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Treating Addiction as a Human Process contains the collected works of Edward Khantzian, thirty-seven articles or book chapters published between 1972 and 1997. Khantzian has added three new chapters, made minor modifications to previously published works, and provided introductions to each of the five sections. His target audience includes patients and their families, as well as students and clinicians. His goal of inclusiveness, both in terms of material and readership, makes this a valuable sourcebook.
During three decades of work with underserved and stigmatized patients, Khantzian has maintained that his psychoanalytic sensibility is his strongest asset; as suggested in the book's title, addiction is a human process. “Drug dependence,” he writes, “is intimately tied to the individual's attempt to cope with his or her internal emotional and external social and physical environment” (p. 65). Accordingly, he uses the empathic treatment relationship as “a valuable source of information for identifying and understanding the psychological vulnerabilities of addicts and how such vulnerabilities might motivate a reliance on drugs” (p. 204).
Khantzian, a master of the addiction literature, is able to cite the nonanalytic literature in support of his work. At one point he states, “In this section I sample material from the genetic-behavioral and psychodiagnostic perspective and compare them to a clinical perspective with a psychoanalytic orientation”; he asserts that his contributions are “complementary rather than competitive” (p. 369).
With relatively few analytic colleagues, Khantzian has been able to make psychoanalysis a force in the field of addiction. Several of his most enduring contributions deserve specific mention. The self-medication hypothesis, which appeared in its final form as a lead article in the Am. J. Psychiatry in 1985, is perhaps most