Theories about drugs

Question 1

Early psychoanalytic theories about addiction

Answer 1

Pleasure seeking, gratification, regression.

Self-destruction, self-punishment

Question 2

Rado (1933) psychoanalytic theory

Answer 2

regression; defense against negative emotional states (depression, frustration, pain)

Question 3

Glover (1932) psychoanalytic theory

Answer 3

Addiction as a defense mechanism against dissociation

Question 4

Fenichel (1945); Savitt (1954) psychoanalytic theory

Answer 4

struggle against depression

Question 5

Abraham (1994) psychoanalytic theory

Answer 5

Homoerotic tendencies behind alcoholism

–> Deficits in coping, pain-relieving function

Question 6

Wurmser (1974) psychoanalytic theory

Answer 6

Drug rescues the person from pain and passion and gives her/him what was missing.

Without the drug: feeling of disintegration
-> help to feel ’normal’

Question 7

(Affect regulation)

Rosenfeld & Chein 1964)

Answer 7

Substance use = adaptive mechanism:

helps the adolescents to cope with adult roles and helps them to palliate anxiety (negative models)

Question 8

(Affect regulation)

Hartmann (1969)

Answer 8

Adolescence – attempt for palliate intrapsychic stress, painful emotions and depression

Question 9

(Affect regulation)

Krystal & Raskin (1970)

Answer 9

Damage of stimulus barrier between person and others
-> cannot defend themselves against painful emotions

Deficits in emotions: infantile, archaic, total, undifferentiated, primitive (alexithymia)

Question 10

(Affect regulation)

McDougall (1984

Answer 10

Overwhelming and elusive emotions

-> obsessive way of regulating emotion

Question 11

Self-Treatment Theory (Wurmser)

Answer 11

Coping against problems

3 basic emotions
Anger (disruption of ideal self and ideal world)
Shame (discrepancy between ideal self and real self)
Rejection (the object does not give everything that the person wants)

Principle emotions increase craving („addictive search”) – as a psychological hunger

pharmacogenetic defense” against overwhelming, preverbal, archaic emotions

Question 12

Different mechanisms behind the choice of the substances

Answer 12

Opioids: suppression of too intensive emotions

Hallucinogens: against emptiness, feeling of senselessness and disappointment

Stimulants: against emptiness, boredom, worthlessness, depression (repression of aggression)

Question 13

Self-Medication Theory (Khantzian)

Answer 13

Drug of choice is the result of an interaction between the action of the drug and the dominant painful feeling of struggle.

Unconscious choice
Depends on the deficits in personality, self-regulation, affect-regulation
Drug use as a maladaptive coping: compensating neurological and developmental deficits

Question 14

Unconscious choice of drug connect to which emotions?

Answer 14

1. Opiates: pain, distress, overwhelming emotions, aggressive tendencies, anger, guilt
2. Cocaine: low self-esteem, deficits in expression of emotions, emptiness, depressive tendencies
3. Sedatives and hypnotics: anxiety, inhibition

Question 15

4. 
Basic principles of psychodynamic theories


(Leeds & Morgenstern, 1993, 1996)

Answer 15

1. Substance use is a manifestation of a latent psychological problem
2. Problems in the regulation of affect and pathological object relations are core difficulties
3. The psychological problem causes substance use
4. The view substance abuse disorders as homogenous

Question 16

Personality traits pron to addiction

Answer 16

Neuroticism, Sensation Seeking, Impulsiveness, Alexithymia

Question 17

TRUE/FALSE

Emotional complexity was a stronger predictor than emotional intelligence in university student

Answer 17

TRUE

Question 18

TRUE/FALSE

The higher the frequency of drug use, the lower the level of emotional complexity

Answer 18

TRUE

Question 19

Family of drug users

Answer 19

1. pathological family system
2. family homeostasis
3. Secondary gain
4. sabotage against recovery

Question 20

Family of an opiate addict (males)

Answer 20

1. Missing father -> blocked identification
2. Symbiotic relationship with mother
3. Deficits in communication and expression of emotions

Question 21

Family of an Amphetamine addict

Answer 21

Losing the father
Low-love
high hostility
Substance use parents

Question 22

Family of a Hallucinogens, cannabis users

Answer 22

Low love
high hostility
Symbiotic relationships
Low level of attachment