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Professor Khantzian shares an emotion-regulation- centered depth-psychological perspective on addictive processes. Rather than critique his even-handed coverage, I would merely supplement his views with some current neuroscientific perspectives in the area. There is still a vast chasm between these approaches, and the needed bridges can only sustain commerce if there is substantive building from both sides with concrete empirical predictions that can be evaluated in laboratory and clinic. To some extent that has already happened, with the recognition by both sides that certain evolved psycho-neuro mechanisms of the brain, such as the mesolimbic and mesocortical dopamine SEEKING pathways (ML/MC DAp), are essential in all kinds of appetitive urges, including ones related to most drugs of abuse (Berridge & Robinson, 1998; Ikemoto & Panksepp, 1999; Kelley, 1999; Koob & Le Moal, 2001; Wise, 1998). However, I will highlight certain problems that still impede progress across the modest bridges that we already have, in the hop that those fragile constructions can be replaced by sturdier ones.
The key issue for depth-psychology is how to utilize the emerging neuroscientific knowledge to hew new insights. I think this largely boils down to evaluating and utilizing the new neurochemical/ psychopharmacological manipulations that modern neuroscience has provided in ways that permit ever more rigorous evaluation and characterization of