ABSTRACT
The primary goals of treatment are to help patients achieve sustained reductions or elimination of psychiatric illness symptoms and addictive drug use. In a normal brain that is not suffering with addiction, the ventral striatum (NAC) hardware that controls motivational processing is healthy and structurally intact. The person has good decision-making and can orient and sequence their behaviors toward goals that are beneficial to them and their family or community. This view of addiction as a civil war happening within the individual fits nicely with a well-known aspect of addiction phenomenology that is readily observable across most patients with the disease. They are to some extent ambivalent about their recovery. The professional framework that any member of the 2 × 4 Model clinical team should be operating under for conducting their relationships with patients should be psychodynamically informed with attention to maintaining appropriate boundaries and noting transference and counter-transference phenomena.
