The Bio-Psycho-Social Approach to Addiction: An Introduction

Why have an alternative to 12 Step if it helps so many people?  Good question.  It does help many people stop drinking and drugging, but it also has not helped countless others.  The 12 Step approach is quite specific with its focus and quite narrow in its scope.  Addiction is an intensely complex problem that needs a broader, more holistic approach.  The Bio-Psycho-Social model of addiction brings just that – a broader, multidisciplinary approach to the treatment of one very complex problem.

There is no one-size-fits-all approach to treating addcition because everyone has different needs and different history and different personality constructs.  The whole idea of a one-size-fits-all approach is very modern in its philosophical orientation, and our times have changed.  Our world and our thinking is much more complex, with many more options, and new problems, that we’ve had to grow out of a modern way of thinking to a postmodern way of thinking.  Life is not as simple as it was in the 50s, where a simple approach like the 12 Steps may have worked just fine.  Life has changed, and so too has our problems.  With this, we need to see the importance of more holistic approaches to life’s issues, and a broader understanding of our lives today.

The Bio-Psycho-Social (which will be referred to as BPS from now on) approach says there are biological reasons for addiction, psychological reasons, and sociological reasons as well.  Taking this into consideration, we must attack this problem multidimensionally.  We cannot just look at someone’s drinking, or drugging.  We cannot just look at someone’s emotional life.  We cannot just look at someone’s relationships.  We need to look at all these major aspects of human life for some answers to our issues, whether they be addiction issues, or other life problems.

Biological

At the present time, it is still a mystery whether or not there are specific genes passed down that determine whether or not someone will develop a substance abuse problem.  We do know that there are likenesses among the chemical makeup of people with addictions.  We also know that we are chemical people, and that the chemical addiction can become quite strong for an addict.  So whether it’s hereditary or not, doesn’t really matter.  What matters is that we respect the fact that we have natural chemicals in our bodies and messing with that can become harmful.  Also, not taking care of our physical bodies, can lead to relapse, as we may become fatiqued, stressed, or malnourished.  Biological explanations can neither be worshipped, nor ignored.

Pyschological

For a long time, the focus on applying psychological principles to the problem of addiction, has been minimal, if not scarce.  Because many have believed addiction to be a disease, the idea that some of our psychological construct might contribute to addiction has been missed. 

A large percentage of the clients I see everyday have experienced either serious to severe abuse in their childhoods, or, at the very least, a problem of overall family dysfunction to the point of pain.  It can easily be followed that these very individuals eventually turned subconsciously to drugs or alcohol to cope with, or adapt to, the inner pain they felt.  Many people have “stuffed” their emotions, or found ways to block out their pain.  These same people also developed irrational beliefs from the abuse and dysfunction since they were only children and did not know any other reality.  It is to be followed, that one would need to look at the way they have processed emotions, and the way they have developed their core beliefs, in order to better understand themselves.  When they better understand themselves, they can better deal with some of the reasons why they may be using.

Sociological

We are also very social beings.  Whether we hate society and groups of people, or find ourselves craving the attention of others, we are affected by people.  One of the biggest “frustrators”, or stressors, for clients dealing with addictions, is their relationships.  A bad argument, or relationship in general can leave one with a substance abuse very frustrated and exhausted at running into the same “wall,” taking them out to use.

We all see ourselves differently within the society which we are a part.  Some identify as minorities, some as women, some as men, some as lower class, some as upper class, some as outsiders, some as different, some as special, and some as just being a part.  How we see ourselves within the society around us has a very heavy influence on our self-esteem; and our level of self-esteem has a very heavy influence on the contribution to using substances in order to cope or adapt.  

As we can see, life in general for human beings is complex.  Substance abuse is complex.  Therefore, the treatment and understanding of addiction should be complex, or multidisciplinary.

Again, it is not my point to put down 12 Step philosophy, but to express the need for this very effective alternative in an age of ever growing complexity.  The 12 Steps have many helpful steps, and their overall focus of community is extremely important.  There are though, some fundamental and philosophical problems with certain Steps, and I will go further into these as we go along.

Until then, let the idea of an alternative approach sink in for those of you looking for one.

 

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15 responses to “The Bio-Psycho-Social Approach to Addiction: An Introduction

  • brian curran

    I must say that this model seems to offer the most satisfactory explanation of addiction, at least to my way of thinking. I’d kind of arrived at the same idea myself and was happy to find it was not only me that saw things this way.
    The trouble is, the 12 step progs seem to offer the most support, I do the meetings largely for the social aspect of therapy, even though much of the stuff gets mygoat. Just thought I’d drop a line. Toodle oo. B.C.

  • Jason

    Thanks for your message Brian. I”ve neglected this site for a while now because I’m in the middle of my masters degree in Marriage and Family Therapy. This is the second comment i’ve gotten in a couple months so maybe I’ll return to offer some more insight, encouragement and education into the life of dealing with an addiction.

  • Joyce

    Hi-
    I have no idea if you will get this, but I am really interested in this approach. I am also completing my Master’s and have accidentally found myself in addictions counseling, which I happen to love. I am really interested in alternatives to the 12 steps. It is not a fit for everyone— and most (if not all) public & free recovery programs are based in them. I specifically have issues with the disease concept, and “powerlessness” over addiction. I do believe it is a disease in that brain chemistry must play a part in it— but, I see that the more important, underlying reasons for addiction can be easily swept aside & dismissed by putting all stock in the disease model.
    Anyway- if you happen to get this— let me know if you have written any more on the subject or have any recent brainstorms along these lines that you’d like to share.
    Thanks,
    Joyce- in New Orleans

  • frank

    See Harm Reduction Psychotherapy by Patt Denning

  • Anthony McCreery

    Hi i found Motivational interviewing by W.R.Miller very interesting

    Anthony
    Dublin Ireland

  • jim warren

    i am a clinical psychologist just starting a biopsychosocial class at a residential facility and need a good entry level text. if you could email some suggestions i would be much appreciative.

    sincerely,

    jim warren

    • Jason

      is the class for clients? staff? students?
      the funny thing is i don’t know of a book that lays out the type of philosophy we work under at our facility and the type of philosophy i have come to adopt. the bio-psycho-social model is not even really a theory so there isn’t much on it. i tend to be more drawn to humanstic/existential psychology and psychotherapy for ways of approaching addiction. those philosophies and theories embedded in the humanistic movement are about helping the whole person. if i had the time and energy i would attempt to write this book. that being said some thoughts on books would be:
      Motivational Interviewing by Miller and Rolnick
      Harm Reduction Psychotherapy by Pat Denning
      In the Realm of Hungry Ghosts by Gabor Mate
      Mindful Therapy by Thomas Bien
      Mindful Recovery by Thomas and Beverly Bien
      CAMH (Centre for Addiction and Mental Health in Toronto) put out a book on Concurrent Disorders Treatment this quite good.
      I’m sure there are others i’m forgetting and others i don’t know about. Again, though, I do not think there is enough literature in this area. You can always email me for more information and discussion at jasonmccarty@mac.com

      Thanks!

  • Ken

    Hello Jason
    I’m an alcoholic in recovery (9 years)who sobered up in the 12 step program.It worked for me and I’ve seen it work for others.I have also seen it not work as well.I realize none of this is news, but it has made me wonder if are of aspects to recovery that I have missed( the why me and not him question). I remember thinking even before recovery that if this alcoholism wasn’t so darn serious it is really very interesting.I’m now going to college pursuing a diploma in Human service work.My practicum at a first nations agency is my first contact with the BPS model
    it seems to fit with the idea of restorative justice.It makes a lot of sense to me and I plan to examine it further.Glad I found this website and look forward to more information on the BPS model
    Thanks

    • Jason

      Sounds good Ken. Yes, addiction is very interesting indeed. Also, yes, 12 step can be very useful, but you are right in that it isn’t for everyone. It was never intended be a “treatment” for addiction but social support. Anyway, good luck in your studies and hope you come to your own understanding of the “why me?”.

  • Juan

    Hi Jason, I am a first year graduate student pursuing my master’s in professional counseling and I came across your website. I am currently studying addictions and I found the info on your site quite helpful. I can see where the biopyschosocial approach can be quite useful in treating addictions. Have you ever use this approach to treat any other disorders, because it seems that it may work in other areas as well. Thanks.

  • Waldemar Ryggmark

    Hello Jason, found your site a couple of years ago but this is the first time I leave a comment. I really like your thoughts about addiction and recovery. I myself are a recovering addict. I work with addicts/gangmembers in Sweden and use the bio-psycho-social(-cultural) approach to my work. I have designed a whole program using a little from the 12 step philosophy, bio-psycho-social-cultural, cbt and own experiences. I’m a GORSKI-CENAPS counselser and much of my work is shaped by the CENAPS model by Terence Gorski. In his book “Learning to live again” he gives a very holistic description of addiction. Kindly Waldemar

  • Jeremy Small

    Thank you. That was insightful. A couple of parts in there really
    hit home for me, and it educated me. Thank you. Keep ’em coming!

  • joshanderson

    Jason,
    I know it’s been five years since your post, but would you be willing to elaborate on what you mean specifically about how our problems have changed (paragraph 2)?
    Thanks

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