This is true for all chronic lifestyle-related illness. It is hard to keep this dynamic concept of biopsychosocial processes in mind. We are so used to seeing these three levels (biological, psychological, and social) as distinctly separate things rather than dynamically interacting processes that it us difficult to keep the continuous dynamic interactions in mind.
In addiction, the reward system of the brain distorts the biological basis of thinking and feeling. The mind reacts psychologically by developing an addictive belief system and self-reinforcing denial systems. These addictive psychological systems cause changes behavior which in turn effects relationships and social consequences. As relationships change, behavior adapts to accommodate changing relationship dynamics. The personality slowly adjusts to accommodate the new emerging social reactions.
The brain is plastic. This means that the brain grows and changes in response to thoughts and behavior. The brain adapts in ways that reinforce the entire addictive process.
The addictive drugs and behaviors become central to “normal” functioning of the brain, mind, and social system.
This entire self-reinforcing process is like a wave passing rapidly from brain to mind to social consequence and back again – but nearly at the speed if light.
It is much easier to think of three concrete things: the addictive brain, the addictive mind, and addictive social/cultural systems. It is important, however, to keep the dynamic interaction of these three levels of being in mind. All three need to be included in comprehensive treatment.
These three levels must be addressed concurrently, not sequentially. All stages of recovery contain physical, psychological, and social recovery tasks. All three approaches need to be integrated in individually designed programs if treatment.