It’s Not Just About the Drinking: Four Hidden Forces that Fuel Alcohol Misuse

By Jeanette Hu, MS

This essay explains the thinking behind my approach to alcohol misuse and the framework that became the Empowered Alcohol-Free 4-Pillar System.

I still remember the August afternoon I walked out of San Francisco General Hospital. The hot summer air against my skin felt surreal as I tried to digest the diagnosis in my hand: Alcohol Use Disorder. The doctor’s words still rang in my ear: You need to drink less. The diagnosis told me nothing I didn’t already know. I didn’t need a medical degree to see that my drinking had become a problem.

For months, I’d been trying to regain control but failed. Each morning, I’d wake up with resolve, “no drinks tonight,” but by evening, it felt like my body had a mind of its own. The thought I need a drink hit out of nowhere, the desire pulling at me with a force I couldn’t shake. Even knowing alcohol was bad for me, saying no left me feeling deprived, like I was missing out on life itself. The craving pulled me in like a black hole, and each failed attempt dragged me deeper into the spiral of shame and isolation, fueling an even more desperate urge to drown it all in another drink.

I tried to seek help, as everyone suggested. I went to medical professionals who told me I had a brain disorder with no cure. I sat in AA meetings where the path to healing began with powerlessness and surrender. I flip through self-help books filled with advice on managing triggers and cravings. While each piece offered me something: the diagnosis validated my struggle, AA gave me a community, the books provided tools—but I was left with the sense that something essential was missing.

I wanted to make sense of my drinking. More than explanations of powerlessness, a disordered brain, or surface-level skills, I wanted to understand the roots of my struggle. Intuitively, I knew drinking was not the cause but the manifestation of something deeper.

What was under the surface? And how could I address the roots, not just the symptoms? Those questions drove me to graduate school in Clinical Psychology. Truth be told, I wasn’t there to help others. I was there to help myself.

As I tried to make sense of my own experience, I began to notice gaps that diagnosis and treatment models don’t fully capture: the link between unmet needs and drinking as a coping strategy, the beliefs that shape emotions and choices of reaching for the bottles, the reinforcement that locks the drinking routine into place, and the narratives that foster a fixed mindset keeping people stuck in a negative loop.

Over time, these themes crystallized into what I call the dependency loop: a negative cycle fueled and maintained by four forces that keep people locked in the same drinking cycle.

The Dependency Loop

Human Needs

From the outside, addictive behavior doesn’t make sense. Why would someone repeatedly engage in a seemingly self-destructive behavior and continue to suffer the negative consequences, when all they need to do is simply stop? I, too, was puzzled by the irrationality of my own behaviors: why would I continue to reach for the bottle when getting drunk each night was risking my dream, my relationship, and my career?

As I got deeper into my graduate studies, I learned the mainstream explanation: alcohol use is a form of maladaptive coping that, over time, changes the brain’s structure and becomes a chronic condition a person is powerless against. While remission is not uncommon, it’s considered a lifelong disorder that requires ongoing management, with relapse often expected.

That explanation made sense in part—yes, the behavior is maladaptive; yes, the brain structures appear to be altered. But I kept circling back to the beginning: what drives someone to choose this behavior in the first place, and to return to it over and over again, long before the brain has changed?

The answer came when I discovered the famous Rat Park study. Isolated rats consumed drug-laced water compulsively, even to death. But when given food, play, and companionship, those same rats overwhelmingly chose plain water over drugs. The difference wasn’t the rats—it was the environment. Maladaptive behavior didn’t begin as maladaptive. It began as an adaptive effort to survive in a deprived environment where healthier coping strategies weren’t available or supported.

I remember the first time I watched Gabor Maté ask his interviewee, “What does substance do for you?” Tears ran down my cheeks when I realized the answer almost always points to something profoundly human, something universal. For me, alcohol meant comfort, connection, and a sense of reassurance that, while I can not count on people, I can always count on alcohol to be available when I need it.

That was the moment it clicked for me: the first force that drives the dependency loop is human needs. At the core, the reason someone reaches for the bottle—or any substance—can almost always be traced back to a universal human need.

When we drink to fall asleep, the need is rest. When we drink to ease racing, worrying thoughts, the need is a sense of security. When we drink to loosen up at a party or on a first date, the need is intimacy, connection, and belonging. But of course, needs alone won’t necessarily drive someone to the bottle. That’s where the second force comes in: distorted beliefs.

Distorted Beliefs

Needs alone don’t lead to a specific behavior; it’s when a need meets a belief that an action will fulfill that need that we act. According to the cognitive theory of emotion, it is our beliefs—not the events or even the needs themselves—that shape emotions and motivations and ultimately drive behaviors and urges.

For example, we all have the need for belonging and connection, but that need alone doesn’t automatically create a desire to drink at a social gathering. The desire is fueled by beliefs such as ‘A glass of wine will help me loosen up and connect better’ (a perceived benefit), or ‘People will think I’m boring if I don’t drink’ (a perceived cost). These beliefs generate the desire to drink, and when the desire is thwarted, they fuel craving.

For me, my first drink at 15 years old was one of the closest things I experienced that resembled love. I remember the warmth wrap around me like a soft blanket as the liquor burned down through my throat. How the void I always felt in my stomach was suddenly filled, and the powerful belief that formed in the moment, “as long as I have alcohol, I would never need people anymore.” For years to come, the need for emotional comfort and the belief that “alcohol will help me take care of any painful feelings” kept driving me to the bottles.

Beliefs about alcohol are simply a subset of our broader belief system—the way we make sense of the world and how to behave in it. They often feel absolutely true, yet they almost always reflect only a partial reality. As schema theory reminds us, the world is too complex for the human brain to process in full. We form assumptions through experience and observation, draw conclusions from those assumptions, and over time, those conclusions harden into beliefs that we treat as if they are reality itself.

The beliefs we hold towards alcohol are especially prone to distortion due to the nature of the substance itself and cultural attitudes towards it. Like most addictive substances, alcohol delivers immediate reward in the short term, while the cost is often delayed and only compounds over time.

If we reflect on our own drinking experience, it’s clear that a glass of wine offers an immediate buzz or quick relief, while the hangover doesn’t arrive until hours later. The more serious negative consequences often take years of repeated use to accumulate and only start to compound when tolerance and dependence build.

As humans, we’re wired to connect actions with their immediate outcomes, but our ability to form associations weakens dramatically when consequences are delayed. This combination of instant reward and postponed cost makes us especially vulnerable to developing a skewed view of an addictive substance like alcohol—magnifying its benefits while minimizing its costs. That’s why alcohol often works like a pitcher plant to a fly: The allure is strong, the descent is slow, and by the time the danger is recognized, the ability to escape is already gone.

Making the matter worse, culturally, alcohol is often framed as a harmless enhancer. Humans form beliefs based on experience and observation. When we see family, friends, and the larger society drink to connect, to relax, to celebrate, we naturally conclude that alcohol is a safe way to enhance our lives. Media and alcohol marketing magnify these perceived benefits while obscuring the costs, further reinforcing the distortion.

In many ways, we are under-informed consumers when it comes to alcohol—sold exaggerated benefits while the harms remain poorly disclosed. And when dependency develops, a predictable outcome of frequent over-consuming an addictive substance, the blame is often misplaced on the consumer rather than the product.

While unmet needs plus the belief that drinking would help fulfill the needs create a desire to reach for the bottle, they alone don’t explain how drinking moves from a choice to what feels more like a compulsion. For that, we have to take a look at learning — how, through repeated reinforcement, a habit loop can become automatic.

Automated Habit Loop

In graduate school, I was taught to see the preoccupations and compulsions around drinking as symptoms of Alcohol Use Disorder — evidence of a hijacked brain. But in my lived experience, they felt less like a brain disease and more like the natural outcome of how the brain learns.

My first drink at 15 taught me that alcohol was a magic potion that could dissolve any feeling too heavy to bear. From then on, whenever I felt emotional pain, I reached for the bottle. Without fail, the clear liquid eased the ache every time. Over the years, through thousands of repetitions, a habit loop began to take shape: the cue was painful feelings, the routine was drinking, and the reward was quick relief. The more often this loop ran, the more it shifted from conscious choice to automatic routine.

Research shows that when a habit loop is repeated enough, activity in the brain regions responsible for conscious decision-making decreases, while efficiency in the habit circuits increases. This is the same mechanism that allows us to brush our teeth without thinking or drive home on autopilot. Once a habit loop has formed, drinking no longer feels like a choice — it feels like second nature.

Even craving, often seen as unique to addiction, is really the glue that holds any habit loop together. Think classical conditioning or incentive salience: cues translate into “want’ for us. Take tooth brushing: the cue is morning breath, the routine is brushing, and the reward is fresh breath. The craving for that freshness is what keeps the loop alive. If you’ve ever skipped brushing your teeth, you know the nagging craving that follows.

With drinking, the process is similar but far more powerful due to the addictive nature of the substance. At first, the reward drives the behavior. But eventually, the cue alone — stress, loneliness, or the anticipation of anxiety — is enough to trigger the craving. The craving binds the loop so tightly that the body moves toward the drink before the mind even catches up.

I believe how quickly a habit loop forms and strengthens also depends on the number of alternative options available. Raised by neglectful parents and growing up in a boarding school, I had no one to turn to for emotional distress and was under-equipped to cope with painful feelings. With few alternatives for self-regulation, alcohol’s quick relief felt potent. My brain quickly formed the conclusion: this stuff works — this is the solution I’ve been looking for.

From then on, whenever distress hit, I returned to the only routine I knew. Without competing options, the loop of distress → drinking → relief became dominant. Over time, more and more cues attached themselves: walking past a bar, hearing ice clink in a glass, even seeing the clock strike 7 pm. Each cue lit up my brain and funneled me toward the same routine: reaching for the bottle.

Neuroscientist Marc Lewis calls this process “deep learning.” Addiction, he argues, isn’t evidence of a broken brain but of the brain’s remarkable ability to rewire itself through repetition. Drinking is learned the same way a pianist practices scales or your fingers learn to find the right keys on a keyboard: through practice, reinforcement, and grooves that deepen over time.

If we borrow the popular ‘10,000-hour’ rule of thumb to drinking, I far exceeded it during my decade-long daily drinking career. Just three hours a day — from 6 to 9 p.m. — adds up quickly, not to mention all the extra hours I spent mentally rehearsing the drinking routine. By that math, many regular drinkers may have far reached ‘expert status’ in their drinking routine by the time they meet the diagnostic criteria of Alcohol Use Disorder.

In other words, what looks like compulsion can also be explained as the brain doing what it does best — learning through repetition — until the pattern becomes second nature. When I finally saw my drinking through this lens, it stopped feeling like proof that my brain was broken and started looking like the inevitable outcome of thousands of hours of practice. This perspective opened the door for me to ask a different question: if the brain can learn itself into drinking, could it also learn itself out?

That question pushes against the fixed narrative of “recovery as lifelong management” and points toward something much more hopeful: not only healing, but growth

Fixed Mindset

This brings us to the last hidden force — one that almost no one talks about: the mainstream narrative that breeds a fixed mindset around healing from alcohol misuse. Over the past few decades, the mainstream narrative of addiction has shifted away from the moral failure model toward the medicalized “brain disease” model. While less overtly stagmatizing, this narrative still acts like a breeding ground for a fixed mindset.

In most clinical settings, we adopt a binary diagnostic system: either a person meets criteria for Substance Use Disorder, or they don’t. If they do, the condition is described as a chronic brain disorder that can never be fully resolved, only managed. Recovery is framed as remission, with relapse expected along the way.

Culturally, we see a parallel in the saying, “Once an alcoholic, always an alcoholic.” It runs deep in 12-step culture and mainstream language. Even years into recovery, AA members continue to introduce themselves as alcoholics.

Both the clinical and cultural narratives suggest that the struggle with addiction is a fixed condition — something you either have or you don’t. For those outside the category, drinking is seen as safe. For those inside it, the struggle is lifelong, marked by ongoing management rather than growth and transformation.

I still remember one of my first AA meetings, realizing very soon that the program was not for me. Despite the warmth and community in the room, something about standing up and calling myself “an alcoholic” — and declaring powerlessness — didn’t sit well. As an entrepreneur and immigrant, I had built my life on the belief that I could create change through persistence and agency. To surrender control, even to a higher power, felt unthinkable.

Over the years, I’ve come to see more nuance in AA’s language — that “powerless” and “surrender” can mean acceptance rather than defeat. Still, paired with the brain disease narrative, the message that reached me was oversimplified: that my struggle was fixed, unchangeable, and permanent.

A fixed mindset is the belief that abilities and traits are static — something you either have or you don’t — leaving little room for growth or change. When it comes to the struggle with alcohol, a fixed mindset frames dependency as an identity rather than a challenge that can be worked through and transformed. The statement “I’m an alcoholic” turns a struggle into a self-definition. The brain disease model reinforces this with beliefs like, “My brain is broken, so I will always struggle,” or “Relapse is inevitable, and there’s nothing I can do.” These messages hinder healing more than they help it.

Mindset research shows that when people adopt a fixed view of themselves — “once an alcoholic, always an alcoholic” — setbacks feel like proof of permanent failure. This shrinks problem-solving, reduces willingness to try again, and deepens helplessness.

I remember in early recovery how each craving felt like evidence my brain was malfunctioning, and every slip seemed to confirm I’d never live normally again. Instead of asking with curiosity, “What can I do differently next time?” my mind sank into doubt: “Can I ever stop drinking?”

Looking back now, I see healing from alcohol misuse as a learning process — reconstructing beliefs around alcohol, replacing drinking with healthier skills, and practicing through trial and error until new patterns take hold. Like learning any new skill, setbacks aren’t signs of permanent struggle; they’re simply part of the process.

Clinical Take Away: The Four Pillars Empowerment System for Change

If the drinking cycle is fueled and maintained by four hidden forces rather than drinking behavior alone, then healing requires addressing each one directly. Over the past years — through both my own journey and my work with clients — I’ve developed what I call the Four Pillars Empowerment System, an approach to disrupt the alcohol misuse cycle and create lasting change.

Value Alignment (Needs)

The first step is uncovering the underlying human needs that drive drinking. When we honor those needs instead of pathologizing them, people begin to approach themselves with compassionate curiosity instead of shame.

I often guide clients through a personal value exploration exercise. Research in Motivational Interviewing and Acceptance and Commitment Therapy shows that clarifying values helps access inner motivation and promote positive change. In this context, value alignment becomes a powerful counterforce to the short-term relief offered by the dependency loop — pointing people toward deeper, longer-lasting fulfillment

Belief Reconstruction (Distorted Beliefs)

In the second step, we uncover the specific alcohol-related beliefs that drive urges. Instead of jumping straight to behavior change, clients learn to pause and notice the thoughts that come before the craving — the internal stories that make drinking feel compelling or necessary.

From there, we use a simple 3-step process:

Name the belief – Bring the thought into awareness (“Alcohol helps me relax,” “I can’t have fun without drinking”).
Examine the belief – Trace how it was learned and reinforced over time, and notice the ways it gets repeated in daily life.
Challenge the belief – We bring in both counter-evidence, lived experiences, and bite-sized psychoeducation to test how well the belief holds up.

Finally, clients are invited to reconstruct the belief based on new information and lived experience — and to keep gathering evidence that strengthens the new narrative.

Skill Expansion (Automated Habit Loop)

In step three, we move into the actual behavior-change part. The science of habit formation teaches us that changing a well-worn habit loop isn’t about removing the behavior entirely, but about keeping the same cue and reward while swapping in a new routine.

Here, the focus is on skill expansion—equipping clients with new coping strategies that can meet the same needs alcohol once served.

Research in Dialectical Behavior Therapy shows that with enough practice, healthier coping skills can eventually become second nature, replacing maladaptive responses. The goal is to build alternative “habit loops” that offer empowering choices where it once felt like there were none.

Mindset Upgrading (Fixed Mindset)

Finally, in the last pillar, clients are offered tools and skills to turn their challenges and setbacks into stepping stones. Here, we help them understand that creating a fulfilling alcohol-free life is a learning process — one that rewires the brain over time. Setbacks aren’t signs of failure or a broken brain; they’re part of the path to lasting change.

Neuroscience backs this up. While chronic alcohol misuse is associated with reductions in grey matter volume, especially in areas like the prefrontal cortex, studies show that this damage is not permanent. Within six months to a year of sustained abstinence, grey matter volume often returns to baseline.

Even more striking: a 2013 study published in PLOS ONE found that after a year of abstinence, some individuals showed greater synaptic density than those who had never misused substances. This suggests that growth — not recovery — may be a more accurate way to describe healing from substance misuse.

Hope Beyond the Label: What We Can Offer

When I think back to that hot August afternoon, diagnosis in hand, what I longed for wasn’t a label or another set of rules — it was hope. Hope that my story wasn’t fixed. Hope that I wasn’t broken. I didn’t set out to create a model; I set out to make sense of why I couldn’t stop drinking.

Years later, both in my own life and in the therapy room, I’ve learned that hope comes from seeing the forces beneath the drinking for what they are: human, understandable, and changeable. That’s what I carry with me now — not just for myself, but for every client who wonders if life can be different. It can.

My hope is that naming these forces offers us, as therapists, another way to help our clients meet themselves — not as broken, but as learners in the ongoing process of becoming whole.

Thank you for reading.

If this way of understanding alcohol resonates with you, a practical overview of the framework can be found here.