Psychoanalysis and Addiction

This paper critically analyzes the relationship between psychoanalysis and addiction. It explores the subject-specific effects of addiction and the role of mourning and melancholia. The paper also discusses effective treatment options for addiction.

Running head: PSYCHOANALYSIS AND ADDICTION
Psychoanalysis and Addiction
Name of the Student
Name of the University
Author Note

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PSYCHOANALYSIS AND ADDICTION
Introduction
According to the American Psychiatric Association (APA) (2019), addiction is a
complex condition. It is regarded as a disease of brain that is expressed through compulsive
substance use in spite of having harmful consequences. Psychoanalytic psychotherapy helps a
person to achieve deeper awareness about themselves along with awareness in their
unconscious desires, motivations and conflicts. Rik Loose (2011), the author of the “Modern
Symptoms and their Effects as Forms of Administration” stated that “It is my contention that
addicts are not addicted to drugs, but are addicted to an effect they get out of drugs, a
subject-specific effect” (pp: 4). The following paper aims to critically analyze the statement
from a psychoanalytic perspective. The paper will begin by providing a critical distinction
between the cultural focus of the addictive substance and psychoanalytic focus over the
subjective-specific effects. This will be followed by the discussion of how the subject-
specific effects are associated with the concept of mourning and melancholia, mania and
surplus energy. The position will be taken in favour of the lost object and the administration
of jouissance. At the end, the paper will highlight a significance of effective treatment for
addiction. The paper will also focus on the predominant models that are associated with the
drug-object and its relation to the behaviour expressed by an addicted person.
Discussion
Psychodynamic and psychoanalytic psychotherapies have their roots present in the
clinical work of the Sigmund Freund, Donald Winnicott and Melanie Klein and others
(Verma & Vijayakrishnan, 2018).

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Cultural focus on the addictive substance and psychoanalytic focus on subject specific
effects
Nearly all the cultures have employed the use psycho-active drugs in order to
facilitate the social interaction or to alter consciousness or to heal. The society’s expanded
chemical manipulation mainly represents a huge technical capacity, along with more wealth,
leisure and choice of individuals. It is also conversely related in a sudden reduction in
constraining social settings, peer pressure of the family standards and expectations along with
personal proscriptions regarding as to what is to be done or not. Addiction to drugs is like any
other behaviour of human (Yao & Zhong, 2014). Drug abuse behaviour in general conceived
of as a final outcome of the biochemical or general characteristics, past learning experiences,
psychological antecedents, motivational states and specific cultural context under which it
unfolds. All these considerations is assumed to be a significant domain in the drug abuse.
Among these, cultural and the social factors play a notable role in subsequent initiation,
maintenance and therapeutic interventions for the drug abuse (Yao & Zhong, 2014). Social
norms, the shared rules help in the specifications of the proper or inappropriate behaviour. A
person who resides in high socio-economic determinants of health, consumption of alcohol or
smoking of imported brands of cigarettes is considered as a symbol of class or superiority.
Such that people from the higher upper class society mainly considers smoking of the top
brand cigarettes or alcohol as a symbol of money or to display their pride possession of
money. Here the main subject matter of the selection of the intoxicated drugs is mainly driver
by the power of money. Moreover, people from the upper class society have a tradition to
smoke or drink in social gatherings. This continuous exposure to cigarette smoking and
drinking generates a sense of addiction leading to the generation of substance abuse. On the
people who belong to the lower middle class or lower class, smoking of tobacco or
consumption of alcohol is regarded as a way to fight against their feelings of failure or lack of

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unemployment or financial crisis. Here the subject matter of effect is neglect or failure in life
(Sudhinaraset, Wigglesworth & Takeuchi, 2016). People who reside in the middle class take
up smoking of tobacco or consumption of alcohol to fight against their work-related stress or
stress of academic life. Thus there the subject matter of effect is fighting against the stress.
Parental influence also has an important role in the generation of the smoking patterns.
Parents have a significant influence on their wards in the process of development of smoking
habits. The disapproval from the parents in smoking makes the children or the young adults
to less likely to initiate the smoking habits (Sudhinaraset, Wigglesworth & Takeuchi, 2016).
Female young adults are more likely to smoke if both the parents are active users of tobacco
smoking. There is a strong relationship between smoking of the mother and the female youth
to develop the smoking patterns. Raised in a home where parents are exposed to smoking
gives the children an easy access to tobacco and thereby provoking them to develop smoking
habits (Yan, Li & Sui, 2014) (Sudhinaraset, Wigglesworth & Takeuchi, 2016). Thus it can be
said that people are not addicted to tobacco or alcohol, but the addiction mainly comes from
the subject matter effect as truly highlighted by Rik Loose (2011).
From the psychoanalytic focus on subject specific effects it can be said that
psychoanalysts have long viewed addictions as pure psychological condition (Dodes &
Dodes, 2017). The main advantage of the psychoanalytic approach is that it focus on the
numerous systematic observations of a single patients made over time. According to the APA
(2018), an addictive behaviour mainly generates from some sorts of emotional stress. It is
regarded as an issue that is strongly buried within the subconscious mind of a person. Such
that addressing it with the help of psychoanalytic theory is extremely overwhelming or is
regarded as unfathomable challenge. In order to decrease the stress, or to eradicate the sense
of depressive behaviour, A drunken state of mind or a night out with friends with alcohol and
smoking generate a sense of thrill that is found to reduce the stressful burden over the mind

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and soul. The thought of cessation of substance abuse generates a sense of fear or threat of
returning to those unpleasant thoughts or emotional stress. This fear of reviving the old
emotional fear prevents an individual to overcome the sense of substance abuse of any kind
be it cigarette smoking, cannabis addiction, and alcohol consumption. From the psychological
point of view, subject matter effect is recovery or sudden relief from stressful behaviour and
not the addiction towards any particular substance like alcohol or tobacco. However,
Barrocas, Vieira-Santos and Paixão (2016) are of the opinion that there are some people who
specifically addicted to cannabis. Cannabis generates a strong sense of addiction in
comparison to tobacco. Such that people whose central nervous system is sensitised with
cannabis, failed to cope with tobacco smoking as cannabis strongly affects the dopamine
signalling unlike tobacco. This sensitization of the dopamine signalling generates a strong
withdrawal syndrome even under the effect of the tobacco smoking. Thus in this case, it can
be said that people are addicted to any particular addicted substance rather than any subject
matter effect (Vasilievich, 2014).
Psychoanalysts mainly treat addictions through examining their relationships with the
affected individuals and the use of the psychodynamic principles. A proper interpersonal
vantage point generates diverse data about the process of disease addiction.
Subject-specific effects on mourning and melancholia, mania and surplus energy and
administration of jouissance
The definition of melancholia fluctuates in the field of descriptive psychiatry. The
definition of melancholia takes various clinical forms and grouping these different clinical
forms results in the generation of somatic rather than psychogenic affections. Melancholia
means monotony that generates a sense of boredom and this constant feeling of boredom
generates a strong sense of depression. There is a strong relationship between melancholia
and mourning. Sigmund Freund (1957) stated that the relationship between the melancholia

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and mourning is justified by a general picture. Mourning is defined as a reaction of loss of a
loved person or to sudden loss of some abstraction that has taken the place of one like one’s
country, an ideal or liberty and so one. In some individuals, same influences lead to the
generation of melancholia instead of the generation of mourning and thus indicating
pathological disposition between the two affect. The distinguishing mental features arising
out of melancholia include painful dejection, complete loss of interest from the outside world,
loss of the capacity to love others and inhibition from all kind of daily living activities and
decrease in the domain of the self-regarding feelings to a certain extend that finds utterance in
the domain of self-reproaches and self-reviling. This culminates into delusional expectations
of punishment. The hamper in the self-regard is not present in mourning. However, the other
features of mourning are same like that of the melancholy. Profound mourning deals with a
sudden reaction of loss of someone who is being deeply loved. It contains certain painful
frame of mind, along with the same loss of interest from the outside world along with the loss
of capacity to adopt with any new object of love (as a sense of replacement (Freud, 1957).
In relation to the mourning and melancholia, and increase in the substance abuse can
be explained under the loss grief addiction model. According to the Kubler-Ross Grief Cycle,
the first stage of the loss of some near and dear ones is denial or the avoidance of the true
facts this is followed by anger or frustration due to encountering certain loss. This phase is
proceeded with bargaining that is struggling to find the meanings of life followed by
depression and finally acceptance. The journal of some people from depression of acceptance
is long or never ending. The majority of the people fail to get the proper emotional support in
order to fight for the loss or overcome their sense of depression. This leads in increase in the
state of melancholia and monotony and increasing the tendency of substance abuse (Hughes,
Kinder & Cooper, 2019).

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(Source: Hughes, Kinder & Cooper, 2019
Alcohol one of the common intoxicating agent in the substance abuse is apparently
cited as an important agent to fight against depression. Alcohol has a sedative effect that
helps to distract from the persistent feelings of sadness or grief or depression. thus when there
is no mental support, people develop a tendency to avoid the persistent feelings of sadness or
try to develop a mental strength in order to overcome the sense of anger, sadness and a
constant melancholy. Alcohol or substance abuse is regarded as one of the important
component of fight against this sense of depressive symptoms. The people who are addicted
to alcohol are of the opinion that consumption of alcohol helps to provide the require courage
or strength to fight against depression. Some people are of the opinion that though the taste of
alcohol is bitter and it burns their throat or the cost is expensive, they prefer drinking alcohol

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because it helps to develop a Trans state of mind. Under this state of maze, they can easily
battle their negative emotions of grief (Lai et al., 2015). From the perspective of the
neurobiology, it can be said that alcohol is a kind of drug that affects the central nervous
system. The type of alcohol that is consumed is ethanol. Ethanol at low concentrations
releases dopamine. Release of dopamine helps to release behaviours that are otherwise
inhibited and thus helping to generate a feeling of relaxation and good mood (Banerjee,
2014).
However, alcohol only temporarily relives the sense of depression. In the long run, the
consumption of alcohol worsens the sense of depression. Consumption of high dosage of
alcohol increases the dopamine requirement of the body or desensitize the dopamine
releasing receptors. Thus sudden cessation of alcohol reduces the release of dopamine from
the body altogether creating alcohol withdrawal syndrome. Alcohol abuse brings bevy
negative effects on virtually in every aspects of life. Alcohol abuse invites in financial
constrains, hampers the academic life and this worsens the depression further. There is a high
sense of depression among the people who are suffering from the alcohol use disorders
(AUD) or suffering from alcohol dependence. The depressed individuals are nor motivated or
addicted towards the alcohol, but they are more addicted with the sense of sedation (subject-
specific effect) that is being produced by the alcohol (Lai et al., 2015).
Charles Melman (2015) helps to summarise the concept of mourning and melancholia
stated by Sigmund Freund. Charles Melman (2015) highlighted that Freund taught us that
there are two different types of losses. First is bereavement or mourning that generate a sense
of sadness and that paradoxically in some cases can generate a phenomenon of happiness, joy
and gaiety. Another type of loss is destruction of personality and identity that is known as
melancholia. In order to fight with these two feelings people get indulge into the substance
abuse or intoxication. Charles Melman (2015) stated that there is a third type of feeling that is

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known as jouissance that is known as physical or intellectual pleasure, delight or ectasy.
Flotta et al. (2014) are some group of individuals who considers that smoking and drinking
helps to increase the level the energy level of the body and thereby helps to elevate the mood.
Under to context of this, it can be stated that drinking of alcohol or smoking of tobacco acts
on the central nervous system and thereby helping to increase the secretion of the selective
serotonine reuptake inhibitors (SSRIs). Increase in the secretion of the SSRIs further helps to
increase the mood and thus assisting in the generation of positive energy (Mallett et al.,
2014).
Predominant models of treatment that focus on the drug- object and behaviour in
relation to it
It is well studied that though mourning involves graves deflection from the normal
activities of life, it still involves a grave departures from the normal attitude of life. It never
regarded as a pathological condition and thus is not referred for the medical treatment.
Moreover from the psychoanalytic point there is no such thing that prove the fact the
individuals expertise in the generation of addiction. However, it is important to pay special
attention to addiction. This s because addiction is an paradigmatic expression of sufferings of
the modern subject. Moreover, it is a crucial problem for the psychoanalysis. Thus, it is
import to investigate the effect of the symptoms and dual diagnosis under the psycho-analytic
framework (Loose, 2011).
The predominant models of treatment that focus on the drug-object and behaviour
include psychological treatments or non-pharmacological interventions (Moos, 2017). One of
the important psycho-analytic models of treatment for the recovery from the drug addiction is
potential of attachment theory. According to Schindler and Bröning (2015) individuals
suffer from the substance abuse disorder for multiple reasons and such sufferings last for

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throughout the year. This analysis highlights that neither historical nor community-based
interventions or other evidence-based behavioural modalities are helpful in process of healing
of the drug addiction. A generating corpus of the research has helped in the establishment that
traumatic experience during the early childhood along with insecure attachments are both
independent as well as interrelated risk factor for developing substance abuse. A growing
evidence of literature suggests that use of the attachment theory can act as potential informed
interventions for fighting against substance abuse. Attachment informed approaches mainly
facilitated development of the attachment with the family members either through effective
communication or by taking part in social or community based activities. This participation
helps in building up healthy relationships with the family members. The building relationship
with the family members helps to fight against the depression. This is because; family acts as
a sole pillar for emotional support and thereby helping to recovery from the depressive
symptoms and this in turn help to fight substance abuse disorder and associated withdrawal
symptoms (Fletcher, Nutton & Brend, 2015). Theory of planned behaviour is another
predominant model of treatment that focuses on the drug- object and behaviour (Zemore &
Ajzen, 2014). In the theory of planned behaviour, states that attitude towards behaviour and
subjective norms along with perceived control helps to shape up an individual’s intentions
and behaviour. Thus, modification of the subjective norms like smoking and drinking
compulsion in the social gatherings helps to change the individuals’ intentions and behaviour
towards the substance abuse. Theory of planned behaviour also helps to fight against the
withdrawal symptoms of substance abuse my increasing an individual’s intensions to change
(Cooke et al., 2016).

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Figure: Theory of planned behaviour
(Source: Cooke et al., 2016)
Mindfulness training as treatment for addictions follows the psychological and
neurobiological model for fighting against substance abuse. Mindfulness training that is
derived from the Buddhist models of human suffering has found to generate preliminary
efficacy for overcoming addictions. This early model is found to show remarkable similarity
to the prevailing models of the addictive process. It main overall lapping is found in the
domain of operant conditioning, both positive and negative reinforcement). The therapy also
provide the required explanatory power for the underlying mechanisms of mindfulness
training including its effects over the principal addictive elements like craving and the
underlying neurobiological process (Brewer, Elwafi & Davis, 2014). Witkiewitz et al. (2014)
stated that mindfulness based theory for the prevention of the substance abuse helps to reduce
the relapse of addiction my pre-occupying the mind with other activities or decreasing the
sense of depression under the application of soothing music. Fortuna, Porche and Padilla

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(2018) are of the opinion that application of the mindfulness-based therapy is effective for the
people with dual diagnosis. For example, application of the mindfulness based therapy helps
to recover from depression and post traumatic stress and thereby helping to recover the urge
to substance abuse in order to fight negative emotions.
Conclusion
Thus from the above discussion, it can be concluded that there is a strong relationship
towards addiction of a particular intoxicating feelings and its outcome based on the
psychoanalytic and psychotherapy. Moreover, the discussion also shows that addicts are not
addicted to drugs, but are addicted to an effect they get out of drugs, a subject-specific effect.
Proper use of the predominant psychoanalytic models of treatment helps to overcome the
addiction to substance abuse and depressive mental state of mind that initiates the tendency of
substance abuse.

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References
American Psychiatric Association (APA). (2018). What’s behind Addiction?. Access date:
27th May 2019. Retrieved from: https://deserthopetreatment.com/addiction-
psychology/
American Psychiatric Association (APA). (2019). What Is Addiction?. Access date: 27th May
2019. Retrieved from: https://www.psychiatry.org/patients-families/addiction/what-is-
addiction
Banerjee, N. (2014). Neurotransmitters in alcoholism: A review of neurobiological and
genetic studies. Indian journal of human genetics, 20(1), 20.
Barrocas, J., Vieira-Santos, S., & Paixão, R. (2016). Parenting and drug addiction: A
psychodynamic proposal based on a multifactorial perspective. Psychoanalytic
psychology, 33(1), 161.
Brewer, J. A., Elwafi, H. M., & Davis, J. H. (2014). Craving to quit: Psychological models
and neurobiological mechanisms of mindfulness training as treatment for addictions.
Charles Melman. (2015). Addiction – Letter 16. Access date: 27th May 2019. Retrieved from:
http://theletter.ie/charles-melman-addiction/
Cooke, R., Dahdah, M., Norman, P., & French, D. P. (2016). How well does the theory of
planned behaviour predict alcohol consumption? A systematic review and meta-
analysis. Health psychology review, 10(2), 148-167.
Dodes, L. M., & Dodes, J. (2017). The case study method in psychodynamic psychology:
Focus on addiction. Clinical Social Work Journal, 45(3), 215-226.

13
PSYCHOANALYSIS AND ADDICTION
Fletcher, K., Nutton, J., & Brend, D. (2015). Attachment, a matter of substance: The potential
of attachment theory in the treatment of addictions. Clinical Social Work
Journal, 43(1), 109-117.
Flotta, D., Micò, R., Nobile, C. G., Pileggi, C., Bianco, A., & Pavia, M. (2014). Consumption
of energy drinks, alcohol, and alcohol‐mixed energy drinks among Italian
adolescents. Alcoholism: clinical and experimental research, 38(6), 1654-1661.
Freud, S. (1957). Mourning and melancholia. In The Standard Edition of the Complete
Psychological Works of Sigmund Freud, Volume XIV (1914-1916): On the History of
the Psycho-Analytic Movement, Papers on Metapsychology and Other Works (pp.
237-258).
Hughes, R., Kinder, A., & Cooper, C. L. (2019). Bereavement and Loss. In The Wellbeing
Workout (pp. 157-161). Palgrave Macmillan, Cham.
Lai, H. M. X., Cleary, M., Sitharthan, T., & Hunt, G. E. (2015). Prevalence of comorbid
substance use, anxiety and mood disorders in epidemiological surveys, 1990–2014: A
systematic review and meta-analysis. Drug and alcohol dependence, 154, 1-13.
Loose, R. (2011). Modern symptoms and their effects as forms of administration: A challenge
to the concept of dual diagnosis and to treatment. Lacan and addiction: An anthology,
1-39.
Loose, R. (2011). Modern symptoms and their effects as forms of administration: A challenge
to the concept of dual diagnosis and to treatment. Lacan and addiction: An anthology,
1-39.
Mallett, K. A., Marzell, M., Scaglione, N., Hultgren, B., & Turrisi, R. (2014). Are all alcohol
and energy drink users the same? Examining individual variation in relation to alcohol

14
PSYCHOANALYSIS AND ADDICTION
mixed with energy drink use, risky drinking, and consequences. Psychology of
Addictive Behaviors, 28(1), 97.
Moos, R. H. (2017). Evaluating treatment environments: The quality of psychiatric and
substance abuse programs. Routledge.
Schindler, A., & Bröning, S. (2015). A review on attachment and adolescent substance abuse:
empirical evidence and implications for prevention and treatment. Substance
Abuse, 36(3), 304-313.
Sudhinaraset, M., Wigglesworth, C., & Takeuchi, D. T. (2016). Social and cultural contexts
of alcohol use: Influences in a social–ecological framework. Alcohol research:
current reviews.
Vasilievich, R. I. (2014). Gnoseological and methodological crisis and new diagnostic
concepts in psychology and psychiatry: focus of attention to addiction
diathesis. British Journal of Science, Education and Culture, 270.
Verma, M., & Vijayakrishnan, A. (2018). Psychoanalytic psychotherapy in addictive
disorders. Indian journal of psychiatry, 60(Suppl 4), S485.
Witkiewitz, K., Bowen, S., Harrop, E. N., Douglas, H., Enkema, M., & Sedgwick, C. (2014).
Mindfulness-based treatment to prevent addictive behavior relapse: theoretical models
and hypothesized mechanisms of change. Substance use & misuse, 49(5), 513-524.
Yan, W., Li, Y., & Sui, N. (2014). The relationship between recent stressful life events,
personality traits, perceived family functioning and internet addiction among college
students. Stress and Health, 30(1), 3-11.

15
PSYCHOANALYSIS AND ADDICTION
Yao, M. Z., & Zhong, Z. J. (2014). Loneliness, social contacts and Internet addiction: A
cross-lagged panel study. Computers in Human Behavior, 30, 164-170.
Zemore, S. E., & Ajzen, I. (2014). Predicting substance abuse treatment completion using a
new scale based on the theory of planned behavior. Journal of substance abuse
treatment, 46(2), 174-182.