Dissociative Retreat and Addiction

Giuseppe Craparo is a psychologist, psychoanalyst, Full Professor of clinical psychology, and Coordinator of the MSc programme in Clinical Psychology at the Kore University of Enna, Italy.

"If you want to know how addiction works, if you want to learn to treat addiction well, read this book. Updating and integrating the study of addiction with psychoanalytic/trauma/dissociation literature and recent findings in neurology, Giuseppe Craparo makes his complex conceptualizations easy to understand. Linking early trauma with inadequate mentalization, symbolization, and integration, he brilliantly explains how early traumatic and dissociated experiences become embodied and somato-psychic. The purpose of what he calls “the drug object” is to regulate unintegrated, powerful, often unbearable affects associated with traumatic early unnegotiated and often unnegotiable relationships. In this way the user has the illusion of control and self-sufficiency. Craparo cogently explains how dissociation is imbricated with problematic drug use: when the drug aestheticizes the pain—reinforcing dissociative defenses, the person is deprived of the experience of accepting and integrating painful affects that may feel unbearable with the rest of current life (along with the requisite mourning) and thus is deprived of the opportunity of learning from experience. A brilliant piece of work that should be read by all who treat addictions." Elizabeth F. Howell, PhD, Faculty, New York University Postdoctoral Program in Psychotherapy and Psychoanalysis"This book has the scope of a manual and the density of a treatise. Giuseppe Craparo succeeds in condensing a profound and rigorous reflection on one of the most complex issues in psychopathology, applying it specifically to the clinical treatment of addiction. The book’s most significant contribution lies in the Developmental–Relational psychopathological model of addiction it proposes. Within this framework, multiple pathogenic processes are interwoven, while the self-therapeutic function of substance use—aimed at regulating mental states dysregulated by attachment-related trauma—clearly emerges. The resulting therapeutic approach is highly coherent with the proposed model and is distinguished by a rare conceptual clarity, making it accessible and clinically useful even for practitioners with less extensive experience."Benedetto Farina, Psychotherapist and Full professor of Clinical Psychology at the European University of Rome, Italy

• Introduction 1. General Aspects of the Concept of Addiction 2. A Developmental–Relational Interpretation of Addiction 3. Neurobiology of Addiction 4. Need or Desire? 5. Alexithymia and Addiction 6. Trauma, Dissociation, and Addiction 7. Traumatic Attachment Identification 8. Dissociative Trauma, Affect Dysregulation, and Addiction 9. Addiction and the Three Levels of Personality Organisation 10. The Monkey on One’s Back 11. Treating Addiction: General Considerations 12. An Integrated Approach to the Treatment of Addiction 13. Feeling Alive and Being Alive 14. Concluding Remarks