Beyond the “Black Box” of the Therapeutic Community: A Qualitative Psychoanalytic Study

This text is the written version of the public defence of my doctoral thesis which took place on September 22nd, 2014 in “Het Pand” in Ghent. It describes an analysis of the functioning of Therapeutic Communities (TCs) using a variety of qualitative methodologies and a psychoanalytic frame for interpretation. An important finding is that the TC approach succeeds in establishing a fundamental change in the emotional and psychic lives of the residents. A state of general numbness – which is characteristic of those who have been addicted for a long time – evolves in the direction of a re-connection to the Other. I have attributed this transformation (process) to the way in which the TC law is managed, that is, to the way in which both the mother- and the father-function are installed. A further step is that the particularity of each resident is allowed to emerge in the process of transformation. I have concluded that the successful processes of transformation in TCs involve both identification and subjectivization on the basis of which an Other life has become possible.

Clinical Considerations about Addiction: In Search of the Addicted Subject

In this contribution the author examines the specificity of a psychoanalytic orientation in clinical work with addicts. A psychoanalytic approach focuses on the subject and his discontent, rather than on the object, the consumed substance, and does not limit itself to the trivia of the substance use but searches for that for which the drug or alcohol use is a solution. A psychoanalytic focus on addiction aims at what lies beyond the supposedly simple stimulus-response cycle of need and its satisfaction and situates need within the dynamics of desire, related to the Other and mediated by speech. Drug use circumvents those dynamics, which has consequences for the transference. The author contrasts a psychoanalytic treatment, aimed at the symbolic working-through of desire and the letting go of imaginary identifications, with an imaginary treatment, aimed at installing an identification with “the addict” or “the former drug user” with accompanying terminology and prescribed behaviour. Arguments are illustrated throughout with clinical case material.

The Addicted Subject caught between the Ego and the Drive: The post-Freudian Reduction and Simplification of a Complex Clinical Problem

Texts by Abraham, Rado, Glover and Gross are explored in order to investigate post-Freudian literature on the question of addiction. The reduction of the Freudian field is analysed in order to produce new foundation stones for a theory on addiction by confronting the (post-Freudian) reduced elements with each other. A reading of the post-Freudian literature shows that it is possible to distinguish between different periods in psychoanalytic thinking about addiction. These periods represent, in their own style, a reduction of Freud’s work. A confrontation between the earlier drive-theory and the later ego(self)psychology period, interestingly enough, does not lead to a synthesis of the two into a higher order of thinking on addiction. Surprisingly, it results in the production of new theoretical elements and a shift in thinking about addiction. Thus, despite the lack of fecundity in most post-Freudian thinking on addiction, the possibility nevertheless exists to produce some material on addiction, providing one analyses or interprets, not just the relevant texts, but precisely what is lacking in these texts.

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The Drug-free Therapeutic Community: A Total(itarian?) approach for the Treatment of a Total Experience

In this article the authors, using psychoanalytic concepts, will discuss the treatment process in a drug-free Therapeutic Community (TC). A TC is a long-term group programme for people suffering from addiction that aims at an identity transformation and a drug-free lifestyle. Although the TC model exists for over 50 years and is applied worldwide, it has always been controversial because of its “totalitarian” approach. Subjects that are under the spell of a drug addiction do not tend to seek treatment for psychological problems. If help is sought, it is usually related to the debts, family problems, prison sentences and so on that are the consequences of addiction. Once the addict has decided to embark on a TC programme, they go through a process of detoxification and enter the drug-free TC peer group. By living together in an environment that is both holding and frustrating, the subject manages to reconnect with his own emotions and thoughts and the process of the becoming of the subject can continue. Affects such as anxiety and anger can be experienced and carried and the mirroring effects of peers provides the material for symbolization. Maintaining the TC values that guarantee a safe environment is essential to this process.

Collecting – An Addiction

Not without irony, the author relates the story of the origin and development of what, in the course of about 45 years of collecting, would become probably the world’s largest collection of Art Brut, Naive and Outsider Art. Charlotte Zander started collecting as a young adult when for the first time she began to earn some money. The objects of her collecting passion were so-called votive pictures and gifts. After her marriage her interest shifted to avant-garde art and still later to Art Brut and Naive Art. The author follows her path from Cologne, via Heidelberg to Munich, where she founded an art gallery and eventually her own museum at Schloss Bönnigheim. With respect to the addictive aspects of collecting, the author stresses the craving to possess an object and the thrill experienced with each new acquisition.