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Dear Sirs,
Sergio de Paula Ramos (2004) presents a view of addiction that is inaccurate. In attempting to formulate a psychodynamic basis founded on the pathology of the father, he overlooks a fact that he notes himself: that no single psychodynamic formulation could possibly apply to such a heterogeneous group. Indeed, people with addictions have a very wide range of psychological issues and structures ranging from quite primitive to quite healthy. Further, it is not enough to say, as de Paula Ramos does, that descriptors such as ‘narcissists … those with oral-sadistic issues, latent homosexuality and other perversions’ (I also disagree with categorizing homosexuality as a perversion) are also present in people without addictions, or not present in all people with addictions. What needs to be emphasized is that these traits—being neither necessary nor sufficient—are irrelevant to the nature of addiction. The psychology of addictive behavior, in fact, can be shown to be identical to that of most compulsive behavior (Dodes, 1996); no one would claim such broad generalizations of people with compulsive symptomatology.
Describing addictions as somehow fundamentally different from other forms of symptomatology, such as compulsions, is an old error in both our literature and social thinking; however, the literature about addiction of the past 30 years has generally eschewed the kind of overgeneralization and over-pathologizing of de Paula Ramos's paper, favoring more nuanced examination of addictive behavior as an ego function. De Paula Ramos's repeated reference to his subjects as ‘chemically dependent patients (CDPs)’ compounds the mistaken separation of these patients by labeling them according to one form of addiction (physical addiction to drugs). Chemical dependency or physical addiction is a relatively insignificant factor in the nature of addiction, a fact that has been noted by a number of writers and is shown by the many people who easily and frequently shift fro