Addiction as an attachment disorder: implications for group therapy.

This article presents a perspective on addiction that not only substantiates why group therapy is the treatment of choice for addiction, but also integrates diverse perspectives from 12-step abstinence-based models, self psychology, and attachment theory into a complementary integrative formula. Attachment theory, self psychology, and affect regulation theory characterize addiction as an attachment disorder induced by a person's misguided attempt at self-repair because of deficits in psychic structure. Vulnerability of the self is the consequence of developmental failures and early environmental deprivation leading to ineffective attachment styles. Substance abuse, as a reparative attempt, only exacerbates that condition because of physical dependence and further deterioration of existing physiological and psychological structures. Prolonged stress on existing structures leads to exaggerated difficulty in the regulation of affect, which leads to inadequate modulation of appropriate behavior and self-care and increased character pathology.