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A psychoanalyst in methadonia
1Montefiore Medical Center, Substance Abuse Treatment Program, Bronx, New York, USA.
Journal of Substance Abuse Treatment
|May 1, 1995
Summary
This study shows that psychoanalytic addiction models align with biochemical deficit theories, supporting methadone maintenance therapy. Methadone aids self-repair and emotional regulation within a supportive care context, improving treatment outcomes.
Area of Science:
- Addiction research
- Psychoanalytic theory
- Biochemical models of addiction
Background:
- Contemporary psychoanalytic addiction models are explored.
- The biochemical deficit model by Dole and Nyswander is discussed.
- Methadone pharmacotherapy's foundation is examined.
Observation:
- Methadone's self-object function in repairing self-deficits, particularly affect regulation, is explained.
- Self-repair dynamics are extended to the relational and programmatic "context of care" in methadone maintenance.
- Clinical issues of resistance and transference are analyzed within intersubjective counseling.
Findings:
- Methadone maintenance treatment (MMT) integrates psychoanalytic and biochemical perspectives.
- Psychophysiological stability, acceptance, and empathy in a secure care context facilitate transformation.
- Treatment involves gradual change in an addicted person's core organizing principles.
Implications:
- Reconceptualizes methadone maintenance as a transformative process.
- Highlights the importance of a secure "context of care" for treatment success.
- Suggests an individualized approach to choosing between maintenance and detoxification.