Addiction has long been deeply misunderstood in both our culture and clinical practice.  Rather than being a reflection of impulsivity or self-destructiveness, or a result of genetic or physical factors, addiction can be shown to be a psychological mechanism that is a subset of psychological compulsions in general.  Correspondingly, for many people addiction is best understood and treated in psychodynamic psychotherapy.  Over the past thirty-five years progress has been made in understanding addictions from a psychological perspective, and in the past 15 years I've developed a new model of addiction that permits a comprehensive view of the nature of addictive behavior.

Through working intensively with people suffering with alcoholism and other addictions, psychoanalysts have learned about many psychological factors that contribute to addictive behavior. Some people use their behavior (drinking, gambling, eating, and others) as a way to "treat" or lessen feelings that seem overwhelming at the time, such as sadness, anger or shame. These feelings seem less intolerable when they are performing their addictive behavior.  People also sometimes perform addictive acts to be free of self-critical feelings. They find that they can be gentler with themselves when they drink, for example.  For others, taking a drug or eating or gambling substitutes for a loved person whom they have lost. They make, in effect, a new relationship with the bottle or the racing track, a relationship that they never have to lose.  In other instances, people use addictive behavior to repair a feeling of deep disappointment with others, or with their image of themselves.  Drinking or eating serves to create a sense that the world is as it should be, or that they are as valuable as they feel they should be.

Starting over 20 years ago, I began writing about a new way to understand addictions and their treatment, a way that encompasses previous ideas while getting to the fundamental issues that underlie all of them.  I've found that addictive acts serve as a way to restore a sense of power when a person feels helpless.  The drinking, gambling, cleaning, eating expresses the great anger people feel at being made powerless, and at the same time the act  itself restores a sense that they can control their own feelings through their own actions.

Once people understand their addictive behavior tnen, as with any behavior, they are finally in a position to master it.  Trying to change one's behavior without understanding it is like trying to fight a tiger while wearing a blindfold.