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March 26, 1968. PANEL ON 'DRUG USE BY ADOLESCENTS'. Aaron Esman, M.D., Dora Hartmann, M.D., Ted E. Becker, M.D., Eugene H. Kaplan, M.D.
Dr. Esman observed that the use of amphetamines, barbiturates, tranquilizers, LSD and its congeners, and marijuana is so widespread that it may be regarded statistically as almost a normative aspect of a developmental phase, and cannot be dismissed as acting out or resistance in treatment. Such drug usage must be approached by dealing first with the defenses that guard it and the conflicts from which it has sprung. The analyst of the drug user must deal with the practical issue of whether prohibition of use of the drug is required in order to make analytic treatment possible, or whether the drug use can be dealt with through the analytic work. Esman presented three clinical examples.
Dr. Hartmann discussed the difference in adolescent responses to the temptation to use drugs in a habitual fasion. In drug-using patients studied by the American Association for Child Psychoanalysis, classical psychoanalysis usually could not be maintained. However prohibition would have led to immediate treatment interruption. Drug-takers who cannot give up the drug are usually passive, depressed, and are unable to be close to others in reality; with drugs they experience an illusion of closeness.
Dr. Becker reported the case of a young woman in intensive psychotherapy for six years. Her drinking, drug-taking, and promiscuity were associated with childhood nighttime abandonment. Intolerance to psychic pain made analysis or satisfactory object relationships impossible. Dr. Kaplan presented a case of a male college student, treated for nine months without effect. Drug usage (LSD) dominated his daily life and was a means of temporarily abolishing his chronic depression and replacing his rage with a feeling of loving everyone without having to be close to anyone.