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Anxiety and depression have always been the inevitable accompaniments of human existence. Prior to the advent of psychoanalysis, material, rather than verbal, solutions leading to diminution or total suppression of these affects were the order of the day. Alcoholic beverages, tobacco, opium, cocaine, and mind-enhancing drugs such as mescaline and a host of others were ubiquitous in all civilizations. Until the mid-20th century, when it was finally banned, inordinately large numbers of the inhabitants of China were addicted to opium. In recent decades we have seen the addition of crack cocaine, LSD, and many other substances that have plagued all societies without exemption. Individuals who became addicted did not have, or would not allow themselves, the luxury of thoughtful contemplation as a means of understanding their compelling need and thus to attempt to delay or avoid a chemical, or action-oriented, defense.
Psychoanalysis has tried to implant a “stop” sign on the pathway of this source of impulse gratification, but with questionable results. The idea of using thoughts along with the verbal expression of their associated feelings was at first a very exciting notion. But little did the psychoanalytic pioneers appreciate the granitelike strength of the resistance of the substance abusers to interference with their need for immediate gratification. As a result, psychoanalysts and psychoanalytically informed therapists have thrown up their arms in surrender. To fill the void, the modalities of group involvement were created, for example, Alcoholics Anonymous (AA), Drugs Anonymous (DA), and the like, all of which have claimed varying degrees of success.
In the book under review, another attempt has been made to introduce psychoanalysis into the therapeutic armamentarium used