In inherent limitation of the medical model is ignoring the fact that a pathological dependence implies that a relationship, one that is emotional and psychological in nature, has formed with the substance or activity (i.e. alcohol/drugs, gambling, porn, sex and love addictions). By neglecting essential emotional aspects there is an implied presumption that addiction is primarily, if not, solely a medical condition and can be fined only terms that are observable, objective and measurable, i.e. behavioral, bodily or physiological. The emotional, psychological and relationship aspects are invisible and subjective in nature, therefore considered to be invalid, barely worth considering. It appears that physical pain takes precedence over emotional pain as well. For example, by defining withdrawal solely as a physiological process, medical issues and physical pain or discomfort), we lose sight of emotional withdrawal the crash after the high wears off which can be as painful, last longer and be more far-reaching. Pathological dependence is a pathological relationship, one in which there is continuous and increasing emotional involvement, and an irresistible attachment develops, as well loss of control. The relationship is with a substance or activity that induces an extraordinary mind and mood altering effect in the form of a rush or high, escape and relief.
The Pathological Relationship
Certainly the term pathological to describe this relationship is apt in a number of ways, beginning with the underlying obsession and desperation that drives the relationship. Tantamount to having a secret love affair, this relationship is carried on behind a cloak of denial and deception, and is separate from the rest of the addict's life. This relationship immediately becomes the primary relationship, more powerful than any other. There is a loss of control, an inability stop thinking about or pursuing the means of relief. While the relationship with the substance or activity provides much needed relief, immediately yet temporarily, it feeds the addiction by further starving the addict emotionally as no real nourishment is provided. Actually the addict is worse off than before he consumed the substance because he is feeling worse than he did before when sober. During the course of this relationship, the addict is becoming increasingly isolated from the rest of the world, from other people and relationships, the level of (pre-existing) pain increases over time. There are a number of other harmful physical effects considering the toxic effects of the substances and increased stress that comes with mounting problems associated with this relationship.
Etiology and Pre-disposing Conditions
What happens when relationships fail to provide adequate emotional nourishment? What happens when we don't receive the affection, attention, acknowledgement and appreciation we require; when we are not heard and understood; when we don't feel loved or special or connected? There is pain and this pain builds over time, as deprivation continues from previous relationships to current ones. Depending on the level or severity of pain (frustration, hunger, dysphoria, anguish, shame, emptiness), there will be a need to relieve that pain. At some point, desperation sets in.