Addiction as a Misguided Method for the Satisfaction of Basic Existential Needs: A Needs Model of Addiction
This is a third article in a series of articles that explores “philosophy as a way of life” for individuals in addiction recovery.
In a recent publication, The Routledge Handbook of Philosophy and Science of Addiction, Robert West and colleagues stated that “The science of addiction is being hampered by confusion in concepts and terms, and a multiplicity of models and theoretical approaches that make little reference to each other.” (West et al., 2018, p. 160). They further state “that a general theory of addiction has yet to be developed, but a key requirement for such a theory is that it should recognize and accommodate multiple viewpoints on addiction, and not be limited to a single viewpoint such as the ‘medical model’ (construing addiction in term of a mental disorder, disease or disease process)” (p. 163).
A hypothesis that I have proposed, in relation to the aim of developing a general and unified theory of addiction, is that the notion of basic existential needs (when understood as ontological) is a unifying construct across models and theories of addiction. In other words, the relationship between basic existential needs and addiction when presented as a central transdiagnostic construct can help to unify seemingly disparate models of addiction into a general theory of addiction. I tentatively refer to this model as the “Needs Model of Addiction.” The aim of this model is not to be an explanatory model of addiction (as there are obviously a multitude of factors involved in the etiology of addiction), but rather to be presented as a unifying model that creates an epistemological and ontological bridge between various models. I will explain below.
Chilean economist, Alfred Max-Neef (1991), who developed the theory of human scale development, stated that: “Fundamental human needs [basic existential needs] are finite, few and classifiable and are the same in all cultures and in all historical periods. What changes, both over time and through cultures, is the way or the means by which the needs are satisfied” (p. 18). He went on to say that:
“Each economic, social and political system adopts different methods for the satisfaction of the same fundamental human needs. In every system, they are satisfied (or not satisfied) through the generation (or non-generation) of different types of satisfiers [the object or process used to satisfy a need]…In short: What is culturally determined are not the fundamental human needs, but the satisfiers for those needs…Furthermore, needs are satisfied within three contexts: (a) with regard to oneself (Eigenwelt); (b) with regard to the social group (Mitwelt); and (c) with regard to the environment (Umwelt). The quality and intensity, not only of the levels but also of contexts, will depend on time, place and circumstances.” (Max-Neef, 1991, p. 18)
According to the theory of human scale development, an individual’s quality of life is correlated with the actualization of nine classes of interrelated ontological needs. In this model, needs are categorized in two classes: existential and axiological, which are combined and displayed in a matrix, “This allows us to demonstrate the interaction of, on the one hand, the needs of Being, Having, Doing and Interacting; and, on the other hand, the needs of Subsistence, Protection, Affection, Understanding, Participation, Idleness, Creation, Identity and Freedom” (Max-Neef, 1991, p. 17).
Max-Neef (1991) is of the opinion that: “Human needs must be understood as a system: that is, all human needs are interrelated and interactive. With the sole exception of the need of subsistence, that is, to remain alive, no hierarchies exist within the system [as opposed to Maslow’s model]. On the contrary, simultaneities, complementarities and trade-offs are characteristics of the process of needs satisfaction.” (p. 17) According to Max-Neef, (1991) any “fundamental human need not adequately satisfied generates a pathology” (p. 22).
In Max-Neef’s (1991) model, satisfiers refer to the method of having a basic existential need met (satisfying the need), and various groups of satisfiers are proposed. Five types of satisfiers are suggested: violators or destroyers, pseudo-satisfiers, inhibiting satisfiers, singular satisfiers, and synergic satisfiers. A brief description of each of the types of satisfiers follows. I then conclude with the relevance this has in the context of addiction and its treatment.
Violators or destroyers are paradoxical in nature because when they are applied to satisfy a need, “not only do they annihilate the possibility of its satisfaction over time, but they also impair the adequate satisfaction of other needs” (Max-Neef, 1991, p. 31). Pseudo-satisfiers “generate a false sense of satisfaction of a given need. Although not endowed with the aggressiveness of violators or destroyers, they may on occasion annul, in the not too long term, the possibility of satisfying the need they were originally aimed at fulfilling” (Max-Neef, 1991, p. 31). Inhibiting satisfiers tend to over-satisfy a given need, consequently, limiting the possibility of other needs being satisfied. Singular satisfiers tend to satisfy one specific need. They are neutral in relation to the satisfaction of other needs. Synergic satisfiers satisfy a given need and “simultaneously stimulating and contributing to the fulfillment of other needs” (Max-Neef, 1991, p. 34).
A similar sentiment is echoed by Vanhooren, Leijssen, and van Dezutter (2017) in their discussion of the application of experiential and existential approaches to treating criminal offenders:
“Very different from cognitive-behavioral approaches, experiential and existential offender therapies focus on the exploration of the underlying dynamics of criminal behavior in terms of their basic existential needs (Braswell & Wells, 2014; Gunst, 2012; Ronel & Segev, 2014; Vanhooren et al., 2015; Ward & Fortune, 2014). Just like all human beings, offenders try to reach fulfillment of their existential needs, such as the need for efficacy, connectedness, love, and meaning (Braswell & Wells, 2014; Ward & Fortune, 2014). The way they try to fulfill their needs or the way they cope with the inability to reach their goals is often through unadjusted or antisocial behavior (Ward & Fortune, 2014). When the basic existential needs are not met, offenders gradually become stuck in a criminal spin: a downward process marked by existential loneliness and alienation.” (p. 15)
From the above description, a “Needs Model of Addiction” proposes that addictive behavior can be understood as violators or destroyers, and pseudo-satisfiers, i.e., misguided methods of having needs met. From a phenomenological perspective, substance use is not merely about the “high” produced by the ingestion of a psychoactive substance, but also about the ability the ingestion of a substance has in satisfying a need(s). Addictive behavior is always directed at satisfying a need, but what differentiates addictive behavior (violators or destroyers) from other methods (or other satisfiers) of having needs met is that it paradoxically destroys the individual’s capacity to meet the need(s) it is attempting to satisfy, as well as the capacity to meet other needs. As an addictive lifestyle progresses, the individual’s capacity to have most of his or her needs met is diminished, until there is a near total reliance on the substance or addictive behavior to meet most basic existential needs.
In conclusion, within the context of the above discussion, a “Needs Model of Addiction” suggests that a addiction recovery program and lifestyle is a process of replacing destroyers/violators with synergistic and singular satisfiers. In short, addiction should thus not be seen as a “disease” to be “treated,” (because seeking to have our basic needs met is not a disease) but rather understood as a misguided method of the normal human behavior of trying to have our basic existential needs met — and thus treatment should not be about “treating the disease” or “fixing” the client, but rather assisting in a lifestyle change where his/her basic existential needs are now satisfied in healthy ways. Hence, the effectiveness of 12 Step programs, which provide a complex and multi-tiered psycho-social-philosophical infrastructure that is a conducive environment to have many of our basic existential needs met in healthy ways.
References to this article to be found in my book, An Integral Foundation for Addiction: Beyond the Biopsychosocial Model.