Chapter 7: Psychic Helplessness and the Psychology of Addiction

I will discuss the papers in this symposium from the perspective of the role in addiction of psychic helplessness and of the narcissistic rage it produces in addiction vulnerable individuals. I will begin by summarizing my views (Dodes, 1990). The essence of psychic trauma is a state of being helplessly overwhelmed by affects, which produces great anxiety. The maintenance of a sense of control over one's own affective state is therefore an essential self-regulatory mechanism, and may also be considered a central aspect of narcissism. Addictive behaviors are sought because they provide a way to achieve a sense of internal emotional control over psychic helplessness. Drugs, for example, are “a device par excellence for altering, through one's intentional control, one's affective state” (Dodes, 1990, p. 401). In addition, drugs are able to reestablish a sense of power without any pharmacologic effect having occurred, as in the commonly reported experience of alcoholics who feel relief at the point they order a drink, or the point of beginning to drink it. Something has been accomplished by the act alone of obtaining the drug. I've viewed this as a signal satisfaction (analogous to signal anxiety) of the drive to reestablish mastery. By starting the chain of events which will lead to