Treating Addiction

Beyond the Pain

By (author) Edward J. Khantzian Foreword by Martin Weegman

Publication date:

13 February 2018

Length of book:

292 pages

Publisher

Rowman & Littlefield Publishers

ISBN-13: 9781538108574

In Treating Addiction: Beyond the Pain, Edward Khantzian offers a collection of his recent works on the study and treatment of substance abuse and addiction. Based on his five decades of experience in working with substance dependent individuals, this volume builds upon Khantzian’s theory of addiction as self-medication and provides insights into how addiction is rooted in human psychological suffering, and not pleasure seeking or self-destruction. Almost without exception, life histories of human discomfort, disconnection, and unhappiness leave those so burdened to be vulnerable to the appeal of addictive drugs, including alcohol. Khantzian’s sensitive teaching voice weaves together an annotated collection of previously published papers into a powerful and engaging volume of effective practice-based treatments. A timely complement to his earlier collection Treating Addiction as a Human Process, this book provides an inclusive and accessible resource for mental health professionals from any background as well as graduate students and those in training.

Foreword by Martin Weegmann
Introduction
Part I. The Internal Terrain of Addiction Psychodynamics
1. Understanding Addictive Vulnerability: An Evolving Psychodynamic Perspective

2. Questions of Substance: Psychodynamic Reflections On Addictive Vulnerability and
Treatment

3. Addiction: Why Are Some of Us More Vulnerable Than Others
4. The Capacity for Self-Care and Addiction

5. The Self-Medication Hypothesis and Attachment Theory: Pathways for Understanding and
Ameliorating Addictive Suffering

Part II. The Self-Medication Hypothesis Revisited
6. The SMH and Addiction as a Problem in Self-Regulation
7. The Self-Medication Hypothesis Revisited: The Dually Diagnosed Patient
8. Self-Medication Hypothesis: Connecting Affective Experience and Drug Choice
9. The Self‐Medication Hypothesis and Psychostimulant Treatment of Cocaine Dependence: An Update
10. The Psychodynamics of Addiction and Its Treatment: An Interview with New Therapist Magazine

Part III. Treatment of Addictive Disorders
11. Reflections on Group Treatments as a Corrective for Addictive Vulnerability

12. More Reflections on Group Therapy (Interview by Martin Weegmann)

13. ‘Dangerous Desires and Inanimate Attachments’: Modern Psychodynamic Approaches to Substance Misuse

14. Reflections on Treating Addictive Disorders: A Psychodynamic Perspective

15. A Psychodynamic Perspective on the Efficacy of 12-Step Programs
Part IV. Reflections and Lessons Learned
16. We Are All At Least a Little Lost and Off-Putting: On Transformation

17. Tragic Trends in the Treatment of Addictive Illness
18. Insights on the Insanity of Addiction
19. The Cruel Scourge of Addiction: An Addiction Psychiatrist’s Clinical View
20. Life Learned from Addictions
21. Psychophobia and Getting it Right
22. The Theory of Self-Medication and Addiction

In Treating Addiction: Beyond the Pain, Khantzian (Harvard Medical School) presents a collection of his previously published, seminal articles that explore the relevance of psychodynamic theory to the current understanding of addictions and their treatment. He traces the evolution of his thinking and provides supporting evidence specifically related to the self-medication hypothesis of addiction. In contrast to some other hypotheses, including recent neurobiological formulations, Khantzian posits that addictions are rooted in suffering and pain as opposed to pleasure. In his formulation, he humanizes those with substance use disorders, acknowledging their psychological vulnerabilities, quest to alleviate pain, and resiliency in the face of challenges. Through his use of case examples and vignettes, he fosters readers' empathy for people struggling with substance use disorders. This perspective is greatly needed at a time when such people continue to be stigmatized and judged. In presenting complex ideas about addictions, Khantzian uses a conversational style that promotes understanding and openness rather than defensiveness regarding alternative views. Throughout the book, he champions the idea of a “kinder understanding of addicted individuals” alongside a more integrated, humanistic approach to treatment.

Summing Up: Recommended. Graduate students through faculty and professionals.