Narcotic addiction and family process: death wish or countertransference

This article critically examines the literature which suggests that families of narcotic addicts push their addicted member toward death. Following an overview of the conventional literature on the family treatment of drug addiction, an alternative perspective is proposed to more fully understand how these families are preoccupied with death. The "suicide-like" quality of addiction is probed both in terms of the intention to die and the countertransference possibilities. The notion of a family "death wish" has the potential to be misinterpreted by the countertransference response of an unseasoned treatment provider. Clinicians are cautioned that this notion can be a potential threat to the patient's life. Implications are presented for the supervision of the family treatment of narcotic addiction.