Substance dependence: a search for security?

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Carse, Mary Carmel
Department of Psychology
thesis / dissertation description
The social learning and psychedynamic perspectives en substance dependence have argued that intrapsychic variables are crucial in its development They have also feimd that substance-dependent people have considerable difficulties in interpersonal relationships, particularly partner relationships. One account ef the connection between a person's internal reality and behaviour in interpersonal relationships is provided by attachment theory. Experiences with primary caregivers in childhood are argued to form the basis ef a person's security in the sense ef self and in relation te ethers. Damaging experiences with such attachment figures can result in insecure attachment which may place the person at risk ef developing psychepathelegy in adult life. A model ef substance dependence is proposed which views substance-dependent people as having severe disturbance ef attachment organisation, and, secondary te this, impairment ef meed and ef functioning in close interpersonal relationships. It is proposed that the substance provides attachment-related security and comfort for such people.Sixty substance-dependent people in six residential rehabihtation centres in Austraha were interviewed about their experience ef substance use and compared with 32 nonsubstance-dependent participants en substance use, attachment, meed and the experience ef close relationship. Approximately half the substance-dependent group was judged te have experienced an attachment relationship with the substance. On two measures ef attachment, the Attachment Style Questionnaire (Feeney, NeUer & Hanrahan, 1994) and the Reciprocal Attachment Questionnaire (West & Shelden- Keller, 1994), substance-dependent people reported greater attachment insecurity than the centre! group. They also reported greater problems with intimacy and mere loneliness in close interpersonal relatiensliips when measured using the Miller Social Intimacy Scale (Miller & Lefcourt, 1986) and the Social and Emotional Loneliness Scale for Adults (DiTemmase & Spinner, 1993). Meed consistent witii the less of an attachment relationship with the substance and underlying attachment insecurity was found te a greater extent in the substance-dependent group, that is, greater depression and anxiety respectively, indicated en the Beck Depression Inventory (BDI) (Beck, 1978) and the Beck Anxiety Inventory (BAI) (Beck, 1987).All components ef the proposed model ef substance dependence were supported, the attachment relationship with the substance by about half ef the substance-dependent group. The model, therefore, is argued to have considerable clinical utiUty. It should assist the comprehension ef substance-dependent people and the difficulties many of them experience in attempting te recover from their dependence. Where an attachment relationship with the substance is thought te be involved in the dependence, it indicates the appropriate method of treatment.