The Use of Drugs by Teenagers for Sanctuary and Illusion

This Paper is a preliminary report on work that is in progress with patients who have used or are using one or more drugs over an extended period of time. The psychoanalytic approach with modifications is the particular technique being used with these individuals. With Karen Horney's concepts of human motivation as the frame of reference, the patients and I have been exploring their character makeup and patterns of behavior, dynamically and phenomenologically. The focus has been, and will continue to be, the total personality and its capacity to change, rather than the removal of the symptom, drug taking. In other words, we are working for greater health and less neurosis.

“Neurosis,” wrote Horney,¹ “is a psychic disturbance brought about by fears and defenses against these fears and by attempts to find compromise solutions for conflicting tendencies,.” The disturbance was called a neurosis only if it deviated from the pattern common to the particular culture. These intrapsychic and interpersonal conflicting tendencies disturb one's relation to himself and others. The conflicts generate anxiety which the individual attempts to handle as best he can. The more neurotic he is, the more rigidly compulsive will he be in coping with these conflicts. In fact, rather than trying to resolve them, many individuals first attempt to escape experiencing the anxiety. They may try to rationalize it, deny it, narcotize it, and avoid all situations, thoughts or feelings which might arouse it.

The period of life known as adolescences is at best a tumultuous time for all concerned. It is a time of flux, ebbs and flows, transitions, leaps and relapses. Periods of absolute certainty give way to periods of absolute doubt Periods of absolute doubt suddenly yield to stands of arbitrary rightness, rigid self-control, and cynicism. Swings from exuberance to despair and back again are not uncommon. It is a time of searching for solutions, often of a magical nature, frequently with a glorificati