Why Behavioral Approaches to Addiction Don’t Always Work

Why Behavioral Approaches to Addiction Don’t Always Work


Behavioral approaches to addiction and substance abuse therapy have been tried in various forms and with limited success.

The reasoning goes that addiction and addictive tendencies are just more behavior…behavior that could be modified if people concentrated their efforts on changing it.

It’s been my direct experience that this does not work. Here’s why.

Behavioral approaches to addiction fall short

A behavioral approach might actually work for some people, and I have no problem with believing this. However, I would contend that such people are merely abusing drugs or alcohol and do not have full blown addiction. If they did, then a behavioral approach would not be sufficient.

Now I also realize that this is the same circular logic that some 12-steppers use to define their solution to alcoholism: they believe that if you can quit without using AA, then you were never alcoholic to begin with. Since I disagree with this logic (but still believe in the usefulness of AA), I want to explore exactly how I believe the behavioral approach fails in treating addiction:

1) Addiction is complicated – any true addict or alcoholic knows that their condition is complicated and was built up slowly over a period of years. We did not become addicts overnight, and our lives typically degenerate into a cesspool of toxicity and poor health that seems to stem from our addiction, including relationship problems, unbalanced emotional states, trouble keeping a job, and so on. It’s not all about the drugs. Addicts and alcoholics who have been using for several years have woven a complicated life into their addiction.

The behavioral approach is woefully inadequate to treat this type of condition. Imagine how complex our lives become in addiction with all of the different relationships we might be dealing with, including friends, family, coworkers, and loved ones, all hidden by this mask of addiction. A behavioral approach would need to be infinitely complicated to deal with these types of issues, reducing our individual thoughts and thought patterns down to “behavior.”

2) Addiction is not driven by behavior, it is only measured that way – I would argue that true addiction cannot be described in behavioral terms, at least as far as motivating factors go. I would agree with the Big Book of AA that addiction is best described as “a physical allergy of the body combined with an obsession of the mind.” Suggestions in recovery programs that attempt direct behavior modification–such as “avoid the people, places, and things that caused you to drink”–are only surface-level tactics that merely scratch the surface of recovery…these are not the core approaches that keep people clean and sober (such as the 12 steps or other similar faith-based programs).

3) Addiction affects the whole person, so only a holistic approach can be effective – behavior modification doesn’t fully treat the spiritual, mental, and emotional side of the disease. At best it helps with the physical and the social aspects, but it cannot hope to address all of these areas. Therefore a holistic approach is better suited to addressing all of an addict’s needs in recovery.