Encounters with Omnipotence in the Psychoanalysis of Substance Users

Lisá,

doi:10.1080/10481881509348851

Cited by 26 publications

(17 citation statements)

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“…As Director (2005) argues, ''chronic substance use is seen as being driven by conflicting and unresolved dynamics that derive from early organizing relationships in a person's life'' (p. 551). Among the scenarios that individuals enact are ''demands for power, desires for surrender, pleas for caretaking ... and longings to be left alone in perfect solitude.''…”

Section: Case Vignette Ii-ronniementioning

confidence: 98%

“…It is the foregoing concepts that have informed our therapeutic work (Ganzer & Ornstein, 1999, 2002, 2004Ornstein & Ganzer, 1997, 2000, 2003 with vulnerable populations in the past decade and that will be elaborated further in this paper as we discuss two successful treatments of individuals recovering from substance abuse. Though an extensive body of literature exists on the application of relational concepts to the practice of psychotherapy, only a few articles (Burton, 2005;Director, 2002Director, , 2005 have appeared that apply these concepts to treatment of substance abuse. Director (2002) views substance use as ''driven by conflicting and unresolved relational dynamics that derive from the early organizing relationships in a person's life'' (p. 551) and contends that ''chronic drug use often marks or serves to implement an underlying omnipotent self-state'' (Director, 2005, p. 567).…”

Section: Psychodynamic Theoriesmentioning

confidence: 99%

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In and Out of Enactments: A Relational Perspective on the Short- and Long-term Treatment of Substance Abuse

Ganzer¹,

Ornstein

2007

Clin Soc Work J

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This paper examines the contribution of a psychodynamic relational perspective to the treatment of substance abuse. Two cases of different lengths are presented to illustrate the therapeutic factors that contributed to successful recovery and long-term abstinence. Followup information on the successful outcome of both cases was available 7 years after the initiation of treatment. We discuss the critical role that the experience and processing of enactments played in both cases.

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Section: Case Vignette Ii-ronniementioning

confidence: 98%

Section: Psychodynamic Theoriesmentioning

confidence: 99%

In and Out of Enactments: A Relational Perspective on the Short- and Long-term Treatment of Substance Abuse

Ganzer¹,

Ornstein

2007

Clin Soc Work J

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“…The role of predispositions in PTSD, primarily family history of psychopathology, neuroticism, cognitive ability and pre-existing maladjustment, is well documented in the literature [6][7][8][9][10].…”

Section: The Role Of Trauma In Drug Use Disordersmentioning

confidence: 99%

“…In part, it is related to the compulsive nature of addiction, much like compulsive disorders in general. I and other psychodynamic investigators have emphasized that the painful, repetitious aspects of addiction are displaced attempts to deal with the vague, confusing and inaccessible feelings that render the person powerless, helpless and out of control [8][9][10]. In such instances, the operative changes from one of relieving suffering to controlling it.…”

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confidence: 99%

Addiction as a self‐regulation disorder and the role of self‐medication

Khantzian

2013

Addiction

102

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Professor Darke, in his scholarly and thoughtful critique, appreciates, as do I, the coexistence of painful psychiatric conditions such as post-traumatic stress disorder (PTSD) and borderline personality disorders (BPD) in the development of addiction, which precedes, and subsequently becomes associated with, the development of heroin dependence [1]. He cites the preponderance of childhood histories of deprivation, traumatic abuse and neglect, conditions that precipitate and cause life-long suffering, and, as one scholar of PTSD has eloquently offered, it is a condition in which there is a failure of time to heal all wounds [2]. Major trauma is a condition that disrupts essential aspects of life, involving regulation of emotions, sense of self, relationship and self-care [3,4]. Professor Darke concludes that the association between these conditions is not by chance, and that the evidence supports the self-medication hypothesis (SMH) and its fundamental premise. Namely, drug-dependent individuals resort to, and become dependent on, these agents because they relieve human psychological suffering and not because they are seeking pleasure from the drugs.In what follows, I will focus primarily on issues that Professor Darke raises which do not appear as much to support the SMH or might seem inconsistent with it. Namely, he offers that (i) there is less of a basis to conclude that drug preference postulated by the SMH is tenable or necessary and, (ii) given that the SMH at its roots is an attempt at self-correction, it does not align so well with the extraordinary pain, danger, self-harm and damage associated with, and a consequence of, addiction.Notwithstanding the absence of empirical evidence, clinical observations (practice-based evidence) suggest that there is a considerable degree of preference/ specificity for an individual's drug-of-choice. I would emphasize that it is a range of painful, unbearable or confusing feeling states that individuals self-medicate that might or might not be associated with psychiatric disorders. Few would argue that intense feelings of rage, aggression and violence predominate with PTSD and BPD. In my experience, it is these intense emotions that heroin-dependent individuals self-medicate. Based on the evaluations of many heroin-dependent individuals, they repeatedly indicate that their main drug preference remains heroin, albeit they use many other substances.It is why in many of my recent publications [5][6][7] I have adopted an overarching understanding of addictive conditions as a self-regulation disorder and, in my experience, other drugs are then employed to self-medicate all the other psychological and behavioral dysregulation induced by the heroin dependency.It is worth mentioning here that my thinking was influenced by the fact that in the mid-1960s, in the middle of my psychiatric training, our nomenclature for the then psychotropic medications changed from referring to them as 'minor tranquilizers' (e.g. Librium) or 'major tranquilizer' (e.g. Thorazine) to designating the ...

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“…Another existing perspective in the treatment of alcohol and other drug users is the psychoanalysis proposal (Director, 2005;Laxenaire, 2010;Loose, 2000;Valentine & Fraser, 2008). Its main specificity lies in recognizing the different ways in which the subject relates to the toxic substances and consequently, understanding that drug use is anchored in the subjective dimension.…”

Section: Introductionmentioning

confidence: 99%

Proposals for the Treatment of Users of Alcohol and Other Drugs: A Psychoanalytic Reading

Ribeiro¹,

Fernandes²

2012

Addictions - From Pathophysiology to Treatment

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However, this conception was strongly challenged from the seventeenth century on, with the development of medical studies, when certain vegetal products that have psychoactive effect started to be valued as a source of energy, stamina, humor and temper balance. As examples, we can mention the opium, originated from the poppy, which was for a long time prescribed as a painkiller, antitussive and antidiarrheal medication, and the marijuana, prescribed as a general sedative, for the specific treatment of rheumatism, neurosis, insomnia, headaches, diarrhea, seizures and anorexia as well as in the therapy of tetanus and cholera (Carneiro, 2006).

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Encounters with Omnipotence in the Psychoanalysis of Substance Users

Cited by 26 publications

References 0 publications

In and Out of Enactments: A Relational Perspective on the Short- and Long-term Treatment of Substance Abuse

In and Out of Enactments: A Relational Perspective on the Short- and Long-term Treatment of Substance Abuse

Addiction as a self‐regulation disorder and the role of self‐medication

Proposals for the Treatment of Users of Alcohol and Other Drugs: A Psychoanalytic Reading

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