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Review Article

Self-medication, traumatic reenactments, and dissociation: a psychoanalytic perspective on the relationship between childhood trauma and substance abuse

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Pages 443-466 | Received 24 Jun 2023, Accepted 15 Oct 2023, Published online: 09 Nov 2023

References

  • Alexander, F. (1950). Analysis of the therapeutic factor in psychoanalytic treatment. Psychoanalytic Quarterly, 19(4), 482–500. https://doi.org/10.1080/21674086.1950.11925819
  • Alexander, F., & French, T. M. (1946). Psychoanalysis and psychotherapy: Principles and application. Ronald Press.
  • Alfonso, C. A. (2021). An overview of the psychodynamics of addiction. Psychodynamic Psychiatry, 49(3), 363–369. https://doi.org/10.1521/pdps.2021.49.3.363
  • Alvarez-Monjaras, M., Mayes, L. C., Potenza, M. N., & Rutherford, H. J. V. (2019). A developmental model of addictions: Integrating neurobiological and psychodynamic theories through the lens of attachment. Attachment & Human Development, 21(6), 616–637. https://doi.org/10.1080/14616734.2018.1498113
  • American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th rev. ed.). https://doi.org/10.1176/appi.books.9780890425787
  • Atwood, G., & Stolorow, R. (1984). Structures of subjectivity: Explorations in psychoanalytic phenomenology. The Analytic Press.
  • Bartholomew, K., & Horowitz, L. M. (1991). Attachment styles among young adults: A test of a four-category model. Journal of Personality and Social Psychology, 61(2), 226–244. https://doi.org/10.1037/0022-3514.61.2.226
  • Bateman, A., & Fonagy, P. (2006). Mentalization-based treatment for borderline personality disorder: A practical guide. Oxford University Press.
  • Baudin, G., Barrault, S., El Ayoubi, H., Kazour, F., Ballon, N., Maugé, D., Hingray, C., Brunault, P., & El-Hage, W. (2022). Childhood trauma and dissociation correlates in alcohol use disorder: A cross-sectional study in a sample of 587 French subjects hospitalized in a rehabilitation center. Brain Sciences, 12(11), 1483. https://doi.org/10.3390/brainsci12111483
  • Baurer, F. M. (2021). Psychodynamic treatment with the addicted person. Psychodynamic Psychiatry, 49(3), 404–424. https://doi.org/10.1521/pdps.2021.49.3.404
  • Beebe, B., & Lachmann, F. M. (1998). Co-constructing inner and relational processes: Self- and mutual regulation in infant research and adult treatment. Psychoanalytic Psychology, 15(4), 480–516. https://doi.org/10.1037/0736-9735.15.4.480
  • Beresford, T. P. (2012). Psychological adaptive mechanisms: Ego defense recognition in practice and research. Oxford University Press.
  • Bifulco, A., & Schimmenti, A. (2019). Assessing child abuse: “we need to talk!” Child Abuse & Neglect, 98, 104236. https://doi.org/10.1016/j.chiabu.2019.104236
  • Borgogno, F. (2007). Ferenczi’s clinical and theoretical conception of trauma: A brief introductory map. The American Journal of Psychoanalysis, 67(2), 141–149. https://doi.org/10.1057/palgrave.ajp.3350022
  • Bromberg, P. M. (1998). Standing in the spaces: Essays on clinical process, trauma, and dissociation. Analytic Press.
  • Bromberg, P. M. (2013). Prefazione [Foreword]. In V. Caretti, G. Craparo, & A. Schimmenti (Eds.), Memorie traumatiche e mentalizzazione, teoria, ricerca e clinica (pp. 7–12). Astrolabio Ubaldini.
  • Bryant, R. A. (2007). Does dissociation further our understanding of PTSD? Journal of Anxiety Disorders, 21(2), 183–191. https://doi.org/10.1016/j.janxdis.2006.09.012
  • Caretti, V., Gori, A., Craparo, G., Giannini, M., Iraci-Sareri, G., & Schimmenti, A. (2018). A new measure for assessing substance-related and addictive disorders: The addictive behavior questionnaire (ABQ). Journal of Clinical Medicine, 7(8), 194. https://doi.org/10.3390/jcm7080194
  • Carlson, E. B., Dalenberg, C., & McDade Montez, E. (2012). Dissociation in posttraumatic stress disorder part 1: Definitions and review of research. Psychological Trauma: Theory, Research, Practice, & Policy, 4(5), 479–489. https://doi.org/10.1037/a0027748
  • Carlson, E. B., & Putnam, F. W. (1993). An update on the Dissociative Experiences Scale. Dissociation: Progress in the Dissociative Disorders, 6(1), 16–27.
  • Chefetz, R. A. (2015). Intensive psychotherapy for persistent dissociative processes: The fear of feeling real. WW Norton & Company.
  • Dalenberg, C. J., Brand, B. L., Gleaves, D. H., Dorahy, M. J., Loewenstein, R. J., Cardeña, E., Frewen, P. A., Carlson, E. B., & Spiegel, D. (2012). Evaluation of the evidence for the trauma and fantasy models of dissociation. Psychological Bulletin, 138(3), 550–588. https://doi.org/10.1037/a0027447
  • Dvir, Y., Ford, J. D., Hill, M., & Frazier, J. A. (2014). Childhood maltreatment, emotional dysregulation, and psychiatric comorbidities. Harvard Review of Psychiatry, 22(3), 149–161. https://doi.org/10.1097/HRP.0000000000000014
  • Dye, H. (2018). The impact and long-term effects of childhood trauma. Journal of Human Behavior in the Social Environment, 28(3), 381–392. https://doi.org/10.1080/10911359.2018.1435328
  • Ferenczi, S. (1932/1988). The clinical diary.
  • Frewen, P., & Lanius, R. (2015). Healing the traumatized self: Consciousness, neuroscience, treatment. WW Norton & Company.
  • Glover, E. (1932a). On the aetiology of drug-addiction. International Journal of Psychoanalysis, 13, 298–328.
  • Glover, E. (1932b). The relation of perversion-formation to the development of reality-sense. In E. Glover (Ed.) (1956), On the early development of mind (pp. 216–234). Imago Publishing Co.
  • Goldberg, A. (1995). The problem of perversion: The view from self psychology. Yale University Press.
  • Goldberg, A. (1999). Being of two minds: The vertical split in psychoanalysis and psychotherapy. Analytic Press.
  • Granieri, A., Guglielmucci, F., Costanzo, A., Caretti, V., & Schimmenti, A. (2018). Trauma-related dissociation is linked with maladaptive personality functioning. Frontiers in Psychiatry, 9, 206. https://doi.org/10.3389/fpsyt.2018.00206
  • International Society for the Study of Trauma and Dissociation. (2011). Guidelines for treating dissociative identity disorder in adults (Third revision). Journal of Trauma & Dissociation, 12(2), 115–187. https://doi.org/10.1080/15299732.2011.537247
  • Khantzian, E. J. (1985). The self-medication hypothesis of addictive disorders: Focus on heroin and cocaine dependence. The American Journal of Psychiatry, 142(11), 1259–1264. https://doi.org/10.1176/ajp.142.11.1259
  • Khantzian, E. J. (1997). The self-medication hypothesis of substance use disorders: A reconsideration and recent applications. Harvard Review of Psychiatry, 4(5), 231–244. https://doi.org/10.3109/10673229709030550
  • Khantzian, E. J. (1999). Treating addiction as a human process. Jason Aronson.
  • Khantzian, E. J. (2003). Understanding addictive vulnerability: An evolving psychodynamic perspective. Neuropsychoanalysis, 5(1), 5–21. https://doi.org/10.1080/15294145.2003.10773403
  • Khantzian, E. J. (2012). Reflections on treating addictive disorders: A psychodynamic perspective. The American Journal on Addictions, 21(3), 274–279. https://doi.org/10.1111/j.1521-0391.2012.00234.x
  • Khantzian, E. J. (2021). Psychodynamic psychotherapy for the treatment of substance use disorders. In N. el-Guebaly, G. Carrà, M. Galanter, & A. M. Baldacchino (Eds.), Textbook of addiction treatment (pp. 383–389). Springer. https://doi.org/10.1007/978-3-030-36391-8_26
  • Kilborne, B. (2002). Disappearing persons: Shame and appearance. State of University New York Press.
  • Klein, M. (1935). A contribution to the psychogenesis of manic-depressive states. International Journal of Psychoanalysis, 16, 145–174.
  • Kluft, R. P. (1984). Aspects of the treatment of multiple personality disorder. Psychiatric Annals, 14(1), 51–55. https://doi.org/10.3928/0048-5713-19840101-09
  • Kohut, H. (1971). The analysis of the self: A systematic approach to the psychoanalytic treatment of narcissistic personality disorders. University of Chicago Press.
  • Kohut, H. (1977). The restoration of the self. University of Chicago Press.
  • Krystal, H. (1995). Disorders of emotional development in addictive behavior. In S. Dowling (Ed.), The psychology and treatment of addictive behaviors (pp. 65–100). International University Press.
  • Lichtenberg, J. D., Lachmann, F. M., & Fosshage, J. L. (1992). Self and motivational systems: Towards a theory of psychoanalytic technique. Analytic.
  • Lichtenberg, J. D., Lachmann, F. M., & Fosshage, J. L. (1996). The clinical exchange: Techniques derived from self and motivational systems. Analytic.
  • Lichtenberg, J. D., Lachmann, F. M., & Fosshage, J. L. (2011). Psychoanalysis and motivational systems: A new look. Routledge.
  • Lindon, J. A. (1994). Gratification and provision in psychoanalysis should we get rid of “the rule of abstinence”? Psychoanalytic Dialogues, 4(4), 549–582. https://doi.org/10.1080/10481889409539038
  • Lotzin, A., Grundmann, J., Hiller, P., Pawils, S., & Schäfer, I. (2019). Profiles of childhood trauma in women with substance use disorders and comorbid posttraumatic stress disorders. Frontiers in Psychiatry, 10, 674. https://doi.org/10.3389/fpsyt.2019.00674
  • Mezzalira, S., Santoro, G., Bochicchio, V., & Schimmenti, A. (2023). Trauma and the disruption of temporal experience: A psychoanalytical and phenomenological perspective. The American Journal of Psychoanalysis, 83(1), 36–55. https://doi.org/10.1057/s11231-023-09395-w
  • Midolo, L. R., Santoro, G., Ferrante, E., Pellegriti, P., Russo, S., Costanzo, A., & Schimmenti, A. (2020). Childhood trauma, attachment and psychopathology: A correlation network approach. Mediterranean Journal of Clinical Psychology, 8(2). https://doi.org/10.6092/2282-1619/mjcp-2418
  • Najavits, L. M. & Walsh, M. (2012). Dissociation, PTSD, and substance abuse: An empirical study. Journal of Trauma & Dissociation, 13(1), 115–126. https://doi.org/10.1080/15299732.2011.608781
  • Nijenhuis, E. R., Van der Hart, O., & Kruger, K. (2002). The psychometric characteristics of the traumatic experiences checklist (TEC): First findings among psychiatric outpatients. Clinical Psychology & Psychotherapy, 9(3), 200–210. https://doi.org/10.1002/cpp.332
  • Pollak, S. D., Messner, M., Kistler, D. J., & Cohn, J. F. (2009). Development of perceptual expertise in emotion recognition. Cognition, 110(2), 242–247. https://doi.org/10.1016/j.cognition.2008.10.010
  • Potik, D. (2020). Psychodynamic approaches for treatment of drug abuse and addiction: Theory and treatment. Routledge.
  • Racamiere, P.-C. (1995). L’inceste et l’incestuel. Les Éditions du Collège.
  • Santoro, G., Midolo, L. R., Costanzo, A., & Schimmenti, A. (2021). The vulnerability of insecure minds: The mediating role of mentalization in the relationship between attachment styles and psychopathology. Bulletin of the Menninger Clinic, 85(4), 358–384. https://doi.org/10.1521/bumc.2021.85.4.358
  • Scarna, H. (2020). Genesis of the heroin-induced addictive process: Articulation between psychodynamic and neurobiological theories. Frontiers in Psychiatry, 11, 524764. https://doi.org/10.3389/fpsyt.2020.524764
  • Schäfer, I., Langeland, W., Hissbach, J., Luedecke, C., Ohlmeier, M. D., Chodzinski, C., Kemper, U., Keiper, P., Wedekind, D., Havemann-Reinecke, U., Teunissen, S., Weirich, S., Driessen, M., & TRAUMAB-Study Group. (2010). Childhood trauma and dissociation in patients with alcohol dependence, drug dependence, or both–A multi-center study. Drug & Alcohol Dependence, 109(1–3), 84–89. https://doi.org/10.1016/j.drugalcdep.2009.12.012
  • Schäfer, I., Reininghaus, U., Langeland, W., Voss, A., Zieger, N., Haasen, C., & Karow, A. (2007). Dissociative symptoms in alcohol-dependent patients: Associations with childhood trauma and substance abuse characteristics. Comprehensive Psychiatry, 48(6), 539–545. https://doi.org/10.1016/j.comppsych.2007.05.013
  • Schimmenti, A. (2017). Traumatic identification. Attachment: New Directions in Relational Psychoanalysis and Psychotherapy, 11(2), 154–171. https://doi.org/10.33212/att.v11n2.2017.154
  • Schimmenti, A. (2018). The trauma factor: Examining the relationships among different types of trauma, dissociation, and psychopathology. Journal of Trauma & Dissociation, 19(5), 552–571. https://doi.org/10.1080/15299732.2017.1402400
  • Schimmenti, A. (2021). The aggressor within: Attachment trauma, segregated systems, and the double face of shame. In O. B. Epstain (Ed.), Shame matters: Attachment and relational perspectives for psychotherapists (pp. 114–132). Routledge. https://doi.org/10.4324/9781003175612
  • Schimmenti, A. (2022). The relationship between attachment and dissociation: Theory, research, and clinical implications. In M. J. Dorahy, S. N. Gold, & J. A. O’Neil (Eds.), Dissociation and the dissociative disorders: Past, present, future (2nd ed., pp. 161–176). Routledge.
  • Schimmenti, A., Billieux, J., Santoro, G., Casale, S., & Starcevic, V. (2022). A trauma model of substance use: Elaboration and preliminary validation. Addictive Behaviors, 134, 107431. https://doi.org/10.1016/j.addbeh.2022.107431
  • Schimmenti, A., & Caretti, V. (2010). Psychic retreats or psychic pits? Unbearable states of mind and technological addiction. Psychoanalytic Psychology, 27(2), 115–132. https://doi.org/10.1037/a0019414
  • Schimmenti, A., & Caretti, V. (2016). Linking the overwhelming with the unbearable: Developmental trauma, dissociation, and the disconnected self. Psychoanalytic Psychology, 33(1), 106–128. https://doi.org/10.1037/a0038019
  • Schimmenti, A., & Caretti, V. (2017). Video-terminal dissociative trance: Toward a psychodynamic understanding of problematic internet use. Clinical Neuropsychiatry, 14(1), 64–72.
  • Shedler, J. & Westen, D. (1998). Refining the measurement of Axis II: A Q-sort procedure for assessing personality pathology. Assessment, 5(4), 333–353. https://doi.org/10.1177/107319119800500403
  • Siegel, D. J. (1999). The developing mind: Toward a neurobiology of interpersonal experience. Guilford Press.
  • Somer, E. (2003). Prediction of abstinence from heroin addiction by childhood trauma, dissociation, and extent of psychosocial treatment. Addiction Research & Theory, 11(5), 339–348. https://doi.org/10.1080/1606635031000141102
  • Somer, E. (2022). Opioid misuse and dissociation: Two powerful modes of distress regulation. In M. J. Dorahy, S. N. Gold, & J. A. O’Neil (Eds.), Dissociation and the dissociative disorders: Past, present, future (2nd ed., pp. 564–572). Routledge.
  • Somer, E., Abu-Raya, H. M., & Nsairy Samaan, Z. (2019). Maladaptive daydreaming among recovering substance use disorder patients: Prevalence and mediation of the relationship between childhood trauma and dissociation. International Journal of Mental Health and Addictions, 17(2), 206–216. https://doi.org/10.1007/s11469-018-0011-9
  • Somer, E., Altus, L., & Ginzburg, K. (2010). Dissociative psychopathology among opioid use disorder patients: Exploring the “chemical dissociation” hypothesis. Comprehensive Psychiatry, 51(4), 419–425. https://doi.org/10.1016/j.comppsych.2009.09.007
  • Steinberg, M. (2023). The SCID-D interview: Dissociation assessment in therapy, forensics, and research. American Psychiatric Association Publishing.
  • Stolorow, R. D. (1988). Transference and the therapeutic process. Psychoanalytic Review, 75(2), 245–254.
  • Stolorow, R. D., & Atwood, G. E. (1992). Contexts of being. The intersubjective foundations of psychological life. The Analytic Press.
  • Stolorow, R. D., Brandchaft, B., & Atwood, G. E. (1987). Psychoanalytic treatment: An intersubjective approach. Analytic Press, Inc.
  • Vaillant, G. E. (1992). Ego mechanisms of defense: A guide for clinicians and researchers. Harvard University Press.
  • Vaillant, G. E., & Drake, R. E. (1985). Maturity of ego defenses in relation to DSM-III Axis II personality disorder. Archives of General Psychiatry, 42(6), 597–601. https://doi.org/10.1001/archpsyc.1985.01790290079009
  • Vonderlin, R., Kleindienst, N., Alpers, G. W., Bohus, M., Lyssenko, L., & Schmahl, C. (2018). Dissociation in victims of childhood abuse or neglect: A meta-analytic review. Psychological Medicine, 48(15), 2467–2476. https://doi.org/10.1017/S0033291718000740
  • Wurmser, L. (2003). The annihilating power of absoluteness: Superego analysis in the severe neuroses, especially in character perversion. Psychoanalytic Psychology, 20(2), 214–235. https://doi.org/10.1037/0736-9735.20.2.214
  • Yeomans, F. E., Clarkin, J. F., & Kernberg, O. F. (2015). Transference-focused psychotherapy for borderline personality disorder: A clinical guide. American Psychiatric Publishing, Inc.
  • Zhang, S., Lin, X., Liu, J., Pan, Y., Zeng, X., Chen, F., & Wu, J. (2020). Prevalence of childhood trauma measured by the short form of the childhood trauma questionnaire in people with substance use disorder: A meta-analysis. Psychiatry Research, 294, 113524. https://doi.org/10.1016/j.psychres.2020.113524

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