It seems to me that addiction:
- is dynamic
- has a form
- consumes energy and manages affects
- is influenced by genes and is also developmental
- has substructures that are simultaneously independent and interdependent
- adapts to reality.
Let me expound each of those points in turn.
Addiction is fluid, not static. Once in place it undulates within, among, and between various factors including periods of abstinence, types of presenting problems, and primary chemical(s) being used.
Nonetheless, addiction has a form. And that form is captured at the screening level by its two first-rank symptoms, and at the diagnostic level by the Big 5 SUD criteria. Addiction includes impulses; these can impact cognition and be given a voice.
Addiction sets up an altered kind and ranking of priorities, as survival mechanisms are arranged. The epigenetic complexity of this includes biological and social epigenetics.
During its course, physical dependence may form, psychological dependence may form, as may cravings and urges. The dissonance between premorbid internalized values and addiction-driven behavior leads to rationalizations and eventually dramatically different values to resolve or prevent dissonance. All of these constitute substructures that operate on their own and may interact.
Ultimately, addiction incorporates all external and internal reality into its central pathology, assimilating what is into its disease-state psychological framework and using-related mechanisms. In that way its imploding cyclonic nature slowly intensifies and progresses over time.
By the way, I borrowed that list of bullet points above from a previous author and will name that author toward the conclusion of this work.
But for now, it further seems to me that recovery:
- is dynamic
- has a form
- requires energy and manages affects
- is influenced by genes and is also developmental
- has substructures that are simultaneously independent and interdependent
- adapts to reality.
Let me expound.
Recovery shifts in time by the individual’s type of path, nature of the current path, and the larger process of change.
However, at the population level its form is recognizable, combining stages and simultaneous changes that are continuous across stages. These simultaneous processes include extrication, accommodation, and shedding. Examples during recovery include serial abstinence by drug class, and the changes associated with each. Wellbeing and its management phase has its own content as well.
Social energy from individuals and groups is a hallmark. And affect management (in both the “do” and “don’t” direction, related to both aversive and pleasurable sensations and feelings) is intrinsic to what recovery is.
Recovery is socially transmitted and socially epigenetic. Recovery is developmental by its nature and its stages of progress, resulting from the (person x environment) contemporary context.
The recovery process and recovery as a thing in itself each have substructural components. The recovery model’s meaning, value, content, and assistance from others found in language and behavior, constitute an external reservoir. And these may be internalized and even incorporated into self. These resources both stand alone and act synergistically with each other and with the person as they are.
Recovery also faces reality and grapples with reality as it is. This further sculpts the self, the (self x reality) intersection, and the lived and present recovery that is potential in time and in the contemporary context. In that way recovery can take on an increasingly cyclonic nature, leading to an expansive kind of “better than well.”
By the way, you will notice I borrowed that same framework once again, and this time applied it to recovery.
So, it would seem that both addiction and addiction recovery involve the human mind. As such, it might behoove us to grasp the nature, structure, and function of the human mind – insofar as we are able to do.
Could we look to the same source for starting places related to the human mind as I used above for both addiction and addiction recovery?
The metapsychology of the human mind outlined by Sigmund Freud (as he was able to achieve with the tools available in his time), included the following assertions. He asserted that the human mind:
- is dynamic,
- has a form,
- is seated in energy and manages affects,
- is influenced by genes and is also developmental,
- has substructures that are simultaneously independent and interdependent,
- and adapts to reality.
It is striking to me that this list is as relevant today, or perhaps even more so, than the era within which Freud developed it.
Perhaps further efforts applying this metapsychology specifically to our work on helping people overcome severe SUDs would be fruitful as a research agenda.
Resources and Suggested Reading
Coon, B. January 28, 2025. Proposing Two First-Rank Symptoms of Alcoholism.
Coon, B. January 26, 2022. A Fresh Look at “The Big 5” Substance Use Disorder Criteria.
Coon, B. July 8, 2021. WHERE is Addiction?
Coon, B. September 8, 2020. The Change Process.
Freud, S. (2008). General psychological theory: Papers on metapsychology. Simon and Schuster.
Recovery Review 