Alcoholism and the Addictive Paradigm: Etiological and Epidemiological Perspectives

Theatrical Release Poster
Theatrical Release Poster

This post examines, summarizes, and reflects on the connection between the addictive paradigm, alcoholism, and “alcoholic” family dynamics. These processes essentially feed into each other, addictive thinking is what allows alcoholism to develop, and alcoholism reinforces and strengthens the addictive thinking. An “alcoholic” family functions in a similar way, as each family member plays a role which he or she contributes to the sustenance of the dysfunctional dynamics and thereby the maintenance of the addiction illness. Key concepts in the addiction field, such as the addictive paradigm, and addictive system are defined and framed. The post also describes the elements of an addictive family system.

A paradigm is the social lens through which we view the world. It is compose of our belief systems, thoughts, and worldviews which subsequently shape our attitudes and behaviors. The addictive paradigm or “addictive thinking” is the lens through which an addict looks at the world which consist of addictive thoughts, behaviors, and habits. The addictive paradigm fuels the addiction and shapes the addict’s perception of reality. His perception of reality is blinded by addictive thoughts. Through the addictive paradigm the addict sees himself to be shameful and not guilty of his or her acts (Twerski, 1990). By not feeling guilt, the addict’s thoughts of reality along with their ethnical reasoning are distorted and he or she continues to pursue their addiction. “Denial, rationalization and projection are core characteristics of addictive thinking” (Twerski, 1990).

LEAVING LAS VEGAS – Trailer ( 1995 )
Trailer for Mike Figgis’s film

Further, their denial that the addiction exists, also forms a part of the addictive paradigm, keeps the addict out of touch with reality, and distanced from their true feelings. Addicts depend on chemical substances, whether it be alcohol or other drugs, to feel “normal”, in order to numb their feelings. This may be because their emotions may be too intense or they may doubt their ability to manage their emotions effectively (Twerski, 1990). One theory is that those who are addicts are hypersensitive to emotions; they feel everything at a heightened intensity as compared to non-addicts (Twerski, 1990). This theory indeed explains the addict’s need to distance themselves from reality and from their emotions. Addicts may also use projection to prevent dealing with uncomfortable feelings such as fear, anger, and jealousy. They accuse other people of having these emotions, as a way to avoid admitting to have these feelings themselves. These aforementioned elements of the addictive paradigm not only contribute to the development of an addiction, but prevent the addict from moving towards the process of recovery.

A system can be defined as an entity that consists of both content, including ideas, roles, and definitions, and processes. A system must also be complete in itself (Schaef & Fassel, 1990). Although a system is made up of many parts, it functions independently from the individuals within the system. For example, a corporation can be thought of as a system, because it has certain rules and norms that exist apart from the current employees of the corporation and that persist over time. Systems can be characterized as either open or closed systems (Schaef & Fassel, 1990). Closed systems do not allow or recognize information that does not fit with existing paradigms, while open systems are more flexible and are open to new information as a means to beginning the process of change. Change exists in open systems. However, all systems reinforce behaviors and processes from those individuals within the system which are consistent with the system, although this may occur subtly and not explicitly (Schaef & Fassel, 1990).

An addictive system can be described as a closed system, as it leaves very little room for change. The addictive system in our society only calls for addictive behaviors and does not allow individuals within the addictive system to have alternative roles and behaviors. It solely promotes addictive thinking and processes and due to the fact that we live in this addictive system, we possess many of the characteristics of the addictive system. The addictive system possesses many of the elements that individual addicts often exhibit, including denial, confusion, self-centeredness, dishonesty, perfectionism, illusion of control, rationalization, projection, and ethical deterioration (Schaef & Fassel, 1990).

The element of denial contributes a great deal to the closed aspect of the addictive system, as it causes individuals within the system to simply ignore what is happening before their very eyes by simply claiming that it does not exist (Schaef & Fassel, 1990). Another characteristic, confusion, keeps us trying to figure out what is going on, and thus makes us powerless and ignorant (Schaef & Fassel, 1990). Self-centeredness causes the addict to define every event in their lives as either “for” or “against” the self (Schaef & Fassel, 1990). This is not mere selfishness, but also a perception that the self is the center of the universe and that nothing else matters. Dishonesty is also a key element of the addictive system, as addicts are often described as “master liars.” There are three levels to an addict’s dishonesty: they lie to themselves, lie to those people around them, and lie to the world at large by putting up a façade of who they really are (Schaef & Fassel, 1990).

Perfectionism is another characteristic of an addictive system. The addictive system falsely assumes that it is possible to be perfect, and thus expects individuals within the system (addicts) to know all the answers and never make mistakes (Schaef & Fassel, 1990). This explains why addicts perceive themselves as failures and are quick to cover up any mistakes rather than constructively learning from those mistakes. The addictive system and addicts also possess an illusion of control, as the addictive system promotes the belief that it is possible to control everything. Addicts often believe that they can use substances to control their feelings, but are often out of touch with their true feelings; this is called “frozen feelings” (Schaef & Fassel, 1990). The sum of all the elements of the additive system can only lead to ethical deterioration (Schaef & Fassel, 1990), addicts have no sense of what is wrong and right, and are consumed in lies, attempts to control everything, and selfishness.

In the 1980s the field of alcoholism began to give increasing attention to the influence of alcoholism on the family, and alcoholism began to be referred to as a “family illness” (Kinney, 2006). Prior to this, alcoholism was mainly studied with regard to its physiological effects. With regard to work in the family therapy field, increasingly a systemic perspective has been taken, which proposes that changes in any one family member affect all the others (Kinny, 2006). Research on addictive family systems suggests that there are 3 roles that family members may take, keeping out of the way of the addict, caregiving, counseling and controlling, or withdrawing and putting up a façade (Kinney, 2006). Usually the spouse of the addict will take on the role of the caretaker and becomes almost like a single parent in the family, although this often only occurs when the addict is the husband (Treadway, 1987). The addict will increasingly feel isolated from the family as a result of their drinking (Treadway, 1987) which will further reinforce their dependence on alcohol as an outlet. The children in the addictive family system will learn how to ignore the chaos within the family and become self-sufficient (Treadway, 1987). Although the non-addict parent serves to hold the family together, they also support the behavior of the addict and thus contribute to the confusion of the children.

The children in the family take on one of 3 roles in the addictive family system, the hero, scapegoat, or the lost child (Treadway, 1987). The “hero” is often the oldest child, and acts like an assistant parent in the family, and defines his or her identity in terms of his or her ability to serve as a caretaker of the younger siblings (Treadway, 1987). It is not surprising that the “heroes” often end up with addict spouses themselves and continue their role as caretakers as adults. The “scapegoat” child acts out and takes the blames for the family problems, and thereby diverts attention from the addict parent. They are also often the first family member brought in for treatment, but when not helped develop a high risk of being alcoholics or drug dependent as adults (Treadway, 1987). Finally, the “lost child” who is often the youngest child, tries to remain uninvolved with the family and seeks out other adults and families as surrogate caretakers, these children will likely find it difficult to develop close relationships as adults (Treadway, 1987). It is clear that the different roles taken on by the children as well as the spouse serve to maintain the addictive family system and prevent it from changing. By failing to hold the addict accountable for their actions, the family reinforces their addiction. However, it is interesting that these roles that are taken on by the family members also serve as coping mechanisms, as a way to deal with the addict’s behavior and its negative influence on the family. It must be very difficult to break out of those roles, as the addictive system is a closed system and prevents change from any individual within the system.


Schaef, A.W., and Fassel, D. (1990). The Addictive Organization: Why we overwork, cover up, pick up the pieces, please the boss, and perpetuate sick organizations. New York, NY: Harper & Row.

Twerski, A. (1990). Addictive Thinking: Understanding Self-Deception. New York, NY: HarperCollins.

Kinney, J. (2006). Loosening the Grip: A Handbook of Alcohol Information. New York, NY: McGraw-Hill

Treadway, D. (1987). The Ties That Bind: Both Alcoholics and Their Families are Bound to the Bottle. Boston, MA: Networker.