinary or deviant are
influential factors in shaping how individuals behave, even when they have the belief they are
acting autonomously or just conforming to social norms (Skinner & Herie, 2014). As a famous
Rockstar, Jackson’s drug and alcohol use does not appear to be out of the ordinary, as it just
seems to be part of the ‘lifestyle’. Jack’s tight social circle is accustomed to substance use and
perceives him to always be in an intoxicated state of mind. For instance, when he comes to pick
Ally up from her home, she initially refuses to get onto the motorcycle with him as she assumes
he had already been drinking. Another display of this is when Ally’s manager, Rez, is sitting
with Jack waiting for her to get ready. Rez asks Jack “no drink?”, as he seems thrown off by Jack
only drinking water. The problem with this is that rather than Jack’s close friends encouraging
him to seek medical attention and overcome his addiction, they seem to be accepting of it.
“Social support is perhaps the single most important factor in successful recovery, within the
web of multiple factors that need to be understood and mobilized to optimize a person’s chances
of lasting change” (Skinner & Herie, 2014). The social dimension of the BPS+ model evidently
illustrates the negative affects Jack’s small social circle has on his battle with addiction. They
seem to ignore his addictive habits and embrace them as natural, rather than being a supportive
and encouraging peer group working to get Jack on the road to sobriety.
Cultural Dimension
Culture relates to the social atmosphere in which an individual finds themselves and its
connection to their personal identity. The degree of integration and association they feel plays a
major role on their subjective experience of quality of life and their susceptibility to addiction
and other health problems (Skinner & Herie, 2014). People take pictures of Jackson everywhere
he goes and stare in awe as they perceive him as a celebrity instead of just a normal person. Such
8
things make it very difficult for Jack to feel integrated into everyday society as he feels isolated
and disconnected from normal people. This causes Jack to often times hang out with groups of
people he does not know on a personal level but merely share one thing in common; drinking
and smoking. Jack reaches his tour bus after his shows where he is surrounded by several people,
all of whom do not even seem to notice that he is there but are rather busy getting intoxicated.
Such shallow relationships cause Jackson to feel lonely and these same people “who report
feeling lonely are more than twice as likely to also have substance abuse disorder” (Boyle,
2018). This substantially worsens Jack’s quality of life as he feels dependent on substances to
help him deal with his disassociation and loneliness with the rest of society. “In low doses,
alcohol can temporarily relieve symptoms of depression and anxiety. It can make a person more
jovial and social, give them a sense of everything being “alright,” and alleviate anxiety” (Faris,
2018). The problem with this, however, is that it can eventually lead to alcoholism when used
frequently, and in this case actually aggravated Jackson’s depression and anxiety. As a Rockstar,
Jackson has considerable trouble immersing himself in everyday society, continously being in
the spotlight. To make matters worse, Jackson is surrounded by superficial individuals who
negatively influence his addiction problem and part take in alcohol and drug use with him. The
cultural dimension of the BPS+ model explains this to be a key contributor to his quality of life
and the vicious loop that is his battle with substance abuse.
Spiritual Dimension
The BPS+ model suggests that there is epidemiological evidence which supports the fact
that individuals with a strong religious affiliation are less prone to addictive behaviours than
those who are not. It also mentions that mutual aid fellowships, which are programs offering
spiritual recovery, are a key to recovery for those who come to believe that they have a chronic
9
condition (Skinner & Herie, 2016). This film does not portray Jackson as a particularly religious
person which, according to the BPS+ model, may be a key contributor to his addiction. Although
Jack does not turn to a higher power for help, he does in fact enroll in a recovery program.
During his first group meeting, Jackson has his head down as if he is in shame and is barely able
to hold his composure. He finally spits out the words “I’m Jack and I’m and alcoholic, drug
addict.” This is a pivotal moment in Jackson’s attempt at sobriety because according to the
American Addictions Centres, step 1 of 12 is to “admit to the group that you have a substance
problem” (American Additions Centres, 2020). This is arguably the most difficult step of them
all because “the biggest problem about realizing admitting you have an addiction is getting past
yourself. Yes, you are your own worst barrier” (Nentwig, 2018). As the BPS+ model proposes,
this fellowship program was able to provide Jackson with the opportunity to finally come to
honest terms with himself and address his severe substance dependency.
Concluding Remarks
The couple’s love and dedication are replaced with tragedy in the drama’s heartbreaking
final act. Maine returns from rehab, still struggling with his personal demons, which end up
getting the best of him. A Star Is Born is powerful in evidently signaling at the risk factors and
warning signs in Maine’s life. Looking at Jack’s addiction through the biological, psychological,
social, cultural, and spiritual dimensions allows for a holistic understanding of his character and
the intricacies associated with his dependence. Unfortunately, Jackson’s addiction singlehandedly directed his career on a downwards spiral and got in the way of his relationships with
loved ones. On his quest to sobriety, his addictions prevailed and put an end to his musical
legacy.
10
References
Beck, C. (2018, June 15). Drinking To Escape Reality? Retrieved October 11, 2020, from
https://www.stopdrinkingexpert.com/drinking-escape-reality/
Boyle, M. (2018, June 27). Why Addicts Are Often Lonely People. Retrieved October 11, 2020,
from https://psychcentral.com/blog/why-addicts-are-often-lonely-people/
Early Drinking Linked to Higher Lifetime Alcoholism Risk. (2011, December 08). Retrieved
October 11, 2020, from https://www.niaaa.nih.gov/news-events/news-releases/early-drinkinglinked-higher-lifetime-alcoholism-risk
Elizabeth Hartney, B. (2020, July 04). How Psychoactive Drugs Change Someone's Mental
State. Retrieved October 11, 2020, from https://www.verywellmind.com/what-is-psychoactive
22500
Farris, S. (2108). Recognizing Forms of Self-Medication. Retrieved October 11, 2020, from
https://www.healthline.com/health/depression/forms-self-medication
HEALTH | What happens when you get drunk. (2001, December 21). Retrieved October 11,
2020, from http://news.bbc.co.uk/2/hi/health/1721987.stm
Herie, M., & Skinner, W. J. (2014). Substance abuse in Canada. Don Mills, Ontario: Oxford
University Press.
Mann, D. (n.d.). Is Alcohol a Truth Serum? Retrieved October 11, 2020, from
https://www.webmd.com/food-recipes/features/alcohol-truth-serum
Michael Bierer, M. (2020, June 23). Is addiction a "brain disease"? Retrieved October 11, 2020,
from https://www.health.harvard.edu/blog/is-addiction-a-brain-disease-201603119260
Mosel, S. (2020). What is a High Functioning Alcoholic?: Definition & Signs. Retrieved
October11, 2020, from https://www.alcohol.org/faq/what-is-a-functioning-alcoholic/
Nentwig, W. (2018, September 27). Hardest Part of Addiction Recovery is Admitting Your
Problem. Retrieved October 11, 2020, from https://thecanyonmalibu.com/blog/hardest-part-ofaddiction-recovery-is-admitting-your-problem/
Paddock, C. (2014). Alcohol disrupts body's sleep regulator. Retrieved October 11, 2020, from
https://www.medicalnewstoday.com/articles/286827
Saitz, R. (2015). Language Can Help Reduce Stigma of Substance Use Disorders: SPH: Boston
University. Retrieved October 11, 2020, from http://www.bu.edu/sph/2015/01/08/language-canhelp-to-reduce-stigma-of-substance-use-disorders/
Skinner, W. (2016). A Bio-Psycho-Social Plus Approach to Addiction and Recovery.
11
Team, U. (2020, September 24). Adults + Booze = Bedwetting? Here's Why It Happens to You.
Retrieved October 11, 2020, from https://health.clevelandclinic.org/adults-booze-bedwettingheres-happens/
The Right Step. (2017, September 01). Why Alcoholism Relapse Is So Common. Retrieved
October 11, 2020, from https://www.rightstep.com/rehab-blog/alcoholism-relapse-common/
The Unfortunate Connection Between Childhood Trauma and Addiction in Adulthood. (n.d.).
Retrieved October 11, 2020, from https://dualdiagnosis.org/unfortunate-connection-childhoodtrauma-addiction-adulthood/
Warner Bros. Entertainment., Cooper, B., Belli, W., Chappelle, D., Elliott, S., & Lady Gaga.
(2019). A star is born. Burbank, CA: Warner Bros.
What Is Step 1 of Alcoholics Anonymous? (2020). Retrieved October 11, 2020, from
https://www.alcohol.org/alcoholics-anonymous/step-1/