Practical and Theoretical Considerations in the Psychotherapy of Alcoholism

Abstract

Alcoholism is viewed as a symptom of an underlying personality disorder; psychological factors are seen as leading to the self-destructive use of this toxic agent. The maintenance of the psychological dependence on alcohol hinges upon a combination of emotional, physiological and pharmacological factors and the end result for the individual is usually illness or oblivion. Evidence from this study suggests that addictive alcoholism is by analytical classification an oral perversion. The fixation at this early level of emotional development seems to be the result of deprivation in a significant emotional relationship during the early years of life. Since the incidence of alcoholism is high in significant family figures, the symptom choice may be culturally and environmentally determined. A deep-seated depression is the predominant affect present in most alcoholics, and denial is the main mental mechanism employed. Treatment must be directed toward establishing a positive initial therapeutic relationship; avoidance of rejection and counter-hostility; with emphasis on reality limits. Treatment goals should be set within the capacities of the patient.