Relational perspectives on the nature of self and the unconscious have transformed how we can understand addictions and substance use problems. Addictions have received little attention in the contemporary literature and therapeutic approaches outside of psychoanalysis have been skeptical of psychoanalytic approaches. It is my contention that viewing substance use problems through the lens of a relational/multiple self-state model offers new clinical possibilities resulting in greater success in treating these patients. In this model, addictive behavior is seen as embedded in dissociated self-states. Therapy focuses on helping the patient to move from dissociation to a true multiplicity and a decreased dependence on substances.