Psychology & Buddhism.pdf

114 G. Rita Dudley-Grant
orientation, or disease theory; a systems theory, which looks at the role of family
and the environment in the development and maintenance of addiction; a psychodynamic
approach; and a cognitive behavioral formulation. Each of these
approaches has generated a specific set of interventions founded on that particular
theoretical formulation.
The disease theory posits that alcoholism and drug addiction is a disease
stemming from a biological substrate, which can be structural, chemical, neuropsychological,
physiological, electrophysiological or genetic. While the actual
physical marker has not yet been identified, studies have strongly suggested biological
links, which may contribute to the development of alcoholism and other
drug addiction in individuals such as found in family, twin and adoption research
(Goodwin, 1979). For example, Dinwiddie and his associates (Dinwiddie &
Cloninger, 1991; Dinwiddie & Reich, 1991) have reviewed the epidemiological
literature and found that there is a significant interaction between genetics
and the environment. This interaction often leads to the increased incidence of
alcoholism in the children of alcoholics.
Systems theories have probably been the most heavily researched, particularly
from the perspective of Adult Children of Alcoholics. Risk factor studies
clearly show the higher prevalence of alcoholism and drug addiction in persons
who have substance abuse in their family backgrounds. Moreover, addiction is
highly associated with dysfunctional interactions in families including all types
of abuses, physical, sexual, domestic violence and child abuse and neglect. The
role of the environment in promoting and maintaining substance abusing behavior
is also recognized. Hence, survey data indicates that while substance abuse
appears to be abating among young adults, it remains entrenched among selected
populations, particularly those in the inner city (Craig, 1993).
Behavioral approaches to the understanding of drug addiction tend to look
at the strong reinforcers inherent in the substance itself, which serve to maintain
the behavior despite its devastating impact. The cognitive behavioral model of
addiction theory draws upon early learning and environmental experiences that
negatively influences the individual. These early abuses and neglects result in
excessively disparaging self-statements contributing to poor self-image, impulsive
behavior including immediate gratification, and dependent helplessness. The
consequence is the repetitive self-destructiveness of addictive behavior, despite
knowledge of negative outcomes (McCrady, 1994).
From a psychodynamic perspective, addiction has been seen as resulting
from a psychological process where the individual is trapped in infantile, narcissistic
repetition compulsion. Immediate gratification is the sole method of functioning.
Psychodynamic theories (Blatt, McDonald, Sugarman, & Wilber, 1984)
look at unconscious processes, which result in and manifest the addiction.
Theoretical constructs such as subconscious motivations and fixations can lead to
psychic dysfunctions. The ensuring disorders such as repetition compulsions,