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This volume offers a rich medley of papers on addiction, its definition expanded to include compulsive sexuality. This monograph is part of
the Workshop Series of the American Psychoanalytic Association and is based on presentations at two seminars for clinicians co-sponsored by the national and local organizations in Washington and Baltimore in 1990. The editor has divided the book into two sections; the first, six clinical and theoretical presentations and the second, four discussions. The book is well written and is an excellent update on the field of addiction from a psychoanalytic perspective, circa the 1990's. It explodes the myth that all that patients with addictive disorders need is treatment that utilizes a disease model and the A. A. philosophy and that psychoanalytic psychotherapy has nothing to offer. Actually, it turns out that all the authors agree that dynamic treatment, in their sampling, is immensely valuable. They agree, too, that addiction is a description rather than a diagnosis, since all character types seem to be represented, each with a segment of personality displaying the addictive character structure, i.e., imperative, dependent, driven to repetitive actions, and self-destructive. The case examples are excellent.
Also, advances in theory and conceptually linked modifications in technique speak eloquently to the maturity of the field, fully incorporating developmental psychoanalytic theory into their undertaking. Most, but not all, utilize varying object relations and self-psychological models that posit early deficiency in the mother-infant bond, from premature symbiotic disruption to the lack of a holding environment. The ensuing helplessness from this overwhelming psychic trauma causes a fixation and longing to return to mother, with consequent longing for an archaic self-object merger transference. The failure in internalization of self-regulating, self-soothing structures, especially regarding affect tolerance, tension regu