Addiction as a Relationship Problem Within a Disease Model

When people talk about addiction, they often describe it in moral terms. “I should know better.” Biological terms. “My brain is wired this way.” Or behavioral terms. “I just can’t stop.” But in the therapy room, addiction almost always shows up as something more intimate than that.

Addiction functions like a relationship. Often, it is the most reliable one someone has ever known.

When I sit with people who are struggling with alcohol, drugs, porn, food, gambling, work, or compulsive sexual behaviors, what they often describe is not a craving for the substance itself, but a craving for a feeling. Relief. Escape. Quiet. Freedom. A feeling their nervous system does not know how to access any other way.

Addiction operates like a thermostat. When emotional temperature spikes, shame, grief, loneliness, anger, fear of dependency, the addictive behavior lowers the heat instantly. It regulates what feels overwhelming.

This is why telling someone to “just stop” makes no sense. They are not using impulsively. They are using intelligently, in the only way they have learned to survive certain internal states.

Often, those states come from very early emotional environments. Maybe you grew up in a home where feelings were ignored or punished. Maybe you had a caregiver who was unpredictable or overwhelming. Maybe you learned that vulnerability was dangerous, or that connection was inconsistent.

Your nervous system eventually adapts. If people cannot soothe me, something else will.

And the addiction becomes a partner. Dependable. Predictable. Always available.

People often tell me they feel embarrassed about this. They say things like, “It’s irrational,” “I’m stupid,” or “I should be stronger than this.” But there is nothing irrational about trying to feel okay.

In AA language, addiction is described as a solution that stopped working. In neurobiological language, it is a conditioned coping strategy that hijacks reward pathways and stress circuits. Both perspectives point to the same truth. You were not foolish. You adapted.

None of this contradicts the idea of addiction as a disease. It describes how that disease is lived, organized, and soothed in the inner world.

In my work, I also pay close attention to attachment patterns. I do not think of attachment styles here as diagnoses, but as emotional survival strategies. Addiction often mirrors the relational worlds people were forced to survive.

Avoidant attachment often leads to solitary addictions such as porn, work, or alcohol, because closeness feels dangerous and self soothing feels safer than being soothed by others.

Anxious attachment often leads to compulsive, relief seeking behaviors because the nervous system is chronically activated by real or imagined disconnection.

Disorganized attachment often results in chaotic patterns of relapse, secrecy, highs and lows, because closeness and distance both feel threatening.

This is why addiction is not just an individual issue. It is a relational one. It forms where there was once a missing relationship, a broken relationship, or an inconsistent one.

This also explains why recovery requires more than willpower. Stopping the behavior without replacing the relationship leaves a person emotionally raw and uncontained.

In therapy, the work often unfolds in a few overlapping ways.

First, understanding what the addiction is doing for you. People do not use “just because.” There is always a function. Relief from shame. Escape from aloneness. Protection from need. Quieting intrusive memories. Regulating anxiety that spikes without warning.

Naming the function removes shame and opens space for choice.

Second, building alternative regulators. Self soothing, grounding, relational support, mindfulness, AA, meditation, and structured routines can become new thermostats. They take time to internalize, but over months, the body learns different ways to come down from emotional spikes.

Third, creating relationships that can hold what the addiction used to hold. A therapeutic relationship. An AA sponsor. A partner. A friend. Someone who can actually show up. Someone who helps you regulate instead of punishing you for struggling.

This is where people often break open. When they realize they have never had a relationship that could hold their pain without turning away.

Fourth, rewiring the nervous system. Slowly, the body learns that it does not die from feeling. It does not die from shame. It does not die from loneliness. It does not die from anger or longing.

This is the true heart of recovery. Not abstinence, but capacity.

People often think the goal of therapy is to become sober. That is not the goal. The goal is to become free. Free enough inside that you are not compelled toward the old thermostat just to survive yourself.

Addiction is never about character. It is about pain, protection, and the longing to feel alright.

Recovery is learning new ways to meet that longing, without having to disappear yourself.

Harrison Tract
Founder
Apex Minds Psychotherapy