Take our Addiction Test

Find a therapist to overcome addiction

Addiction treatment often confuses short-term sobriety with real psychological healing.

Trauma drives addiction for many people, yet most programs still fail to address it.

Recovery systems prioritize compliance over agency, weakening long-term change.

Normalizing relapse allows ineffective treatment models to persist without reform.

For decades, addiction treatment in the United States has relied on a familiar explanation when people relapse: recovery is hard, addiction is chronic and setbacks are part of the process. That narrative is often delivered with compassion, but it can obscure a more troubling reality. Many treatment failures are not personal shortcomings. They are predictable outcomes of how recovery is currently designed.

This is the central argument of addiction specialist Jimmie Applegate’s newly released book, Addicted to Failure, which examines how the modern recovery system repeatedly produces poor outcomes while attributing them to individual weakness rather than structural design. Drawing on neuroscience, trauma research and decades of clinical experience, Applegate challenges some of the most deeply ingrained assumptions in addiction treatment and asks why a system with such consistently disappointing results continues to defend itself as effective.

When Sobriety Is Mistaken for Healing

One of the book’s core critiques is the field’s tendency to equate short-term sobriety with recovery. Residential programs still operate around fixed timelines, most commonly 30, 60, or 90 days, despite extensive evidence that the brain systems responsible for impulse control, emotional regulation, and decision-making take far longer to stabilize.

From a psychological perspective, this mismatch has serious consequences. Trauma responses do not resolve on a calendar. Attachment wounds do not heal simply because substance use pauses. Yet patients are often discharged with the implicit message that they are ready, even as the neurological and emotional vulnerabilities that drove addiction remain fully active.

When relapse follows, the explanation rarely centers on premature discharge or incomplete treatment. Instead, individuals internalize failure. Over time, repeated exposure to this cycle can foster shame, hopelessness, and a sense of learned helplessness, all of which psychology recognizes as powerful obstacles to sustained behavior change.

The Trauma Most Programs Still Ignore

A central theme in Addicted to Failure is the field’s ongoing failure to meaningfully address trauma. Research consistently shows that a majority of people with substance use disorders have significant histories of childhood adversity, emotional neglect, or chronic stress. In psychological terms, substances often function as regulators for nervous systems shaped by prolonged threat rather than as simple sources of pleasure.

When treatment focuses narrowly on stopping substance use without addressing trauma, individuals are left without the coping mechanisms that substances once provided. The resulting emotional overwhelm is frequently interpreted as resistance or lack of commitment, when in reality it reflects a nervous system struggling to function without adequate support.

Take our Addiction Test

Find a therapist to overcome addiction

From this perspective, relapse is not mysterious. It is a predictable attempt to restore regulation in the absence of safer alternatives.

Compliance Over Understanding

Another dynamic Applegate highlights is the role of authority bias within treatment culture. Patients are often encouraged to comply rather than to understand. Questioning treatment models may be labeled denial or unwillingness, even when those questions reflect genuine insight into one’s own experience.

Psychological research consistently shows that autonomy and agency are essential to lasting behavior change. People are more likely to sustain difficult transformations when they are active participants in their care rather than passive recipients of rigid protocols. Systems that discourage curiosity may inadvertently reinforce the same powerlessness that addiction itself thrives on.

The Problem With One-Size-Fits-All Recovery

The book also challenges the field’s reliance on singular explanatory models of addiction. Is addiction a brain disease, a trauma response, an attachment disorder, or a spiritual deficit? From a psychological standpoint, the insistence on one dominant narrative creates unnecessary confusion and shame for individuals who do not respond as expected.

Human behavior is rarely driven by a single cause, and addiction is no exception. Effective treatment must be integrative and flexible, adapting to individual differences rather than forcing people to conform to standardized frameworks that fail to account for complexity.

When Failure Becomes Normalized

Perhaps the most provocative argument in Addicted to Failure is that relapse has been normalized to the point that it quietly lowers expectations. When failure is framed as inevitable rather than preventable, systems lose the incentive to evolve.

Psychology teaches that expectations shape outcomes. Treatment models built around anticipated breakdowns tend to produce them. This does not suggest that recovery is linear or effortless, but it does raise an important question: why are we still defending approaches that repeatedly fall short of what human psychology requires?

Rethinking What Recovery Actually Demands

Applegate’s work ultimately points toward a model of recovery that aligns closely with established psychological research. Longer treatment durations based on clinical need rather than insurance timelines. Trauma-informed care integrated with medical treatment. Family systems are addressed rather than ignored. Education that helps individuals understand their own brains. Environments that prioritize dignity, agency, and meaning rather than compliance alone.

The question, then, may no longer be why people relapse, but why we continue designing systems that make relapse so likely. When poor outcomes persist across populations, psychology teaches us to examine the system, not just the individuals within it.

Addicted to Failure does not argue that recovery is easy or uniform. It argues that our current approach too often confuses survival with healing, and familiarity with effectiveness. In the end, Applegate makes it clear that if addiction treatment is to evolve, it requires letting go of models that feel reassuring but consistently fail the very people they claim to help.

© Psychology Today