Substance Abuse as Symptom: A Psychoanalytic Critique of Treatment Approaches and the Cultural Beliefs That Sustain Them [Hardcover]

Louis S. Berger (Author)

Book Description

Publication Date: May 1, 1991 | ISBN-10: 0881631027 | ISBN-13: 978-0881631029 | Edition: First edition.

What can psychoanalysis contribute to an understanding of the etiology, treatment, and prevention of substance abuse? Here, Louis Berger contests both the orthodox view of substance abuse as a "disease" explicable within the medical model, and the fashionable dissenting view that substance abuse is a habit controllable through the "willpower" fostered by superficial treatment approaches.

According to Berger, substance abuse is first and foremost a symptom. He argues that it is only by grasping this fact that we can understand why standard approaches to treatment and prevention have failed. Berger invokes a wide spectrum of recent analytic insights about infant and child development, the psychology of narcissism, and primitive character disorders in making the case that substance abuse masks serious preoedipal (or "midrange") psychopathology. Such psychopathology, operating at both cultural and person levels, explains why certain individuals become dependent on illicit drugs; it is equally revelatory of why the substance abuse "establishment" -- and society at large -- continues to misconstrue the nature of the problem and to proffer ill-conceived and ineffective remedies.

After thoroughly examining the motives, conscious and unconscious, that maintain "mainstream" myths about substance abuse, Berger points the way to alternative approaches to prevention and treatment.

Editorial Reviews

Review

"Berger offers a thoughtful and impressive review that critiques an exclusively biological model of substance abuse and persuasively presents the evidence that psychological suffering and distress are at the root of addictive disorders. . . . Berger provides an empathic and sophisticated appreciation of addicts' vulnerabilities, avoids simplistic or reductionistic explanations of addiction, and considers the modifications of theory and practice that are required to access, understand, and modify the psychological and developmental facts that predispose individuals to addictive disorders."

- Edward Khantzian, M.D., Contemporary Psychology

"Dr. Berger has persuasively questioned the legitimacy of the traditional vision of addiction.  He has dared to challenge the shibboleths of the 'medical model' and its derivative applications to the addicted person.  Instead of a biological orientation that mandates a disease process, he offers a sociopsychoanalytic perspective which places the person and not the therapeutic system at the center of our concerns.  One need not embrace all of Berger's social, political, and epistemological assumptions to appreciate the justifiable optimism in his message.  This book is a worthwhile adventure for any health professional who wishes an alternative to the bankruptcy of contemporary approaches to the problem of addiction."

- J. Gordon Maguire, M.D., Training and Supervising Analyst, Chicago Institute for Psychoanalysis

"Substance Abuse as Symptom is a courageous and radical undertaking.  Louis Berger tackles one of the most salient problems in our society, looking deeply into the history and assumptions that define it.  Approaching substance abuse from a sociocultural perspective and as a psychotherapeutic problem, he demonstrates, in both respects, the fertility of sophisticated psychoanalytic thinking.  His social criticisms are trenchant, his social proposals appropriately tentative and modest, his therapeutic suggestions theoretically grounded and practically applicable.  This is a praiseworthy book."

- Alvin G. Burstein, Ph.D., Professor and Director of the Clinical Psychology Program, University of Tennessee

About the Author

Louis S. Berger's rich professional life spans the fields of electrical engineering (B.S.), physics (M.S.), music (M.M.), and clinical psychology (Ph.D.).  Formerly on the faculty of the Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, he is now Staff Psychologist at Southwest Research Institute, San Antonio, Texas.  Dr. Berger is the author of Introductory Statistics: A New Approach for the Behavioral Sciences (1981) and Psychoanalytic Theory and Clinical Relevance: What Makes a Theory Consequential for Practice? (Analytic Press, 1985).

Product Details

• Hardcover: 259 pages
• Publisher: Routledge; First edition. edition (May 1, 1991)
• Language: English
• ISBN-10: 0881631027
• ISBN-13: 978-0881631029
• Product Dimensions: 9.1 x 6.1 x 1.1 inches
• Shipping Weight: 1.3 pounds (View shipping rates and policies)
• Amazon Best Sellers Rank: #2,635,785 in Books (See Top 100 in Books)

More About the Author

Louis Berger is a native of Prague. His rich professional career spans the fields of electrical engineering (B.S., Princeton), music (M.M., University of Texas), physics (M.S., Trinity University), and clinical psychology (Ph.D., University of Tennessee). He was a cellist with the Boston Symphony Orchestra, and returned to technical work as a Senior Research Scientist at Southwest Research Institute in San Antonio, Texas, initiating and conducting research in a broad variety of subject areas ranging from electromagnetic fields to speech perception in noisy environments. Ultimately he followed a long-standing, intense interest in psychoanalytically oriented therapy, returning to graduate school and completing training in psychology. After a post-doctoral fellowship at the Texas Research Institute of Mental Sciences in the Houston Medical Center he began a long career as a therapist, academician, and consultant that includes an appointment as Assistant Professor in the Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine. He was in private practice until he returned to Southwest Research Institute in 1990 to serve in the newly established position of Staff Psychologist. Currently he resides in rural Central Georgia.

His most recent books make up the trilogy Humanity's Madness: Consequences of Becoming Literate (2011 -- a Kindle Book); Language and the Ineffable: A Developmental Perspective and Its Applications (Lexington Books, 2011); and Averting Global Extinction: Our Irrational Society as Therapy Patient (Jason Aronson, 2009). Earlier publications include The Unboundaried Self (2005), Psychotherapy as Praxis (2002), Substance Abuse as Symptom (1991), Psychoanalytic Theory and Clinical Relevance (1985), Introductory Statistics for the Behavioral Sciences (1981), and over 50 professional papers and book reviews, most of which are republished in Issues in Psychoanalysis and Psychology: Annotated Collected Papers (2002).