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In this rather complete treatment of addictions, the reader is presented with a book that allows for an overview of this complicated field. The editors have obviously taken great effort to approach the area from various perspectives: historical, social, psychosocial, and behavioral. What this reviewer found enlightening was their excellent review of the literature, from earlier researchers and authors to the more recent ones.
The historical section deals with selections from Brechner's “Licit and Illicit Drugs”. In this chapter, one is reminded that society's attempt to suppress drug abuse usually lead to an “increased interest in, and use of drugs,” and has “created new drug problems”, and served only to compound the effects of the drug problem by imposing restrictions and punishment upon users. The section on the psychodynamics of addiction was one in which the various contributors such as Zinberg, Rado, Chein, Vaillant, Wurmser, and Krystal give the psychologist, mental health practitioner, and psychoanalyst a series of approaches that will be most useful in daily practice, as well as in methadone clinics, hospitals, or therapeutic communities. The discussions range far afield. We witness the thinking of Rado, who in his earliest writings in 1933 spoke of the importance of looking at “the nature of the psychic situations which makes acute demands,” on the mental life of the patient.
Chein's approach through his classic book “The Road to H” opened the door to the need for us to look at the level of certain defenses, to the unconscious process as well as the psychophysiological reactions of the abuser. Wormser's “Psychoanalytic Consideration” chapter adds to our understanding of the dynamics of the addict in that he speaks of the concurrent causes and the defect of affect defenses as well as the faulty formation of the ego ideal.
Krystal's and Raskin's theory of the developmental history of affect adds to our understanding of affect disturbances in drug dependence, th