Despite decades of addiction treatment and billions of dollars spent annually, relapse rates remain staggeringly high. Overdose deaths are increasing, and no unified or standardized protocols exist for treating substance use disorders effectively. In Chapter Three of Prelude to a Paradigm Shift for Addiction, I confront the dangerous myths underpinning the current treatment model and propose an alternative hypothesis grounded in psychology, self-responsibility, and the transformational power of thought.

This article expands on the central argument of Chapter Three: addiction is not caused by drugs, alcohol, or a diseased brain. Instead, it is rooted in poor self-esteem and a negative self-image. Healing addiction requires psychological transformation—not just abstinence or symptom management, but a profound change in how individuals think about and value themselves.

Treatment methods evolve out of a belief system. Our current approaches to addiction are built upon four presuppositions—explored in Chapter Two—which are unsubstantiated, deceptive, and harmful. These assumptions include:

1. Drugs and alcohol are inherently addictive.
2. Addiction is a physiological disease, particularly of the brain.
3. Addiction is not a choice, and individuals are not responsible for it.
4. There is no cure for addiction—only a daily reprieve.

Each of these ideas lacks sufficient empirical support. More importantly, they lead to interventions that disempower clients and promote dependency rather than healing. The current paradigm must be challenged and replaced with a more accurate, empowering philosophy.

Contrary to popular belief, drugs and alcohol are not inherently addictive. There is no conclusive scientific proof that substances like opiates or alcohol cause addiction in every person who uses them. Many individuals consume these substances without developing dependency. The question, then, is not why people use drugs or alcohol, but why some individuals use them repeatedly despite negative consequences.

Drugs and alcohol trigger a pleasurable response in the brain—primarily through dopamine release. This pleasurable response becomes associated with emotional relief. Over time, a habit forms: the substance is used not to enhance life but to escape emotional pain. The problem is not the substance itself, but the individual’s emotional need for relief.

Addiction is not about chasing a high. It’s about avoiding a low. People continue using because they don’t feel good when they’re sober. This suggests a psychological issue—not a chemical dependency, but a persistent effort to numb pain caused by low self-worth and a damaged self-image.

Why do some individuals feel compelled to use substances repeatedly while others do not? The answer lies in the internal emotional landscape of the user. If a person does not feel good about themselves while sober, they will seek ways to escape their emotional discomfort. Substances become the means by which they temporarily alleviate internal suffering.

This suffering often stems from a negative self-image: the deeply held belief that one is not good enough, not worthy, or fundamentally flawed. When sober, these thoughts surface. When using, they are numbed. Therefore, the addiction is not to the substance itself but to its effect on the psyche—it is a coping mechanism for emotional pain.

The medical establishment promotes the idea that addiction is a chronic brain disease. Organizations like the American Medical Association and the American Society of Addiction Medicine have institutionalized this view. Yet, there is no definitive scientific proof that a diseased brain causes addiction.

Yes, substance use can alter brain chemistry. But this is a consequence—not a cause—of addictive behavior. The true origin lies in a person’s thoughts, beliefs, and emotional pain. By focusing on the brain alone, we neglect the psychological and cognitive components that are central to the problem.

Addiction is not a physiological disorder—it is a psychological one. It is a repetitive, compulsive behavior driven by an attempt to escape the emotional pain caused by negative thoughts. These thoughts—”I am not good enough,” “I am unworthy,” “I am broken”—are often formed in childhood and reinforced over time.

Dr. Nathaniel Branden, in The Six Pillars of Self-Esteem, writes about the link between addiction and the avoidance of consciousness. When people become addicted, they are not seeking pleasure—they are seeking numbness. They are using substances to avoid awareness of their pain.

Similarly, Louise Hay emphasized that we are responsible for our thoughts and that we can choose to reject negative ideas about ourselves. Addiction is sustained by a refusal to confront and change these thoughts.

One of the most damaging beliefs in the current paradigm is that people suffering from addiction are not responsible for their behavior. This belief is rooted in the disease model, which claims that addiction is a condition that happens to someone, not something they create.

But if addiction is caused by thought patterns—by beliefs we have chosen to accept and internalize—then we are responsible for it. This is not about blame. It is about empowerment. We can choose to think differently. We can choose to heal.

Both rational emotive behavior therapy (REBT) and cognitive behavioral therapy (CBT) assert that our thoughts shape our emotions and behaviors. These modalities emphasize responsibility and choice. They demonstrate that transformation is possible when we take ownership of our internal narrative.

Where do these harmful beliefs come from? Often, they are absorbed during early life experiences. Children may interpret criticism, neglect, abuse, or trauma as evidence that they are unworthy. These interpretations become self-limiting beliefs. Over time, these beliefs form the core of a person’s identity.

Carl Jung referred to this as the “Shadow”: the unconscious belief that we are fundamentally flawed. When these beliefs are unchallenged, they lead to self-sabotaging behaviors—such as addiction. Substances become a way to quiet the inner critic and avoid the pain of the shadow.

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Perhaps the most insidious assumption in addiction treatment is that there is no cure. This belief reinforces the idea that individuals are powerless over their condition. It also ensures a steady stream of repeat clients for the treatment industry.

But this belief is false. Addiction is not a lifelong sentence. It is a condition that can be healed—by changing how we think about ourselves. When individuals transform their negative self-image and begin to love and accept themselves, the need for substances disappears. There is no longer anything to escape from.

The cure for addiction lies not in medication or abstinence alone, but in a radical shift in thinking. When individuals take responsibility for their beliefs, when they choose to create new thoughts that affirm their value and worth, they break the cycle of addiction.

Louise Hay writes that every problem we face exists because there is a need for it. Once we meet the underlying need—the need for self-acceptance, love, healing—the behavior no longer serves a purpose and naturally fades away.

Behavior is belief-driven. Change the belief, and the behavior follows. When a person truly believes they are good enough, they will no longer harm themselves with drugs or alcohol. They will begin to live in a way that honors their wholeness.

The central hypothesis of Prelude to a Paradigm Shift for Addiction is this:

The root of addiction is not physical. It is psychological. It is a negative self-image and poor self-esteem that drive addictive behavior. The solution is not found in external interventions but in the transformation of the individual’s thinking.

As this hypothesis is developed in subsequent chapters, I propose a practical, implementable therapeutic model that focuses on changing self-perception. This model can be applied in telehealth settings or integrated into existing treatment programs.

Wayne Dyer tells the story of a man who drops his keys inside his house but looks for them outside under the streetlight because it’s brighter there. This story perfectly captures what we’ve done in addiction treatment. We’ve searched for the cause of addiction in brain chemistry, in substances, in trauma. But we’ve ignored the one place where the answer truly resides: within.

The source of addiction is not external. It is not drugs. It is not alcohol. It is not trauma or even brain chemistry. It is the story we tell ourselves about who we are—and whether we are worthy of love.

If we believe there is no cure, we stop searching. We resign ourselves to failure. We lose hope. And when treatment centers promote the idea that addiction is incurable—while also promising healing—they send a mixed and destructive message.

This message traps individuals in a cycle of relapse and return. It sustains the financial success of treatment programs but fails the very people they claim to help. It’s time to end this cycle. It’s time to tell the truth.

There is a cure for addiction. It is not a pill, a program, or a meeting. It is a person’s willingness to change their thoughts about themselves. It is the choice to love oneself, to see oneself as whole, worthy, and enough.

When that change occurs, the need for addiction vanishes. There is no longer a void to fill, no pain to numb, no self to escape. There is only presence, peace, and freedom.

Addiction is not a life sentence. It is a cry for love—a cry that can be answered by each individual’s commitment to see themselves in a new light.

The current addiction treatment model is based on false assumptions that disempower clients and limit their potential for healing. It is time for a new approach—one rooted in psychological truth, personal responsibility, and unconditional self-love.

Chapter Three of Prelude to a Paradigm Shift for Addiction calls us to confront these dangerous myths and embrace a transformative philosophy. We must stop looking outside ourselves for answers and start looking within.

Let this be the beginning of a revolution in addiction recovery—one that empowers individuals to reclaim their worth, rewrite their stories, and create lives free from the need to escape.

Dr. Harry Henshaw is a licensed mental health counselor with over four decades of experience in addiction treatment and transformational counseling. He is the author of the groundbreaking book, Prelude to a Paradigm Shift for Addiction, and the founder of Enhanced Healing Counseling.

Dr. Harry Henshaw

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