The Bio-Psycho-Social Model Of Addiction

Posted on May 20, 2014

The Compass Of Pleasure
by David J. Linden
Michael Werner, SMART Recovery® Volunteer Coordinator, Wilmington, NC


CompassDr. Linden is a professor of neuroscience at Johns Hopkins University School of Medicine and has provided us with an authoritative science-based understanding of addictions: The Compass Of Pleasure.

In past years many models of the causes of addictions have been proffered, but it is only in the past few years that the neuroscience has had new tools to probe how the mind works in real time. We have greatly increased our knowledge of addictions from the study of the neurochemistry and neural pathways of the brain. The body of knowledge to support a bio-psycho-social model of addictions has been greatly supported by the new evidence.

Evolution has given us reward circuits to help us to survive and reproduce. Addictions subvert this normally helpful process and grow stronger over time, as the reward circuits in the brain are high-jacked.  The Compass Of Pleasure explains this new complex understanding clearly, but without dumbing it down.

I highly recommend this book, in fact it is something I think is a “must read” for everyone in SMART interested in a scientific approach to addictions. It is the best book on the biology of addictions I have seen, with a balance of scientific thoroughness presented in a style that makes it accessible by anyone. It is clear, funny, evocative, intellectually stimulating, and most important, provides a welcome alternative narrative to both the standard disease model, and the “it’s just a bad habit” psychological model.

The reality of a bio-psycho-social model is more nuanced and interactive. In our case we are focused, as we should be, on the cure and not the cause of addictions. Still, a fundamental understanding of the biology of addictions is crucial to our understanding of addiction recovery. In addition, I have found that having meeting participants understand the biological aspects of addiction demystifies that problem, relieves them of a lot of guilt, and empowers them to train the rational mind to “trump” the biological drives and proclivities and get off of “automatic pilot.” 

It is obvious from the science that treatment of addictions will be best served by a combination of pharmacological agents and the psychological tools we have now,  integrated into a whole treatment program.

The Compass Of Pleasure
by David J. Linden
(Viking books, New York NY, 2011)

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