3 February 2015

ADDICTION AND ATTACHMENT PART 2

As discussed in last week’s blog difficulty overcoming ineffective attachment styles (Ainsworth, 1989) can leave certain individuals vulnerable to addictive compulsions as compensatory behavior for their deficiency. Many theorists have attempted to explain addiction and alcoholism and its roots. They all tend to agree on the etiology. Drug and alcohol addiction stems from early trauma or a disturbed parent-child interaction.

Drugs is seen as an affect regulator for the addict. The drug allows the addict to then tolerate difficult emotions and psychic conflict. Drugs also serve as a replacement for these effects or a means of avoiding painful affects. In this way, drugs serve as an external substitution for what would otherwise be internal self-regulating functions in the addict. In the same way that the human body has the need for food and oxygen, the child has psychological needs for a caregiver who responds empathetically to his or her psychological needs for parental approval and seeks an idealized figure that he or she can internalize. When these needs are not met the individual will suffer and as Kohut described that individual’s sense of self will be damaged.

Impairments in attachment result in problems that surface during adolescence and early adulthood. This corresponds with the time period that individuals start using drugs and alcohol. Bowlby (father of attachment theory) believes that individuals who come from an insecurely attached attachment to parents in childhood have feelings of being unloved and isolated. this puts them at risk for depression, alcoholism and suicide.  When a child does not have a secure bond with their primary caregiver then that child will subsequently have deficits in his or her ability to self regulate, and must look for an external source to compensate for the lack of internal functions of self regulation and self soothing.

Keeping this in mind, the addict has learnt in their childhood that significant others cannot be depended upon and as a result, such individuals have difficulties forming secure ties. they also tend to lack a sufficient degree of internal resources when under stress. stress is a major high risk situation for relapse and one can postulate that if the addict does not develop a secure recovery support system then attachment issues will need to be addressed with that addict as part of their recovery. What we can also see is also that at a neurological level, narcotics may functionally fulfill the need for social attachment and addicts often personify their drug and report that opiates replace the need for friends and normal social interactions. This tends to vary depending on the individuals attachment style. Attachment styles as discussed can be either secure or insecure. the insecure attachment styles are the divided into a fearful one, preoccupied and dismissing. In next week’s blog I will discuss these different attachment patterns and our affect regulation for each attachment style.

Dr Sandra Darmanin Clinical Psychologist at Mindright