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Although short on clearly defined and specifically devised treatment plans, psychoanalysis is long on theories claiming to explain the etiology and psychodynamics of substance abuse. Psychoanalytic theories and approaches to the treatment of substance abuse have gone through three different major cycles, corresponding to the theoretical dominance of id psychology, ego psychology and object relations theory, as well as theories of narcissism and the self. We believe that, together, self psychology and the work of Stolorow and collaborators (see, for example, Atwood and Stolorow, 1984; Ulman and Stolorow, 1985; Stolorow, Brandchaft, and Atwood, 1987) on psychoanalytic phenomenology and intersubjectivity offer possibilities for advancing the psychoanalytic understanding and treatment of substance abuse disorders.
Kohut (1977a) contended that the potential “explanatory power of the new psychology of the self” (p. vii) was especially great in the area of “the addictions”. He (Kohut and Wolf, 1978) subsequently mentioned “addictive behavior” (p. 416) as a major symptom of narcissistic behavior disorders. Unfortunately, however, with a few noteworthy exceptions in the application of self psychology to the eating disorders (see, for example, Geist, 1984; Goodsitt, 1984; Brenner, 1986), self psychologists have failed to follow Kohut's lead by