Addiction and a Loaf of Marbled Rye Bread

I find it interesting that the medical establishment has been debating the cause of addiction for hundreds of years. Some feel it’s biological. Others swear it’s psychological.

Which side is right?

Actually, both sides are correct. Every addiction contains elements of the biological, as well as the psychological. In my opinion, it’s not a matter of one or the other. Instead, we should be asking how much of an individual’s addiction is biological, and how much is psychological? Then we will be addressing all facets of an addiction.

M. Jellinek, the founder of the disease concept of alcoholism, felt there were five types of alcoholics. This reminds me of something I saw on a Jerry Seinfeld show about a loaf of marbled rye bread.

The ratio of dark pumpernickel to light rye varies within the loaf, depending on where you slice it. The same is true for the ratio between the biological and psychological components of addiction.

For example, I’ve worked with addicted individuals who have experienced trauma and psychological despair. In that case, the addiction is more psychological than biological in origin. On the other hand, I’ve worked with clients suffering from ADHD and chemical imbalances. In this instance, the nature of the addiction is more biological than psychological.

It’s important to realize addiction is never static. In many ways, it’s a moving target. No matter how an addiction begins, it becomes more biological with each passing day, as it rewires the physical structure of the brain. However, if addiction were strictly biological, we’d have shots, pills, and surgical procedures to cure or correct it. But we don’t. Not even after hundreds of years.

If we are to treat addiction successfully, we must understand that both biological and psychological elements are present. Addressing both gives us the ability to help more people enjoy long-term recovery. And that’s what it’s all about, isn’t it?


Marc F. Kern, Ph.D., aka "The Habit Doc" is a nationally syndicated addiction expert and harm reductionist. To learn more about Dr. Kern's philosophies and read more posts like this one, please visit 

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Marc Kern