The Psychology of Gossiping – in a snapshot

Adapted from AIPC (2022), Institute Inbrief, Issue 363.

Oftentimes, a brand new year is used like a clean slate. We can do this any time throughout the year, however, I understand that there is an added element of our “collective consciousness” in the universal atmosphere motivating us with some renewed energy and will. At this time of year, humans perceive that everyone else is also feeling hopeful, invigorated, and full of promise. But the road to realisation of goals is littered with the carcasses of broken dreams, unfulfilled promises, and intentions that dissipated in the stress and mundane of everyday life – our goals did not receive the “oxygen” required to be sustainable.

What is our “Will”?

Have you ever fallen short of accomplishing you New Year’s Resolution? Sometimes, even before the end of New Year’s Day? People many think, “I don’t have the will power to sustain it”, however, if we look at this from the perspective of Psychosynthesis, a transpersonal psychology, we will understand why our understanding of “will power” if often incorrect. If you did anything today, you have will inside you. You have drive, motive, and energy.

While our will may not have all the “power” that we would like it to have, our will is always present with us, somewhere. Psychosynthesis counsellors, especially trained to be observant about will, acknowledge that one of their sacred duties with clients is to track their will, but all mental health professionals can tune more into the willing function of self, for the ultimate good of the client. What do we need to know to do that?

First, will isn’t just desire energy. It is not synonymous with control, it is not about “strong-arming” someone, and it isn’t merely about repressing undesirable material.

Personal and transpersonal will

At a personal level, “will” can be understood as an essential impulse toward our own wholeness. It is that drive within us which coordinates the often-conflicting parts of our personalities into self-expression. As the function closest to the self, it regulates and directs other functions, such as imagination, intuition, impulses, sensations, thoughts, and feelings. It is will which guides us toward personal integration. As we align our lives with a broader vision for what we may be, we go beyond personal will, receiving guidance from transpersonal will: the will of Self (as opposed to “self”).

Along that journey, however, people can fail to execute our will in a way which allows our goals to be realised. This post looks at the aspects of will, which, if they are not employed or are employed badly, can stunt the client’s intentions, keeping their goals from ever realising.

Aspects of will: Strength, Skill, and Virtue

Strength

When people make statements as mentioned above, decrying their lack of “will power” or “internal energy”, they are probably referring to the most well-known aspect of will: that is, “strong will”. It is believed that when we are born, we are unaware that we are separate from our birth giver. The beginning of individuation (the process of forming a stable personality) is the beginning of recognising that “will” exists. We are not only separate from Mum; we actually want something other than what Mum seems to be giving us. We come to see that we have arms and legs and a mouth, so we use these tools to explore the world the way we want to. We learn that crying will have certain needs met. It is the aspect of “strong will” that ensures that our willed act — say, crying for food — contains enough intensity or “drive” to carry out its purpose (getting us fed).

In other words, have you ever seen a really hungry baby stop crying after a very short time if it is not fed? Generally, not. It is possible that our new diet or exercise regime has failed because we didn’t elicit the intensity or “drive” to the intention to exercise or stick to our new diet. We may need to explore what situations in life are keeping us from applying greater intensity to the question. Maybe our desire to change is not worth the requisite “will” or “energy”. The road of least resistance is very common as we age and accumulate more life responsibilities.

This is not true for everyone. Some people will vehemently proclaim that do want to change. It is not lack of wanting, or lack of “will”. What is missing may be the second aspect of “will”, equally important to the first: that of skilful will.

Skill

Several sayings are relevant here:

1. Environment is stronger than will power.
2. When imagination and will power go up against one another, imagination wins every time.

These axioms allude to the often-unrecognised reality that we cannot generally achieve our goals through strong will, alone. Consider the alcoholic who desperately wants to stop drinking but they continue relapsing. If we put our will into competition with other psychological forces — such as impulse or feeling — it becomes overwhelmed; we end up stressed without accomplishing our goal. What we are missing in this case is likely to be the capacity to develop strategy, approaching the goal skilfully, and practically. Oftentimes, we want to achieve our goal without attaining the skills necessary to achieve it.

If you want to lose weight, for example, could think that you simply need to eat fewer calories and the extra kilo’s will start dropping off. Calories in Vs Calories out. But your role as strategist can be very helpful if you establish, for example, whether you’re often in situations where controlling food intake is difficult: say, when going out to eat or eating at private parties, or it’s the holiday like Christmas. Are you eating balanced meals, with sufficient protein (for example) to sustain yourself? Are you getting enough sleep to avoid overproduction of the hunger-inducing hormone ghrelin? How much do you know about body composition, the endocrine system, metabolism, nutrition, and exercise physiology?

There are myriad ways to be skilful around weight loss plans, and you may need to consider adopting some of them for success. For example, do you have effective interpersonal skills to communicate your needs to the people in your life that exercise and healthy eating is valuable to you, and you need their support? Or do you have the skills to join a peer group that exercises regularly. Perhaps you could improve your financial skills to budget for a Personal Trainer.

If we must merely “strong-arm” ourselves to achieve every end, we end up exhausted and discouraged, with few accomplishments. “Skilful will” allows us to use will not as a direct power or force, but as a function which stimulates, regulates, and directs other functions of ourselves so that they lead to the goal. For example, learning mindful eating skills may cultivate a relationship with bodily sensations which allows you to observe the sensation of true hunger pains as opposed to times when you eat because of boredom or wanting to feel good (temporarily). You can also learn skills to meet alleviate boredom or feeling emotionally nourished in other ways.

Even with employing strong and skilful will, however, your may not achieve your goal(s). That’s okay. Please do not judge yourself. It’s what Buddhism called the second arrow. That is, you already didn’t meet your goal (the first arrow) and then you judge yourself for it (the second arrow). You are human, not superhuman.

A third aspect, equally important with the first two, may also need to be employed. It is “Virtuous Will”.

Virtue

Is your goal something you can achieve all by yourself through prudent use of strong and skilful will? No one is an island; we all live in communities and interact with family, friends, co-workers, gym instructors, enemies, and others on a regular basis. Those willed acts that succeed in accomplishing the will-er’s goal do so because they have considered the need to choose goals that are consistent with the welfare of others and the common good of humanity. They also must be consistent with “virtuous will” to the “self”.

The bottom line here is that many people need to do serious work around having virtuous will for themselves. For example, if you “hate” yourself for weighing more than what you would like, the motivation for change is unlikely to succeed because it is born in self-hatred. It is more effective to improve your self-esteem and sense of worth as a person, independent of your goal, so that any weight loss and subsequent weight maintenance can be in the context of “something I do to value myself; I like myself as I am and want to enhance the health of that self”.

Accessing transpersonal will

According to Roberto Assagioli, the founder of Psychosynthesis, using our will doesn’t stop with developing strong, skilful, and virtuous will: the three aspects of personal will. Assagioli claims that we can manifest all three of those and still be unhappy if we do not see how our personal goals align with something greater than ourselves. Having that solid sense of meaning and purpose to achieve something beyond the benefit of our little “self” helps us to reach beyond the limitations of ordinary consciousness to more expanded, intense states of awareness.

To yearn for that and not have it is what Viktor Frankl called “the abyss experience”: the opposite of Maslow’s peak experience (Boeree, 2006). Yet it is often in the abyss and despair of meaninglessness that we feel the pull of the superconscious, activating our transpersonal will and giving us access to another level of being. And then life becomes more interesting, as we try to balance the needs of material life (our immanence) and those of our higher levels of being (our transcendence), experienced as intentions arising from our transpersonal will.

Even the hypothetical person’s goal of weight loss (seemingly a very personal goal) may be able to access transpersonal will. Let’s say you lose the weight, arriving at your goal weight. You may enjoy a slender new body for a while, but ultimately that may not be enough to sustain lasting contentment, peace, and satisfaction. Looking “good” may not be the sole purpose of the original intention. If you can transform your goal, however, to a goal more inclusive of potential good for humanity as a whole — you may find that your personal will is aligned with transpersonal will. Just look at all the people on Youtube trying to help others, or the reward and continued sobriety members of Alcoholics Anonymous are given by “helping others”. Transpersonal will goes beyond the self and comes back to support our intention. Perhaps you want to write about healthy-body image as a method to transcend your Will to others.

The Will and the End of this Article

An effective and intentional use of will increases joy, openheartedness, and equanimity. Through use of not only strong will, but also skilful and good will — and perhaps even transpersonal will — your New Year’s resolutions will be far more likely to succeed, and you can experience willing as an act that leads to joy.

References

3. Assagioli, R. (1973/1984). The act of will: A guide to self-actualization and self-realization. Wellingborough: Turnstone Press.
4. Boeree, C. G. (2006). Viktor Frankl. Personality theories. Shippensburg University. Retrieved on 5 November, 2012, from: Website.
5. Mental Health Academy. (n.d.). Understanding Will. Mental Health Academy.

I want to preface this post by stating that the concepts and suggestions I’ve made below are my own thoughts, opinions, and suggestions based on my own experience working in the mental health sector and lived experience. There may also be numerous grammatical and logical errors. I know that you’re intuitive enough to understand what I’m attempting to describe and explain. Therefore, there will be no references section at the end. This is merely an expression of thoughts, a stream of consciousness (William James coined the term Stream of Consciousness).

Episodic, acute, and chronic anxiety can be miserable and debilitating. Individuals living with anxiety have generally experimented with many techniques to cope with anxiety symptoms, and they have often been practicing these techniques for months, years, or decades. Anxiety is life changing. Current treatment can be efficacious at reducing the intensity or frequency of symptoms for the vast majority of people living with anxiety, but only at best. I, myself, have tried the deep breathing technique commonly advised by mental health professionals, and it can be about as useful as taking a sugar pill. There is credible science that supports deep breathing exercises can improve symptoms and recovery rates for stress, anxiety and depression levels – but what about for an anxiety attack or a panic attack or intense chronic symptoms of anxiety?

Sometimes nothing is effective enough for immediate relief. It is my contention that building a relationship with a trained psychiatrist, specialised in this domain, is an essential first step. Your treating specialist(s) will need to have extensive experience and a comprehensive understanding of the debilitating impacts of anxiety, anxiety attacks, and/or panic attacks. I recommend psychiatry because you will need someone who can prescribe short-term medication, schedule 4 or greater, to alleviate the pain rapidly. All symptoms a person may experience from any condition in the anxiety family present a risk for searching for any immediate relief. This is true for you or me or anyone. Without prompt and effective medical care readily available, many people who do not have a plan for managing anxiety will potentially search for an unhealthy substitute to acquire relief.

These substitutes are often unhelpful long term but effective short term. We all know what they are: alcohol and other drugs, sexual promiscuity or sex addiction, love addiction, gambling, excessive or unhealthy eating habits, self-injury, addictive forms of gaming, impulse spending, co-dependent or dependent behaviours on people, people pleasing, running away (avoiding reality), raging, reckless driving and other criminal behaviour, and relying on pharmaceuticals (legally prescribes or otherwise) that will have long-term unhealthy side effects. People know how to “doctor shop”, and although this area of medicine is becoming much more regulated, it still occurs. Unfortunately, there are people who do require certain types of legal drugs, in a timely manner, to find relief as a means of not engaging in any of the previously mentioned behaviours.

Some people may not have much faith in the field of psychiatry or psychology – HOWEVER – you may find yourself in a situation one day where you will need a doctor who knows your history to increase the likelihood of prescribing medication to treat anxiety when you need it most. This medication usually has addictive properties. An ethical psychiatrist will usually be unwilling to prescribe more than a single repeat of potentially addictive medication to treat their patients. This is standard, regulated medical practice in Australia.

Anyone working in the drug and alcohol sector or has regular contact with a person living with anxiety, or any form of addiction, will know that patients – people – are not being seen in a timely manner top treat anxiety before the patient starts looking elsewhere. Even once the patient has accessed some type of medical care, the length of care is not long enough for the patient to be “well enough” after discharge or ending their hourly session, to be on their own in the community safely without becoming vulnerable to their condition in a short time and looking for more relief to ease their pain and improve their well-being.

If a person or a patient cannot depend on the medical system in the way they need to feel safe and well, they will almost certainly begin to lose faith and trust in health professionals, and ‘the system’. This perpetuates their internalised stigma being reinforced, yet again.

I am not saying the patient doesn’t have a significant responsibly of their own to make valuable choices outside of medical treatment. I quote what someone once said to me, “You may not have asked for this disease, but it becomes our responsibility to stay well”. That is our duty as the person living with a health issue of any kind. There are things we certainly must do (or not do) to stay as healthy as possible. The help make not be there in a timely manner the next time we need immediate help.

It can take weeks or more to enter a detox facility. It can take months to enter a rehabilitation facility. It can take months for an available appointment to open with a psychiatrist. It becomes our responsibility to know that even when we’re feeling well and back to “normal”, we must continue those relationships with medication professionals. It becomes our responsibility to try alternative medicines if that’s something you’re interested in. Let’s face it, psychiatrists cease their practice, our professional relationship has reached it’s potential for adequate, loving care, or we want to try something new.

Start the process of finding a reliable, qualified, and credible psychiatrist today. I would recommend finding a counselling psychologist or other mental health professional that you have a productive and friendly working relationship with – and if you want to practice Buddhism, or acupuncture, or hypnotherapy, or any other complementary and alternative medicine – do it. If you want to connect with God – do it. If you want to see a naturopath – do it. Whatever it is, this may very well be a lifelong journey for you. Based on my own experience, don’t stop because you think you’re “all better now”. The previously mentioned professions or treatment options or lifestyle choices can be extremely expensive, but I would encourage you to save for it, find less expensive options. Sitting in church is free, or listening to an online guru can be the price or maintaining your mobile service bill.

I once knew of a fellow peer in treatment alongside me who said he saved money for years to travel overseas to have a procedure not available in Australia at the time for this purpose. He wanted blood transfusions and heat therapy for chronic pain that didn’t doctors could not determine had physiological origins. The peer was sure it had to, and medical investigations in Australia come up negative. The peer explained the theory behind blood transfusions and heat therapy – he believed – were supposed to improve his blood circulation and blood flow to treat the chronic pain he’d been living with for years after a workplace accident. Even this procedure overseas proved ineffective in mitigating his chronic pain. So, next he tried the wim hof method. He changed is diet. He exercised differently. He tried hypnotherapy. Finally, he turned psychology to treat stress and process childhood trauma. He was being treated for this a private facility where I was a patient at that time. I lost contact with him after I ended my own treatment episode. I don’t know if he’s still living with chronic pain or not.

The following are some very basic and well-known strategies in the Western world of psychology that you can begin to practice today, and then practice every day after that too – even for 5-20 minutes:

– learning about anxiety – your specific “causes” and the conditions more generally

– mindfulness

– relaxation techniques

– correct breathing techniques

– dietary adjustments

– exercise

– learning to be assertive

– building self-esteem

– cognitive therapy

– exposure therapy

– structured problem solving

– support groups

My firm believe is this:

Strong, healthy, quality relationships are essential to treating anxiety and other psychological illnesses. This about your life today: are you lonely (romantically or otherwise), are you a stressed individual, do you regularly feel like you job is stressful or unfulfilling, do you feel sad a lot, are you feeling pointless a lot, or feeling helpless a lot, feeling shame a lot, getting angry a lot over considerably minor things? etc. etc. etc. I would strongly encourage talking to a professional and begin exploring what options you have available to you.

Try, explore, play with a few methods of treatment. However, this must take a priority in your life. It must balance will all the many other obligations and responsibilities people encounter daily.

Type alternative medications or approaches to psychology. There are so many. It can be fun to try out a few when your finances permit. Even planning a holiday every 3-6 months is taking care of your well-being.

Many blessings friends.

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