The Most Neglected Aspect of Addiction Recovery

Written by Steve Rose

Steve Rose, PhD, is an addiction counsellor who assists those struggling with substance abuse, gambling, gaming, and internet addiction.

I used to think addiction was an obsession with pleasure.

Growing up with a stable upbringing, secure mental health, and a relative lack of any enduring hardships, I assumed people regularly used drugs because they loved the pleasure of getting high.

It never occurred to me that perhaps people are not addicted to pleasure; people are addicted to a way of escaping pain.

This way of thinking about addiction changed everything.

Rather than a form of overindulgence, I began thinking of addiction as a form of self-medication. Thinking about it as merely an overindulgence only recognizes the tip of the iceberg, neglecting the massive invisible pain underneath.

What are the underlying causes of addiction?

The underlying causes of addiction can be classified in each of the following areas: psychological, biological, and social/ spiritual.

Although many people might use substances to escape from psychological pain caused by trauma, not everyone who has suffered a trauma will form an addiction.

Also, one could argue genetic risk factors cause addiction. But this still didn’t answer the question of why some people with a genetic risk don’t form an addiction.

As a sociologist, I decided to look at how our social environments also contribute to addiction.

Our brains don’t operate in a vacuum. Our minds are continually sending and receiving signals within our social worlds. We are social beings and therefore need to look at our social context to understand addiction better.

Everything I learned from my research on veterans in transition to civilian life as taught me that social life matters… a lot. Without strong social ties, we risk feeling isolated, and life loses meaning.

Feeling isolated is different than being alone. We can feel isolated within a crowd, and we can feel connected while alone.

When we feel isolated, we experience a lack of meaning. Meaning comes from being connected with something larger than ourselves. Some people may think of this as a form of spirituality. Our social environments may also fill this function.

Becoming obsessed with the social roots of addiction, I needed to create a model of how this worked. I felt like I was on the verge of figuring it out.

One evening, everything seemed to click. I’d been thinking about the individual, society, and the interaction between the two. But what was the missing link?

I believe the missing link is purpose. 

Treating addiction by rebuilding purpose

Addiction closes us off to the outside world. We are so preoccupied with self-medicating, we cannot see beyond ourselves.

We are also closed off to our inner world. We lose touch with our unique skills and ability to contribute to the world. We lose touch with our values and no longer focus on our prior interests.

Our basic psychological needs go unmet, feeling isolated, trapped, and on a downward spiral. Meaning collapses, and we fall into despair.

Addiction is a way of coping with the pain of this despair.

Luckily, addiction doesn’t need to be the answer.  Overcoming despair requires connecting with a sense of purpose.

Rebuilding purpose takes time. It requires gaining a certain level of awareness regarding our unique abilities, values, and interests. It then requires connecting our capabilities to a social context where we can gain a sense of contribution and belonging, two major ingredients of purpose.

Someone with an addiction may feel so preoccupied, self-concerned, and isolated; the word “contribution” and “belonging” is the last thing they can think about.

Although it may take time, I believe rebuilding purpose should be the central long-term treatment goal for persons with addiction.

Purpose builds meaning

Addiction is a problem of meaning.

Rather than merely looking at addiction as a disease, we need to broaden our understanding of what drives addiction so we can better address its root causes.

How is addiction a problem of meaning?

Without a sense of meaning and purpose, a person may turn to drug use and addictive behaviors to fill the void of an existential vacuum. The problem is that this void is infinite. In eternal torture of this infinite void leaves a person feeling like they can never get enough.

As one goes further down this infinite rabbit-hole, one takes on an increasingly distorted view of themselves and the world. Not only can they never get enough, but they themselves are never enough.

In this void, defense mechanisms protect the ego, perpetuating self-destructive behaviors. They are rationalized, minimized, and justified at all costs.

As one’s former self becomes a faint glimmer at the beginning of a long tunnel, the descent into addiction reorients one’s sense of meaning and purpose. If it takes over, the addiction becomes the sole guiding principle.

Why get up? Why leave the house? Why do anything? Engaging in the addiction becomes the sole purpose.

It is paradoxically a nihilistic sense of purpose. It answers the why question but leaves the person caught in a self-referential loop of desperation and despair. Like Victor Frankl said: “suffering without meaning is despair”.

So how do we get someone out of an addiction?

The answer is not simple, nor is it easy. Beyond potentially useful medical treatments, we need to look at rebuilding the persons “why”. As Friedrich Nietzsche said: “He who has a why to live can bear almost any how”. 

Victor Frankl proposed his concept of logotherapy as a treatment for addiction. Put simply, it is a form of talk therapy that attempts to rebuild a person’s sense of purpose by exploring things that are meaningful to them.

Although this concept is not often used in the addictions field, the more recent concept of motivational interviewing builds on the same ideas, becoming a gold standard counseling technique with hundreds of studies showing its effectiveness.   

Motivational interviewing is a collaborative conversation focused on helping a person gain motivation to change. This is done by eliciting their reasons for change and collaborating on an action plan. See Miller and Rollnick’s book for more information on this counseling method: Motivational Interviewing: Helping People Change.

If you’re struggling to support someone with an addiction, you may be interested in reading my article: The Ultimate Guide to Helping Someone Change.

When talking to a loved one suffering from an addiction, it is important to remember that they already likely feel socially isolated, so harsh judgments, criticisms, and tough love are generally counterproductive.

Ideally, a person struggling with an addiction accepts treatment and can find a high-quality counselor or psychologist. Counseling can help someone connect with their “why”, rebuilding purpose, in addition to building helpful coping tools for dealing with painful thoughts and emotions.

Although counseling can be helpful, it still focuses on the individual. Increasing the use of counseling while neglecting an unhealthy social environment is like trying to fix an overflowing sink by buying more mops. Instead, we need to look at the source of the problem and work on turning off the tap.

Purpose is found in community

How do social environments produce addiction?

Unhealthy social environments produce addiction when there is a lack of community. When people no longer feel like they belong, and their sense of purpose is lacking, they are left with the existential vacuum mentioned in the beginning. In his book SuicideSociologist Émile Durkheim states:

“Man cannot become attached to higher aims and submit to a rule if he sees nothing above him to which he belongs. To free him from all social pressure is to abandon him to himself and demoralize him.”

Community is essential to our “why”. At its root, community means being integrated into a network of individuals who you feel have your back, and therefore, you have theirs. On the one hand, this is a sense of belonging; on the other hand, it is a sense of service. This is what gives us real meaning.

As we all continue to reach out every day to the things that save our lives from utter meaninglessness, we need to be mindful of how our social environments foster this sense of resilience through purpose and belonging.

No one randomly wakes up one day and rationally decides to become addicted to something. Addiction is a symptom of larger forces.

Rather than looking at addiction as an individual disease, we need to understand addiction as a social disease.

Individual counseling needs to help connect individuals to their broader social environment, while politicians, business owners, and everyday citizens need to work at facilitating better communities.

Practically speaking, this may involve counseling for the family of someone suffering from an addiction. According to a Canadian study, family counseling is the most neglected aspect of treatment.

Other unique treatments include cultural interventions, specifically when supporting indigenous populations. A review of the literature on cultural interventions found “benefits in all areas of wellness, particularly by reducing or eliminating substance use problems in 74% of studies.”

Summary

When we have a why (purpose), we figure out the how. It is community that helps us connect to this why.

Since I’ve come to this understanding of addiction, I’ve noticed how many misconceptions still exist.

When we blame addiction solely on the individual, narrowly viewing it as excessive pleasure-seeking, we neglect the deeper reasons driving the addiction.

In the treatment field, this is also neglected. Individual counseling to develop coping skills is essential, but these coping skills cannot answer the deeper question: what will fill the void of meaning?

Expecting someone to give up an addiction without offering a source of meaning is a recipe for relapse.

If you are interested in reading more on my approach to developing a purpose, you can check out my article here: What Does It Mean to Have a Purpose?

Looking for Mental Health Support?

BetterHelp.com provides online counseling for persons struggling with anxiety, depression, low-self-esteem, social isolation, and various other issues. Check out their site here to learn more. Their main benefit is lower costs, high accessibility via their app, and the ability to switch counselors quickly and easily.

Online-therapy.com also offers support for persons looking to optimize their mental toolbox. Click here to learn more about their program based on the evidence-based practice of Cognitive-behavioral Therapy (CBT).

*As an affiliate partner with Better Help and Online-therapy.com, I may receive a referral fee if you purchase products or services through the links provided.

If you are looking for a specialist near you, use the Psychology Today therapist directory here. Although prices are generally higher on this directory, many of the practitioners accept insurance. 

As always, it is important to be critical when seeking help, since the quality of counselors and therapists are not consistent. Also, one of the most important factors in successful treatment is the quality of the therapeutic relationship. If you are not feeling supported, it is important to seek out another practitioner.

Curious if online therapy works? I wrote an article here, looking at the evidence.

If you’re just bored and looking for a new hobby, check out Skillshare. with thousands of classes to choose from, this online community allows you to gain new skills, network with peers, and find new opportunities. Check out their free trial here.

*As an affiliate partner, I may receive a commission if you sign up for a free trial. 


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44 Comments

    • Steve Rose

      Thanks for the interest! I will keep publishing articles here, but in addition to the articles, I have started a new project recording an audio/visual series of online modules explaining practical techniques on how to communicate with someone suffering from an addiction. It is still in progress, so any suggestions on content that may be relevant to you is helpful.

      Reply
  1. Eliza

    Pretty true.
    Addiction thrives in isolation.

    Reply
    • Steve Rose

      For sure! This is why our natural fight or flight response to addiction, further isolating the individual, tends to make it worse.

      Reply
  2. The Work-Life Fitness Project

    I was just thinking of how helpful would it be to also design something on “how to self-talk” with one’s own addiction.
    And I couldn’t agree more with you on how changing the perspective we see addiction. How do we help people rebuilding purpose? I will think about it…

    Reply
    • Steve Rose

      Thank you for the suggestion! Self-talk tools are for sure helpful in working through cognitive distortions that further isolate us in unproductive thought patterns. When it comes to rebuilding purpose, I’ve recently come up with a model that seems to be helpful. Over the next few articles, I will try to lay it out in a more practical way.
      Thank you for your input. I look forward to hearing your own thoughts on rebuilding purpose.

      Reply
  3. Penny A Dean

    This is absolutely one of the very best articles I think I have ever read on addiction and I should know I am addicted to weed and ice atm, normally a poly user I have cut out a lot of drugs but these last ones, and the ice is proving far more difficult that I ever anticipated.
    This article could explain my hump. I don’t have any real life friends and am not allowed out so isolation is something I have become accustomed to over the last 18 years. That is not health for any young woman, let alone human being.
    Isolation and a lack of social bonds does bring about a lack of meaning and purpose.
    Purpose is that ideal on the horizon, that promise of something better, the wanting to give something back, the need to be needed and to be loved and to love. Purpose brings hope, passion, fulfillment and a sense of pride, it fills the void that is full of pain in which addiction festers and lies in wait greedily.
    … Wow. You rally put this so simply and eloquently,
    You are cut off from the entire world through your addiction, everything you view, touch, smell, taste, say, portray and do is shaped and viewed through the lens of your drug of choice in some way, shape or form. You become self-involved and retreat from others into a world that takes away all of the anguish inside. You become comfortably numb.
    Sometimes…
    You are just so filled with shame, loneliness and confusion that the way seems very dark and experiencing self doubt about your recovery is a harrowing experience.
    You are scared of who you confide in, because you have experienced judgment and condemnation before and the harsh stinging nettle of criticism thrown at you from all sides, including yourself.
    You have shrunk into a shadow of what you once were and all that you could be.
    Authenticity is lost, when you pride yourself on being real.
    Belonging and contributing are the last things we are thinking about, because we never believed we were good enough to be part of.
    Purpose brings hope and hope springs eternal….Maybe there is hope, for me, out of this thing called ICE….
    Thank you for a superb article.
    Very well said
    Kind regards
    ~Angelbrite~
    P.S I shall try to get my partner if he has time to share here, He doesn’t use or drink and has witnessed me love my drugs more than him for 18 years with patience, love, kindness, compassion and a steadfast loyalty which I have never known before. I am sure he could describe what it is like in a manner that I cannot.

    Reply
    • Steve Rose

      Wow! Thank you for sharing your personal experience. Looks like you are struggling with quite a bit of social isolation. If you don’t mind sharing, what is it that keeps you from being “allowed” out?

      Reply
  4. peaceoutandin17

    Hi Steve,
    I am very interested in your perspective on addiction (and other mental health issues) as a sociologist. I typically see things from a psychology point of view–more looking at the individual and not necessarily the person’s connections. Thank you for sharing this article. I’m going to check out what else you have written here.

    Reply
  5. bidayatalnihaya

    Steve, really interesting to understand the difference between isolation and loneliness; there seems to be a lot in the media that our generation is the loneliest so this is very topical. Would be good to hear how you would put your thoughts above into practice.

    Reply
  6. hurlwinds

    You’re right.
    Drugs and alcohol are never the issues for those of us who are addicts. At least not in the beginning.
    Drugs and alcohol are our solution; we are the problem.
    We had shit going on prior to turning to substances and that same shit is still waiting on us when we get sober, but now we get to face them absent of having the chance to turn around and cling to the coping mechanism that we’re used to utilizing. Whether that be the bottle, the straw, the razor blade, the promiscuous sex, the needle, etc. It’s uncomfortable for a long time after, and it sucks ass.
    I always refer to my early sobriety as “repair mode,” because I’m just scurrying around, helplessly trying to fix everything that I can. I say “helplessly” because I destroy all of my relationships while I’m using so by the time I’m ready to cut the bullshit, I have to put the pieces back together myself.
    Do I blame anyone other than me for that? No, absolutely not. I take full responsibility, but it’s hard. It’s really hard getting sober, and sometimes, it’s even harder to stay sober.
    Thankfully, I’ve been doing it for almost year now. Some days I don’t want to be, but it’s possible.
    Fuck addiction.

    Reply
    • Timeless Classics -- Poetry by Ana Daksina

      I’m sorry — the first part of that comment was lost. In it I offered that many of our culture’s independent self medicators would be uniquely, significantly and creatively contributive to our culture were it not for factors such as the extreme poverty caused by, and preoccupation with, problematic supply lines, inability to interface with an already prohibitively repressive employment system due to nearly universal drug testing, societal snap judgments around any uniqueness in personal appearance, facial expression, mannerism and tone of voice, and constant and overwhelming fear of imprisonment, as well as the total disruptions of periodic imprisonment itself.
      The link was meant to provide a resource for insight into long prevailing reasons for self medication in the creative arena.
      Happy to provide further communionon on this topic, with which my life path has brought me into frequent connection.

      Reply
    • Timeless Classics -- Poetry by Ana Daksina

      This comment has been scrambled like eggs in the sending. It’s first half, rewritten after itdisappeared, now appears as a reply to mr. hurl. It won”t copy and paste, and I just can’t write it a third tHope manage to unscramble it!

      Reply
      • Steve Rose

        Thank you, Ana! I figured it out. Your article makes a strong case for the link between creativity and self-medication. Your following quote illustrates this very well: “Such individuals, in the words of Robert Lowell, ‘see too much, and feel it with one skin-layer missing.'”

        Reply
    • hurlwinds

      I liked the article. It made me feel weird, but in a good way. Although I suppose I could just feel weird because I’m back on drugs. So much for a year, eh?
      Thanks for dropping the link!

      Reply
  7. LateNightGirl.org

    Good article. Thanks for the honest approach and an open mind.

    Reply
  8. A Goddess Awakening

    wow, this post really struck a chord with me. I decided after losing my mum to addiction it was time to finally be brave enough to write about my experience in the hopes that it raises awareness.

    Reply
  9. bennotzogood

    Really enjoyed this read. For an insight please check out myvaliumstory.org

    Reply
  10. Mark Kerry

    A very thought provoking and reasoned article. The area about isolation and being alone hits a cord with me. I am at risk of carrying out my addictions when I choose not to try or have social connections. At the moment I am going through my latest withdrawal and I am beginning to see my life’s purpose was about self. Letting self will run wild and not having a the desire to connect with others on a healthy intimate basis.

    Reply
  11. heroin heroine

    Thank you Steve for this article. My daughter suffers from addiction. She is 22. (You subscribed to my blog awhile ago). I think you are spot on re: the root causes. And I appreciate that you pointed out that it is both internal and external isolation. I could respond for an hour – LOL – but am on my way to work, unfortunately! 🙂 I just know that from the earliest age my daughter was “different.” She seemed to have a high anxiety/level of discomfort internal button.. and she was always trying to “fit in” but seemed to fail quite a bit at that. She tried so hard, and she never seemed to value her own strengths – always overshooting. When she would sleep I would whisper in her ear that she was smart, beautiful and loved by me. (Because I am not sure she believed it when she was awake). BUT she has found LTR – and it was through the 12 steps (which I think gave her enormous purpose and made her confront things she was uncomfortable with – and therefore work thru them). And she lives with others in LTR so she has found her “community.” She did recently relapse – but she found her way back quickly and that I think is because she has finally found inner strength – and has a social circle that loves her – and a job that she is really good at. She is n o longer isolated.

    Reply
  12. Maria Williams

    Thanks for sharing good information keep sharing more related article love it

    Reply
  13. DR AZMIN

    thanks keep posting

    Reply
  14. John Colin

    A very thought provoking and reasoned article. The area about isolation and being alone hits a cord with me. I am at risk of carrying out my addictions when I choose not to try or have social connections. At the moment I am going through my latest withdrawal and I am beginning to see my life’s purpose was about self.

    Reply
  15. Avneet Singh

    When you are connected with your purpose, you see nothing more than achieving your goals. Thanks for posting!

    Reply
  16. erfanju

    Addiction is a way of coping with the pain of this despair. when we care and love with addiction then you leave this habit.

    Reply
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    Reply
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    Reply
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    Reply
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    Reply
  21. The CareKart

    Well said! Really very informative blog. Keep the good work up.

    Reply
  22. Sunil

    very impressive post, thank you for sharing.

    Reply
  23. Geraldine McMath

    Really interesting article. I love this! Thanks for sharing.

    Reply
    • Steve Rose

      Thank you!

      Reply

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