Bio-Psycho-Social Plus (B P S +)

“The Spectacular Now” film revolves around the protagonist Sutter Keely and opens
up with him writing a college application. One of the questions on the application is about a
hardship he has ever encountered and how he tackled it. His answers shades some light on
this character who is seen as the life of the party but losing his girlfriend threw him over the
edge. He decides to take it easy and hook up with girls and uses his capacity to access alcohol
to catch the attention of two attractive students. This leads to him getting caught by his
girlfriend who moves on to another focused guy and leaves him. This makes Sutter to drink
and drive and even passes out in strangers’ lawns. He does not even remember where he has
left his car showing a problem with alcohol already. His problem with alcohol gets worse as
his mother is away most of the time working. His mother does not want him to see his dad.
His alcohol problems make him kick out his girlfriend out of his car who is hit and breaks her
arm. All this serve to make the situation worse for Sutter who feels bad about himself and
these feelings increase his alcohol problem as we progress.
BPS+ model of addiction

In this film, we see that Sutter’s addiction can be applied the Bio-Psychosocial plus
model that encompasses five dimensions namely biological, psychological, social, cultural
and spiritual. according to Marilyn Herie & Maté, (2015) the BPS model was created to assist
medical experts to place illness and health in biological space and also incorporate other
contributing factors such as psychological, social, cultural and spiritual.
Under the biological realm, addiction is viewed as a “brain disease”. Skinner, (2014)
stresses on the importance of going beyond looking at neurobiological element alone when
looking at the biological element of addiction. School of Medicine, (2015) categorizes
biological factors into past and present. When looking at the past, the first element to be put
into consideration is genetics. When close relatives have addiction problems there are

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increased chances that genetics could be involved in the issue. The second issue to be taken
into consideration when looking at the biological past of an individual is history of pregnancy
and birth. Some variables to be considered include whether an individual was exposed so
substances, alcohol and medication among others during their time on their mother’s womb.
Others to be factored in when analyzing biological factors include birth trauma and
hospitalization for a long time. Other factors that can symbolize problems under biological
past can be previous illnesses such as endocrine disorders, seizures among others. Past
substance abuse can also trigger problems such as addiction.
Under biological present conditions, one can look at the present illness that a patient is
suffering from in addition to any impact the illness has on psychiatric presentation. Other
factors to be considered include medication the individual is on presently and the effects of
that medication sch as psychoactive effect and finally the side effects of the medication.
Other factors to be considered are the effects of alcohol on the specific psychiatric symptoms
and possible effects of the substance withdrawal which in our case is the alcohol being
consumed by the protagonist in the film (School of Medicine, 2015).
According to (Skinner, 2014) psychological element of BPS+ model of addiction is
related with the body and brain. Psychology is defined as the study of the human mind in
addition to the methods in which human subjective behavior and experience are created,
shaped and evoked. Some of the factors to take into account are the drives and urges that
make an individual take a particular behavioral approach. Skinner, (2014) tells us that the
psychological elements helps us understand addiction better and how behavior is shaped. The
author even argues that addiction is a disorder of choice, an idea that other researchers hold a
contrary opinion towards. Behavior changes instantly in a scenario whereby the rewards are
changed. According to School of Medicine, (2015) there are components that help us
understand an individual’s psychological processes better that can lead to addiction and other

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problems which are divided into past components and present components. In the past
components, history of trauma, and resiliency are factored in. In addition, sources of positive
self-image and role models can be assessed as some can be heavy alcoholics hence the
problem in the patient. Understanding how the patient handles loss is also critical. Quality of
relationships can also be assessed with an individual’s important people around such as
friends, grand parents and employers among others. If there are any past medical problems,
they should be factored in too. In addition, present psychological issues should be factored in
too such as present issues that could have triggered the problem, the present stressors and
their meaning, coping skills, present developmental demands such as aging and its impact to
the patient’s problems (School of Medicine, 2015).
In relation to the social element (Skinner, 2014) tells us that the direct social context is
important in prevention initiatives in addition to gathering support when an individual is
trying to find solutions to addictive problems. People are more likely to pick up behaviors
valued by others in their social field as opposed to behaviors that do not have the normative
pressure. This idea is echoed by Marilyn Herie & Maté, (2015) who says that social
dimension is related to the direct and immediate interpersonal domain that is closest to a
person who develops some form of addictive disorder. This are people that the person
interacts with on a frequent basis such as friends, family, colleagues and even other students
as in the case of the protagonist in the movie. A bigger spectrum can be adopted that
incorporates macro-social factors which can be linked to gender, race and economic class can
help better understand addiction issues. This approach is critical in understanding the social
aspects bringing up addiction in an individual. Among the areas that would help establish a
problem under this section is analyzing the individuals support system, the present
relationships status with important people in the individuals life and their financial status.

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Also their current housing arrangement can be a pointer to the source of the problem and
cultural influences.
Understanding health and illness better requires adequate understanding of the cultural
aspect. Culture is the social environment in which an individual has grown up and lives and
its connection to their personal identity. The level of connection the person feels influences
their subjective experience of life in general and their vulnelabirity to health problems and
addiction (Skinner, 2014). Cultural rediscovery is significant and can influence minority
groups such as LBGT, refugees and indigenous people who speak a common language in
relation to the challenges they face while celebrating their unique identities. Marilyn Herie &
Maté, (2015)argues that culture is a missing element when it comes to understanding
addictiona and peoples vulnerability. When people are in environments they are respected,
that expects positive input from them and gives them necessary reward for these in addition
to offering supprt and protection to the people in need the community becomes healthier with
the people who make it up. Understanding the cultural background of people with addiction
is important. This should take into account the cultural belief system of the patient. The idea
of addiction should be viewed through the eyes of culture since culture influences meaning
and how people perceive and approach life. Culture is a great way of understanding addictive
behavior and is interlinked with spirituality (Marilyn Herie & Maté, 2015).
Skinner,( 2014) tells us that when one is keen in listening to individuals with addiction
problems, they are likely going to encounter a spiritual element in their lives that can take a
religious or non-religious angle. Finding an individual cure is sometimes a major problem to
the patient since this problem requires to find a deeper solution from within as opposed to
approaching it from a perspective and viewing the issue pragmatically. It is crucial to
maintain with respect the spiritual window open whereby the healing and therapeutic process
respects the patient’s religious views and a person will to find solution in the best way they

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know how to. It will entail helping every client to find solution through their preferred
methods of gaining wisdom and insights. Spirituality is strongly linked to low addictive
behavior among people and also can help protect health and overall personal wellbeing.
People struggling with addiction have incorporated spirituality in the healing process which
has worked wonders (Marilyn Herie & Maté, 2015). Some questions to ponder about under
spirituality include understanding the spiritual belief system of the patient, how they meet
their spiritual needs, understanding their religious practices and community and their early
childhood experiences on religion (School of Medicine, 2015).

Analysis of “The Spectacular Now” using BPS+ model

The biological aspect of Sutter’s problem is clearly displayed when he goes out in
search of his father. Having been exposed to his fathers drinking at a young age. We see that
his father clearly has an alcohol and tobacco problem. Sutter had been predisposed to
alcoholism at a young age which increased his susceptibility. Aimee who had taken Sutter to
meet his dad and was there for moral support immediately sees where Sutter got his negative
traits from. Genetics can be a strong indicator to the source of an addiction problem. Sutter is
not presented in the movie as having other illnesses, does not have head injuries or suffers
from past substance abuse which fall under biological analysis.
Under psychological factors that could have triggered his alcohol addiction problem,
Sutter has an absent father who left them while he was young. To pay the bills, his mother is
working double shifts and does not have much time for her son. His mother is not addressing
the issue at hand Sutter is facing. In addition, he wants to see his father but his mother is
obsessed bout making it impossible for the young man to make contact with his father. Sutter
believes that his father was a good man whom his mother wrongly cast out of her life. His
father is probably his role model and the image he has of him was that of a man who loved
his drink. Among the current stressors include the pressure to perform well and join the

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university as we can see him applying for university admission at the start of the movie. In
addition, his girlfriend dumped him and this made the situation worse. Wanting to see his dad
and being denied an opportunity to see him is also another stressor. Sutter is very young but
is constantly drinking to a stupor as a coping mechanism of life pressures. Sutter always has
this soft drink cup that he pours alcohol to from a hip flask that he walks around with and can
be seen doing this in school, work and almost everywhere which shows the magnitude of his
addiction.
Under the social factors, the patients support system is weak. His mother is never
around and they are not in touch with the father. He is always partying but surrounded by
fake friends. Stutter has a lot of pressure to drink from his peers as he is even regarded as the
life of the party. The trunk of his car has a cooler full of beer. We see Sutter pressuring
Aimee to join the bandwagon and start drinking despite the fact that she was not a partaker of
the bottle. He even buys her a flask at some point which shows that social pressure is getting
her to be an alcoholic too.
Culture plays an important part in identity formation and Stutter comes from a place
where drinking alcohol is considered cool. There is a culture of partying and drinking alcohol
whenever one attends this parties. Not much is relatable to spiritual realm in this film.

Conclusion

Addiction is a product of multiple sources which ought to be analyzed critically in
order to come up with a lasting solution. In the film, the issue of alcoholism is never resolved
but Stutter finds purpose and meaning in his life which could turnaround his life to a life of
sobriety. Through the application of Bio-Psycho-Social Plus model, it is easier to understand
and develop lasting solutions to different addiction problems.

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References

Marilyn Herie, ,. W., & Maté, G. (2015). Fundamentals of Addiction : A Practical Guide for
Counsellors. Boston: ProQuest Ebook Central.
School of Medicine. (2015). Bio-Psycho Social-Spiritual Model. Retrieved October 9, 2020,
from Universisty of Nevada : https://med.unr.edu/psychiatry/education/resources/bio-
psycho-social-spiritual-model
Skinner, W. (2014). A Bio-Psycho-Social Plus Approach to Addiction and Recovery.
Toronto: University of Toronto.