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This clinical study offers a hypothesis concerning pathological drinking. Seven patients who received intensive psychotherapy are described. According to Higgins, psychoanalysis at present regards alcoholism as resulting from a sequence
of events: threat of oral narcissistic deprivation, anxiety, drinking, elation. But Higgins believes that the anxiety allayed by drinking is specifically related not only to oral but also to sadistic, genital-sexual, and other impulses. The alcohol may diminish awareness of internal or external stress, or, by its depressant action, may facilitate the operation of a mechanism of defense.
The initial stages of alcoholism thus arise out of a variety of psychological conflicts. These conflicts continue to be the specific causes of the drinking as long as it is moderate. However as the drinking continues, the pleasure of intoxication, rather than the relief from the original anxiety, becomes the goal, and the early specific psychodynamic conflict is overshadowed by the nonspecific oral narcissistic gratifications.