The Four Causes of Addiction

The Four Causes to Addiction

There are only four causes of all addiction. It may seem as if there are hundreds, but there are only four.  You have quit many times, only to relapse, even if there were long periods of sobriety. What draws you inexorably back is the unresolved conditions produced by one or more of the four causes listed below. As you read the list of examples, write down the numbers of the ones that apply to you. When you are finished, email the numbers to us:  Include your contact information and we will get back to you promptly and tell you what we can do to help end your addiction. It is certain you have an unresolved Cause. It is nearly certain you have forgotten the original cause because of the pain, the shame, the sadness or the hurt you experienced when you remembered it when it was still fresh. Or you may even remember it, but do not credit it with causing and keeping alive your current addiction. You may have examples we haven’t listed; add those to your list. Regarding neurotransmitter imbalance, there’s no need to list it as everyone who has an addiction to drugs, including alcohol, has a neurotransmitter imbalance.

The Four Broad Categories

1A Neurotransmitter imbalance

       2B Events of the past you have not been able to reconcile.

       3C Current conditions you can’t cope with.

4D Things you believe that aren’t true.

A Brief Description of The Four Causes

Cause 1A

1A Neurotransmitter imbalance. In the first 3 ½ years after we opened Passages, everyone who came was given an electroencephalograph exam (EEG). The psychiatrist who administered the EEG testing is one of the foremost psychiatrists in EEG testing. Each client had eight electrodes placed on the top of his or her head to read electrical impulses from the surface of their brain. We read their brain waves for fifteen minutes, then took the quietest ten seconds, when the brain was at its most restful state, and processed it through our computer where we had the baseline from New York University. There was not one person whose brain wave patterns were within the normal range. We discovered that those people who had fast brain wave patterns were using drugs marijuana, opiates and alcohol in an attempt to slow themselves down and feel normal. Those who had slow brain wave patterns were using speed drugs: cocaine, Adderall, methamphetamine, Ritalin, and caffeine. Everyone was seeking a drug that made them feel normal or balanced.

Cause 2B

Events of the past you haven’t been able to reconcile. Life brings us challenges. Some of the challenges are painful, demoralizing, identity crushing, unbearable, humiliating, shameful, depressing, mentally disturbing and they all cause trauma that can live in our brain forever causing us great pain both mental and physical. If the trauma and pain are substantial enough, the memories are stamped indelibly on our brain and in some cases, in our muscle tissue. Many years may pass, but the memories are still there, buried in your subconscious, hurting all your days. One of the most beneficial attributes of a human being is the ability to forget. Whenever the images of the painful trauma emerge, we block it in an attempt to ease the pain. After a while, the event is buried. The memory of it is still there, but our recall system has shut it down from everyday consciousness; yet it is still there, subliminally causing us to medicate ourselves with drugs and alcohol particularly when the same traumatic feeling you experienced during the original trauma are felt again, even though they may not trigger a memory of the original event.  Left to continue its disruptive action, we either suffer or medicate the pain away, unaware of the cause. As you read the examples, write down the numbers of the ones that apply to you and email them to us at

  • B1 Sexually Abused at any time or multiple times.
  • B2 Physically abused as a child
  • B3 Physically abused at any time
  • B4 Victim of bullying
  • Verbal abuse – being yelled at, called names
  • Emotional Abuse – is defined as “stupid” or “wrong”
  • Shamed for being shy
  • Shamed for Self-Expression
  • Shamed for your sexuality
  • Narcissistic abuse
  • Seeing violence occur in your home even if you did not experience it
  • Being introduced to porn or snuff films at a young age by a parent or sibling or babysitter
  • Made to feel like a failure i.e. “You’ll never amount to anything.”
  • Being told they were not wanted “I wish I had an abortion”
  • “I wanted a girl.”
  • “I wanted a boy.”
  • Being told you ruined your parents’ lives
  • Being criticized for your appearance – “too fat, too thin, too ugly, pimples, a deformity.”
  • Being raised in a cult with frightening rituals and practices
  • Overly critical parents
  • Being a victim of parent ‘kidnapping” – one parent kept you from the other
    • Ignored by family
    • Ignored by siblings
    • Abandoned by a parent or parents as a child
    • No listened to or understood
    • Emotionally unavailable parents
    • Made to feel unsafe
    • Not receiving protection from the non-abusive parent
    • Emotionally disconnected parents/family
    • Being raised by a mentally ill parent
    • Absentee Parents
    • Absence of positive role models
    • Sent away to live somewhere else
    • Lack of approval.
    • Not allowed to pursue your interests
    • Not allowed to pursue one’s choice in education or career
    • Severe poverty and conditions
    • Being lost in a large family
    • Lack of affection from parents and siblings
  • Parent’s Divorce
  • Family Addiction
  • Being the scapegoat in your Family
  • Too strict parents
  • Too lenient parents
  • incest
  • No structure in your family
  • Sibling rivalry
  • Not measuring up to family expectations
  • Being made to act as the parent to the parent instead of being allowed to be a child
  • Infantilized by Parents – not allowed to grow up
  • Unresolved grief over the death of a parent
  • Unresolved grief over the death of a sibling
  • A single parent with multiple sexual partners
  • Abuse by a stepmother
  • Abuse by a stepfather
  • Death of a primary caregiver when you were a child
  • Constant Conflict between parents or family members
  • You were adopted
  • Uprooted, frequent relocations
  • Having a long-term illness as a child
  • Loss of a job
  • Unfair judgment put on you.
  • Kept back a grade or multiple grades in school
  • Unfair treatment in school
  • Missed opportunity
  • Passed over for promotion
  • Filing for bankruptcy
  • Failed business
  • Early success and accomplishments, then failure
  • Loss of health
  • Loss of a close relationship
  • Loss of reputation
  • Loss of purpose
  • Loss of dreams
  • Moving to a new area
  • Unhappy marriage (the ideal not being fulfilled)
  • Childbirth problems
  • Adoption
  • Empty Nest (children moved away)
  • Diagnosed with a learning disability
  • Unable to achieve education
  • mid-life crisis
  • Aging process
  • Losing identity/sense of self to being a wife and mother
  • Severe accidents
  • Suicide (by loved one or attempt on one’s own life)
  • Death of loved one
  • Abortion
  • Victim of a Crime of Violence
  • Victim of a natural disaster
  • Divorce
  • Betrayal
  • Scandal, public humiliation
  • Loss of custody of children
  • Death of a child
  • Degenerative illness
  • Injury or disabled
  • War experience
  • Chronic pain
  • Being brought up in the foster care system
  • Being robbed or taken advantage of by a friend or family member
  • Loss of a family pet


Current conditions you can’t cope with.  We all experience stress in one form or another. When stress reaches a level we can’t tolerate, instead of working on ways to reduce the stress either by eliminating the cause or moderating it with calming techniques, we turn to medications for relief. Here are some of the conditions:

  • C1 Unbearable physical pain from a car accident, workplace accident, or a bad fall
  • C2 An illness such a Chron’s Disease, hyper or hypothyroid, HIV, or liver cirrhosis which causes uncomfortable symptoms like mood swings, insomnia, anxiety, or depression.
  • C3 Recent diagnoses with a mental illness
  • C4 Body dysmorphia (Imagined physical defects)
  • Lack of coping strategies
  • A home environment not supportive
  • Passive suicidal ideation
  • Cannot manage life emotionally
  • Lack of life purpose
  • Lacks insight – poor insight into anger or anxiety
  • Balance of work, life, play
  • Lack of support
  • Not taking responsibility
  • being out of touch with self and others
  • Interpersonal conflict and stress
  • Absence of flexibility, difficulties with change
  • Difficulties in regulating emotions
  • Difficulty accepting reality as it is
  • OCD-Having obsessive thoughts
  • Detachment – all the aforementioned such as childhood abuse, trauma, or loss, lack of love can cause us to detach as a survival mechanism. This behavior can stay with us throughout our entire lives and can go unrecognized for many years.
  • in an unhealthy relationship or relationships
  • spouse/family member still using drugs or alcohol
  • returning to the same unhealthy environment after treatment
  • Stress from returning to work or starting a new job
  • Loved one passing away
  • lack of coping skills
  • feelings of unacceptance
  • feelings of low worth and low self- esteem
  • Falling away from support or whatever helps them from not relapsing; i.e. church supportive friends, exercising)
  • Lack of focus,
  • mental noise; scattered thoughts of no consequence.
  • struggling with decision making, overthinking, can’t make up their mind, uncertainty confusion about how to move forward and which path to choose,
  • unable to commit, procrastination.
  • Self-shame
  • Fear of not being good enough.
  • Fear of being alone,
  • Fear of dying,
  • fear of rejection
  • Fear of the future
  • Lack of self-trust or belief, not fitting in with family’s conditions
  • Doesn’t like job/career
  • Self-critical/judgmental
  • Negative self-talk
  • Feeling lost
  • Purposeless
  • Unhappy with Physical self-image
  • Can’t accept the aging process
  • Regrets or angry at their past
  • Hyper Sensitive to energy due to their childhood traumas
  • Lack of spirituality
  • Being disappointed with yourself for not achieving your life’s goals
  • No support system
  • Toxic environment
  • One I hear of frequently changes in life role- having to take on care of aging parents, having older children return home, etc. frequently it also has to do with forcing bad relationships to work (whether these are romantic, friendship, or family) and failing to enact healthy boundaries.
  • Change in work status (up or down) some promotions cause people to feel they may not deserve the promotion and self-sabotage, conversely being demoted, laid off, or outright fired is devastating to self-esteem.
  • Change of residence. moving cities can unbalance someone. Change of countries, even change of homes can cause one to feel unbalanced for a time triggering abuse.
  • Divorce or ending a relationship. Or simply a development of conflict within the relationship.  Death of a family member. Death of a child.  Abortion.
  • Empty nest syndrome I am seeing this a lot more recently where the primary caretaker usually the mother lacks life purpose after the children are grown and starts drinking a lot more
  • Being in the “sandwich” between aging parents and the needs of their children. 
  • Relationships are a very common one, marriages, family, judgment from both
  • High-stress jobs/careers or unhappy with a job/career.
  • Being unable to identify their path in life, finding purpose, and joy.
  • I am part of my family business and they want me to be something I am not.
  • My job is very stressful, I work nonstop many hours per day. 
  • I cannot find my place in this society. I feel out of it
  • My head does not stop. I have thousands of thoughts.
  • lack of lifestyle and balance
  • legal issues
  • chronic pain
  • unemployment
  • not feeling financially stable and still dependent on family or spouse
  • unable to rely on family or spouse because they have passed away or abandoned me
  • insomnia
  • Out of work
  • Financial worries
  • Loneliness
  • Boredom
  • Bad marriage
  • Bad relationships
  • Problems with children
  • Special needs children
  • A general feeling of dissatisfaction with life
  • Feeling stuck
  • Custody battles
  • Co-parenting issues
  • Aging parents requiring care
  • Doubting their sexuality
  • Unsure whether to come out or not
  • In a physically abusive relationship
  • Anxious disorder
  • Medical diagnosis
  • Aging process
  • Unexpected natural disasters
  • Lack of a rewarding social circle
  • Lack of family support
  • Raising a child
  • Being forced to be a part of the family business instead of pursuing their own dreams
  • Working non-stop many hours per day
  • Can’t find their place in society
  • Racing mind, thoughts do not stop
  • Divorce or failing marriage
  • Business decline or bankruptcy
  • Return of older children to the home
  • Lack of intimacy in marriage
  • The difference in parenting styles leading to conflict
  • Poor health
  • Fertility problems
  • Erectile dysfunction
  • Menopause
  • School pressures
  • Work/Life balance
  • Lack of friends
  • Spouse’s physical, mental, health issues
  • Raising a special needs child
  • Dealing with teenage/adult children’s own drug or alcohol abuse
  • Adult children being financially dependent and the stress that comes with
  • Raising grandchildren
  • Caring for elderly parents
  • Dealing with and treating an eating disorder
  • General dysfunctional family dynamics
  • Affairs
  • Partners who abuse
  • Conflict with family members
  • Homelessness
  • Isolation
  • Lack of purpose
  • Physical pain
  • Phobias
  • Undiagnosed mental illness
  • Probation/jail time
  • Failing business
  • Failing marriage
  • Unresolved issues in a multi-generational family business
  • Loss from natural disasters
  • Death of a family member or loved one
  • Delabializing illness
  • Diet
  • Inability to control their finances or budget
  • Children with disabilities
  • Lack of job skills
  • Lack of education
  • Lack of self-sufficiency
  • Numerous attempts in treatment or to get sober
  • Standard of living
  • Poor tolerance for discomfort
  • Career dissatisfaction
  • Failing mental capacity as they age
  • Lack of awareness of personal beliefs
  • Dominant family member


Things we believe that aren’t true. What we believe to be true about the world in which we live and about ourselves May not be what is actually true. Some of it we learn from parents, some from teachers or friends or things we read or see in the media. What we believe to be true shapes our actions, our thoughts and indeed our very lives. Here are some examples:

  • D1 I am worthless
    • D2 I am a disappointment
    • D3 I will never be free of my drug of choice
    • D4 One week of treatment and I am ready to go home
    • I can still drink socially or use marijuana without leading to a relapse
    • I am cursed
    • I have done something wrong in past lives
    • I have no control
    • I am too dumb to learn new skills
    • Life is not worth trying
    • My teacher/ mother/ father/ pastor/ priest said I would never amount to anything
    • It’s genetic and out of my control
    • Anger. Much of the time. Unreasonable anger. Quick to anger. Uncontrollable anger.
    • “Not being honest about the treatment they need”
    • I can go on vacation and drink or use and not have it affect me
    • Remembering when using was “fun” in the beginning and only romanticizing it
    • Judgments from family members
    • “I’m not good enough”
    • “No one cares about me”
    • “I don’t deserve to be loved “
    • “I don’t deserve anything good in my life because I hurt so many people”
    • “I’m a failure”
    • “I don’t believe I can change”
    • “Staying sober is impossible”
    • “Being sober is boring”
    • These are frequently inherited or misinterpreted messages from childhood, ex: your sister was the smart one, no one expects much from you, you’ll never succeed because of x, y, or z
    • A belief that the person is entitled to a life free from pain and discomfort. (we are sold this on TV “ask your Dr. if this drug is right for you.
    • The belief that they are damaged goods. essentially tragically flawed, like “I’m an alcoholic.” 
    • The belief that they cannot change
    • The belief that they are trapped by obligation or circumstances
    • The belief that their life has no meaning.
    • Spiritual emptiness
    • Due to most past trauma, a lot of clients believe they are in fact worthless, this is very common with addiction.
    • The other big one, of course, is the incurable disease theory…the shame and guilt of it cause most clients to put off seeking help sooner. 
    • I am not good enough
    • I am not worthy enough,
    • I am not capable enough to go through this
    • The world is unsafe, and no one is to be trusted
    • The only way to deal with my emotions is to numb them with alcohol and drugs
    • Alcohol/drugs are a part of my identity and the only way I fit in
    • I will never live up to expectations
    • Everything is my fault
    • I was abused because I deserved it
    • I am unlovable
    • I’ve made so many mistakes, I will never be able to repair them
    • I will never succeed
    • I am not pretty enough, good enough, smart enough
    • I am helpless
    • I am powerless
    • I am alone
    • I will never be happy
    • The only way to deal with pain is drugs
    • My situation will never improve
    • I am not worth the expense of treatment
    • I am unforgivable
    • I can only get sober through will power and self-determination
    • I am owed something (sense of entitlement)
    • The whole world is against me
    • Drugs and alcohol give me the energy to get things done
    • Getting wasted is a rite of passage
    • I don’t have the opportunities that others have
    • I don’t deserve happiness
    • I am stupid
    • I have been using for as long as I can remember so I don’t think I can live life without it
    • No One expects much from me
    • I won’t ever have fun again if I’m sober
    • Taking care of myself is selfish
    • I’m too old to change
    • People won’t like me if I’m sober
    • I will always need medications for pain/anxiety
    • I won’t ever be happy
    • I can’t do it
    • I can’t survive without this relationship
    • I need extreme stimulation
    • I perform better on drugs
    • My feelings are facts
    • My value comes from the approval of others
    • It feels normal to live in chaos
    • It is not going to happen to me (negative consequences)
    • It is not me but everyone else who has the issues
    • It is in my genetic background to be an addict
    • I have ADHD and cocaine helps me focus
    • I have anxiety and it can only be managed with Xanax
    • 1 month of treatment and I’m ready
    • Nothing matters anymore
    • My addiction is a disease that is incurable
    • I am no longer able to change or grow as a person
    • I need to be smarter/more successful/better than I am
    • Refusing to engage in the world keeps me safe
    • I have already ruined my life and relationships, so I can’t stop now
    • Drugs and alcohol give me the warmth and comfort I can’t get anywhere else
    • I will never find love and acceptance from people who don’t use
    • There are no consequences to using
    • I can safely use
    • My talent is based on my substance abuse

How to Contact Passages Addiction Treatment Centers:

Call Passages Addiction Treatment Centers today if you or a loved one is battling an addiction to drugs and alcohol. Our admissions department is available 24/7 and can be reached directly by calling our toll-free number at (888) 397-0112. We look forward to speaking with you soon.

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