The Psyche's Search for Relief

Psychology is the discipline by which the Psyche (the soul) seeks to understand the Psyche.  While the study of experiential phenomena is intrinsically interesting, it is the motivation to relieve suffering that drives the profession. 

For the Psyche, addictive disorders may be the greatest source of unnecessary suffering. Paradoxically, it is the motivation to relieve its suffering that maintains the addictive trap.  Consider the unintended consequences of using a substance or activity for pleasure or relief.  Mr. Hasslebring, for example, uses alcohol to "escape the stress and have a little fun."  But any external agent that has the power to grant pleasure or relief comes at a price: Mr. H. wants to use it again.  He may eventually want it so much that he loses control over how much he uses.  The technical term for this predicament is, The Paradox of Control: The consequence of using an incentive (alcohol in this case) as an emotion-focused coping device is to lose control over incentive use.

A nasty consequence of the paradox of control is that the conventional treatment strategy (in which the patient assumes the passive role while the treatment provider directs the action) typically makes the problem worse.  Both the treatment provider and the patient view the problem as a disease, over which the patient is powerless.  The best thing for the patient  to do is comply with the treatment regime developed by the provider.

For medical problems where the skill of the surgeon or the effectiveness of the medication is what determines outcome, this approach works well.  However, for problems involving self-management, treatment based on the medical model ultimately produces poor long-term outcome, despite inspiring reports of heroic short-term outcome.