The Self Psychology of Addiction and its Treatment

Narcissus in Wonderland

Richard B. Ulman, Harry Paul

• Verlag: Routledge
• Jahr: 2013
• ISBN:
  9781135451585
• Auflage: 1
• Thema: Psychologie
• Thema: Psychoanalyse

In the time of Freud, the typical psychoanalytic patient was afflicted with neurotic disorders; however, the modern-day psychotherapy patient often suffers instead from a variety of addictive disorders. As the treatment of neurotic disorders based on unconscious conflicts cannot be applied to treatment of addictive disorders, psychoanalysis has been unable to keep pace with the changes in the type of patient seeking help. To address the shift and respond to contemporary patients' needs, Ulman and Paul present a thorough discussion of addiction that studies and analyzes treatment options. Their honest and unique work provides new ideas that will help gain access to the fantasy worlds of addicted patients.

The Self Psychology of Addiction and Its Treatment emphasizes clinical approaches in the treatment of challenging narcissistic patients struggling with the five major forms of addiction. Ulman and Paul focus on six specific case studies that are illustrative of the five forms of addiction. They use the representative subjects to develop a self psychological model that helps to answer the pertinent questions regarding the origins and pathway of addiction. This comprehensive book links addiction and trauma in an original manner that creates a greater understanding of addiction and its foundations than any clinical or theoretical model to date.

Part I An Introduction to a Self-Psychological Model and Theory of Addiction

Chapter 1 Narcissus in Wonderland

THE NARCISSUS COMPLEX

The subtitle of this book, Narcissus in Wonderland, is more than a catchy phrase. We have borrowed the character of Narcissus from ancient Greek mythology, and in so doing, we have located this mythical figure in the wonderland of Lewis J. Carroll’s famous book for children, Alice’s Adventures in Wonderland (1865). In transporting Narcissus to wonderland, we are constructing a self-psychological allegory about the addicted patient as narcissistically disordered. Such a person is a lost soul who wanders aimlessly in an addictive “wonderland.”

According to Greek mythology (see, for example, Grimal, 1990; see also, Doty, 1993), Narcissus starved to death because he became so enamored and transfixed by his own image as it was reflected in a pool of water. The myth of Narcissus warns us that individuals can destroy themselves in the process of becoming fatally infatuated by the sight of their own reflected images. In moving from the mythological to the psychological, we can undertake a self-psychological reinterpretation of the underlying message of the story of Narcissus.

Our self-psychological reinterpretation would read as follows: early developmental forms of narcissism, and, especially those expressed as archaic narcissistic fantasies (see Ulman & Brothers, 1987, 1988 for a full explanation on the nature and function of these unconscious presences), possess the inherent power to induce a hypnoid state or hypnotic-like trance in an individual (see Abse, 1966; see also Dickes & Papernik, 1977, and Laplanche & Pontalis, 1988). In such a trance-like state, a person may become so mesmerized and self-absorbed as to become oblivious and indifferent to normal concerns about health and well-being.

Moreover, our self-psychological perspective emphasizes the importance of the fact that psychologically Narcissus loses himself in an image as reflected back to him by a pool of water. In the context of the Greek myth of Narcissus, the pool of water, although an inanimate and nonliving thing, takes on animate and almost semi-human qualities. It does so because it reflects back to Narcissus an image of his own human face. In this sense, therefore, Narcissus relates to and uses the pool of water almost as if it were another animate and living being.

According to Strozier (in Kohut, 1985), Kohut had a keen interest in Alice’s Adventures in Wonderland “from which he could always lovingly quote long passages” (p. 5). Thus, for the purpose of our study, we deem it fitting to bring together Narcissus from Greek myth and Alice from Wonderland. Together they create our self-psychological allegory about narcissism and addiction.

Moreover, there is a significant, yet somewhat obscure, etymological connection between narcissism and addiction. The words narcissism and narcotic, although seemingly unrelated, actually have the same Greek root, namely narke. The latter can be translated as numbness or numbing. It would appear, therefore, that both words refer to a kind of deadening of sensation or dulling of awareness. Indeed, narcissism and narcosis (a general term referring to any drug- or chemically induced stupor or state of unconsciousness) have similar implications. They both imply that consciousness or subjective awareness have been altered in the direction of self-absorption in the former and obliviousness in the latter.

Narcissism and narcosis (as synonymous with addiction) may be compared like this: in the case of narcissism an archaic form of self-love functions like a narcotic drug that induces a state of enraptured self-absorption; whereas, in the case of narcosis, a drug or other substance produces a narcissistic state of bliss characterized by an ecstatic trance and euphoric obliviousness. (See Rosenman, 1981, p. 545, for support of our connection between Narcissus and addiction.)

The Narcissus in wonderland of this book is an addict who is in love with an image of the self as dissociatively altered in the reflecting pool of narcissistic fantasy and mood. And, the wonderland that Narcissus inhabits is a domain in which magic and illusion reign supreme. A variety of psychoactive things and activities serve for an addict as magic wands creating spells that arise in the context of the dissociative alteration of conscious awareness. Narcissus, like Alice, undergoes many strange and bizarre adventures in an altered state of mind in which the surreal and fantastic become the norm.

We use our self-psychological allegory, in which we place the mythical character of Narcissus in Carroll’s magical Wonderland, to focus on a previously hidden and unconscious complex—the Narcissus complex. (See Hamilton, 1982, for a discussion of the importance of the myths of Narcissus and Oedipus for psychoanalytic theory; see also Rosenman, 1981, as well as Bruhm, 2001; Dufresne, 1996; Jacoby, 1985; Schwartz-Salant, 1982, for both Freudian and Jungian discussions on the importance of the myth of Narcissus to an understanding of narcissistic psychopathology.) This psychic constellation is analogous to and modeled after Freud’s famous Oedipus complex, which he discovered as the unconscious basis for both neurosis and psychosis. From his classical perspective, Freud (1953 [1916-1917]) argues that psychosexual and aggressive fantasies are the unconscious bedrock of the Oedipus complex and its accompanying neurotic and psychotic psychopathology.

In a clear anticipation of our concept of the Narcissus complex, Tartakoff (1966) contends that “infantile narcissistic fantasies” (p. 232) are at the unconscious core of what she calls the “Nobel Prize Complex” (p. 236). Tartakoff coins this evocative term in the course of describing the unconscious fantasy lives of a group of psychoanalytic patients. These patients are “exemplified by individuals who ... entertain ambitious goals: e.g., the wish to be President, to attain great wealth, to become a social leader or to win an ‘Oscar’” (p. 236). According to Tartakoff, two of the “infantile narcissistic fantasies” that unconsciously organize the “Nobel Prize Complex” are: “(1) the active, omnipotent fantasy of being the ‘powerful one,’ with grandiose features; and (2) the passive fantasy of being the ‘special one,’ chosen by virtue of exceptional gifts” (p. 237).

In linking the “infantile narcissistic fantasies” with the “Nobel Prize Complex,” first, she warns: “Nonetheless, whenever autonomous functioning remains irrevocably associated with grandiose narcissistic fantasies fostered in childhood, true autonomy may not be achieved no matter how great the individual’s potentialities” (p. 246, emphasis added). Then, she adds: “In this instance, one is reminded of an addiction which is characterized by an insatiable desire to recover an infantile state of gratification which can never be fulfilled in reality” (pp. 246-47, emphasis added).

We maintain, building on Taitakoff’s work, that an unconscious system of archaic narcissistic fantasies make up the Narcissus complex. The latter is expressed symptomatically or characterologically in the form of an addiction. More specifically, we believe that a fantasy of being a megalomaniacal self and empowered with magical control is at the center of the underlying system of illusions constituting the Narcissus complex. (For some recent studies of megalomania, see Lifton, 1999, and Steiner, 1999.)

In the case of addiction, such a narcissistic fantasy centers on a narcissistic illusion of a megalomaniacal being that possesses magical control over psychoactive agents (things and activities). These latter entities allow for the artificial alteration of the subjective reality of the sense of both one’s self and one’s personal world. Under the influence of these intoxicating fantasies, an addict imagines being like a sorcerer or wizard who controls a magic wand capable of manipulating the forces of nature, and particularly those forces of human nature. Eventually, a person becomes a captive of these addictive fantasies and then becomes an addict lost in a wonderland. A recent film by Darren Aronofsky entitled Requiem for a Dream—a movie based on a 1978 novel by Hubert Selby with the same title— presents a contemporary cinematic portrayal of addiction that is amazingly consistent with our own view. The main characters in this film are addicted to a variety of things and activities; however, all as different means to a similar end, namely, entering into an addictive fantasy state, or self-state. The characters from this movie are, therefore, remarkably similar to our addicted patients in being “fantasy junkies.”

The primary nature of their addiction, like that of our addicted patients, is therefore, to a fantasy [the end] rather than to any particular thing or activity [the means]. In both instances, fantasy assumes primacy in being the unconscious determinant of addiction, whereas the things and activities assume only a secondary status.

We are not alone in recognizing the importance of the myth of Narcissus (in contrast to Freud’s focus on the myth of Oedipus) to a psychoanalytic understanding of modern life and thought. First, there is Lasch’s famous book, The Culture of Narcissism: American Life in an Age of Diminishing Expectations (1979). In another instance, Alford (1988) analyzes the Greek myth of Narcissus as a basis for applying the psychoanalytic concept of narcissism to the study of modern schools of political theory. Or, to take another good example, Berman (1990) employs the Narcissus myth as the means by which he conducted his applied psychoanalytic study of narcissism as a hidden yet central dimension in the text of many modern novels.

And, Shay (1994) in his work, Achilles in Vietnam: Combat Trauma and the Undoing of Character, takes the Greek mythical figure of Achilles as a point of departure for an examination of posttraumatic stress disorder (PTSD) in Vietnam combat veterans. In essence, he argues that the Vietnam combat veteran is analogous to Achilles in being a modern-day version of the mythical warrior. And, like Achilles, the veteran of the Vietnam War is cursed with a fatal flaw—namely, an Achilles heel—that exposes him to emotional breakdown in the heat of battle. More specifically, Shay draws a parallel between Achilles and the Vietnam combat veteran in a fashion analogous to the way in which we compare Narcissus to an addict.

We follow the lead of Lasch, Alford, Berman, and Shay in utilizing Greek mythology to gain a psychoanalytic understanding of the unconscious dimension of modern phenomenon taking place in the contemporary world. In this sense, we are also following in Freud’s footsteps in returning to antiquity to understand modernity. (Nussbaum, 1994, turns this intellectual perspective on its head, so to speak. She takes modern thought on the nature of psychotherapy and the psychotherapeutic process as a lens through which to illuminate ancient Greek insights on psychic maladies and their remedy.)

ALICE IN WONDERLAND

Our notion of Alice as an addict lost in a wonderland in which both conscious awareness and subjective experience are radically changed by mind altering agents is not original to our work. The idea is inspired by the lyrics of a song, “Go Ask Alice,” by Jefferson Airplane, a popular rock group of the 1960s. The group sings about Alice’s adventures in Wonderland and the strange effects of mind and mood altering substances on her subjective sense of herself and her immediate surroundings.

For example, they sing about one drug making Alice bigger and another making her smaller. Clearly, there is an important implication based on the drug-induced distortions in Alice’s physical size. It stands as a metaphor related to the psychoactively induced metamorphosis which Alice undergoes as a result of using these potent agents.

Jefferson Airplane is not alone in reinterpreting Carroll’s Alice’s Adventures in Wonderland as an allegory for the dangers of addiction. Martha Morrison (1989) entitles her moving, autobiographical account of her hard won victory over drug addiction—White Rabbit: A Doctor’s Story of Her Addiction and Recovery. She uses the “White Rabbit” and the “Mad Hatter” of Carroll’s Alice for purposes similar to that of Jefferson Airplane.

In fact, Morrison begins her book with a long quote from the lyrics of “Go Ask Alice” written by Grace Slick; thereby making a clear connection between her book and the song. These lyrics describe the strange world Alice explores during her substance-induced trip. The lyrics include references to several addictive substances, such as pills, hashish, and mushrooms, all of which were drugs fads in the 1960s.

Both Slick and Morrison reinterpret Carroll's story of Alice on the basis of allegory. Both view it as a literary device alluding to the mind-altering and reality-bending effects of drugs. And, both song writer and autobiographer interpret the Alice story as containing an implicit warning to those considering or already using addictive drugs: an individual who uses these psychoactive agents can become an unwitting captive of an altered state of consciousness from which it is not so easy to escape.

We agree with Slick and Morrison regarding the underlying meaning of Alice’s Adventures in Wonderland. We also read it as a story warning about the dangers to a person who enters an addictive state of mind, with little or no regard for the deleterious effects to one’s mental health and well-being. From this vantage point, the story of Alice may be reinterpreted as follows: an individual who repeatedly alters consciousness over a long period of time through the addictive abuse of psychoactive agents may experience an initial sense of pleasure and euphoria; however, eventually, such a form of addictive repetition leads to the serious warping and distortion of a person’s sense of the subjective reality of self and the world.

From the perspective of the 1960s, we understand Slick and Morrison as reinterpreting Carroll’s story as a cautionary tale: it warns us that if we foolishly alter our state of mind, as Alice does through the careless use of magical potions, we risk becoming unwitting captives of these potent agents. As a result, we may lose ourselves in a surreal world which has been transmogrified from a blissful wonderland into a mortifying hell.

Unlike several other well-known literary artists and poets of the 18th and 19th centuries, it appears that Carroll was neither a user nor abuser of addictive drugs, such as cocaine and opium, both of which were commonly abused during that era. Yet, he is reputed to have had a perverse fascination with young girls—one bordering on what some might describe as a pedophilic perversion.

In a fashion similar to an addict, Carroll appears to have been obsessed, not, however, with drugs but with young girls; in addition, in some instances he was quite compulsive in his behavior toward them. For example, he was especially fond of taking pictures of nude little girls (J. Jackson, personal communication, 1993; see also Cohen, 1995, for a recent biography of Carroll). In this sense, Carroll is like an addict—both mentally obsessed with a particular thing and very compulsive in his behavior as regards it.

In the context of our current discussion, Carroll’s story about Alice’s Adventures in Wonderland may be viewed as symbolic of his unusual fascination with little girls. (See Greenacres, 1955b; Grotjahn, 1947; Schilder, 1938; Skinner, 1947 for psychoanalytic studies of Carroll and Alice’s Adventure in Wonderland. See also, Wullschläger, 1995, for a study of Carroll’s life and personal fantasies). As such, the story is reflective of both the obsessive and compulsive nature of Carroll’s preoccupation with young girls.

It appears that both perversion and addiction share obsessive-compulsive characteristics. Perhaps this helps to account for the respective positions of Jefferson Airplane and Martha Morrison regarding the allegorical nature of Carroll’s story. Indeed, they believe it is an allegory that Carroll intended as a warning. He warns about the inherent dangers attendant to the use (abuse) of psychoactive agents that radically alter one’s sense of the subjective reality of oneself and one’s personal world.

However, Carroll is by no means the only 18th/19th century author who can be interpreted as writing allegorically about drug-induced states of phantasmagorical transmogrification. For example, Robert Louis Stevenson’s The Strange Case of Dr. Jekyll and Mr. Hyde, originally published in 1886, may be read similarly as an allegorical story about Stevenson’s probable experiences with cocaine (see, for example, Schultz, 1971). Or, to cite another instance, Samuel Taylor Coleridge’s “Kubla Khan,” written in the late 1790s, may be interpreted as an allegorical description of his experiences with opium (see, for example, Marcovitz, 1964; Weissman, 1989).

Moreover, both Stevenson’s Dr. Jekyll and Mr. Hyde and Coleridge’s “Kubla Khan” were probably written in the midst of each author’s abuse or dependence on, respectively, cocaine and opium. In addition, both works appear to have been imaginative creations emanating from the dreams of these two authors.

Writing about Stevenson, Schultz (1971) notes: "Jekyll and Hyde was the product of a fantastic dream" (p. 91, emphasis added). Marcovitz (1964) observes about “Kubla Khan“ that Coleridge was ”an opium addict and ... he had said that the poem was dreamed during an opium sleep" (p. 411). Marcovitz adds: “On re-reading the poem, it suddenly appeared to me as a dream epitomizing the psychology of addiction” (p. 411).

We take seriously the suggestions of both Schultz and Marcovitz concerning the dream-like, and hence, unconscious origins of Dr. Jekyll and Mr. Hyde and “Kubla Khan.” It is possible, therefore, that by employing the standard technique of psychoanalysis we can analyze these works as if they were dreams. Thus, we can arrive at a psychoanalytic interpretation of these works as the unconscious expression of the addictive fantasies of the respective authors. For example, Marcovitz states:

I believe that the poem provides us with the most elegant example in all literature of the fantasy which the addictive drug fulfills, together with the evidence fo...