Substance use disorders are immensely costly economically and socially, but also in relational terms. The helping fields have struggled to arrive at consensus about substance use disorders and to endorse effective treatment approaches. We suggest that counselors will find it useful to frame substance use disorders as a type of relational disorder, a cycle wherein early nurturance disruption leads to brain function vulnerability and subsequent interpersonal difficulty. This difficulty in establishing and maintaining connections with others, in turn, can lead to susceptibility to substance use disorders. This article discusses basic neurophysiology surrounding substance use and relational disorders that can be used to inform efficacious counseling approaches for working with individuals facing substance use disorders. Such approaches explore the connection between substance use and relational disorders in terms of long-term exposure to nonnurturing environments. Our hope is that conceptualizing substance use disorders as relational disorder will assist clinicians in building more informed conceptualizations of their clients and reconsidering how they may work to rebuild this relational capacity, drawing on the brain's adaptive nature and potential for healing.
