Addictive states of mind

Addictive States of Mind is published as part of the Tavistock Clinic Series and is edited by Marion Bower, Robert Hale and Heather Wood. The book contains a foreword, an introduction by the editors and 10 chapters, each tackling the issue of addiction from a particular clinical or organisational perspective influenced by psychoanalytic thinking. The contributors include clinicians from the Tavistock and Portman clinics as well as those working in substance misuse services and inpatient units.

Vanessa Crawford's opening chapter ‘Challenges in a substance misuse service’ describes the complex pathologies of addicts and the difficulties involved in trying to build trusting relationships with a patient group whose survival can depend on avoiding and/or perverting intimacy in order to protect their addiction. The chapter not only highlights the depth of thinking required to support each individual patient but also stresses how important it is to develop an awareness of how the behaviours of the patient group can be replicated in the staff group. Crawford's paper courageously sets the tone for the diverse yet complementary clinical perspectives covered in the 10 chapters, each of which feels to be the result of a tenacious and passionate struggle to understand addiction, addictive behaviours and the complicated conscious and unconscious dynamics present when working with these patients.

As well as chapters which discuss issues related to adults addicted to drugs, alcohol, gambling, sex and paraphilias, Biddy Youell explores how children of addicted parents can become caught up in intergenerational addiction and Marion Bower considers adolescents' use of alcohol as a factor in the organisation of their defences against re-emerging infantile anxieties. Searching questions are asked throughout the book. For example, Susannah Rose discusses the difficulties in classifying anorexia nervosa as an addiction rather than an addictive behaviour. Angela Foster in her chapter on femal