Addiction is often described as a relationship pathology. “Substance use disorders (SUDs) negatively affect individual social functioning,” wrote Pettersen, Landheim, et al in their 2019 study on how social relationships influence substance use disorder recovery. “In spite of a well-known tendency to consider SUD recovery an individual concern, several studies have evidenced that these processes do not occur in a vacuum.”
The authors point out that people with SUD “often lack many of the same social supports that those without SUDs have, experience isolation and domestic violence, and experience marital problems… On the other hand, supportive relationships with caring family, partners, and friends—including individuals who do not use substances themselves—have proven to be helpful in abstaining and maintaining sobriety.”
In this context, it is useful to look at attachment theory, a psychological, evolutionary, and ethological theory concerning relationships between humans first developed by British psychiatrist John Bowlby. He described attachment as a “lasting psychological connectedness between human beings.” The most important principle is that children need to develop a relationship with at least one primary caregiver for normal social and emotional development.
According to this model, there are four types of attachment:
- Ambivalent or anxious attachment: Children become very distressed when a parent leaves. This attachment style is considered uncommon.
- Avoidant attachment: Children with this attachment pattern avoid parents or caregivers, showing no preference between a caregiver and a stranger.
- Disorganized attachment: These children display a confusing mix of behavior, seeming disoriented, dazed, or confused.
- Secure attachment: Children who can depend on their caregivers show distress when separated and joy when reunited.
Avoidant, anxious, and disorganized are considered insecure attachment styles.
The Blanchard Institute offers a variety of flexible treatment options that can accommodate your individual needs. Our gender-specific continuum of care includes a partial hospitalization program (PHP), an intensive outpatient program (IOP), regular outpatient treatment, recovery management (RM), and a withdrawal management program. We provide the structure, support, and education clients and their families need for long-term recovery.
Blanchard programs are heavily relationship and family-focused. “Patients are with us for several months and families are required to participate as much as the identified patient,” says founder and CEO Ward Blanchard. “With us, family involvement is more like family restructuring or realignment.”
What’s your attachment style?
Secure. Avoidant. Anxious. Disorganized? Assessing a client’s attachment style can provide important insights into the deeper, underlying reasons for a person’s drug and alcohol use.
“Clients are given a short test to determine their attachment style,” says Olivia Garcia, LCSW-A, LCAS-A, one of Blanchard’s counselors at its Lake Norman facility. “We look at why it’s important to know your attachment style and how it’s related to a person’s disease of addiction.”
Insecure attachment styles have been linked to unhealthy attempts at self-medicating emotional pain with drugs and alcohol.
“Longitudinal studies and meta-analyses indicate that secure attachment is a protective factor against substance abuse, and insecure attachment is a risk factor for substance abuse,” wrote Andreas Schindler in his 2019 study on attachment and substance use disorders. “Taken together, the general link between insecure attachment and SUDs today is well established, and there is moderate to strong evidence for the assumption of insecure attachment being a risk factor for SUD.”
Dr. Bowlby didn’t think that an attachment style could be changed. “However, newer research on attachment theory has found that there are ways people can learn to cope with and even overcome insecure attachment,” reported Angelica Bottaro on Verywell Health last year. “Different types of psychotherapy can help people with their attachment styles. One example is cognitive behavioral therapy (CBT), which helps people look at and challenge their distorted thoughts and negative behaviors. Another example is dialectical behavioral therapy (DBT), which can help people better regulate their emotions, cope with distress, and consider different perspectives.”
Addiction is frequently driven by mental health conditions such as depression, anxiety, and trauma—especially childhood trauma and post-traumatic stress disorder (PTSD). Co-occurring substance use and mental health issues tend to reinforce each other. People with mental health disorders may use drugs and alcohol to feel better temporarily while substance misuse can harm brain function and contribute to mental health disorders.
The Blanchard Institute uses a dual-diagnosis approach to treat both SUD and any co-occurring mental health disorders, using a combination of CBT, medication management, group therapy sessions, and family therapy sessions.
Our admissions process is discrete, confidential, and non-invasive. Call us at (704) 288-1097—our experienced admissions specialists will guide you through the process and treat you with the dignity and compassion you deserve.