Addiction: Clinical and Theoretical Considerations (original) (raw)

Although all human beings crave certain things, why do some develop such intense cravings that they will not or cannot stop trying to satisfy them even at the risk of self-destruction? What determines the particular object, substance, or situation that is so desperately craved? In the case of drug addictions and alcoholism, the causal strands of such cravings may be said to involve a complex interaction of the substance craved, social or cultural influences, and personal psychopathology, but the precise way in which these factors interact continues in many respects to baffle us. We have been largely unable translate our presumed knowledge into effective treatment or prevention. Medical, legal, economic, and sociocultural problems seem to confound the therapeutic process. The frequent failure of treatment efforts directed toward social rehabilitation, and of the counseling and methadone programs developed during the sixties and early seventies, has led to a renewed interest in applying psychoanalytic perspectives to the psychodynamics of drug and alcohol abuse (Blaine and Julius, 1977). The present study aims at contributing to the psychodynamic understanding of addiction. This paper will emphasize certain psychological characteristics which may be found in severely addicted persons. Addicted persons who come into psychoanalysis, to be sure, constitute a very limited sample (Yorke, 1970). Recreational