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Running Head: NARCISSISTIC RAGE and ADDICTION 1 Narcissistic Running head: NARCISSISTIC RAGE AND ADDICTION 1 Narcissistic Rage and Addiction: Adlerian Theory and Intervention A Research Paper Presented to The Faculty of the Adler Graduate School __________________________ In Partial Fulfillment of the Requirements for The Degree of Master of Arts in Adlerian Counseling and Psychotherapy __________________________ Donna Wallace September 2014 NARCISSISTIC RAGE AND ADDICTION 2 Abstract An alternative to the biomedical model, psychiatrist and psychoanalyst Dodes (2009) proposed a psychological theory for the treatment of addiction and the prevention of relapse, describing, substance use as a compulsive act of displacement. This paper will outline Dodes' theory, and describe the psychoanalytic base thereof. It will present the major concepts of Adlerian theory and from that viewpoint, examine parallels or contrasts between Dodes' theory and Adlerian theory. Both classical and contemporary Adlerian views on chemical dependency treatment will be summarized. Finally, this writer will propose individual and group interventions for Adlerian psychotherapy for the treatment of addiction based on these conclusions. These interventions will include the writer's own attempt to connect Pew's priorities to specific core emotional vulnerabilities. Also, it will outline the writer's original use of the "empty chair" technique as a method of determining and ranking the client's psychological priorities in order to facilitate treatment. Keywords: addiction, narcissistic rage, narcissistic injury, Adlerian theory, psychoanalytic theory, object relations theory, compulsion, displacement, compensation, psychological priorities NARCISSISTIC RAGE AND ADDICTION 3 Table of Contents Abstract..........................................................................................................................................2 Introduction....................................................................................................................................8 Linking Compulsion and Displacement with Addictive Acts...........................................8 The Role of Psychological Compromises..........................................................................9 Avoidance of Distress.........................................................................................................9 Narcissistic Rage Versus Narcissistic Personality Disorder Diagnosis..............................9 Dodes' Psychoanalytic Pathway to Addiction Summarized..........................................................10 Powerlessness: A Clarification of Terms......................................................................................10 The Path to an Adlerian Comparison.............................................................................................12 The Psychoanalytic Building Blocks of Dodes' Theory................................................................12 Sigmund Freud...................................................................................................................12 Freud and the Unconscious Mind......................................................................................12 Displacement, Defense Mechanisms and Repression....................................................... 13 The Self and Object Relations Theory...............................................................................13 Object Relations Theory........................................................................................14 Adler and Object Relations Theory.......................................................................14 Freud's Id, Ego and Superego............................................................................................15 Adler on the Ego...................................................................................................16 Drive Theory.................................................................................................................................16 Narcissism.....................................................................................................................................17 Trauma versus Phobia in Theories on Narcissism.............................................................17 Shock and Trauma.............................................................................................................17 NARCISSISTIC RAGE AND ADDICTION 4 Narcissistic Disturbances and Narcissistic Injury.............................................................18 Development of Narcissistic Injury..................................................................................19 Narcissistic Rage...............................................................................................................20 Kohut's Thoughts on Narcissism and Narcissistic Rage...................................................21 Anxiety and Addiction.......................................................................................................23 Summary of Introductory Section..................................................................................................23 Alfred Adler...................................................................................................................................24 The Individual Psychology of Alfred Adler..................................................................................24 Holism...............................................................................................................................25 Unconscious Versus Un-Understood or Nonconsious.......................................................25 Fictionate Goal...................................................................................................................26 The Tasks of Living...........................................................................................................26 Social Interest.....................................................................................................................27 Movement and Teleology..................................................................................................28 Usefulness and the Vertical and Horizontal Plane.............................................................29 Life Style............................................................................................................................29 Organ Inferiority, Aggressive Drive, and Masculine Protest............................................30 Inferiority...........................................................................................................................30 Discouragement and Inferiority.............................................................................30 Pampering and Neglect......................................................................................................31 Safeguarding.....................................................................................................................32 Compensation ...................................................................................................................32 Tricks of Self-Deception...................................................................................................32 NARCISSISTIC RAGE AND ADDICTION 5 Differentiation, Private Logic, and Common Sense.........................................................33 Adlerian Psychodynamics..............................................................................................................33 Neurotic Psychodynamics..................................................................................................33 Psychotic Psychodynamics................................................................................................34 Personality Disordered Psychodynamics...........................................................................34 Adlerian Psychodynamics versus the DSM IV..................................................................35 Processing Styles in Neurodynamics.............................................................................................35 Symptoms......................................................................................................................................37 Neuroses and Symptoms...................................................................................................37 Psychic Shock................................................................................................................................38 Adler on Narcissism......................................................................................................................38 Adler on Compulsion Neurosis.....................................................................................................38 Interrelated Phenomenon...............................................................................................................39 Shame, Anxiety, Perfectionism, Abandonment, and Worthlessness.............................................39 Shame................................................................................................................................40 Shame and Rage................................................................................................................41 Adler on Shame.................................................................................................................42 Anxiety..............................................................................................................................42
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