'Alcoholism and Addiction.': Ernest Simmel.

Psychoanalytic Quarterly, Vol. XVII, 1948, No. 1, p. 6.

The author's first premise is that the effect of alcohol depends on the use that the ego derives from it. He then differentiates four groups: the social drinker, the reactive drinker, the neurotic drinker and the alcoholic addict. In the first two groups alcohol defends the ego against external circumstances, whereas it serves the latter two classes to defend their ego against unconscious conflicts. The social drinker is defined as one who is dependent on the consumption of liquor for the enjoyment of social companionship. The reactive drinker suffers too much deprivation or suppression of instinctual desires in his personal life.

The neurotic drinker seeks to escape from his self-inflicted misery. Unconscious incestuous identifications may approach the surface and precipitate alcoholism in the neurotic. The elation revives and replaces orgastic sensations experienced in the remote past. It releases instinctual energies withdrawn from the object. This pattern of behaviour very often repeats the way he hid his masturbation from his parents. These patients frequently have had parents whose attitudes combined an incestuous seductiveness along with a puritanical attitude toward sex. Thus multiple super-egos are developed.

If the ego regresses beyond the phallic, the anal and oral stage (gastro-intestinal stage), the alcoholic becomes an addict.

The elation re-establishes the infantile pleasure principle within the conscious mind of the alcoholic. The urge for sexual contact with an object is replaced by a desire to devour it—the original identification by devouring. Many of his patients were caught as children in the midst of an orgastic elation. In bouts of drinking the addict becomes again a baby with only one object—his mother.

Everything connected with acting out their addiction has symbolic meaning—drink the last drop—to finish baby's bottle, beer and urethral pleasures, etc.

All of his alcoholic patie