is one of the most consistent dominating themes
in the treatment of addiction.
Alcoholics and addicts demand and require
certain levels of gratification
if they are going to tolerate the relinquishing of their primary source of gratification ---
namely the drugs and/or alcohol.
Addiction, as defined in self psychology, is the result of
deprivation of developmentally appropriate
needs for gratification.
Alcohol, drugs, food, sex, and other forms of
potentially addictive behavior are
attempts for self repair.
The addict and alcoholic
try to acquire externally
what cannot be provided internally
because of defects in the psychic structure.
No, a therapist cannot
"love their addicts into health"
because this is what the addict
has been trying to do symbolically with chemicals.
Rather, the addicted individuals needs to learn how to
without immediate gratification
since it is through
managing tolerable levels of frustration
that psychic structure is laid.
Too much anxiety interferes
with the necessary trust and safety
required for openness, exploration,
and revealing of one's self to occur.
Optimal gratification means that the
therapist will provide enough
nurturing or emotional responsiveness
until addicts or alcoholics
are able to provide it to themselves
without returning to old methods of gaining immediate gratification.
Early stage treatment with substance abusers
requires more gratification than later stage treatment.
Most substance abusers
cannot tolerate the frustration and regression
that is induced by some in early stages of recovery.
However, addicts and alcoholics
respond more favorably to a
direct, practical, no-nonsense approach
and if therapy is to work it requires
active emotional engagement.
Addiction as an Attachment Disorder - Flores