Narcissism and Addiction

There is an emphasis with the new drug czar on the brain and brain chemistry. Hopefully we won't forget that it is the way children are raised that predisposes them to drug and alcohol use. When children are scorned, criticized, humiliated, disregarded for who they are the resulting frustration and rage is turned inward resulting in attacks on self-esteem, bodily organs, and the executive function of the ego.  Drugs and alcohol are then used to deal with the repressed rage. For instance, crack has an anti-rage function.
The self is attacked in depression-I'm a piece of shit- bodily organs are attacked in psychosomatic illness, and the functions of the ego are attacked in thought confusion. Therapists can turn this around but they have to understand that is the anger-frustration turned inward that is causing the problem. It is an emotional experience that patients need to have- to verbalize all their feelings without retaliation. This does not happen overnight. I hate you because you (you the therapist) did not love me enough comes before the painful memory of not being loved.  Childhood experiences are very painful and the patient's defenses against remembering these experiences have to be respected. Therapists who want to be nice, and can't accept their own hatred- called a countertransference resistance- will fail at listening to their clients. Dr. Spotnitz who coined the term Modern Psychoanalysis was responsible for proposing that repressed hatred was behind the cloak of narcissistic problems and also proposed treatment techniques to facilitate change.

People - patients and therapists-often wince at hatred but like it or not, repressed hatred can cause mental illness. A famous psychoanalyst wrote- you can't reach objective love unless you reach objective hate. Opioids like crack/heroin serve an anti-rage function. Alcohol also serves a similar function, although somewhat different. People with drinking problems will drink at their partners to hurt them rather than communicate their feelings.

So all this fits with narcissism and addiction. Narcissism is a cloak for frustration-aggression turned inward. So when my patient became more aware of her anger at me and could express it (taking it from the ego-I'm worthless- to the object world-her therapist) she said she experienced less of a need to use crack.