The Value of Relational Psychoanalysis in the Treatment of Chronic Drug and Alcohol Use

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

“…Clinical practitioners, too, have avoided focusing on transference and insight-oriented treatment for fear that such an approach will promote relapse, so therapeutic efforts frequently follow a more structured cognitive approach, and often the substance abuse is treated separately and earlier than the underlying trauma or character issues. Director (2002) argues, however, that the ''treatment relationship mobilizes the selfsame hopes and threats that occasion the solution of drug use everywhere else in the patient's object world'' (p. 567). Our own view follows her argument and supports her view that underlying the substance abuse are ''conflicting and unresolved relational dynamics that derive from early organizing relationships'' (p. 551) and that addressing these dynamics is the core of treatment.…”

“…He viewed his father as a benevolent figure whom he sought out and lived with. The dynamics of Ronnie's case parallel the work of Burton (2005) and Director (2002Director ( , 2005 because his drug use helped to mobilize a self-state that needed to feel powerful as well as to provide a state in which he could feel connected and soothed. It is interesting to note that Ronnie was able to become intensely involved in the 12…”

“…This mutual participation involves the therapist and the client in enactments of old patterns, which when experienced and reflected upon, lead to the development of new patterns of living and new ways of experiencing relationships. 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.…”

“…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).…”

“…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). Burton (2005) views addictions as ''embedded in dissociated self-states'' (p. 587) that Director (2005) says represent ''specific affects, feelings about self and other, attitudes about the world-that give rise to needs and longing that are captured and seemingly realized in characteristic acts of drugs use'' (p. 568).…”