Changing psychoanalytic conceptions of addiction

After an outline of historical predecessors, the article discusses the most important explanations of, and therapeutic approaches to, addiction in the German- and English-speaking countries. In the early stages, drive -theoretical persuasions categorized addiction as a perversion. Things changed with the arrival of the concept of "tense depressiom" ("Initialverstimmung") and the explanation of the compulsive propensity for addictive self-sedation as resulting from early narcissistic experiences of disillusion. Kleinian authors spoke of destructive internal parts of the self engaged with via addictive acting -out, while until today mainstream ego psychology has viewed addiction as a consequence of defective defense or a structural psychic defect. A more recent approach sees addiction either as a defense symptom in various personality disorders/neuroses or as a defense system in its own right originating from (unsuccessful) interaction between the early self and its relational objects.