The misappropriation of prescription drugs by teens in the United States is a growing public health issue. Using a nursing theory framework, the scope of the problem of prescription drug use among teens is reviewed. Equal in variety to manifestations of addiction are sundry psychological theories that attempt to explain and treat the problem. Hardy (2011) was able to look into four traditional models for recognizing alcoholism (social learning theory, tension reduction theory, personality theory, and interactional theory,) in addition to five theoretical models that were developing at the time of their writing.
An approach to treating and understanding addiction that has created a huge amount of research in current decades, and which displays big promise for effective treatment of those who are undergoing addictions, has derived from attachment theory. From a nursing framework, this paper will make the attempt to communicate those features of attachment theory pertinent to understanding addiction from its theoretical viewpoint, describe addiction in terms of attachment, and recognize how addiction is being treated as an attachment disorder. Significant research studies which pursue to create addictions as a problem ingrained in attachment and to inspect the efficiency of attachment-oriented psychotherapy in treatment of compulsions will be reviewed from the nursing point-of-view
Research shows that there is an estimation of more than eight million children that are younger than the age 18 live with at least one adult who has a substance use disorder that is a rate of in excess of one in 10 children (Flores, 2012). The mainstream of these children are younger than the age of 5 (Pulver, 2014). Furthermore, these studies of families with substance use disorders show patterns that meaningfully effect child development and the probability that a child will tussle with behavioral, emotional, or substance use difficulties (Caplan, 2012). The negative impacts of parental substance use disorders on the family consist of disturbance of rituals, attachment, communication, social life, roles, routines, and finances. Investigations also makes the point that families wherein there is a parental substance use disorders are characterized by an setting of secrecy, loss, emotional chaos, violence, conflict, or abuse, role reversal, and fear.
Relationships are what serve as the communication channels that attach family members to each other. When it comes to attachment theory, it gives a way of recognizing the quality and development of relationships that are among family members. John Bowlby (1988) created attachment theory by way of the clinical study of humans and mammalian species. He made the assumption that at the time of a baby's birth, the main relationship, normally with the mother but not all the time, serves as the pattern for all succeeding relationships during the course of the life cycle. This association produces a subsystem within the greater family system. It is through this association, at a pre-language level, that infants are able to learn how to communicate and connect to their setting. They do this through cooing, rooting, crying, and clinging. The way in which the main caretaker replies to these signals will create the quality of the affection. In general, if the child experiences the key caretaker as nurturing and responsive, a secure attachment will develop. However, if the child happens to experience the main caretaker as insensitive or inconsistently responsive, an attachment that is insecure could possibly form that could outcome in a diversity of difficulties as well as depression, anxiety, and failure to flourish.
A patient with a substance use disorders, who has mood swings, too involved with getting high or spending major amounts of time getting better from the effects of substances, could possibly miss the chances to nurture healthy attachment. As a result, the intricate attachment system that is constructed on hundreds of thousands of reciprocal and implicit connections among infant and attachment figure will be affected (Hardy, 2011). When it comes to tone, eye contact, soothing touch, volume and rhythm of voice, and the talent to read the needs of the infant are all difficult building sections of attachment. When it comes to healthy attachment, it is looked at as being something that is a part of the psychological immune system of kinds.
Just as human being need a physical immune system to contest off illness and disease, likewise, the relational attachment system provides protection against mental complications and illness (Rothbaum, 2012). When there is no healthy attachment system, a child is much more defenseless to stress and as a result more liable to having difficulties with trauma, anxiety, depression, and other mental illness. Attachment theory suggests that the excellence of the parents' attachment system that developed in infancy will affect their aptitude to practice healthy attachments to their own offspring and with other adults.
Recognizing Addiction through Attachment Theory
To get a better understanding of addiction, attachment theorist start by asking the important question: "Why?" Why do people become alcoholic? Why does the compulsive consumer keep rushing to the fridge; or the person that cannot get enough sex? In moments of clearness, every experienced addict expects the sense of shame they will feel after acting out. However addicts are the ones that are always feeling obliged to act out and powerless to stop themselves. Alcoholics often display a pathology of anxiety, depression, and relational issues. For years, these were assumed as things which drove people to drink. Nevertheless, thinking has shifted in the last ten years after seminal studies for instance that of Malerstein (2011), who came to the conclusion, "a lot of the psychopathology that is observed in the alcoholic is the result, not the reason of alcohol abuse" (p. 200). The difficulties once believed to be what drove individuals toward addiction have been discovered to be symptoms that will decrease when the addict refrains. A dissimilar source of dependence is obligatory.
Affect Regulation and Addiction
Attachment theorists make the suggestion the usual, biological need for joint affect regulation as a starting point in getting a better understanding of what addiction is supposed to be like. Schmitt (2008) made the claimed that secure attachments are essential when it comes to human affect regulation through life, not just during the time of being a baby and early childhood. Certainly, research has been able to display that the attachment system's affect regulating work is vital when it comes to upkeep of cognitive resources; humans are able to self-regulate for only so long before their capacity to do so is meaningfully weakened (Elkashef, 2012).
If every kind of human need some kind of a mutual affect regulation, and effective affect regulation is reliant on attachments that are secure, it follows that adults with attachment styles that are insecure will have difficulties with affect regulation. Deprived of the capacity for both intimacy and autonomy, uncertainly attached adults will respond to their trouble in forming relations that will most likely meet the biological desire for emotional management by looking for something else that they believe will be able to control their affections (Zepf, 2013). This issue is compounded by the negative emotional experiences of those with insecure attachments, who classically feel anxious, unworthy, and embarrassed of themselves or their conduct. Such an emotional state is unbearable for any length of time, and the timidly attached adult, on account of their unmet developmental want, lacks the capability to turn to relationships so as to help facilitate these strong emotions. As a result this person will persistently follow external sources of rule in an effort to self-medicate his or her emotional pain.
Addiction, formerly, can be assumed from an attachment viewpoint as an effort to order affect which eventually fails and strengthens the very interpersonal difficulties from which the negative affective state comes from. For example, a nurse has a patient named Bill that is insecurely attached and she has been able to discover that he has been exhibiting the feelings and behaviors of someone who is ambivalent or preoccupied, he may even make the attempts to medicate his feelings of nervousness and lowliness and fear of neglect with drinking. On the other hand, if his drinking becomes obsessive, it will likely result in damage to his present relationships that serves to strengthen in his mind the risks of attachment.
Handling Addiction as an Attachment Disorder
The purpose of psychotherapy from the viewpoint of attachment theory is to make available a corrective interpersonal experience which will adapt the client's internal working model and the implicit rules and patterns which guide all of his or her close relationships. The goal of therapy is to help the client attain that optimal balance of intimacy and autonomy, the ability to be relationally close to others and independent. The therapeutic relationship becomes an opportunity for the client to experience an attachment in which they feel another person is attune to their emotions. The therapy environment becomes a holding environment,…