Isn’t addiction just psychological?

No. And that bias is dangerous. Like other illnesses in the nervous system, addictions are biological and psychological and social. Ignoring anyone area just leaves our door open for the addiction to overwhelm a person. With many addictions, there can be a 10 to 30% rate of suicide, so, everything that can be done should be done for the person who has an addiction.

That being said, the psychological issues in addiction are many.

The psychological issues can be treated by a certified addiction counselor. This is someone who has a four-year degree and additional training specialized in understanding addiction. The current state of the science supports medication assisted therapy. That means there is an understanding that practically all addictions have big biological issues and big psychological issues. So most addictions do best with using a medicine to counteract the biological issues and then zeroing in on the psychological issues at the same time with specialized counseling.

Why specialized counseling? In addiction, there are many tricky issues that come up. A person often denies the consequences of the addiction, and then, when they realize them, they are overwhelmed and feel helpless and hopeless, which just gives them incentive to go back to the addiction to numb the pain. So there’s many self-defeating cycles of behavior that can be going on. A good counselor will point this out, so the person with the addiction can see the big picture and not get caught by the psychological tricks that come out from the chemical imbalance in the brain of someone suffering from an addiction.

A good counselor will form a strong, trusting bond with the patient. And from there, be able to confront the patient with the issues feeding into the addiction, starting with issues that are the least emotional, and working up to those that are more emotional.

Despite many advances in creating new psychotherapies for addiction and new medicines for addiction, the main issue is patients don’t follow through. They may take a medicine for a few weeks or a few months and then quit it and quit seeing the doctor prescribing it, coming up with some excuse. Likewise, they can give up on a therapist saying they just didn’t “connect“ with the therapist. Because of this, it’s important that the person with an addictionto involve friends and family in the whole treatment process. Then if a person feels like quitting some aspect of their therapy, friends and family can follow through and encourage the patient to follow through on their treatment. If there’s problems with the doctor or therapist, let them know, maybe just with an email to the office secretary.

For example, people in addictions project their own negative self image on others and think others have a negative image of them. This is called projecting your issues on others. A person with an addiction may want to give up on a therapist, saying the therapist didn’t “connect” with them. But when asked what it is the therapist was supposed to understand about the patient in order to connect, the patient says, “I don’t know.” But they don’t want to confront others, or be confronted, because of real or potential rejection sensitivity, a common issue in addictions. Here a friend might say, “I wonder if you’ve been running from issues for years. Here’s a chance to work through an issue. Tell the therapist you feel he doesn’t get you, and start the conversation. He’s shown he cares about you and really wants what is best for you, so I think you should give him the benefit of the doubt.” And then the patient follows through. This is an example of how interpersonal support can help the therapist and psychiatrist meet a patient’s needs.

In light of all this, it’s very much worth it to treat one’s addiction. It can save your life.