i.theories of addiction

transcript

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.

Week 1

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?

A. The Physician

pronounced the driver, “Dead from Massive Head Trauma”.

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.”

The Meteorologist

blamed the death on “weather conditions at the time of the crash.”

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.

Illustration points out how one event can be viewed differently by various professionals.

The same holds true for Addictions and Chemical Dependency!

EclecticTo pick and choose individual aspects that you like rather than accepting the “whole package”

AddictionA relationship with a substance or activity, which replaces Healthy Relationships with People (develops tolerance & leads to uncontrollable use)

ToleranceNeed for more & more to produce the desired effects

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

Jekyll/Hyde

“normal”/”addict”; addictive personality

HomeostasisThe 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

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

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.

We will be looking at 11 Models of Addiction in a general Chronological Order:

Earliest Latest

T eacher

A ssigned

C hild

C upcakes

B ecause

P leasure!

A. Emphasize personal choice as the cause of alcohol problems

B. Drunkeness viewed as sinful; spiritual deficit

C. Willful violations of societal rules/norms

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

US Courts do not excuse behavior because of “alcoholic” label

A. Emphasized Moderation or “Temperance”

B. 1919 - 18th Amendment banning the manufacture, sale, transportation or importation of alcohol (abstinence)

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.)

E. Cause of Alcohol problems is the Alcohol itself (Pharmacologic Properties)

A. 1935 - Alcoholics Anonymous (AA) came into being, introducing the “disease concept”

B. Alcoholics viewed as substantially different than non-alcoholics - making them incapable of drinking in moderation

C. Likened to an “allergy to alcohol” arising from ◦ Physical, ◦ Psychological & ◦ Spiritual Causes

“1 Drink, 1 Drunk”

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

◦ 1. Alcoholics - removes responsibility & justifies humane treatment instead of punishment

2. Other Drinkers - alcohol doesn’t affect them, only “alcoholics”

3. Medical Community - requires medical treatment

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)

H. Intervention - the “Quest for the Test” to determine who is alcoholic

The assumption is that alcohol/drug problems evolve from a knowledge deficit and lack of information about use & abuse. Drug Abuse

Resistance Education

A. Emphasize the roots of Alcoholism in abnormalities of personality

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”

C. Also may arise from low self-esteem, sex-role conflicts, drive for power or control by persons who feel powerless (abusive when drinking/using)

D. Assumption is that alcoholics are people with particular personality types & the resolution requires a restructuring of the personality

E. Assumes that the Alcoholic displays an unusually high level of defense mechanisms (such as Denial)

A. Pavlovian conditioning (Stimulus-Response Theory) emphasizes role of learning in shaping drinking behavior & craving for alcohol

B. Skinner’s work in Operant Conditioning indicates that if drinking alcohol leads to rewarding consequences, it is likely to continue or increase

C. Other incentives:◦ Tension reduction

◦ “Time out” from societal rules

◦ Positive social reinforcement from companions

◦ Enabling behaviors from family

A. Emerged in 1970’s; Gives emphasis to Genetic & Physiological processes as the causes of alcoholism

B. Predisposition due to things like Heredity, Abnormal Alcohol Metabolism, Unique Brain Sensitivity, etc.

C. Pharmacologic Addiction is represented in this model

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

A. Focus on Interactions between the individual and the environment in shaping patterns of alcohol use

B. Emphasizes modeling, peer pressure & also the importance of coping skills.

(Reliance on Drug Use for Coping Purposes = Psychological Dependence)

C. Cognitive Processes - Expectations (Beliefs that Alcohol causes Beneficial & Desirable Effects)

D. Treatment includes Cognitive Restructuring

A. View Individual behavior as an inherent part of a larger social system (which tends to maintain an overall status quo, & will resist change)

B. Individual’s problem is the malfunctioning or “dysfunction” of a larger system

C. Usually the larger system is thought of as the Family (members take on Roles to play interactive “games”)

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)

A. Assumption that the Higher the Level per Capita of Alcohol Consumption, the Higher the Level of Alcohol Problems that they will Experience

B. This is influenced by◦ Availability of alcohol

◦ Costs

◦ Convenience of access

◦ Legal regulation

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

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

G. Availability restricted by ◦ Increasing cost (by taxation)

◦ Regulation of the number, location & hours of places that sell

◦ Prohibition of advertising

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)

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

Agent Host Environment

Temperance

Educational

Characterological

Conditioning

Biological

General Systems

Sociocultural

American Disease Social Learning

Put the 10 Models into the Corresponding Category:

1. Moral

2. Temperance

3. American Disease

4. Educational

5. Characterological

6. Conditioning

7. Biological

8. Social Learning

9. General Systems

10. Sociocultural

11. Public Health Model

Public Health Model Public Health Model Public Health Model