Webb Therapy Uncategorized Addiction Theories

Addiction Theories

There have been various theories and models proposed over time to help us understand why individuals use alcohol and other drugs, and why some people become dependent or ‘addicted’ but not others. The following are several models or theories of addiction. They reflect the political, medical, spiritual, and social forces of those times in history.

The Moral Model

Alcohol and tobacco was introduced in the Western countries during the 1500’s. The widespread use and misuse of chemical substances resulted in a range of social problems and it was thought by some that substance use was “problematic” and “morally wrong” (Lassiter & Spivey, 2018). The moral model viewed AOD dependency as a moral and personal weakness that involved a lack of self-control, and was often viewed as a potential danger to society (Stevens & Smith, 2014).

The moral model considered addiction a “sin” and a result of free, yet irresponsible, choice. Therefore, many politically conservative groups, religious groups, and legal systems tended to punish the individual who uses AOD. The moral model or attitude towards addiction can still be seen today in certain cultures. Those who still believe addiction is morally “wrong” tend to perceive the most appropriate way to treat the individuals who use AOD are through legal sanctions, such as imprisonment and fines. For example, in many countries, drivers who are caught under the influence of alcohol or other drugs are not considered for treatment programs but instead receive court sentences as punishments (Fisher & Harrison, 2017).

This model has been rejected by alcohol and other drugs professionals as unscientific and contributes to the stigma surrounding addiction and substance use (White, 1991, cited in Fisher & Harrison, 2017).

The Disease Model

This model takes up the medical viewpoint and proposes addiction as a disease or illness that an individual has. It proposed that addiction is a disease that is progressive and chronic whereby the individual holds no control as long as the substance use continues. In other words, their addiction will continue to deteriorate with the continuous AOD (Thombs & Osborn, 2019). It also proposes that individuals who uses AOD can never be cured from addiction, though it can be readily treated through sustained abstinence such as self-help fellowships and treatment community. 

In the 1940s, Jellinek proposed a disease model in relation to alcoholism, arguing that it is a disease caused by a physiological deficit in an individual, making the person permanently unable to tolerate the effects of alcohol (Stevens & Smith, 2014). Jellinek identified signs and symptoms and clustered them into stages of alcoholism, as well as progression of the disease, which form the basis of 12-step or Anon-type programs (e.g., Alcoholics Anonymous and Narcotics Anonymous; Stevens & Smith, 2014). 

Under the disease model, treatment requires complete abstinence. Once an individual has accepted the reality of their addiction and ceased substance use, they are labelled as being in recovery, but are never ‘cured’ (e.g., “Once an alcoholic, always an alcoholic”; Thombs & Osborn, 2019). Whilst originally applied to alcohol dependency, it has now been generalised to other substances and many traditional substance use treatment models are based on this model (Capuzzi & Stauffer, 2020; Stevens & Smith, 2014).

The disease model offered an alternative to the moral theory, helping to remove the moral stigma attached to addiction and replacing it with an emphasis on treatment of an illness (Capuzzi & Stauffer, 2020). Disease theory helped to explain how some people experience the physiological effects of addiction such as dependence, tolerance, and withdrawal more than others, and how these mechanisms are caused by a biochemical abnormality in an individual which increases their likelihood of developing a dependency (DiClemente, 2018). 

While the disease model was well received by a range of professionals, many criticised it because research did not find that the progressive, irreversible progression of addiction through stages always occurs as predicted (Capuzzi & Stauffer, 2020). Additionally, many in the AOD field argued that the model did not address the complex interrelated factors that accompany dependency (Stevens & Smith, 2014). Finally, some professionals argued that the concept of addiction being a disease may also convey the impression to some individuals that they are powerless over their dependency and/or not responsible for the consequences of destructive addictive behaviours, which can be counteractive to treatment (Capuzzi & Stauffer, 2020).

Genetic and Neurobiological Theories

These theories suggest that some people may be genetically predisposed to develop drug dependency. For example, individuals usually begin substance use on an experimental basis. They then continue using because there is some reinforcement for doing so (e.g., a reduction of pain, experience of euphoria, social recognition, and/or acceptance, etc.). Some people may continue to use substances in a controlled or recreational manner with limited consequences while others progress to non-medical use and eventually develop a dependency. Why? Genetic and neurobiological theories propose that this is the result of a genetic predisposition to drug dependency (Fisher & Harrison, 2017). 

Factors being considered by researchers in the genetic transmission of dependency on alcohol include neurobiological features such as an imbalance in the brain’s production of ‘feel good’ neurotransmitters or in the metabolism of ethanol, which is the key component of alcohol (Stevens & Smith, 2014). Other researchers explored genetic differences in temperament and personality traits which they argued may lead to certain individuals becoming more vulnerable in the face of challenging environmental circumstances, leading to AOD use (Stevens & Smith, 2014). Genetic predispositions such as these may explain why some individuals develop dependency on AOD while others in similar situations do not.

The Psycho-dynamic Model

This model proposes that substance use may be due to an unintentional response to some difficulties that an individual experienced in their childhood. This explanation is based on the theory that was put forward by Sigmund Freud, whereby the problems of whether we are able to cope with difficulties as adults are linked to our childhood experience. Many counselling approaches today are based on this theory which aim to seek understanding of people’s unconscious motivations and to enhance how they view themselves (Capuzzi & Stauffer, 2020).

The Psycho-dynamtic model also believes that AOD use is often secondary to a primary psychological issue. In other words, alcohol and other drugs is a symptom rather than a disorder, and AOD use is a means to temporarily relieve or numb emotional pain. For example, an individual suffering from depression might self-medicate with stimulants to relieve the enervating effects of depression or manage their anxiety by using benzodiazepines (Fisher & Harrison, 2017). 

There is evidence to support this model, whereby childhood traumatic events are associated with mental health problems and substance use disorders. Wu et al. (2010) conducted a study among 402 adults who were receiving substance use disorder treatments. They revealed that almost all (95%) of the participants experienced one or more childhood traumatic events, and 65.9% of them experienced emotional abuse and neglect from their childhood. The authors also reported that the higher the number of childhood traumatic events experienced, the higher the risk of substance use disorders and mental health problems such as post-traumatic stress disorder. 

Personality Traits

Some theorists suggest that certain individuals have certain personality traits that are linked to AOD dependency. For example, dependency on alcohol has been associated with traits such as developmental immaturity, impulsivity, high reactivity and emotionality, impatience, intolerance, and inability to express emotions (Capuzzi & Stauffer, 2020).

Social Learning Model

This model suggests that social learning processes such as observing other peoples behaviours (i.e., modelling) and cultural norms are important in the process of learning behaviours. Albert Bandura proposed Social Learning Theory which would argue that substance use is initiated by environmental stressors or modelling people around you with “perceived status”. For example, a child observes their parents use alcohol in social situations and the child is therefore more likely to perceive that AOD use for social situations is appropriate (Harrison & Fisher, 2017); the association between socialisation and alcohol has been established.

The social learning model also recognises the influence of cognitive processes such as coping, self-efficacy, and outcome expectancies. Some researchers are currently focusing on how an individuals expectation of the effects of drugs influence the pattern of AOD use and resulting dependency. Russell (1976, cited in Wise & Koob, 2013) suggested that dependency on substance is not only chemical (biological) but also behavioural and social in nature. 

It has also been suggested that substance use occurs when an individual thinks substance use is a coping mechanism. This can be learned from television and film, social medial, peer influence, or messages from caregivers during childhood. The individual hopes the AOD use will relieve from them from stress (Stevens & Smith, 2014). 

Socio-cultural Model

Different from the previous models, the socio-cultural model perceives substance use as an issue of society as a whole instead of focusing only on the individual. People tend to overestimate the influence of internal and psychological factors while underestimating the external and environmental factors, even among some alcohol and other drugs workers (Gladwell, 2000, cited in Lewis, Dana, & Blevins, 2015). Thus, this model highlights the importance of how society shapes substance use behaviours, such as cultural attitudes, peer pressures, family structures, economic factors, and more (Bobo & Husten, 2000). For example, Coffelt et al. (2006) found that parents’ alcohol use are associated with their children’s drinking behaviour, whereby when the adult’s alcohol problems increased, the likelihood of their adolescent child’s alcohol use increased. 

The Biopsychosocial Model

Substance use behaviour cannot be explained or understood scientifically or spiritually based on a single variable, antecedent, or “cause”. Biological, psychological, learning, social and cultural context all contributes to explaining why addiction develops and maintains. The interactions between these factors are presented in The Biopsychosocial Model – arguably the most commonly used model to explain addiction today. The model suggests that substance use and the progression of substance dependency can be explained by recognising that the body and mind are connected within a social and cultural context (Skewes & Gonzalez, 2013).

The model allows any combination of biological, psychological, social and cultural factors to contribute to AOD misuse and dependency, rather than a single dominating factor. This is much more holistic and integrative when attempting to understand the determinant of addiction (Stevens & Smith, 2014).

References:

  1. Bobo, J. K., & Husten, C. (2000). Sociocultural influences on smoking and drinking. Alcohol Research and Health, 24(4), 225-232. 
  2. Capuzzi, D., & Stauffer, M. D., Sharpe, C. W. (2020). History and etiological models of addiction. In D. Capuzzi, & M. D. Stauffer (Eds.), Foundations of addictions counseling (pp. 1-22). Pearson Education.
  3. Coffelt, N. L., Forehand, R., Olson, A. L., Jones, D. J., Gaffney, C. A., Zens, M. S. (2006). A longitudinal examination of the link between parent alcohol problems and youth drinking: The moderating roles of parent and child gender. Addictive Behaviours, 31, 4, 593-605. https://doi.org/10.1016/j.addbeh.2005.05.034 
  4. DiClemente, C. C. (2018). Addiction and change: How addictions develop and addicted people recover. The Guilford Press.
  5. Fisher, G. L., & Harrison, T. C. (2017). Substance abuse: Information for school counsellors, social workers, therapists, and counsellors. Pearson Education. 
  6. Lassiter, P. S., & Spivey, M. S. (2018). Historical perspectives and the moral model. In P. S. Lassiter, & J. R. Culbreth (Eds.), Theory and practice of addiction counselling. (pp. 27-46). Sage Publications. 
  7. Lewis, J. A., Dana, R. Q., & Blevins, G. A. (2015). Substance abuse counselling. Cengage Learning.
  8. Skewes, M. C., & Gonzalez, V. M. (2013). The biopsychosocial model of addiction. In P. M. Miller, A. W. Blume, D. J. Kavanagh, K. M. Kampman, M. E. Bates, M. E. Larimer, N. M. Petry, P. D. Witte, S. A. Ball (Eds.), Principles of addiction: Comprehensive addictive behaviours and disorders (pp. 61-70). Academic Press.
  9. Stevens, P., & Smith, R. L. (2014). Substance abuse counselling: Theory and practice. Pearson Education. 
  10. Teesson, M., Hall, W., Proudfoot, & Degenhardt, L. (2012). Addictions. Taylor & Francis Group.
  11. Thombs, D. L., & Osborn, C. J. (2019). Introduction to addictive behaviours. The Guilford Press. 
  12. Wise, R. A., & Koob, G. F. (2013). The development and maintainance of drug addiction. Neuropsychopharmacology, 39, 254-262.
  13. Wu, N. S., Schairer. L. C., Dellor, E., & Grella, C. (2010). Childhood trauma and health outcomes in adults with comorbid substance abuse and mental health disorders. Addictive Behaviors, 35(1). 68-71. https://doi.org/10.1016/j.addbeh.2009.09.003 

Related Post

What does human development mean to you? How often are we thinking about our own development? Here is a start (“,)What does human development mean to you? How often are we thinking about our own development? Here is a start (“,)

Hello readers. I hope you are well. I imagine some of you are struggling and some of you are flourishing. Life consists of both. As humans, we relish pleasurable feelings and experiences and we tend to dislike uncomfortable emotions and experiences. I get it. I am just like you. We share this. I hope that provides some comfort.

What is human development?

Human development can be described as “systematic changes and continuities in the individual that occur between conception and death, or from “womb to tomb”” (Sigelman, De George, Cunial, & Rider, 2019, p. 3).

Human development involves the continuities (i.e., what remains consistent across time) and the systematic changes (i.e., patterns of change that are expected to come in order across time) that one experiences throughout the lifespan. Based on my education, there are three domains of continuity and change: 1. The physical and biological, 2. Cognitive (i.e., mind processes/thinking), and 3. Psychosocial and emotional. Let’s open these one at a time.

Physical development includes:

  • Physical and biological processes (e.g., genetic inheritance).
  • Growth of the body and its organs.
  • Functioning of physiological systems (e.g., brain).
  • Health and wellness.
  • Physical signs of ageing and changes in motor abilities.

Cognitive development includes:


Perception: the sensing of stimuli in our environment (internal and external), sending that information to the brain to be identified and interpreted in order to represent and understand our experience of the world and give it meaning. All perception involves signals that go through the nervous system.

Attention: the ability to actively (and often, involuntarily) process specific information in the environment while tuning out other details. Attention is a very interesting cognitive process because when we bring mindfulness to our thoughts we become open to the direction and attention of our mind. Remember this: where attention goes, energy flows.

Language: very broadly, Language is a communication system that involves using words (i.e., sounds arranged together) and systematic rules to organise those words into sentences and meaning, to transmit information from one individual to another. I was never very interested in language when I was studying at university however that has changed. We used language and concepts to talk to ourselves, about other people, and it is open to misinterpretation, error, and oftentimes language can be used as a means to hurt people or … bring us closer together.

Learning: very broadly defined as a relatively permanent change in behaviour, thinking, and understanding as a result of experience. Experience is everything from formal education to unique personal experience. We learn from each other, the world around us, books, movies, self-reflection and education etc. All of which are experiences.

Memory: Memory refers to the processes that are used to gather, organise, store, retain, and later retrieve information. I’m sure you’ve all seen a tv show or read a book about a person with Amnesia or Alzheimer’s disease. Imagine what your life would be like if you didn’t have the function of memory. I wouldn’t be able to type this very well, I don’t think. I wouldn’t remember my loved ones or what was dangerous in my environment. I know we all have unpleasant memories too and that may feel like a negative evolutionary by-product – however it is actually designed to protect us. Memory is finite – we actually forget a lot of stuff, or perhaps more accurately, we do not have the capacity to store and recall everything we experience.

Intelligence: I would like to reframe intelligence from what might be a common belief. Intelligence does not mean academically gifted as is considered valuable in Western society. I think Olympians and caregivers/parents have an intelligence that I do not because I haven’t learned their skills. Intelligence involves the ability to learn (i.e., sport, academics, the arts, swimming, survival, interpersonal skills), emotional knowledge, creativity, and adaptation to meet the demands of the environment effectively

Creativity: I consider creativity to be an evolutionary gift of our imagination, providing humans with the ability to generate and recognize ideas, consider alternatives, think of possibilities that may be useful in solving problems, communicating with others, and entertaining ourselves and others. Creativity can be stunted when we are struggling or caught in reactivity to external pressures or perceived stress.

Problem solving: is a process – yes, a cognitive one but also a behavioural process. It is the act of defining a problem; determining the cause of the problem; identifying, prioritizing, and selecting alternatives for a solution; and implementing a solution. Problem solving can be both creative or stress driven. I like to say whenever I am solving a problem I am also making a decision. A decision of mine is a choice. At university, our problem solving lessons were coincided with decision making which is why I think of it that way.

Psychosocial development involves:

Aspects of the self (i.e., your identity – which may change over time), and social and interpersonal interactions which include motives, emotions, personality traits, morality, social skills, and relationships, and roles played in the family and in the larger society. This is a huge area to be explored. I will endeavour to elaborate on our psychosocial development in later blogs.

In the late 1950’s, a German-American developmental psychologist named Erik Erikson created a theory for human psychosocial development across the lifespan. His theory suggests that human personality develops in a predetermined order through 8 stages of psychosocial development. See the table below:

Age or StageConflictExampleResolution or “virtue”Key Question to be answered
Infancy (0 to 18 months)Trust vs. MistrustBeing feed and cared for by caregiver.HopeIs my world safe? Will I be cared for?
Early Childhood (2 to 3 years)Autonomy (personal control) vs. Shame and DoubtToilet training and getting dressed.Will I would add self-efficacy here too.Can I do things for myself, or will I always rely on others?
Preschool (3 to 5 years)Initiative vs. GuiltInteracting with other children and asserting themselves in their environment e.g., during play.Purpose Taking initiative, leading others, asserting ideas produces a sense of purpose.Am I liked by others or do I experience disapproval by others?
School Age (6 to 11 years)Industry (competence) vs. InferiorityStarting formal education and participating in activities.CompetenceHow can I do well and be accepted by others?
Adolescence (12 to 18 years)Identity vs. Role Confusion (uncertainty of self and role in society)Developing social relationships with peers and sense of identity.Fidelity (loyalty) The ability to maintain loyalty to others based on accepting others despite differences.Who am I and where am I going in my life? What are my personal beliefs, values and goals?
Young Adult (19 to 40 years)Intimacy vs. IsolationDeveloping intimate relationships.LoveAm I loved and desired by another? Will I be loved long-term?
Mature Adult (40 to 65 years)Generativity vs. StagnationVocation and parenting, typically.Care Contributing to the world to demonstrate that you care.Will I provide something to this world of real value? E.g., children or valuable work, art, a legacy etc.
Maturity (65 year to death)Ego Identity vs. DespairReflection of your life. Feelings of satisfaction and wholeness.WisdomWas I productive with my life? Can I accept my life and have a sense of closure and completeness?

Understanding Addiction: A Modern, Integrative PerspectiveUnderstanding Addiction: A Modern, Integrative Perspective

Abstract

Addiction is a complex, multifaceted phenomenon that has been described variously as a disease, disorder, syndrome, obsessive-compulsive behaviour, learned behaviour, or spiritual malady. Modern scientific understanding emphasises addiction as a chronic brain disorder shaped by neurobiological changes, learning, and social context. This article examines each conceptualisation and presents an integrated definition that aligns with current neuroscience, psychological, and public health evidence.

Conceptualising Addiction: Labels and Their Accuracy

No single label fully captures addiction’s complexity; each highlights certain truths while overlooking others.

Disease

From a medical perspective, disease is the closest match. Addiction involves persistent neurobiological changes in reward, stress, and self-control circuits, increases relapse risk over years, and shows substantial genetic vulnerability (~50–60%) (NIDA, 2018; Heilig et al., 2021). Treatments improve outcomes but rarely “cure” the condition. This framing is used by the American Society of Addiction Medicine (ASAM), NIDA, WHO ICD-11, and DSM-5-TR (as “Substance Use Disorder”) (NIDA, 2018).

Disorder

Disorder is also scientifically accurate and slightly less medicalised. DSM-5’s “Substance Use Disorder” captures behavioural, psychological, and biological criteria and recognises functioning and harm rather than framing addiction strictly as a lifelong disease (Heather, n.d.; Heilig et al., 2021).

Syndrome

Addiction may be described as a syndrome because it is a cluster of symptoms with behavioural and physiological manifestations, without a single causative factor. However, the term is too generic for practical use outside clinical texts (Blithikioti et al., 2025).

Obsessive and Compulsive Learned Behaviour

Addiction involves learning, habit formation, and compulsion through reinforcement of rewarding behaviours (Hyman, 2005; Hausotter, 2013). Yet describing it solely as learned behaviour ignores genetic predisposition, neuroadaptation, withdrawal, and social factors.

Spiritual Malady

Some mutual-aid traditions characterise addiction as a spiritual malady. While this may be meaningful for individuals, it is not scientifically explanatory: addiction can be adequately explained via biological, psychological, and social mechanisms (Lewis, 2017).

Modern Integrative Definition

The most accurate contemporary description of addiction is:
“A chronic, relapsing disorder of brain circuits involved in reward, stress, and self-control, shaped by learning, environment, and social context”.

This definition encompasses:

  • Disease/disorder: medical accuracy
  • Learned behaviour and compulsion: neuroscience and behavioural accuracy
  • Social determinants: public health relevance
  • Flexibility for personal or spiritual interpretations

In short, addiction is best understood as a bio-psycho-social condition that is treatable and sometimes reversible, rather than a deterministic, lifelong curse.

Neurobiology: Why Addiction Is Considered a Brain Disorder

Repeated substance use alters structural and functional brain circuits involved in reward, stress, motivation, memory, and self-control (Nwonu et al., 2022; NIDA, 2018). These changes can persist long after use stops, explaining why addiction is more than a matter of “bad habits” or weak will (NIDA, 2025).

Chronicity and Relapse

Addiction is often chronic and relapsing. Even after long periods of abstinence, cues and stressors can trigger relapse (Meurk et al., 2014; SAMHSA, 2023). Key regions implicated include the basal ganglia (habit formation), extended amygdala (stress), and prefrontal cortex (decision-making) (Kirby et al., 2024). Nevertheless, many individuals achieve stable remission, highlighting heterogeneity in clinical outcomes (Heilig et al., 2021).

Learning, Memory, and Habit Formation

Addiction exploits neural mechanisms of learning and memory: rewarding behaviours are repeated and consolidated into habits, with cues triggering compulsive responses even when the substance’s reward diminishes (Hausotter, 2013; Lewis, 2017). This intertwines biological disorder and learned behaviour.

Critiques and Limitations

Some scientists caution that framing addiction strictly as a brain disease is simplistic:

  • Brain changes may resemble those from other motivated behaviours (Lewis, 2017).
  • Many recover without formal treatment (Heilig et al., 2021).
  • Social, environmental, and psychological factors are crucial to understanding addiction (Blithikioti et al., 2025).

Thus, while the disease model is powerful, it does not fully represent addiction’s heterogeneity or socio-psychological dimensions.

Implications for Treatment

Addiction is treatable, not simply curable. Interventions combining pharmacological and behavioural approaches, alongside social support, can foster long-term recovery (Liu & Li, 2018; Heilig et al., 2021). Like other chronic conditions, management — rather than elimination — is often the realistic goal (NIDA, 2018). Neural circuits can gradually readjust, particularly when environmental and personal factors support recovery.

Conclusion

Addiction is a learned, compulsive brain disorder with chronic potential, shaped by neurobiological, psychological, social, and environmental factors. Recognising addiction as both a disorder and a behavioural learning condition avoids extremes: it is neither an unchangeable fate nor merely a moral failing. This integrated perspective supports nuanced understanding, compassionate care, and effective treatment strategies.


References

Blithikioti, C., Fried, E. I., Albanese, E., Field, M., & Cristea, I. A. (2025). Reevaluating the brain disease model of addiction. The Lancet Psychiatry, 12(6), 469–474. https://doi.org/10.1016/S2215-0366(25)00060-4

Hausotter, W. (2013). Neuroscience and understanding addiction. Addiction Technology Transfer Center (ATTC) Network. https://attcnetwork.org/neuroscience-and-understanding-addiction

Heather, N. (n.d.). What’s wrong with the brain disease model of addiction (BDMA)? Addiction Theory Network. https://addictiontheorynetwork.org/brain-disease-model-of-addiction

Heilig, M., MacKillop, J., Martinez, D., Rehm, J., Leggio, L., & Vanderschuren, L. J. M. J. (2021). Addiction as a brain disease revised: Why it still matters, and the need for consilience. Neuropsychopharmacology, 46(10), 1715–1723. https://doi.org/10.1038/s41386-020-00950-y

Hyman, S. E. (2005). Addiction: A disease of learning and memory. The American Journal of Psychiatry, 162(8), 1414–1422. https://doi.org/10.1176/appi.ajp.162.8.1414

Kirby, E. D., Glenn, M. J., Sandstrom, N. J., & Williams, C. L. (2024). Neurobiology of addiction (Section 14.5). In Introduction to Behavioral Neuroscience. OpenStax. https://socialsci.libretexts.org/…/14.05:_Neurobiology_of_Addiction

Leshner, A. I. (1997). Addiction is a brain disease, and it matters. Science, 278(5335), 45–47. https://doi.org/10.1126/science.278.5335.45

Lewis, M. (2017). Addiction and the brain: Development, not disease. Neuroethics, 10(1), 7–18. https://doi.org/10.1007/s12152-016-9293-4

Liu, J. F., & Li, J. X. (2018). Drug addiction: A curable mental disorder? Acta Pharmacologica Sinica, 39(12), 1823–1829. https://doi.org/10.1038/s41401-018-0180-x

Meurk, C., Carter, A., Partridge, B., Lucke, J., & Hall, W. (2014). How is acceptance of the brain disease model of addiction related to Australians’ attitudes towards addicted individuals and treatments for addiction? BMC Psychiatry, 14, 373. https://doi.org/10.1186/s12888-014-0373-x

National Institute on Drug Abuse. (2018). Drugs, brains, and behavior: The science of addiction (Rev. ed.). https://irp.nida.nih.gov/…/NIDA_DrugsBrainsAddiction

Nwonu, C. N. S., Nwonu, P. C., & Ude, R. A. (2022). Neurobiological underpinnings in drug addiction. West African Journal of Medicine, 39(6), 874–884. https://pubmed.ncbi.nlm.nih.gov/36063103

Substance Abuse and Mental Health Services Administration. (2023). What is substance use disorder? U.S. Department of Health and Human Services. https://www.samhsa.gov/substance-use/what-is-sud

Australian Institute of Professional Counsellors. (2021). Finding Meaning: Masculinity in Crisis (Issue 358 // Institute Inbrief). Retrieved from https://mailchi.mp/aipc/institute-inbrief-179116?e=5e8ce9018dAustralian Institute of Professional Counsellors. (2021). Finding Meaning: Masculinity in Crisis (Issue 358 // Institute Inbrief). Retrieved from https://mailchi.mp/aipc/institute-inbrief-179116?e=5e8ce9018d

Finding Meaning: Masculinity in Crisis


Many young men seek counselling because they feel lost (Seidler, et al., 2016). This happens especially in today’s world, where the boundaries of how a man is supposed to behave are shifting rapidly. It’s a difficult time for young men to find their place in life as they struggle to adapt themselves to changing social attitudes and norms; there’s plenty of content in the media illuminating harmful male behaviours, but there isn’t a legitimate mainstream discussion of how masculinity ought to be propagated. As a result, many young men are growing into adulthood without a map – they lack a male voice of compassion and authority to guide them on how to integrate masculinity into their lives.

In our writer’s experience, men who have been referred for counselling often have a very strong underlying sense of purpose and a desire to be good people; their anxiety, depression, and harmful behaviours are often symptoms of feeling unable to actualise their potential. It’s a counsellor’s job to help men articulate this sense of purpose in constructive and positive ways, and offer guidance on enacting their perceived purpose effectively. 

A study from the University of Connecticut has identified three major factors that determine whether men believe their lives are meaningful (George & Park, 2016):

  1. They feel that their lives make sense, and have continuity
  2. They are directed and motivated by meaningful goals
  3. They believe their existence matters to others

Researchers discovered that sources of meaning tend to fall into two main categories: meaningful relationships and a meaningful profession (George & Park, 2016).

There is no doubt that this generation of males is developing a unique relationship with masculinity, and it’s not necessarily for the betterment of their relationships or professions (Black & Westwood, 2012); men’s desire for professional success can be interpreted as a validation of the patriarchal system, while their pursuit of romantic relationships can be perceived as misogynistic (LeanIn, 2019). While some men are certainly exploiting systems which privilege them, often times the prevalence of this attitude discourages “good” men from progressing and developing themselves (Hoff, 2016). This article is not making a stance on any social/political issues: it is merely articulating some causes and concepts that can assist counsellors in understanding this very nuanced issue, so they can help men find meaning in the modern world.

What even is masculinity?

Masculinity and femininity denote sets of attributes that most people can intuitively identify – for example, it doesn’t take a discerning anthropologist to tell the girls section of the toy store apart from the boys section. But regardless of the value of this distinction, what exactly is the nature of it? Defining masculinity and femininity is a little more nuanced than simply referring to their apparent differences; not all people have the same understanding of what masculinity and femininity are, and how they manifest themselves. For example, conceptualisations of masculinity and femininity vary vastly across cultures and historical periods (Reeser, 2010); as such, there can be confusion about what these terms mean, and how we can embody them effectively.

Across time, however, typically agreed-upon standards for masculine conduct involve strength, courage, and leadership (Kimmel, 1994); these traits reflect a desire for meaning – you only inhabit strength and courage when a compelling reason to do so arises. Young men today, knowingly or not, are crying out for responsibilities that offer this type of meaning in their lives (Frankl, 2006). They want to know what it means to be who they are in the world right now – what can they do, and how can they best live? It’s time that we help them find the answers to these questions.

Currently, there is a lot of heated discussion about whether masculinity – or any kind of gender categorisation – is a genuine natural occurrence, or a mere social construction that we can/should dispose of; the question of whether masculinity is inherent in biology or if it arises through socialisation has been debated for hundreds of years (Martin & Finn, 2010). This is a question that does not have a black-and-white answer; studies on prenatal androgen exposure – among other developmental events – have shown biological links to expressions of masculine or feminine traits (Martin & Finn, 2010), however, it can be argued that these differences are exaggerated and articulated further by social influences (Wharton, 2012).

Whichever perspective you align with, an often unacknowledged aspect of these conversations is that while some forms of masculinity are harmful, some are also powerful forces for good. It’s possible (and advised) for men to have a productive and integrated expression of their masculinity (Jung, 2009) – one that allows them to use their strengths to achieve fulfilment. Unfortunately, the current culture is lacking in content which identifies what these strengths are, and thus fails to encourage men to embody them; as detailed above, many young men feel lost because of this.

It should also be stated that masculine traits are not exclusive to men; masculinity and femininity are not synonymous concepts to gender or sexual identity (Butler, 2006). That being said, this article is specifically addressing the mental health of men with masculine attributes. 

Why is masculinity in crisis?

There are a variety of reasons why young men feel uncertain about how to navigate the contemporary world. These include, but are not limited to, the following 3 observations:

1) The increasing separation between traditional male roles and the reality of modern life

The roles of men in the traditional household and workplace are changing. Men are becoming more inclined to be actively involved in child-rearing and housework. However, there is still often an expectation for them to maintain the traditional breadwinner role (Martin & Gnoth, 2009). Men are finding themselves stuck in limbo between the past and the future. Discerning one’s purpose thus becomes difficult, leading to feelings of emptiness (Rogers, 2010); men without a  defined mission will generally find themselves feeling a tremendous sense of lack (Deida, 1997). In this day and age, young men are extremely worried about what they will do after college, and the answer is likely “Go overseas for a few years, then come back.” This reflects a lack of encouragement to make powerful decisions towards meaningful futures.

2) A lack of positive masculine role models in society

For many children, fathers are either absent or not present enough, and this has lasting impacts on the way males view themselves and their sense of meaning/purpose in the world (Single Mother Guide, 2012). Men who grow up without an emotionally involved father has been correlated with long term effects including increased likelihood of dropping out of high school or college, and increased likelihood of substance abuse (McLanahan, Tach, & Schneider, 2014). These problems are exacerbated by the fact that many young men are searching for their place in the world and attempting to figure out what it means to be a man in today’s society – there is not always an adult male figure for them to look up to. 

The men who are often placed in the media limelight are there by way of some transgression or moral failing. While the modern world is rightly campaigning for positive representations of identities in media, it seems as though this effort circumvents men (Tarrant, et al., 2015). It is understood that men have historically tended to see themselves in positions of power and dominance, but this is not a reason to avoid exposing men to genuinely positive role-models in our current time. It is to the detriment of the mental health of many young men that we do not see more positive representations of masculinity (Tarrant, et al., 2015); ones that represent the compassionate and purposeful core of the masculine ideal.

3) Social media content either teaches men harmful ways of interacting with others, or degrades the concept of masculinity in general

The following two types of social media content are tough for today’s men to navigate. Firstly, there is a large online community of content creators calling for men to be ruthlessly successful; young men are bombarded with images of ‘alpha-males’ and are expected to adopt this image into their own definitions of masculinity. This makes it more difficult for boys to embrace their sensitive sides, leading to a lack of emotional literacy (Stratford, 2020). Content creators rarely offer antidotes to this effect, and are failing to provide helpful insights into the psychological reality of becoming a good man with a meaningful life. These online figures often try to convey an image that their life is perfect, when in fact this is often far from the truth; men are being encouraged to strive for false images of fulfilment (Stratford, 2020). This is a major concern for both men and women. 

Secondly, while some men are being plagued by the alpha-male image, others are being exposed to content that degrades masculinity in general. The conduct of certain men has been the object of fair scrutiny over recent years, and there are arguments to be made for how this conduct has been an expression of masculinity. There is, however, no grounds for suggesting that masculinity in general is problematic. This view has created a culture in which masculinity is demonised; while this might be a perceived course-of-action for eradicating its more toxic forms, the more immediate effect is that good men are feeling alienated and ineffectual (Rogers, 2010). Rather than encouraging men to be better, we are constantly reminding them that they are harmful; a result of this is a generation of men who are unmotivated and aimless (Salter, 2019). A study has found that male respondents who have experienced gender-based cyberbullying feel compromised in how they feel they are permitted to exist in society (Chen, et al., 2015). Men are seen as less attractive and less desirable to women when they post images of themselves on their Instagram account, as it is seen as the promotion of male dominance rather than a harmless expression of an individual (Fox & Rooney, 2015). This phenomenon leads to a significant decrease in men’s self-esteem, which results in paralysis and stagnation in their professions and relationships.

So, how can counsellors help men find purpose and meaning?

As counsellors, we can offer strategies to help men identify and organise the meaningful facets of their lives. Viktor Frankl, the author of Man’s Search for Meaning, created logotherapy, which is based on the presumption that a man’s main motivation is to find meaning in life, as opposed to the pursuit of pleasure or power (Marshall & Marshall, 2012). Some techniques he used were dereflection (focusing on high-level goals instead of on themselves) and Socratic dialogue (open-ended questions to uncover dormant aspirations). If, for example, a client is passionate about saving the environment, this type of therapy can assist them in finding a practical way to focus their time and efforts on realising their potential in doing so.

Meaning therapy (Wong, 2010) incorporates aspects of cognitive-behavioural therapy and positive psychology, and helps people take on more meaningful responsibilities in their lives while encouraging them to pursue goals that serve others. It advocates psycho-educational approaches that equip men with the mental toolkit necessary to create a vision of an idealised future for them to begin moving towards.

Similarly, self-authoring is a process by which people organise their lives into a narrative structure, making their past, present, and desired futures more easily understandable (Peterson, 2005). By creating a map of one’s life, it can become far simpler to identify who you are, what you value, and what you need to do to be of most service to yourself and your community. As with most approaches that attend to creating meaning, it is based on reflection and awareness. 

A culture of masculine content creation must be encouraged to counter the fear of being construed as ‘too emotional’, or ‘not manly enough’. It’s time we begin working together to help young men find meaning, and develop a culture which is focused on stopping the cycles of toxic masculinity, whilst encouraging healthy expressions of masculinity in its stead.

In summary… 

Young men today are having a difficult time finding their place in the world. The current cultural climate surrounding masculinity – as well as the absence of positive role-models for younger generations – is leading to a decrease in the quality of mental health. Men must be taught how to integrate their masculine dispositions into their lives; how to lead, how to care, and how to love with purpose and commitment. There is an urgent need for discussion to take place around what masculinity means, and how we can encourage healthy expressions of it; it is my hope that this article has encouraged us all to begin engaging with this conversation. 

Recommended Links: Men In Mind Program (by Movember), Men and Emotions: From Repression to Expression (Article), Men, Emotions and Alexithymia (Article)

References:

  1. Butler, Judith (2006) [1990]. Gender trouble: feminism and the subversion of identity. New York London: Routledge. 
  2. Cunningham, C. E., Chen, Y., Vaillancourt, T., Rimas, H., Deal, K., Cunningham, L. J., & Ratcliffe, J. (2014). Modeling the anti‐cyberbullying preferences of university students: Adaptive choice‐based conjoint analysis. Retrieved from webpage.
  3. Deida, D. (1997). The Way of the Superior Man. S.I.: Sounds True.
  4. Fox, J., Rooney, M. (2015) The Dark Triad and trait self-objectification as predictors of men’s use and self-presentation behaviors on social networking sites. Personality and Individual Differences
  5. Frankl, V. E., Kushner, H. S., & Winslade, W. J. (2006). Man’s search for meaning. Boston, MA: Beacon Press.
  6. Hoff, C. (2016). Five Ways Patriarchy Affects Men and their Relationships. Retrieved from webpage.
  7. Jung, C. G., Shamdasani, S., & Hoerni, U. (2009). The red book = Liber novus: A readers edition. New York: W.W. Norton &.
  8. Kimmel, Michael S. (1994). “Masculinity as Homophobia: Fear, Shame, and Silence in the Construction of Gender Identity”. Theorizing Masculinities. Thousand Oaks: SAGE Publications, Inc. pp. 119–141. 
  9. LeanIn.Org and SurveyMonkey survey (2019)
  10. Maria Marshall; Edward Marshall (2012). Logotherapy Revisited: Review of the Tenets of Viktor E. Frankl’s Logotherapy. Ottawa: Ottawa Institute of Logotherapy. 
  11. Martin, Brett A.S.; Gnoth, Juergen (2009). “Is the Marlboro man the only alternative? The role of gender identity and self-construal salience in evaluations of male models”. Marketing Letters. 20 (4): 353–367. 
  12. Martin, Hale; Finn, Stephen E. (2010). Masculinity and Femininity in the MMPI-2 and MMPI-A. University of Minnesota Press. pp. 5–13. 
  13. McLanahan, S., Tach, L., & Schneider, D. (2013). The Causal Effects of Father Absence. Retrieved from webpage.
  14. Peterson, J. (2005). Self Authoring. Retrieved from https://www.selfauthoring.com/
  15. Reeser, Todd W. (2010). Masculinities in theory: an introduction. Malden, Massachusetts: Wiley-Blackwell. 
  16. Rogers, Thomas (November 14, 2010). “The dramatic decline of the modern man”. Salon.
  17. Salter, Michael (2019). “The Problem With a Fight Against Toxic Masculinity”. The Atlantic. 
  18. “Single Mother Statistics”. Single Mother Guide. (2012)
  19. Seidler Z. E., Dawes A.J., Rice S. M., Oliffe J. L., Dhillon H. M. (2016). The role of masculinity in men’s help-seeking for depression: A systematic review. Retrieved from webpage.
  20. Stratford, H. (2020). ‘Be a man’ – toxic masculinity, social media and violence: Innovation Unit: Creating impact – reducing inequalities – transforming systems. Retrieved from webpage.
  21. Tarrant, A., Terry, G., Ward, M., Are Male Role Models Really the Solution? Interrogating the ‘War on Boys’ Through the Lens of the ‘Male Role Model’ Discourse. (2015). Retrieved from webpage.
  22. Westwood, M. J., & Black, T. G. (2012). Introduction to the Special Issue of the Canadian Journal of Counselling and Psychotherapy. Retrieved from webpage.
  23. Wharton, Amy S. (2012). The Sociology of Gender, second edition. Hoboken, NJ: Wiley-Blackwell.
  24. Wong, P. T. (2009). Meaning Therapy: An Integrative and Positive Existential Psychotherapy. Retrieved from webpage.