One of the first steps in recovery is gaining an education about the diagnosis of addiction or in clinical terms chemical dependence. There are many different models to explain addiction. In reality, it must be considered a multi-dimensional process, which has a bio-chemical aspect and it occurs within certain personal and social contexts. In simple terms it is a bio-psycho-social disease.
The biological aspect of addiction is the neurological response in the brain which can be identified by certain genetic markers. Addiction can also occur where there is no previous family history once the neural pathways have become changed irrevocably though continued substance abuse. Kutlends research(1998) has shown there are certain genetic markers which are all shared by substance abusers reinforcing the counseling approach based on treating addiction as an illness, a central premise of the twelve-step program.
Whether it is drugs, alcohol, food or sex, the psychological aspect from which addictive behavior grows is analgesia; the addict self medicates to alleviate psychic pain or to gain control over a chaotic and anxious emotional state.The core emotions most often behind addiction are shame and anger. Learning to heal the shame and manage anger are goals of addiction counseling as well as learning to “let go” of resentments, another common emotional trigger. In some instances the onset of addictive behavior can be precipitated by emotionally painful events such as loss or trauma or a phase of life problem occurring during adolescence or retirement. Many people who self medicate may in fact be suffering from a dual diagnosis. This means that there is an underlying mood disorder such as anxiety, depression or Bipolar Mood disorder which will need to be treated before a stable recovery can be established.
Unraveling the social aspect of addiction means implementing the family disease approach, which has grown within the twelve-step program, and spawned the term “Codependency”. This is seen as a classic response to growing up in a dysfunctional family. In 1990, The National Council on Codependency developed the following definition: “Codependency is a learned behavior, expressed by dependencies on people, and things outside the self: these dependencies include neglecting and diminishing of one’s own identity. The false self that emerges is often expressed through compulsive habits, addictions and other disorders that further increase alienation from the person’s true identity, fostering a sense of shame.” (Whitfield 1991 p.10). This concept of codependency is useful in helping clients accept step one of the twelve step program: “They are powerless over areas of their lives which they have tried to control”.