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June 2022

The development of addiction and the dynamics of motivation

Journal/Book: Psychotherapeut. 1996; 41: 175 Fifth Ave, New York, NY 10010. Springer Verlag. 225-235.

Abstract: At the end of the 19th century the rule of abstinence was introduced into the treatment of alcoholism. Eversince the issue of motivation has been at the centre of modern treatment of addiction. At any time of the process of change the conflict arises wether to maintain or give up addictive behaviour. This basic problem has been reformulated again and again during the last 50 years. Attention was focused on the central idea that this process of change arises out of the development of addiction. At the same time the complexity and intrapsychic dynamic of the coping process have been described with ever more sophistication. Initially the concept of phases in the development of addiction was formulated. According to the underlying model of illness, the addiction gets worse and worse until a low is reached. This led to the therapeutic metaphor of rock bottom according to which the various negative consequences of the critical confrontational process lead to a gradual overcoming of the addiction. The model of coping formulated later stresses the powers of self-change within a maturation process. These powers turn against an addictive process which at midlife comes up against limits. This led to the therapeutically useful metaphor of a revolving door which emphasizes the importance of specific coping processes in different stages of change. In modern psychotherapy a motivational model of the intrapsychic dynamics of the process of change was developed. The opposing motivations towards maintaining the addiction or overcoming it through self-imposed abstinence reflect the ambiguity towards change as the core issue of the problem of motivation. The metaphor of a balance was created showing the pros and cons of either side of the conflict.

Note: Article J Petry, Psychosomat Fachklin Munchwies, Turmstr 50-58, D-66540 Neunkirchen, Germany

Keyword(s): development of addiction; motivation for change; process of self-change; ambivalence; RECOVERY

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