Addiction Makes Sense – (Part 2 Adopting a health model in addiction treatment)

One of the biggest shifts in addiction treatment happens when we stop asking

What is wrong with this person?

and begin asking

What is this behaviour doing for them?

Because addiction makes sense

Not morally
Not socially
Not in terms of consequences

But psychologically, emotionally, biologically, and relationally

Most addictive behaviours regulate something

Overwhelm
Shame
Loneliness
Hyperarousal
Emotional pain
Disconnection
Nervous system collapse
The absence of safety
The absence of meaning

That does not make addiction healthy, It makes it understandable

Research over the last few decades has consistently shown strong relationships between trauma, attachment disruption, chronic stress, adverse childhood experiences, emotional dysregulation, and later substance use disorders

The ACE Study found a graded relationship between childhood adversity and later addiction risk (Felitti et al., American Journal of Preventive Medicine, 1998)

Attachment research has repeatedly demonstrated that early relational environments shape emotional regulation, stress response, identity formation, and coping strategies later in life (Bowlby, 1969; Schore, 2003)

Trauma research further expanded understanding of how human beings adapt physiologically to chronic states of threat, disconnection, and survival stress (Porges, 2011; van der Kolk, 2014)

From this perspective, addiction stops looking random

It begins to look biological adaptive intelligence, evidence that the system is working exactly as it’s designed to do

An attempt to regulate unbearable internal states when healthier regulation, relational safety, emotional processing, or nervous system capacity were not sufficiently available

This understanding changes treatment

Because if the behaviour is adaptive, then simply removing the behaviour does not automatically resolve the underlying conditions that made it necessary

When people are struggling or even relapsing, we can ask

What is the person still trying to survive internally?

That does not remove personal responsibility, It deepens understanding

And understanding changes outcomes

A model and understanding of health does not ask people to identify as permanently broken underneath their coping patterns

It asks

What happened?
What adapted?
What remains unresolved?
What capacities were never fully developed?
What does this person need in order to no longer require escape?
Fundamentally different to pathology

Addiction makes far more sense when we stop viewing people as pathology first and begin viewing them as human beings adapting to life the best way they could

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Are you or your organisation seeing the health in people more and more, and want to adopt a model of health? send me a DM