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Tijdschrift voor Psychiatrie 62 (2020) 7, 575 - 581


Addiction and self-control: A three-layered model to support recovery

A. Snoek

background Loss of self-control in addiction is often hard to understand. addictive behaviour has both voluntary and involuntary aspects. A better understanding of how people with addiction lose control over their lives gives more options for recovery.
aim To gain insight in the different factors that undermine self-control in addiction, and to develop a model to better identify these factors.
method Longitudinal, qualitative research (n = 69) among people with (mostly) opioid and alcohol dependency. Respondents were interviewed four times over 3,5 years to gain a better understanding of their goals and what frustrated the achievement of those goals.
results Different theories have a different understanding of what self-control is, or when behaviour counts as self-controlled. Self-control can be exercised on three different levels: to carry out our intentions (short term), to achieve goals (long term), or to live life according to our values and self-understanding. These three layers of self-control influence each other, as well in loss of self-control as in recovery. conclusions Loss of self-control or agency in addiction almost never has a single cause, but is caused by a set of complex, interacting factors. The three-layered model of self-control makes these different levels of self-control (intentional, instrumental, normative) explicit and offers important leads for recovery.

keywords addiction, agency, qualitative research