Most professionals no longer see addiction as arising from a character flaw or a lack of willpower. Unfortunately, the addict often believes that his or her personal shortcomings are at the root of the addiction. This belief is based on accumulated experiences, like multiple failed attempts at stopping or cutting down, well-meaning but misguided loved ones suggesting that he or she just “try harder,” and above all, an awareness of the increasingly high costs associated with addictive behaviors.

Furthermore, the little bits and pieces of the recovery community that make it into the mainstream such as, “don’t have a pity party,” and “we are powerless over our addictions,” can often result in false beliefs about what recovery looks like.  Within context, these simple sayings have great meaning, but alone, they are confusing at best, and at worst can be used as weapons against the addict - don’t feel bad for yourself or, I’m powerless, so I might as well have another drink.

Today we recognize addiction as a chronic disease that changes both brain structure and function. Just as cardiovascular disease damages the heart and diabetes impairs the pancreas, addiction hijacks the brain.
— Harvard Mental Health Letter

Because of all of this misinformation, many addicts will never seek help, and many will continue to believe that their weaknesses are to blame. One of the first tasks in the therapeutic process is establishing a meaningful and accurate account of what addiction is, and how it works. The professional community is understanding that the brain of an addict looks different than the brain of a non-addict. This may be because of use, or it may predate use, but either way, it matters for recovery.  This is not an excuse, it is a reality. We are understanding that addiction is a very complex disease with multiple systems involved in its formation and continuation.

What does that mean for treatment? It means that there is no such thing as one-size fits all treatment for addictive diseases. Some people respond well to talk therapy, others respond better with the addition of medication. The twelve steps work great for many people, but some don’t find meetings further their recovery. Many people will have relapses, but some will not. All of these differences between people mean that it is important that the therapy be highly flexible and responsive. My motto when working with people struggling with addiction is: Do What Works.