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In the case study involving Sofia Santiago, the client suffered from alcohol addiction and has been in recovery from alcohol for twenty years. The family background reveals that Ms. Santiago had no knowledge of her biological father; however, the guardian figure representing her father was extremely an alcoholic, who she thought for many years that was his father. Cases of child molestation at the age of 15 led to low self-esteem and depression. Ms. Santiago associated her drinking habits with her Hispanic origin, which later developed to 10 years of addiction. This paper attempts to explain the theories of addiction in relation to the case study; the paper starts with a discussion of the major theories of addiction and then identifies the factors related to the addiction.
Major Theories Discussion
Addiction refers a failure to abstain from a behavior irrespective of efforts aimed at doing so or complaints by the individual that he/she cannot control the behavior. Numerous theories have been suggested in attempt to explain the causes and maintenance of addiction, with each theory being unique in its concepts and assumptions regarding addiction. This discussion focuses on the major concepts of three theories of addiction, which include behavioral, psychoanalytical and cognitive theories.
Behavioral theories of addiction place direct emphasis on observable behaviors. Behavioral models of addiction entail various aspects such as socio-cultural values, situational factors, personality differences and situational variables. With regard to cultural values, it is apparent that different cultures perceive different substances in variant ways. It is through the difference in perception that plays a significant role in encouraging the use and reaction towards an addictive act or substance (Thombs 145). The fundamental inference is that the presence of a substance in a particular culture can lead to addiction. In this case, an example is there is a cultural acceptance of drinking for every individual in the Hispanic culture, whereby people drink to pass time. With regard to social values, it is apparent that observable behavior can play an integral role in initiating addiction; perhaps, Ms. Santiago developed an alcohol addiction because of his extremely alcoholic stepfather. In addition, some level of drinking was allowable in the family values. The core assumptions under behavioral theories are that an addiction is a learned behavior, and people develop addictive behaviors, especially drug abuse, when modeled by other people or situational variables (Thombs 158).
Psychoanalytical theories of addiction perceive drug addicts are self-medicating, and drug abuse and addict is symptom that indicates the underlying psychological issues affecting the individual. An addictive behavior is somewhat an example of a maladaptive psychological coping strategy. In most cases, individuals develop an addictive behavior out of the need to resolve an internal conflict, implying that when they succeed to resolve the conflict, drug use will be needless. However, failure to resolve the internal conflict results in the development of an addictive behavior. Anxiety is the primary force behind psychoanalytic theories of addiction. In cases whereby anxiety overwhelms an individual, such a person depends on defense mechanisms like denial, justification, projection and avoidance to engage in drug addiction. Denial is a common phenomenon among alcoholics, who frequently deny suffering from the problem, as in the case of Ms. Santiago. A contemporary psychoanalytic approach of drug addiction is that people abuse substances as defense method against anxiety. People abuse alcohol and other substances in order to protect themselves against devastating anxiety and other painful emotions like loneliness and depression. Such emotions make a person vulnerable to develop an addictive behavior by developing effective coping mechanisms. In the case of Ms. Santiago, such emotions of depression are evident in the case of child molestation that took place during her childhood. In addition, Ms. Santiago states that alcohol made her sociable and overcome depression associated with family problems.
Cognitive theories of addiction suggest that self-regulation is plays an integral role in the development of addiction problems. Self-regulation refers to a planful action undertaken to alter the course an individual’s behavior, the capacity to plan and monitor one’s behavior effectively; mostly due to changing situations (Thombs 147). Self-regulation entails planning, taking into consideration the physical and social factors and individual goals. Under the cognitive addiction model, addictive behaviors derive from developing an extreme dependence on external structures to preserve psychological and physical balance. In addition, expectations, beliefs and behavior of surrounding persons play an integral role in influencing the person’s mental set. For instance, Ms. Santiago claimed that alcohol made her sociable and eliminates the fear of people. As a result, she developed methods to increase her drinking through using diet pills and cocaine because they enabled her to drink longer.
Issues/Factors Related to Client’s Addiction
The DSM-IV criteria for addiction involves a maladaptive behavioural pattern that leads to clinically significant impairment of stress, which is evident through persistent substance abuse leading to significant failures to fulfill important obligations at work, home or school. It is apparent that Ms. Santiago was not able to control her children and called many sick days off at her place of work. The second criterion involves the use of recurrent substance in scenarios that are physically hazardous (Thombs 154). The third criterion involves continued substance use irrespective of persistent social and interpersonal problems imposed by the substance. For instance, Santiago was frequently a blackout drinker, and sometimes got hurt and woke up in strange places without remembering how she got there. In such case, it is apparent that she could not fulfill her family roles as a mother, yet she continued using alcohol, which impaired her judgment.
The possible biological contributions to his drug addiction could result from adoption by a non-biological father who was alcoholic. The degree to which genetic factors influence addiction is unclear in this case because Santiago had no knowledge of her biological father. Alcohol and other drugs play a significant role in self-medication, as explained under the psychoanalytic theory of drug addiction. Drug abuse in itself is a symptom of the core psychological problems affecting the addict; as a result, the addicts perceive drug use as a maladaptive and psychological coping strategy for the underlying social problems. Self-medication of alcohol results from the fact that it depresses the central nervous system, and naturally calms nervous reactions, impairs memory recall, which creates a relief for people struggling with emotional and psychological issues.
Social influences play an integral role in a person’s addiction because of the coercion associated with imitating behaviours of people around. Substance abuse is a social learning process that involves surrounding involves. In this case, Santiago could have learned drinking from her stepfather and the fact that drinking is a common social norm among the Hispanics. Her alcohol addiction affected numerous multiple domains of her functioning including work, health and family. For example, her addiction affected work through frequent sick days off, although she managed to keep her job. The addiction also affected the family in the sense that she lost control over her children and her boyfriend threatened to leave her if she could stop the addiction. With regard to health, it is evident her blackout drinking played a role in her contracting HIV/HIV/AIDS.
The family plays an important role in maintaining the dysfunctional family system because it influences the social values adopted by a person. For instance, family values shape one’s personality and reaction to substances. In this case study, Santiago’s family background was extremely dysfunctional as characterized by an alcoholic father, child molestations and allowable drinking, which played a significant role in developing the addiction.
Denial is a common phenomenon with addiction, Santiago states that there was more shame in admitting that she had problem with alcohol. As a result, she devised methods to increase her drinking by using rum, cocaine and diet pills, which she admitted that were the real problem. Denial maintained her addiction through justification of the behaviour and devising methods to increase her drinking.
The individual and social factors account for ongoing sobriety among the client included the perceived dangers associated with drinking on close people around her. Ms. Santiago was scared of getting hurt and was afraid that something bad could happen to her children. Perhaps, this realization played a significant role in establishing the efforts to sobriety. The recovery methods used include psychotherapy, which facilitated her realization of the depression, and the causes and triggers of her drinking. The treatment was effective in helping the client overcome the addiction.
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