The PANY Bulletin

Psychoanalytic Association of New York
Volume 39, Number 1 Spring 2001

New Study Group on Psychoanalysis and Substance Abuse
Dr. James Schluger

I'd like to extend an invitation to anyone interested in helping to establish and participate in a new study group. Broadly, the focus of the group will have to do with psychoanalysis and substance use/abuse/dependence/addiction. For the past several years I've been dividing my time between clinical work in my private practice and neuroscience research, both clinical and basic, as clinical director of the Laboratory of the Biology of Addictive Diseases at the Rockefeller University. One of my longstanding interests has been the integration of psychoanalysis and neuroscience. Among the various lines along which the search for bridging concepts between these two disciplines is proceeding, I think exploring intersections between the addictions and psychoanalysis could be particularly rewarding. I think some of the areas which might prove fruitful are drives, motivation, affect regulation, and consciousness, among others.

Another source of motivation for establishing this group has been my clinical experience in treating substance-related problems. I have frequently been struck by the persistence of feelings of helplessness, aversion, and even repugnance in thoughtful and sophisticated clinicians, often, but not always related to counter-transference issues. Conversely, while some clinicians appear to be more comfortable and effective in helping patients with substance related problems, often these clinicians may have difficulties seeing these problems in the broader context of the patient's overall mental life.

I hope to create a forum for several types of explorations. Foremost, I'd like to have presentations of clinical material from psychoanalyses and/or psychoanalytic psychotherapies where substance use has been a factor. In addition to the particular dynamic issues this could raise for discussion, an additional perspective I'd like to explore is related to some of Mark Solms' work, in which he describes analytic listening to patients with defined neurologic lesions, and considers neuroanatomic localization and analytic theory. I think the neurobiology of substance related problems has developed to a sufficient extent that one could begin to consider specific substance related syndromes in terms of localized "lesions" and listen to affected patients from a similar perspective. I'd also like to take an analytic look at some of the current neuroscientific data and theories about addiction, as well as some of the treatment modalities currently out there, and clinical material from them. Further, I think it would also be interesting to think analytically about social issues related to substances.

I would like the participants in this group to have expertise in at least one of the following areas, and minimally, an open-minded interest in the remainder: psychoanalysis, substance abuse treatment, and neuroscience. So far, the group consists of Pauline McHugh (whom I work with at the Rockefeller, and whom many of you know from the institute) and myself. If you are interested please contact me at my office, 212-533-6566.