What’s New in Addiction Treatments?
The last 20 years have altered the preferred modes of treatment from the mid 1900’s to 2000. The field went from psychoanalysis, though useful, it had little or no empirical support, through the role of reinforcement schedules in behavioral control, which eschewed the need for a brain, into cognitive behavioral therapy CBT which dealt with cognitive processes which didn’t have the knowledge available about the role of the nervous systems in both physical and psychopathological processes. These minor territorial battles culminated in a requirement for empirically evaluated strategies that could be placed in the clinician’s therapeutic toolbox because they were “evidence based best practices”. These were empirically tested therapeutic protocols/procedures with replicable results. At the end of that Era several lines of empirical research began to bear fruitful additions to our understanding of the origin of addiction.
Studies of Obesity by The Kaiser Permanente Medical Group found that obesity had a psychological advantage in protecting one from abuses of many types. The result was the introduction of the role of Adverse Childhood Experiences (ACEs) in many physical health and psychologically detrimental consequences. If you are interested, you can obtain your own ACE score online by pasting “Got your ACE score” in your browser, and a discussion of ACEs and the ACEs scale for the number of ACEs you were exposed to and a scale for resilience, the ability to resist the physiologically debilitating effects of the impact of experiencing ACEs.
I have been cautioned to keep the blog short so this enough for now. The teaser for future blogs includes what we learned about antecedents to addiction: epigenetics, the role of attachment, additions to our understanding of the roles of stress, chronic stress, trauma and other intriguing “Tid bits”.