April 2024: “A Psychoanalytic Approach to Addiction: The Analyst’s Internal Frame as a Technical Tool” presented by Caron Harrang, LICSW, FIPA, BCPsa

“A Psychoanalytic Approach to Addiction: The Analyst’s Internal Frame as a Technical Tool” Caron Harrang examines the psychoanalytic treatment of addiction noting that it has historically been seen as inappropriate by analysis unless or until the patient has achieved abstinence. With some exceptions, a psychoanalytic understanding of addiction has languished, leaving the analyst ill prepared when it is discovered that the patient is engaged in a pattern of psychoactive substance use that endangers their somatopsychic health and wellbeing. Summarizing the major psychoanalytic contributions to an understanding of addiction, she concurs with Ramos (2004) that a compromise of paternal function is a common feature amongst patients experiencing severe substance use disorders. The analyst may unconsciously collude with this compromise by failing to directly address indicators of problematical substance use. If recognized, these moments of compromise can facilitate (re)attunement of the analyst’s attention the patient’s emotional experience, helping to restore a sturdier analytic frame. Clinical vignettes drawn from Ramos (2004), Brady (2016), and the presenter’s clinical encounters with addiction illustrate how these cycles of compromise and recovery, may over time, through a process of unconscious identification with the analyst’s paternal function, strengthen the patient’s capacity to weather somatopsychic turbulence without returning to the false promise of freedom from unbearable psychic pain via the use of psychoactive substances. Learning Objectives 1. Participants will acquire an understanding of the major theories of addiction in the psychoanalytic literature over the past century. 2. Participants will learn what is meant by the analyst’s internal frame and how it may be influenced by one’s theoretical model(s) of addiction. 3. Participants will acquire an understanding of the concept of paternal function and its significance as a technical tool in working with substance use disorders.