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Swiss Cheese and Addiction

Having dealt with addiction indirectly for quite a bit of my life, it is a topic that I know can be complex. This can be for people struggling with addictive behaviors, along with the family members or partners that have to try to process or support them. In my practice, there are several factors that I see regularly and lots of approaches one can take to address addictive behavior.


One of the most effective models to explain addiction, and it’s one I use all the time, is the Swiss cheese model of addiction. The basic premise is that all of the factors that contribute towards addiction are like pieces of Swiss cheese with holes that layer together, or on top of each other.


Some may have smaller holes, and some may have bigger holes, which all contribute to the process of the addict breaking through the cheese and causing an addictive behavior or relapse.


Depending on who you ask, there are several key factors at play. These include:


· Resilience and Attachment Style

· Effective Parenting or Mentoring

· Stable Environment

· Peer Connections

· Community

· Social and Financial Safety


As you can see, the first three factors are things that are provided (or not provided) when the person is usually quite young. Resilience is a person’s ability to process emotions like safety and also deal with adversity. A good example of this is a distant parent who doesn’t have a strong connection with their child. That can result in the child having stunted abilities to form emotional bonds with others.


What is an attachment style? It is a way that a person reacts to interpersonal relationships, heavily influenced by trust and self-worth. If there is a distinct lack of trust with others and low self-worth caused by past events when a child is quite young, then they may have an attachment style that lends itself towards impulsive behavior and poor emotional processing, two things that can lead to addiction.



An unstable environment that is always in upheaval or conflict can be generational, which is why addiction tends to also be generational. Children mimic what they see, and while there is also a genetic predisposition to addiction, having a home environment where you are exposed to addictive behaviour creates another layer of possible problems.


The final three factors tend to come into play when you are slightly older or as an adult, but they are influenced by the first three. Being able to connect properly with peers is something that is formed when you are young, but can also be something you can establish when you are older with some work on behavior.


Community can be created later in life. A good example of this is either churches or self-help programs that give the addict a place to feel comfort and support from outside sources, which they may not have experienced previously. Those people who have good social support networks or friends also tend to have a much easier time not succumbing to addiction.


And of course (especially in today’s world), feeling safe and supported both socially and financially lowers stress levels, which can help to control impulsive behaviors as well. Especially when the economy is tough and households are experiencing financial stress far beyond what is normal, the need to soothe and relax can easily lead down the garden path to an addiction.


Remember also, addiction can be substance based (ie alcohol, drugs – something you consume) and also process based (ie gambling, porn or even shopping or social media). No matter what type of addiction it is, it can be difficult to manage and possibly affect your physical, mental, or economical health.


The model looks like this, with each slice representing one of the factors:



As you can see, if one of these factors is the only one in play, the likelihood of something breaking through the cheese is slim. However, if there are holes in three or four of these things, then there is a much higher chance, and when all of them are in play it is virtually certain that it can lead to addictive behavior.

This applies to relapses as well. The cheese still has holes in it, and even if one of the layers is addressed, it doesn’t mean that another can’t open up further and make you vulnerable again. A multi-pronged approach to deal with more than one of these issues at the same time is always best if it is possible to do so.


Dealing with past trauma along with establishing a new environment is a good example of that, along with creating foundations of support and social safety. Only closing off one slice of cheese often isn’t enough to create enough of a barrier.


For those of you who are dealing with an addiction yourself, there is most definitely hope. One thing I tell my clients often is that awareness is important when it comes to being able to understand where behaviors come from. Some of these factors came into play decades ago, but that doesn’t mean that they cannot be addressed for you today. By doing so through therapy and other means, you can block off some of the areas of the layers of cheese that might lead you to relapse.


The therapy should focus on the dialogue you have with yourself, and a competent therapist won’t just sit there and listen, they will give you options and tools to adjust how you think. Far too often I hear of therapists who just sit there, nod, and repeat things back. This is in my opinion impractical and doesn’t help to solve the issue.


If you have a loved one dealing with an addiction, you can often find some reasoning behind how they are behaving and possibly even a solution to give them support they require in order to close up some of the holes they have in their cheese. This can also help you to understand that their behavior has nothing to do with you personally, and is usually caused by a combination of intrinsic and extrinsic problems.


I sincerely hope that if you’re struggling with addiction, this gives you a bit of insight into what the multiple layers of your affliction might look like and what you can focus on to help yourself. As always, I am available to talk to you about your situation and even if I’m not able to help, at least I can point you in the right direction.

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