I would like to point you to a brief article by Sally Satel in today's New York Times Science Section that mirrors my own sentiments about the usefullness of insight into how a maladaptive behavior, such as drug use or over-eating, might have originally started. Insisting on finding a cause can be an excuse for not working on changing a maladaptive behavior, and knowing a cause doesn't guarantee that behavior will change. There is no convincing data for the effectiveness of insight therapy, while there is such data for cognitive therapy - which trains one to note what isn't working when it starts up and choose to do something else. Satel says "It is time to retire the myth that insight is a prerequisite for change," and she offers two case studies:
"...the grail-like search for insight can backfire when it becomes a way for patients to avoid the hard work of change. This was my experience with Joe, a 24-year-old heroin addict. At every session, Joe would talk about his childhood relationship with his father, seeking new clues for how it damaged him and drove him to heroin...When I tried to change the topic to on-the-job stresses, which he linked to heroin craving, he said he’d rather “do psychotherapy.” Joe was forestalling the need to make practical changes. The many-layered drama with his dad doubled as an excuse for using heroin, absolving him of the responsibility to quit. When I proposed that possibility to him, he said, “Maybe you’re right.” But nothing really changed. He died of an accidental overdose a few months later."
"..insight has no guaranteed relationship to change. A colleague of mine treated a 45-year-old woman, Joan, who came for therapy because she hated her chunky body. Joan firmly believed that once she discovered The Reason for her overeating she would stop...After a few months, Joan told my colleague that her father had developed cancer the year she went off to college...“You know, I never made the connection until now,” she announced triumphantly, “but I started overeating when he began to waste away. It’s like I was trying to nourish him through myself.” ..A poignant metaphor, yes, but months later she hasn’t lost a pound."