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Treating Addiction

Beyond the Pain

Edward J. Khantzian - Foreword by Martin Weegman

In Treating Addiction: Beyond the Pain, Edward Khantzian offers a collection of his recent works on the study and treatment of substance abuse and addiction. Based on his five decades of experience in working with substance dependent individuals, this volume builds upon Khantzian’s theory of addiction as self-medication and provides insights into how addiction is rooted in human psychological suffering, and not pleasure seeking or self-destruction. Almost without exception, life histories of human discomfort, disconnection, and unhappiness leave those so burdened to be vulnerable to the appeal of addictive drugs, including alcohol. Khantzian’s sensitive teaching voice weaves together an annotated collection of previously published papers into a powerful and engaging volume of effective practice-based treatments. A timely complement to his earlier collection Treating Addiction as a Human Process, this book provides an inclusive and accessible resource for mental health professionals from any background as well as graduate students and those in training.
  • Details
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  • Author
  • Author
  • TOC
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  • Reviews
  • Reviews
Rowman & Littlefield Publishers
Pages: 292 • Trim: 6⅜ x 9½
978-1-5381-0857-4 • Hardback • February 2018 • $179.00 • (£138.00)
978-1-5381-0858-1 • Paperback • February 2018 • $80.00 • (£62.00)
Subjects: Psychology / Psychotherapy / Counseling
EDWARD J. KHANTZIAN, MD, is professor of psychiatry at Harvard Medical School and past president of the American Academy of Addiction Psychiatry. Dr. Khantzian is a distinguished scholar, psychiatrist, and psychoanalyst, specializing in addictions for more than forty years. His other work includes Treating Addiction as a Human Process and (with Mark J. Albanese) Understanding Addiction as Self Medication: Finding Hope Behind the Pain.
Foreword by Martin Weegmann
Introduction
Part I. The Internal Terrain of Addiction Psychodynamics
1. Understanding Addictive Vulnerability: An Evolving Psychodynamic Perspective

2. Questions of Substance: Psychodynamic Reflections On Addictive Vulnerability and
Treatment

3. Addiction: Why Are Some of Us More Vulnerable Than Others

4. The Capacity for Self-Care and Addiction

5. The Self-Medication Hypothesis and Attachment Theory: Pathways for Understanding and
Ameliorating Addictive Suffering


Part II. The Self-Medication Hypothesis Revisited

6. The SMH and Addiction as a Problem in Self-Regulation
7. The Self-Medication Hypothesis Revisited: The Dually Diagnosed Patient
8. Self-Medication Hypothesis: Connecting Affective Experience and Drug Choice
9. The Self
‐Medication Hypothesis and Psychostimulant Treatment of Cocaine Dependence: An Update

10. The Psychodynamics of Addiction and Its Treatment: An Interview with New Therapist Magazine

Part III. Treatment of Addictive Disorders

11.Reflections on Group Treatments as a Corrective for Addictive Vulnerability

12.More Reflections on Group Therapy (Interview by Martin Weegmann)

13. ‘Dangerous Desires and Inanimate Attachments’: Modern Psychodynamic Approaches to Substance Misuse

14. Reflections on Treating Addictive Disorders: A Psychodynamic Perspective

15. A Psychodynamic Perspective on the Efficacy of 12-Step Programs

Part IV. Reflections and Lessons Learned
16. We Are All At Least a Little Lost and Off-Putting: On Transformation

17. Tragic Trends in the Treatment of Addictive Illness

18. Insights on the Insanity of Addiction
19. The Cruel Scourge of Addiction: An Addiction Psychiatrist’s Clinical View
20. Life Learned from Addictions
21. Psychophobia and Getting it Right
22. The Theory of Self-Medication and Addiction
In Treating Addiction: Beyond the Pain, Khantzian (Harvard Medical School) presents a collection of his previously published, seminal articles that explore the relevance of psychodynamic theory to the current understanding of addictions and their treatment. He traces the evolution of his thinking and provides supporting evidence specifically related to the self-medication hypothesis of addiction. In contrast to some other hypotheses, including recent neurobiological formulations, Khantzian posits that addictions are rooted in suffering and pain as opposed to pleasure. In his formulation, he humanizes those with substance use disorders, acknowledging their psychological vulnerabilities, quest to alleviate pain, and resiliency in the face of challenges. Through his use of case examples and vignettes, he fosters readers' empathy for people struggling with substance use disorders. This perspective is greatly needed at a time when such people continue to be stigmatized and judged. In presenting complex ideas about addictions, Khantzian uses a conversational style that promotes understanding and openness rather than defensiveness regarding alternative views. Throughout the book, he champions the idea of a “kinder understanding of addicted individuals” alongside a more integrated, humanistic approach to treatment.



Summing Up: Recommended. Graduate students through faculty and professionals.
— Choice Reviews


I would recommend Khantzian’s book to beginners and practitioners alike. It shows beginners the person behind this disorder, while serving as a reminder for experienced practitioners of the human suffering associated with drug misuse.
— Martin Weegmann, psychologist, psychotherapist, and author, United Kingdom


Few patients suffer as much as those with addictive disorders and few doctors understand the pain and suffering these patients go through as much as Dr. Khantzian. This book is a must read for all healthcare professionals and families helping their patients deal better with their aching souls.
— Richard Frances, Clinical Professor of Psychiatry, New York University, MD, clinical professor of Psychiatry, New York University


Few patients suffer as much as those with addictive disorders and few doctors understand the pain and suffering these patients go through as much as Dr. Khantzian. This book is a must read for all healthcare professionals and families helping their patients deal better with their aching souls.
— Richard Frances, Clinical Professor of Psychiatry, New York University, MD, clinical professor of Psychiatry, New York University


It has been my joy and privilege to work with and learn from Ed Khantzian for more than a quarter century. These collected works flesh out the many facets of the self-medication hypothesis, as I have heard Ed clearly and patiently articulate them over the years. At its heart, the approach to understanding and treating people suffering with addictions that Ed has pioneered is empathic and compassionate. It sees beyond the stigmata of addiction to the vulnerability and suffering at its core. Reading this book is bound to make us all better companions and caregivers of those we know and love who struggle with addiction.
— Mark Albanese, director, Adult Outpatient Psychiatry & Addiction Service, Cambridge Health Alliance


This is a masterful, humanistic perspective on addiction and its treatment from a thought leader who helped define the very nature of this field. It’s a must read for anyone who wants an understanding of where we have been and where we are heading with treatment.
— Marc Galanter, M.D., professor of psychiatry, New York University School of Medicine


Treating Addiction

Beyond the Pain

Cover Image
Hardback
Paperback
Summary
Summary
  • In Treating Addiction: Beyond the Pain, Edward Khantzian offers a collection of his recent works on the study and treatment of substance abuse and addiction. Based on his five decades of experience in working with substance dependent individuals, this volume builds upon Khantzian’s theory of addiction as self-medication and provides insights into how addiction is rooted in human psychological suffering, and not pleasure seeking or self-destruction. Almost without exception, life histories of human discomfort, disconnection, and unhappiness leave those so burdened to be vulnerable to the appeal of addictive drugs, including alcohol. Khantzian’s sensitive teaching voice weaves together an annotated collection of previously published papers into a powerful and engaging volume of effective practice-based treatments. A timely complement to his earlier collection Treating Addiction as a Human Process, this book provides an inclusive and accessible resource for mental health professionals from any background as well as graduate students and those in training.
Details
Details
  • Rowman & Littlefield Publishers
    Pages: 292 • Trim: 6⅜ x 9½
    978-1-5381-0857-4 • Hardback • February 2018 • $179.00 • (£138.00)
    978-1-5381-0858-1 • Paperback • February 2018 • $80.00 • (£62.00)
    Subjects: Psychology / Psychotherapy / Counseling
Author
Author
  • EDWARD J. KHANTZIAN, MD, is professor of psychiatry at Harvard Medical School and past president of the American Academy of Addiction Psychiatry. Dr. Khantzian is a distinguished scholar, psychiatrist, and psychoanalyst, specializing in addictions for more than forty years. His other work includes Treating Addiction as a Human Process and (with Mark J. Albanese) Understanding Addiction as Self Medication: Finding Hope Behind the Pain.
Table of Contents
Table of Contents
  • Foreword by Martin Weegmann
    Introduction
    Part I. The Internal Terrain of Addiction Psychodynamics
    1. Understanding Addictive Vulnerability: An Evolving Psychodynamic Perspective

    2. Questions of Substance: Psychodynamic Reflections On Addictive Vulnerability and
    Treatment

    3. Addiction: Why Are Some of Us More Vulnerable Than Others

    4. The Capacity for Self-Care and Addiction

    5. The Self-Medication Hypothesis and Attachment Theory: Pathways for Understanding and
    Ameliorating Addictive Suffering


    Part II. The Self-Medication Hypothesis Revisited

    6. The SMH and Addiction as a Problem in Self-Regulation
    7. The Self-Medication Hypothesis Revisited: The Dually Diagnosed Patient
    8. Self-Medication Hypothesis: Connecting Affective Experience and Drug Choice
    9. The Self
    ‐Medication Hypothesis and Psychostimulant Treatment of Cocaine Dependence: An Update

    10. The Psychodynamics of Addiction and Its Treatment: An Interview with New Therapist Magazine

    Part III. Treatment of Addictive Disorders

    11.Reflections on Group Treatments as a Corrective for Addictive Vulnerability

    12.More Reflections on Group Therapy (Interview by Martin Weegmann)

    13. ‘Dangerous Desires and Inanimate Attachments’: Modern Psychodynamic Approaches to Substance Misuse

    14. Reflections on Treating Addictive Disorders: A Psychodynamic Perspective

    15. A Psychodynamic Perspective on the Efficacy of 12-Step Programs

    Part IV. Reflections and Lessons Learned
    16. We Are All At Least a Little Lost and Off-Putting: On Transformation

    17. Tragic Trends in the Treatment of Addictive Illness

    18. Insights on the Insanity of Addiction
    19. The Cruel Scourge of Addiction: An Addiction Psychiatrist’s Clinical View
    20. Life Learned from Addictions
    21. Psychophobia and Getting it Right
    22. The Theory of Self-Medication and Addiction
Reviews
Reviews
  • In Treating Addiction: Beyond the Pain, Khantzian (Harvard Medical School) presents a collection of his previously published, seminal articles that explore the relevance of psychodynamic theory to the current understanding of addictions and their treatment. He traces the evolution of his thinking and provides supporting evidence specifically related to the self-medication hypothesis of addiction. In contrast to some other hypotheses, including recent neurobiological formulations, Khantzian posits that addictions are rooted in suffering and pain as opposed to pleasure. In his formulation, he humanizes those with substance use disorders, acknowledging their psychological vulnerabilities, quest to alleviate pain, and resiliency in the face of challenges. Through his use of case examples and vignettes, he fosters readers' empathy for people struggling with substance use disorders. This perspective is greatly needed at a time when such people continue to be stigmatized and judged. In presenting complex ideas about addictions, Khantzian uses a conversational style that promotes understanding and openness rather than defensiveness regarding alternative views. Throughout the book, he champions the idea of a “kinder understanding of addicted individuals” alongside a more integrated, humanistic approach to treatment.



    Summing Up: Recommended. Graduate students through faculty and professionals.
    — Choice Reviews


    I would recommend Khantzian’s book to beginners and practitioners alike. It shows beginners the person behind this disorder, while serving as a reminder for experienced practitioners of the human suffering associated with drug misuse.
    — Martin Weegmann, psychologist, psychotherapist, and author, United Kingdom


    Few patients suffer as much as those with addictive disorders and few doctors understand the pain and suffering these patients go through as much as Dr. Khantzian. This book is a must read for all healthcare professionals and families helping their patients deal better with their aching souls.
    — Richard Frances, Clinical Professor of Psychiatry, New York University, MD, clinical professor of Psychiatry, New York University


    Few patients suffer as much as those with addictive disorders and few doctors understand the pain and suffering these patients go through as much as Dr. Khantzian. This book is a must read for all healthcare professionals and families helping their patients deal better with their aching souls.
    — Richard Frances, Clinical Professor of Psychiatry, New York University, MD, clinical professor of Psychiatry, New York University


    It has been my joy and privilege to work with and learn from Ed Khantzian for more than a quarter century. These collected works flesh out the many facets of the self-medication hypothesis, as I have heard Ed clearly and patiently articulate them over the years. At its heart, the approach to understanding and treating people suffering with addictions that Ed has pioneered is empathic and compassionate. It sees beyond the stigmata of addiction to the vulnerability and suffering at its core. Reading this book is bound to make us all better companions and caregivers of those we know and love who struggle with addiction.
    — Mark Albanese, director, Adult Outpatient Psychiatry & Addiction Service, Cambridge Health Alliance


    This is a masterful, humanistic perspective on addiction and its treatment from a thought leader who helped define the very nature of this field. It’s a must read for anyone who wants an understanding of where we have been and where we are heading with treatment.
    — Marc Galanter, M.D., professor of psychiatry, New York University School of Medicine


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