Introduction: Breaking the Cycle of Addiction
Welcome! In this chapter, we explore the different ways psychologists try to help people overcome addictions. Breaking an addiction isn't just about "willpower"; it involves complex biological changes and deep-seated habits. We will look at three main ways to reduce addiction: biological (drugs), behavioural (learning new associations), and cognitive (changing thoughts). Finally, we’ll look at Prochaska’s Six-Stage Model, which explains the journey a person takes when they decide to change their behaviour.
Don’t worry if some of the medical or psychological terms seem a bit heavy at first. We will break them down step-by-step!
1. Drug Therapy
Drug therapy treats addiction as a physical problem in the brain. Because addiction changes brain neurochemistry (like how dopamine works in the reward system), medicine can be used to "rebalance" the brain or make the addiction less rewarding.
How it works:
- Agonists: These are "substitute" drugs. They activate the same receptors in the brain as the addictive substance but are safer and controlled. For example, methadone is used to treat heroin addiction. It satisfies the craving without the dangerous "high."
- Antagonists: These block the brain's receptors so the addictive substance has no effect. If a person takes an antagonist and then tries to use their drug of choice, they won't feel any pleasure from it.
- Reducing Withdrawal: Some drugs help manage the horrible physical feelings (withdrawal) that happen when someone stops using nicotine or alcohol.
Quick Review: Drug therapy is great because it acts fast and is easy for the patient to do (just take a pill or liquid). However, it might just be swapping one drug for another, and it doesn't fix the underlying reasons why the person started the addiction in the first place.
2. Behavioural Interventions
These treatments are based on the idea that addiction is a learned behaviour. If you learned to love smoking or gambling, you can "un-learn" it through conditioning.
Aversion Therapy
This is based on Classical Conditioning. The goal is to make the person feel a strong dislike (aversion) for their addiction by pairing it with something unpleasant.
Example: An alcoholic might be given a drug (an emetic) that makes them feel extremely sick if they drink alcohol.
1. Alcohol (Pleasure) + Emetic (Nausea) = Vomiting.
2. After several repetitions, the person associates Alcohol = Nausea.
3. They no longer want to drink because the thought of it makes them feel sick.
Covert Sensitisation
This is a "kinder" version of aversion therapy. Instead of actually making the person sick in the real world, the therapist asks the person to imagine the unpleasant consequences.
Example: A smoker might be asked to imagine smoking a cigarette that is covered in feces or imagine themselves getting extremely ill in front of their family. Because this happens in the person's mind (covertly), it is less physically distressing than real aversion therapy but uses the same logic of negative association.
Key Takeaway: Behavioural therapies are good for breaking the immediate "habit," but they require the person to be very motivated to keep going with the treatment.
3. Cognitive Behaviour Therapy (CBT)
CBT assumes that addiction is caused by irrational thinking and poor coping skills. The goal is to change how the person thinks about their addiction and give them the tools to handle life without it.
The Two Main Parts of CBT:
- Functional Analysis: The therapist and patient work together to identify "triggers." These are the people, places, or feelings that make the person want to use (e.g., "I only gamble when I'm stressed about money").
- Skills Training: Once triggers are found, the patient learns new ways to cope. This includes:
- Cognitive Restructuring: Challenging the "addict logic" (e.g., "I'm due for a win").
- Social Skills: Learning how to say "no" when friends offer them a drink or a cigarette.
- Stress Management: Learning to relax without using a substance.
Did you know? CBT is often considered one of the most effective long-term treatments because it empowers the patient with skills they can use for the rest of their lives.
4. Prochaska’s Six-Stage Model of Behaviour Change
Prochaska realised that people don't just "quit" overnight. Change is a process, not a single event. He identified six stages people go through when trying to stop an addiction.
The Six Stages:
- Pre-contemplation: The person has no intention of changing. They might be in denial ("I don't have a problem").
- Contemplation: The person starts to think they should change but isn't ready yet. They weigh the pros and cons ("I'd save money, but I'll be bored").
- Preparation: The person decides to change and starts making small plans (e.g., buying nicotine patches or booking a doctor's appointment).
- Action: The person actively changes their behaviour (e.g., stops smoking). This stage usually lasts about \(6\) months.
- Maintenance: The person has stopped the behaviour for more than \(6\) months and is working hard to prevent a relapse.
- Termination: The "ultimate goal." The person is no longer tempted and has \(0\%\) chance of returning to the old habit. Note: Some psychologists think this stage is rare; many people stay in 'Maintenance' forever.
Why is this model useful?
It helps therapists match the treatment to the stage the person is in. You wouldn't give "Action" advice to someone who is still in "Pre-contemplation" because they aren't ready to hear it!
Common Mistake to Avoid: Don't think of this as a straight line. People often "recycle" through the stages. Someone might reach Maintenance, have a relapse, and drop back down to Contemplation. This is a normal part of the process!
Summary Table: Comparing Interventions
Drug Therapy: Focuses on Biology. Fast-acting but treats symptoms, not causes.
Behavioural: Focuses on Learning. Breaks habits through association (Classical Conditioning).
CBT: Focuses on Thinking. Provides long-term coping skills and triggers awareness.
Prochaska: Focuses on the Process. Recognises that change takes time and happens in stages.
Quick Review Quiz
1. Which therapy uses an "emetic" to create a negative association? (Answer: Aversion Therapy)
2. What is the first stage of Prochaska's model? (Answer: Pre-contemplation)
3. In CBT, what do we call the process of identifying "triggers"? (Answer: Functional Analysis)
You've reached the end of the notes for reducing addiction! Remember, the AQA exam often asks you to compare these methods, so think about which ones are easier to stick to and which ones treat the "root cause" of the problem.