Addiction: A brain disease with a biological foundation
Addiction is a brain disease with a biological foundation, which means that it couples together the mental and physical states of the individual in an action which can lead to negative or bad behavior. There are many types of addictions but two of the biggest addictions in modern times are sexual addiction and drug addiction. Many young people develop both addictions or one or the other, either becoming addicted to Internet sexual sites or becoming addicted to illicit street drugs like heroin or marijuana. Either addiction can be damaging to the person’s health, and in some cases they can even be deadly. In fact sexuality and drug addiction can sometimes even be linked (Newcomb, 2014). For young people these two issues are especially dangerous as “experimentation with addictive drugs and onset of addictive disorders is primarily concentrated in adolescence and young adulthood” (Chambers, Taylor, Potenza, 2014, p. 1041). Additionally, drugs and sex are now more easily and readily available than at any time ever before and the temptation to use them both or abuse them can lead to habit-forming practices. In short, the young are very susceptible to these kinds of addictions. This paper will look at sexual and drug addiction to show how both behaviors and substances can be abused and lead to worse behavior (such as stealing, solicitation, self-abuse). It will give an examination of clinical issues associated with these addictions and also provide Christian worldview implications that can result in the overcoming of obstacles related to these addictions.
Description of Substance/Behavior
Pill usage by anyone can be habit forming but with adolescents the problem of taking pills is especially concerning because of the young age at which the habit can be learned and therefore the longer the habit has to shape the rest of the life. The fact that too many adolescents are being misdiagnosed by physicians who interpret symptoms as signs of ADHD only shows how parents and doctors are failing their children (Mullet, Rinn, 2015). It is the responsibility of parents and doctors to be more aware of how the pharmaceutical industry wants to broaden the diagnosis formula for everyone so that it can sell more drugs. Big Pharma wants everyone on drugs and parents and doctors view drugs as an easy way out of dealing with teenagers’ issues. But the fact is that teenagers have issues because no one wants to deal with them. People need to take time to meet young people halfway, more than halfway, to help them through their stage of life without complicating it by helping them get addicted to pills. Drugs for ADHD diagnoses can lead to drug addiction because the drug has addictive properties. Chambers et al. (2014) show how “developmental changes in neurocircuitry involved in impulse control” for instance serve as the biological basis for the addiction (p. 1041). Indeed, the researchers note that “psychiatric disorders commonly identified with disturbances in reward motivation and substance use disorder comorbidity are associated with impulsivity” (Chambers et al., 2014, p. 1042). This means that the addiction basis has roots in both a biological immaturity (impulsivity) that is also psychological in nature as well (the need for stimuli/reward/pleasure). It is a neurobiological basis, in other words, according to Chambers et al.
The biological foundation of drug addiction is like that of sexual addiction. Kalivas and Volkow (2014) have shown how “neuroimaging of addicts are integrated with cellular studies” to reveal that “dopamine” produced in the body is the main biological basis response that triggers addiction as the individual seeks a release of the dopamine sensation. In more explicit terms, “cellular adaptations in prefrontal glutamatergic innervations of the accumbens promote the compulsive character” of the high that sex and drug addicts seek (Kalivas and Volkow, 2014, p. 1403). The drug and/or sex addict seeks to control the prefrontal innervations which produce a stimulant in the body and because of their impulsivity they are more inclined to chase this high without giving concern to damage that it can produce. Drug use can harm the lungs (by smoking) and the organs of the body through infection, if using needles. Loss of limbs can result if gangrene sets in. With sexual addiction, back problems can result and rawness of genitalia can lead to infection as well depending on the exacerbated nature of the addiction. The potential for disease such as syphilis is also attached to both drug and sex abuse as the two are often linked in the impulsivity biological motivator in young persons.
There are also gender-related issues with addiction that relate to sex instincts and biological bases. The reason Cotto (2010) gives for the different motivations in genders for using drugs is that females are more appearance or outcome motivated whereas males simply want to experience a high, in general (Cotto, 2010, p. 408). The types of drugs they use explains this: females tend to abuse pills/prescription drugs whereas males tend to abuse marijuana. The fact the females also had higher usage rates of cocaine indicates that, according to this thesis, they are using the drug to control performance or weight. The reason that the researcher gives appears to be based on general gender perceptions. The idea that women are “more sensitive” to cocaine than men and thus more easily addicted is how Cotto explains the higher rate of usage (Cotto, 2010, p. 406). This may be seen as a gender stereotype or a biological perspective. At any rate, any discussion of how genders differ or why they differ is bound to bring up the topic of gender studies and what makes men and women different. In equality states, the topic is taboo because one is discouraged from discussing gender differences. Do the reasons Cotto suggests make sense? Yes: the researchers identify the differences between genders and highlight the biological foundations of actions associated with each gender; bending the gender associations creates a tension within a dichotomy that seeks a physical alleviation through the application of drugs. The mental state is affected by the physical and vice versa, as a result.
The stress that sexual minorities encounter in their daily lives is likely a reason for higher drug usage. Sexual experience in youths is another reason for “impulsive” drug use, as the urges of young bodies make such actions more enticing and habitual (Newcomb, 2014, p. 309). However, the limitations of the study itself could be one reason why the results Newcomb et al. encountered are what they are: the survey size was limited, the number of sexual minorities was limited, and the samples were single items rather than community-based items. When make generalizations about groups based on single items rather than community studies it is tempting to base the reasons for outcomes on the individuals’ experiences/background. The fact that sexual minorities were found by Newcomb et al. to use more drugs because they are sexually experienced and therefore more impulsive sounds reasonable, but the idea should be tested among a larger community study, as the researchers themselves suggest. The biological basis of exposure to one set of behaviorisms at a young age could very well be the factor that leads to more exposure to other sets of behaviors leading to more addictions (Karila et al., 2014).
Clinical Issues
Clinical considerations of drug and sexual addiction include the biological aspects that each has for counseling/treatment. Weaning individuals off drug and sex addiction requires an awareness of the impulse motivation as well as the endorphins that are released in the body, which are similar to morphine and create a momentary feeling of euphoria. There is a connection between depression and the drive to seek this euphoria through drug use or excessive sexual stimulus, such as masturbation. Thus the biological foundation actually consists of a neurobiological foundation; therefore, clinical treatment should consider that the cause of the impulse is related not simply to a physical aspect but to a combination of physical and mental (Sasso, Strunk, Braun, 2015).
Cognitive therapy (CT) or cognitive behavior therapy (CBT) as it is also called would be useful in dealing with the patient’s presenting issues of suicide because there has been considerable research performed that locates successful treatment of addiction in the nexus of the depression-stimuli dichotomy (McNeil, 2013). The patient in the case of addiction can suffer from a form of hopelessness, which is related to depression, and thus CT could be a beneficial treatment mode. CT allows the patient to focus on actions in one’s life that can be changed in order to affect a different, more positive outlook and reinforce a more stable disposition. Thus it highlights the way that mental states affect biological states which affect actions. Indeed, it is all related in terms of ebb and flow, give and take, with biological factors in term exacerbating mental states. Exercise, for example, can release endorphins as well but because it is viewed more as work and less and pleasure, there is some degree of will power that must be exercised in order to pursue exercise as an antidote to sexual addiction or drug addiction.
During the cognitive therapy sessions, the therapist would be able to use my “congruent” traits to help the patient deal positively and effectively with his “incongruence” (McNeil, 2013, p. 8). The whole thus helps the fractured and fragmented to put the pieces more in order. Cognitive therapy in this case would thus be instrumental because of the depressive/hopelessness core that the patient is experiencing and also because this core impacts the biological basis of addiction, which is the impulse/endorphin release paradigm, which the individual seeks. Likewise there is the study by Asamsama, Dickstein, and Chard (2015) that shows how cognitive therapy is a good approach to dealing with serious issues of depression/addiction and why it can be a beneficial treatment modality because of its focus on altering client behavioral patterns and the use of the Beck Depression Inventory-II model.
Thus future modalities of treatment of addiction are likely to take into consideration the CBT model because of its emphasis on neurobiological treatments, focusing on actions and ways of thinking that relate to the desire of the individual to seek the release of flood of endorphins/chemicals into the body for the “high” that results. The high is sought because of the low that the individual wishes to avoid, coming from stress, depression, despair, or an incontinent desire for pleasure, etc. Ethical issue and biological aspects related to this addiction that might affect counseling are the need to connect with the individual and on intimate basis, which means exercising strict confidentiality and empathy. A pharmacological treatment of addiction is more like a patch, as it does not effectively get to the neurological associations that the individual has made. Thus ethical considerations should be given to how the individual’s life can be better facilitated towards exercising restraint and a more positive lifestyle with supports from family and peers.
Christian Worldview Implications
Such is why a Christian worldview has positive implications: individuals can find in Christian communities, such as churches and groups, the positive peer/family/social support that they need to turn their addiction barriers/challenges into opportunities for personal and spiritual growth. The biblical basis for a Christian approach is most notably situated in the fact that Christ is the “way and the truth and the life” (John 14:6). Christ, in other words, offers a universal portal through which all individuals can pass in order to overcome their addictions/problems/concerns.
Christian counselors have the freedom to exercise a Christian worldview approach to counseling because researchers have shown that spirituality has a direct bearing and impact on counseling positivity and success and that Christian prayer is a divine way of dealing with issues such as sexual addiction (Gilbert, 2014, p. 87). However, some caution should be exercised on the part of the counselor because of cultural and/or religious sensitivities. Thus it is ethical to discuss up front whether or not the individual wants to engage in Christian-oriented therapy and healing in order to overcome the biological bases of the addiction. It should be pointed out to the individual that a neurobiological approach has been shown by researchers to have the most encompassing approach to the problem of addiction and that this approach can be facilitated by CBT and by a life of prayer, as Gilbert (2014) notes. The spiritual dimension of healing, of grace, and of Christianity can be discussed but it should not be forced on the client or patient if he or she does not want it. There is the biblical foundation for not forcing it upon those who are unwilling, as Christ Himself leaves the village after healing the possessed man after it frightens the inhabitants and they ask Christ to leave (Matthew 8:34). He does not stay and oblige them to hear Him.
Nonetheless there are many positive associations that can be made between the Christian worldview and overcoming the neurobiological basis of sexual and drug addiction, which depends upon the flooding of the body with chemicals that produce a euphoric response. The individual is seeking release from the pains of the world, but Christ says that one should take up his cross and follow Him. Christ gives the example of suffering through the pains and taking them in stride and not giving in to the temptation to avoid them or to seek release from them through an impulsive indulgence of pleasure-giving behaviors.
Likewise, the Christian counseling approach does not have to harp on moral weakness, as the biological basis of the brain disease that is addiction does not imply a moral stigma or weakness of will. However, the disease model may not be entirely appropriate as it does not adequately factor into account the impact of the will, of the mental state, and the desire of the individual. A CBT approach for instance would not rule out the focus of eliminating the concept of addiction as a disease because this pits the individual in a context that is adversarial instead of controlling. The individual should be made to show how he or she is in control of the addiction and not the addiction in control of him or her. Therefore it is helpful to examine how the disease label can be removed so that a more spiritual approach with positive social supports can be given.
For an addict, the counselor should ask if the person was religious of if he or she had any particular inclination towards prayer as a form of intervention. We might discuss the subject of prayer and what researchers in the past have indicated about it and whether or not it can be an effective approach to therapy. If the person were inclined to pray or had expectations of prayer being helpful, methods could be discussed and how to use prayer effectively in the session. The important thing to do would be to set parameters so that both the client and counselor know what is expected of both. Once parameters have been set — say, for instance, to begin and end each session with a prayer to God — it would be important to note what is being praying for, how it is wanted for God to intervene. That would entail devising a prayer for the session. It could be one agreed upon or one the counselor and patient write. It could also be left open and each prayer could be spontaneous. Who would lead the prayer would also have to be discussed. In this way, prayer would be used to assist in the therapy but it would not be the sole means of therapy. Also it would show that the counselor is respectful towards the client’s wishes and needs and that he is open to whatever course of action he or she saw as best. This would facilitate the formation of a strong alliance between me the therapist and the client. This alliance based on trust and respect is important in the development of the therapy and would also improve the chances of prayer being effective in the course of the sessions.
Conclusion
In conclusion, sexual and drug addictions have a biological basis that is also considered neurobiological in that the mind is seeking a euphoric state. The effect of drugs and sex excess on the body can be devastating, as it can lead to depressive states (not having the high all the time), dependency, disease, infection, and the harming of organs like lungs, kidneys, heart, depending on the severity and use. Prayer can be an effective addition to CBT counseling for these diseases and the Christian worldview can give assistance to the therapy by providing a spiritual emphasis that can help in turning the addict’s life around away from pleasure-seeking towards a more Christian orientation of carrying one’s cross.
References
Asamsama, O., Dickstein, B., Chard, K. (2015). Do scores on the Beck Depression
Inventory-II Predict Outcome in Cognitive Processing Therapy? Psychological Trauma: Theory, Research, Practice and Policy, 7(5): 437-441.
Chambers, A., Taylor, J., Potenza, M. (2014). Developmental Neurocircuitry of Motivation in Adolescence: A Critical Period of Addiction Vulnerability. The American Journal of Psychiatry, 160(6): 1041-1052.
Cotto, J. (2010). Gender Effects on Drug Use, Abuse, and Dependence. Gender Medicine, 7(5): 402-213.
Gilbert, D. (2014). The Novena to St. Boniface of Tarsus: A Pastoral Program for Addressing Sexual Addiction in Colonial Mexico. Catholic Social Science Review, 19: 87-109.
Kalivas, P., Volkow, N. (2014). The Neural Basis of Addiction: A Pathology of Motivation and Choice. American Journal of Psychiatry, 160(8): 1403-1413.
Karila, L. et al. (2014). Sexual addiction or hypersexual disorder: Different terms for the same problem? A review of the literature. Current Pharmaceutical Design, 20(25): 4012-4020.
McNeil, A. (2013). Person-Centered Therapy and Transgenerational Family Therapy.
HTP 2025-Systems of Pscyhotherapy.
Mullet, D., Rinn, A. (2015). Giftedness and ADHD: Identification, Misdiagnosis, and Dual Diagnosis. Roeper Review, 37(4): 195-207.
Newcomb, M. (2014). Sexual Orientation, Gender, and Racial Differences in Illicit
Drug Use in a Sample of U.S. High School Students. American Journal of Public Health, 104(2): 304-310.
Sasso, K., Strunk, D., Braun, J. (2015). Identifying Moderators of the Adherence-
Outcome Relation in Cognitive Therapy for Depression. Journal of Consulting and Clinical Psycholgoy, 83(5): 976-984.
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