The Flawed Psychology of Forcing People to Hit “Rock Bottom”

June 25, 2019

While teaching a class on eminent psychologist Abraham Maslow’s human hierarchy of needs theory to aspiring behavioral health professionals, a student raised her hand to ask me the following question:

“Is this where the idea of people struggling with addiction having to hit “rock bottom” comes from?”

This insightful student was looking up on the screen at Maslow’s hierarchy of needs pyramid and referring to the all-too-common thinking surrounding people living with addiction. Nearly all of us have heard the notion somewhere along the way that people living with addiction must hit a proverbial “rock bottom” before being “willing” to change their addictive behavior. Nearly none of us have escaped being socially indoctrinated into the idea that in order to best support somebody living with addiction, we must move out of the way to allow for their inevitable fall to “rock bottom.” We have been told that to do otherwise would mean “enabling” the person to continue on with their addiction. Sadly, this thinking has been a poisonous source of tremendous unnecessary harms, the most tragic of which continues to be countless preventable deaths.

As the inquisitive student and remainder of the class looked up at the largely projected pyramid of Maslow’s hierarchy of needs, all present could visually see that at the bottom of the pyramid lie basic physiological needs being met such as food, shelter, rest, etc. Closely following the bottom of the pyramid on the second level is basic psychological needs being met such as feeling safe, secure, etc. To that end, the student’s question and what she was getting at could be rephrased as:

“Is Maslow’s theory where the idea comes from that people struggling with addiction have to go without food, shelter, rest, safety, security, etc. in order to want to get better?”

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By Brooke M. Feldman, MSW

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