Maslow’s Expanded Hierarchy in SUD Education and Treatment

The disease of addiction is one that affects body, mind and spirit. Without addressing all three, the risk of relapse can be higher with consequences increasing in severity over time, including the possibility of overdose and death. The founders of Alcoholics Anonymous knew that when they wrote, “We are convinced to a man that alcoholics of our type are in the grip of a progressive illness. Over any considerable period we get worse, never better” (Anonymous, 2001, p. 30). While this may sound fatalistic, the paradoxical truth is that by committing to what we call “full body recovery” in our book Enable-ism™ not only is long-term recovery possible but the attainment of both basic and growth needs identified by Maslow’s hierarchy. 

Maslow’s original hierarchy identified what he termed four deficiency needs that when met support obtaining the higher growth need of self-actualization. His updated model retained the four deficiency needs - physiological, safety, love/belonging, and esteem – while adding three additional growth needs, creating a more comprehensive and fluid eight-tier model:

  • Cognitive needs - knowledge and understanding, curiosity, exploration, need for meaning and predictability. 
  • Aesthetic needs – appreciation and search for beauty, balance, form, etc. Self-actualization needs – realizing personal potential, self-fulfillment, seeking personal growth and peak experiences. 
  • Transcendence needs – a person is motivated by values which transcend beyond the personal self (McLeod, 2018, para 33-36).  

Maslow’s eight-tiered hierarchy, like the 12 Steps, can be a useful tool in SUD education and treatment, for both the substance dependent person as well as their family.  

    Given that addiction is a family disease, the ability to meet the family’s most basic needs, let alone realize one’s potential as an individual, can be of significant challenge in the presence of active addiction but it is not impossible as members of Al-Anon and other family groups would attest. While we can “hope and certainly pray that every member of the family, including the addict, decides to embark on the journey, each ultimately must decide that for him or herself” (Woodbury & Woodbury, 2017, p. 118). Not an easy journey by any means but one that when embraced can lead to Maslow’s ultimate growth need, that of transcendence, or as the 12 Steps call it, a spiritual awakening.  

    In looking at Maslow’s Hierarchy through the lens of SUD recovery, it can serve to both identify unmet needs as well as encourage the work that leads to the fulfillment of them. Recognizing that addiction has no doubt affected every part of the individual’s life as well as the family as a whole, and  “that most behavior is multi-motivated…determined by several or all of the basic needs simultaneously rather than by only one of them” allows for a more fluid approach (McLeod, 2018, para 25). This in turn supports resiliency and “the potential for adaptation, reinvention, and positive growth [as] immediate problems are addressed [and] families become more resourceful in dealing with unforeseen problems and proactive in averting future crises” (Walsh, 2016, p. xii). Any family who has suffered from the traumas of active addiction would in theory more than welcome that. In actuality, it puts to the test to shift from what Maslow calls a self-centered survival mode to a problem-centered thriving one (McLeod, 2018, para 47). This again is where his theory can be a valuable tool for those in early recovery. Learning to work towards and trust in the hope that in time their deficiency needs will be satisfied, while simultaneously cultivating the attributes that contribute to the meeting of growth needs. 

This of course reflects to a certain extent the difference between needs and wants. Like the person with a SUD, family members can over time become excessive, operating in a self-centered survival mode by their “attempts at controlling the addiction which not only hinders the family’s ability to recover but undermines its ability to function as a healthy unit” (Woodbury et al., 2017, p. 20). This speaks again to the value of 12 Step recovery and its emphasis on inventorying one’s behaviors, identifying one’s character defects, and making amends accordingly. 

Addiction can all but destroy morality and violate one’s personal values. The work of recovery can prove invaluable to meeting not just physiological and safety needs but also those of love and belonging that fosters intimacy and rebuilds trust. These can in turn assist in the cultivating of esteem needs that result from one’s sense of accomplishment. It recognizes that while “persistent adversity may prevent families from living out their values” that families in recovery can “be encouraged to get in touch with their deepest values and to commit to live in ways that support their best aspirations” (Walsh, 2016, p. 57).

Addiction is, in large part, a problem rooted in self. For this reason alone, Maslow’s Hierarchy of Needs can be a valuable tool in the work of recovery. While aspects of his model include experiences that provide for positive personal gratification, it goes far beyond that. In seeking the ultimate growth need of transcendence, the needs of others are served as well which parallels the altruism of the 12th Step (McLeod, 2018, para 36). Yet another application of Maslow’s theory is that he “did not equate self-actualization with perfection” (McLeod, 2018, para 51). This is critical for those in early recovery and especially those who may have grown up in homes in which perfection was expected as a means of compensating for the family’s dysfunction. Indeed, part of what can contribute to relapse, chemical or otherwise, is the notion that we can modify our behavior in order to become “good” rather than commit to learning and practicing those behaviors that contribute to growth. Without such a shift, at the very least growth is stunted, and at the very most, such perfectionism conceals what is a faulty foundation. 

A life of recovery is meant to go beyond meeting mere deficiency needs. Rather than focusing solely on what is lacking or the pathology, tools such as Maslow’s hierarchy allow us to assist others in focusing on their potential and how that might be attained through the satisfying of their growth needs. “It understands the blessings that result from embracing future possibilities while finding hope in the midst of the inevitable peaks and valleys of daily life. A hope that sustains and enlightens our path, knowing that yesterday’s lessons can provide today’s wisdom in preparation for tomorrow’s challenges” (Woodbury et al., 2017, p. 183). 



Alcoholics Anonymous: The story of how many thousands of men and women have recovered from alcoholism, 4th ed.  (2001).  New York, NY: Alcoholics Anonymous World Services, Inc. 
McLeod, S. (2018, May 21). Maslow’s Hierarchy of Needs. Simple Psychology. Retrieved from
Walsh, F. (2016).  Strengthening Family Resilience, 3rd ed.  New York, NY: The Guilford Press.
Woodbury, B. & Woodbury, L. (2017).  Enable-ism: Bridging the recovery gap between the family and the addict.  Anaheim, CA: Good Son Publishing, Inc. 

Bill and Linda Woodbury
Co-Owners of Bridging the Recovery Gap
Co-Authors of Enable-ism  
Tel: (562) 221-2860 

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