Carl Rogers stated, “The curious paradox is that when I accept myself just as I am, then I can change (see http://www.brainyquote.com/quotes/authors/c/carl_rogers.html). Many modern approaches to addiction recovery utilize a dialectical model to examine the change process. Third wave behavioral therapies such as Dialectical Behavioral Therapy (DBT), and Acceptance and Commitment Therapy (ACT), along with mindfulness meditation (MM), and the 12 Step Recovery model of Alcoholics Anonymous (AA) use a dialectic based on acceptance of what is and change to what can be. These modern methods make use of the practices of Buddhism that may be effective treatments for addiction recovery. Moreover, when regarding addiction as a form of attachment as defined by the Buddha, the possibility of change comes as a concession to suffering.
As a biopsychosocial disease, addiction affects every facet of a person’s life, and is a true form of suffering. It is difficult to elucidate addiction without considering the criteria of two disorders, Substance Dependence and Substance Abuse in American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM IV). According to the DSM IV, the characteristics of Substance Abuse include the use of a drug despite significant negative consequences, using the drug in situations that may be dangerous, recurring legal issues, and social maladaptive behavior while intoxicated. Likewise, including the features of Substance Abuse, Substance Dependence becomes more severe and has as its fundamental qualities the physiological and psychological need for the drug. Substance Dependence has two essential aspects, tolerance for the drug [needing larger amounts of the drug to produce the same effect] and physical withdrawal symptoms (4th ed.; DSM-IV; American Psychiatric Association, 1984).
These elements give an understanding to the external, internal and interpersonal suffering addiction causes as a form of attachment to the pleasurable, and avoidance of pain.
The concepts of attachment and avoidance are central to Buddhist thought. Moreover, they are the cause of suffering. Boeree (1997) noted suffering comes from attachment to experiences and from the avoidance of them as well. We see in the word, anicca- impermanence, that all objects and perceptions are momentary; therefore, attachment to them will lead to suffering. Attachment in Sanskrit relates to two words, “trishna” [ironically] means “thirst” or “desire” and “devesha” translates to avoidance. Attachment, as a means of fulfilling a desire, or as a means of depriving oneself goes against what the Buddha called, “The Middle Path” (Buddha Dharma Education Association, 2011). Therefore, The Middle Path forms a principle of non- attachment to extremes. When one considers addiction as an idea of suffering and attachment, the Buddhist concepts of desire and escape become clear.
Chen (2010) contended that the “secondary...