An educational program for the assessment and development of psychological-mindedness in the chemically dependent

Substance abusers can be conceptualized as alexithymic (Sifneos), psychically traumatized (Krystal), without internalized standards (Wurmser), and narcissistically defective (Kohut). Each of these theoretical systems conveys an important vantage point from which to view the rise of substance use and abuse and personality deterioration within the international community during this time of cultural fragmentation. Culture has been described as contributing to aspects of internalized psychic structure (Horney), to the maintenance of that structure (Bion), and to its members' performance of ongoing functions of mirroring and idealizing (Kohut). A detoxification program is described within which a psychological component has been found effective in stabilizing patients, in developing psychological-mindedness, in preparing some for psychic structural development, and in the creation of a facilitating, humanistic environment.