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The case used in this paper is a complicated, multifaceted one. However, to illustrate a few thoughts on technique, one of its salient features will be singled out; namely, that of drug addiction—the 'step-child of psychosis'.
The problem of addiction began to appear in psycho-analytic literature (3), (16) about three decades ago. Earlier Freud (7) had remarked on the relation between the desire for drinking and smoking and lip erotism, and Abraham (1) had observed the psychological relations between sexuality and alcoholism, equating perversion with addiction. Following Freud's Schreber case (8), latent homosexuality came to be considered the important aetiological factor in alcoholism, and addiction was suspected to be strongly connected with paranoid psychoses.
In discussing the erotic and destructive tendencies in drug addiction, Rado (17), (18) included in oral erotism not only the mouth region, but also the stomach and intestines, the processes of digestion and absorption, and the diffused sense of well-being which he called 'alimentary orgasm'.
Glover (10), (11), (12) considered that Rado's idea of alimentary orgasm postulated a constitutional element which, being prestructural, could have no psychic content. Glover suggested, instead, a specific psychological aetiology of addiction implying a fixation to a primitive oedipal system as a defence against violent sadistic impulses. He did not consider homosexual manifestations as direct aetiological factors, but as restitutions that have strong libidinal cathexes. Drugs represent a transition between the externalized sadism of a paranoid system and the internalized sadism of a melancholic system. Addiction is thus an improvement on paranoia as an attempt to deal with an early depressive pattern.
As to therapeutic attempts, Simmel (21) described treating addicts with a combination of milieu and psycho-analytically oriented therapy. He believed suicide was a possible danger in a régime of imposed abstinence.