Drug Addiction and Psychoanalysis
Addiction and Psychoanalysis (Chapter 2)
Table of Contents
TOC o “1-3” h z u HYPERLINK l “_Toc516729978” Abstract PAGEREF _Toc516729978 h 3
HYPERLINK l “_Toc516729979” 2.1 Statement of Purpose and Structure PAGEREF _Toc516729979 h 4
HYPERLINK l “_Toc516729980” 2.2 Literature Review PAGEREF _Toc516729980 h 5
HYPERLINK l “_Toc516729981” 2.2.1 Drug Addiction PAGEREF _Toc516729981 h 5
HYPERLINK l “_Toc516729982” 2.2.2 Addiction Affecting Human Lives PAGEREF _Toc516729982 h 6
HYPERLINK l “_Toc516729983” 2.2.3 Dynamics of Treating Drug Addiction PAGEREF _Toc516729983 h 7
HYPERLINK l “_Toc516729984” 2.2.4 Psychoanalysis and Implication for Human Life PAGEREF _Toc516729984 h 10
HYPERLINK l “_Toc516729985” 2.2.5 Curing Drug Addiction with Psychoanalysis PAGEREF _Toc516729985 h 12
HYPERLINK l “_Toc516729986” (a) Technological advancement. PAGEREF _Toc516729986 h 12
HYPERLINK l “_Toc516729987” (b) Psychotherapy and counselling. PAGEREF _Toc516729987 h 14
HYPERLINK l “_Toc516729988” (c) Brain and psychoanalysis. PAGEREF _Toc516729988 h 15
HYPERLINK l “_Toc516729989” (d) Behavioral dynamics. PAGEREF _Toc516729989 h 17
HYPERLINK l “_Toc516729990” 2.2.6 Complementary Therapies and Interventions PAGEREF _Toc516729990 h 18
HYPERLINK l “_Toc516729991” (a) Pharma-therapy. PAGEREF _Toc516729991 h 18
HYPERLINK l “_Toc516729992” (b) Personal preferences. PAGEREF _Toc516729992 h 20
HYPERLINK l “_Toc516729993” (c) Treating Addiction. PAGEREF _Toc516729993 h 21
HYPERLINK l “_Toc516729994” 2.3 Summary of Literature Review PAGEREF _Toc516729994 h 23
HYPERLINK l “_Toc516729995” 2.4 Search Design PAGEREF _Toc516729995 h 24
HYPERLINK l “_Toc516729996” 2.5 Theoretical Framework PAGEREF _Toc516729996 h 25
HYPERLINK l “_Toc516729997” 2.5.1 Addiction, Theories and Dependency PAGEREF _Toc516729997 h 25
HYPERLINK l “_Toc516729998” 2.5.2 Treating Addiction and Ideas on Psychoanalysis PAGEREF _Toc516729998 h 29
HYPERLINK l “_Toc516729999” 2.5.3 Linking the Theoretical Domains and Critical Analysis PAGEREF _Toc516729999 h 32
HYPERLINK l “_Toc516730000” 2.6 Strengths and Weaknesses PAGEREF _Toc516730000 h 35
HYPERLINK l “_Toc516730001” 2.7 Summarizing Theoretical Framework PAGEREF _Toc516730001 h 37
HYPERLINK l “_Toc516730002” 2.8 Research Gap PAGEREF _Toc516730002 h 37
HYPERLINK l “_Toc516730003” References PAGEREF _Toc516730003 h 39
AbstractDrug addiction is a serious sociological issue around the world and healthcare providers, researchers and social workers are constantly working towards finding solutions for this problem. Several theories have been provided in the literature that address the idea of drug addiction, its development and possible interventions. It has been mentioned that the person goes through an emotional journey both while getting addicted to something and getting rid of his addiction as well. In most instances, addiction starts with using drugs for fun or by peer pressure and it takes some time for an individual to realize that he is addicted to it. Psychoanalysis is one of the most useful interventions to overcome drug addiction as it helps the person get attached to his inner emotions and strengthen his struggle against addiction. Theories available around drug addiction and psychoanalysis provide profound insights into the practical domain but available literature can be expanded by understanding what healthcare providers think about it and how psychoanalysis helps people of various demographics with their drug addiction.
2.1 Statement of Purpose and StructureDrug addiction is a serious issue that can quickly ruin an individual’s life because of his over-dependency on the substance. In many instances, substance abuse is linked to alcoholism only, but in reality, addiction to any drug including heroin, marijuana, alcohol, ecstasy or any drug falls within the category of substance abuse. There are no second thoughts on the idea that drug addiction makes the life of the addict miserable and that is why he is considered as a victim. It is so because even if the person is aware of the fact that he is an addict and also knows the negativities of this compulsion, he is not in a position to pull himself away from him.
This study is designed to analyze substance abuse and drug addiction in detail and scrutinize how the addiction influences human lives. Another significant aspect of the study is to review the role of psychoanalysis in treating addiction. Since medical science made so much progress regarding suggesting ways of treating significant diseases, many creative perspectives have been introduced as effective interventions for destructive human behavior. One of these thoughtful ways is the use of psychoanalysis in treating drug addiction. The method of psychoanalysis was introduced by Sigmund Freud who provided it as a way of using the power of the human brain to solve its problems, and that is precisely how it is used to treat drug addiction.
This literature review is structured in a way that it is divided into various sections and sub-sections. The purpose of dividing the sections into further segregation was to ensure that all aspects of the scenario are discussed, and relevant literature is analyzed. The purpose of literature review in any study is not only to review the work that other researchers have done in the field, but it is also focused towards finding similarities and differences of these studies with own work and then looking for a gap in the literature that can be filled by further research. The next section will provide a detailed review of the available literature on drug addiction, and psychoanalysis and sub-sections are broken down to address specific topics. After that, a summary of the literature is provided while the section after that discusses the search design and how the pool of literature was accessed and narrowed for this research. The section after that puts light on the theoretical framework of the study and discusses the strengths and weaknesses while looking for a gap in the literature.
2.2 Literature Review2.2.1 Drug Addiction
Drug addiction is a severe behavioral issue that can turn a human’s life upside. In the field of psychology, a wide variety of literature addresses the issue of drug addiction and talks about how it influences human lives. The reason talking about drug addiction is crucial is that it is not only about one individual who gets addicted to the drug and kills his social and personal life; it is because many other lives are associated to that person that gets equally affected too CITATION Den171 l 1033 (Denzin, 2017). This section will discuss how the concept of drug addiction and its influence on human lives is discussed in the literature and what ideas are provided.
It was discussed by Kim, Strathearn, & Swain (2016) that human brain acts in a certain way which might vary individual to individual. While for some people, it is easier to resist the drug addiction, it might be impossible for others. These differences that can easily drag one person to drugs while the other can be completely normal. However, one factor worth noticing here is how the external factors of an individual put an impact on the probability of him turning out to be an addict. For instance, a troubled teen with the lousy company is more prone to getting involved in bad habits like drug addiction compared to a mature working individual with the valuable company.
Another paper by Koob & Volkow (2016) provided a similar argument and puts light on some additional aspects not discussed in the previous work. It is argued that while external factors play an active role in a person getting addicted to drugs, the mental state of an individual is another aspect to be considered. For instance, aspects like the emotional stability of a person, how he got involved into drugs, what motivates him to keep doing drugs and ideas of reward and deficit need to be considered to understand the entire spectrum of drug addiction and its impacts. The argument provided in the study is strong because while for some people, drug addiction turns out to be a disaster of a lifetime, others might get involved into drugs after they have gone through a tough time and want to get rid of the negative thoughts and depression. No matter what direction the stream goes, it is evident that the victim always remains in the middle of it getting negatively affected for life.
2.2.2 Addiction Affecting Human LivesThere has been a broad global concern on how drug addiction is affecting human productivity and how the effects can be mitigated. Many organization have joined hands globally to address the issue while the field of literature is also playing its part by providing a theoretical background on the matter. It is reported by Csete, et al. (2016) that drug addiction is one of the most significant concerns for a global health organization. It is because addiction is not just a single behavioral issue in itself, it is a potential start to many other physical, mental and sociological issues that cannot be controlled. For instance, one of the most common diseases that drug addiction gives rise to is Aids. Drug addicts often use syringes to inject themselves with the substance. While a small number of them might have access to clean injections every time they do drugs, a majority of addicts use a single injection for a large group which is an open invitation to aids. Additionally, use of contaminated equipment, smoking, drinking and other habits can lead to tuberculosis, cancer, hepatitis or other health issues. On top of that, these drug addicts, in most cases are not very serious about their health, and when they realize about their illness, it is already too late CITATION Wor156 l 1033 (Wormer & Davis, 2015).
It is argued in the literature that drug addiction comes with an acute absence of a sense of responsibility which can never be recovered. This theoretical argument is supported by empirical facts as well when a large number of criminals are found to be drug addicts and involved in some substance abuse. Wormer & Davis (2015) reported that drug addiction takes away the sense of responsibility from a person and also makes him vulnerable enough that he comes incapable of making healthy choices in life. In these instances, some argue that the addict is responsible for dragging himself into the situation while others argue that he is just a victim with no control over his decisions after his addiction reaches a certain level. It is supported by other studies as well as Muller & Homberg (2015) mentioned in their work that each type of drug has an inevitable impact on human brain which is specific to that drug only. Because of the specific impact of various drugs, human behavior can widely vary between two individuals because of what type of drug they are using. Because of that discrepancy, the treatment required by these individuals requires is also supposed to be different.
2.2.3 Dynamics of Treating Drug AddictionThere are numerous research studies discussing the treatment of drug addiction and these talk about various ways to treat addiction. While some studies talk strictly about medication, others also suggest therapy and other intervention to bring the victim back so he can live a healthy life. It has been argued in research that the first thing that needs to be done for a victim of substance abuse is to detect his addiction and see how intense it is. However, there are many hurdles at this stage as the person might easily be hiding his addiction from people around him. The argument provided in the research is applicable in a real-world scenario as well. For instance, if there is a teenager who gets addicted to smoking or any other type of drug which is way more harmful, he would never go to his parents and ask for their permission before starting using it. In most instances, youngsters are influenced by their peers and get involved in addiction because they are trying to fit in and socialize. It eventually leads them to addiction, and even though they do not realize its severity, the people around that person find it the hard way CITATION Kai12 l 1033 (Kail & Cavanugh, 2012).
Due to this lack of exposure for people related to drug addicts, it is suggested in the literature that a close watch is put on vulnerable people who are prone to habits like these. It might not sound like something easily doable, but in a practical setting, there are several emotional indicators that can provide insights on how vulnerable a person is to be an addict. For example, an experiment Kail & Cavanugh (2012) tested a large number of people, and the purpose of the experiment was to check the wits, level of intellect, quick responses, attention, aggression, patience, irritability and other emotional factors to judge their vulnerable. It was concluded that people who were less attentive were more prone to developing bad habits because of their need for an escape. Nevertheless, another aspect that could have made the study more contextual is to segregate the individuals by their age groups since a person’s age and his surrounding matter a lot when it comes to his habit patterns CITATION Rej12 l 1033 (Rejda, 2012).
It is reported by Dicther (2017) that for the treatment of addiction, it is crucial that the victim himself understand his situation and considers himself bound to the addiction that needs to be recovered. It is a rational argument since drug addiction is like any other physical disease in which the patient himself has to be self-aware about his illness which is the first step towards healing. If the patient does not cooperate, it becomes almost impossible for doctors and healthcare providers to treat the person. It works the same way for drug addicts as well, and something worth noticing here is that in drug addiction, emotional vulnerability of the victim is way more compared to a patient with any physical illness. Since the patient has a compulsion to do drugs over and over again, it is hard for him to think of anything else at that time which makes him even more miserable CITATION Ste171 l 1033 (Stebbins, 2017).
When it comes to treating drug addiction, it is narrated in the literature that many other factors like the economic and social well-being of the victim play a crucial role in the healing process. On the other hand, person sufficiency of the person is another factor which determines how fast the healing process will go to the individual. Goranitis, Coast, & Day (2016) mentioned in their work that treatment of drug addiction is a methodological process where several underlying factors play a crucial role. The way the study is linked to the capability approach of Amartya Sen is impressive and provides profound insights into the sociocultural aspect of the whole equation. It is mentioned that since the capabilities within and across countries are different, people have different approaches to drug addiction and alternative ways of living. Therefore, the way addiction is treated also vary depending on what part of the world the individual lives and what alternatives he has in life.
A study was conducted by Barry, McGinty, Pesocosolido, & Goldman (2014) to provide insights on drug addiction treatment, its effectiveness and discrimination in policy formation. A total of 709 individuals were involved in the study, and their illness intensity, addiction level, public attitudes and treatment processes were analyzed in detail. Additionally, the extent of social stigma was also scrutinized to observe how policy formation is operating in the domain. The observations of the study were surprising as respondents did not support policies designed to make these people socially comfortable while they go through the treatment process. Additionally, there were also sceptical responses to the drug addiction treatment policies while all of these respondents did not want any of their closed ones to be a victim. These results portray the social tendencies of negative behavior towards drug addicts in the society. The findings provided insights on although people do not want their closed people to be in that situation, they still do not want policies that try to fit them in the natural streams of the society.
2.2.4 Psychoanalysis and Implication for Human LifePsychoanalysis is a unique concept in the field of psychology which was once an alien due to its wild assumptions and how it was portraying human mind and its manipulation. The idea was introduced by Sigmund Freud, and he talked about how human mind can be designed and controlled to solve his problems. At first, it sounds like a long shot, but psychoanalysis turned out to hold vital importance in the field of psychology s it provided a unique perspective into studying human minds.
The idea that the discussion of drug addiction and psychoanalysis comes hand in hand in the field of psychology is because of how sensitive a human brain becomes under the influence of drug addiction and the extent of help needed to restore it. As reported in many studies, drug addiction makes a person vulnerable that he is not in a position to detect his addiction. At this stage, analysts report that he needs an external intervention that gives his wits a boost. That is when psychoanalysis enters the equation CITATION Ste151 l 1033 (Stellwagen & Lewitus, 2015).
It is reported by Spenzzano (2015) that psychoanalysis is not only a psychological intervention to help individuals overcome their fears and insecurities, but it is also an entire system of constructive mental manipulation that assists people in looking into their psychological frameworks that in turn, assists them in controlling their actions and reactions. The idea provided in the study is supported by other analysts as well as Lindersmith (2008) mentioned that psychoanalysis is more of freedom for people going through the process than a restriction. No matter if a patient has a drug addiction problem or any other physical or mental illness, psychoanalysis provides the individuals with a self-awareness that they can use as a tool to repress the negative thoughts and construct positive mental streams. In this way, psychoanalysis helps patients get out of the neurotic misery for short and a long-term as well.
Something that makes psychoanalysis incredibly useful to treat both physical and mental issues in individuals is because of the tools of repression and construction used in the treatment process. According to Newman & Newman (2018), whenever a person has a physical or mental issue, many underlying emotional connections are developed with that. On the other hand, some emotions are also repressed to such an extent that it negatively influences the physical and mental wellbeing of the person. When this process goes on for a long time, the condition gets worn with time and psychoanalysis helps in reversing the process. It assists in constructing positive thought streams and represses the negative ones so that the individual can get back to his routine and healthy life.
Several other studies have addressed the matter and have provided their insights on the idea of psychoanalysis as being useful as a treatment process. It was mentioned by Silveria, et al. (2018) that psychoanalysis has the power to assist humans in addressing their deepest fears and pulling them out. It allows the person to face his fears and emotional disability so that he can handle the situation once and for all. That is the reason psychoanalysis is widely accepted and used by psychologists and healthcare providers in the domain as it is a unique and customized way of treating people. The idea sounds rational in the field of psychology because many issues in a patient are initiated by mental problems that are later intensified. However, there is still a need to address several loopholes here including the fact that psychological issues are not always the beginning and in some instance, an actual physical problem initiates a set of problems. Nevertheless, psychoanalysis might be a useful resolution in both instances, but the origin of the problem in the patient can be different. Additionally, linking the idea back to the capability approach of Amartya Sen, it is possible that the outcome of psychoanalysis is different for two people depending on how they are living their lives and what options do they have after getting healed on a permanent basis.
Hoffman (2016) built upon the argument provided above and mentioned that the results of psychoanalysis could vary on an individual basis because of how individuals perceive and receive the information. It might not sound like a very promising theory from a conceptual point of view, but practically, the idea makes more sense. When two individuals are brought in for psychotherapy or psychoanalysis, it is never guaranteed that the person will leave after getting wholly healed since there are multiple other factors involved in the process. Therefore, due to the individual differences, it is entirely possible that both receive the treatment differently and while one starts healing at a faster pace, the other does not show any symptoms at all because he does not find the therapy useful.
2.2.5 Curing Drug Addiction with Psychoanalysis
(a) Technological advancement.
Healthcare providers and psychologists around the world have been putting their efforts into figuring out ways to help drug addicts overcome this compulsion. In that context, the community of researcher did not hold back either and contributed a lot to how various treatment interventions especially psychoanalysis can be used as a tool against drug addiction. It was mentioned by Marsch (2012) that with the world making incredible discoveries and advancements in all fields, addictive substances are also taking on the same track and have started to become more and more intense. In that context, it is crucial to make sure that the interventions used to cure addiction are also evolving to the same extent so that the cure mechanism is as advanced as the disease. This idea provided in the paper is very forward-looking and paves the way for further growth in the fields of psychology and healthcare at the same time. It is also argued that the therapeutic techniques suggested in the area of psychoanalysis evolve at the same rate and technology is incorporated into the system. While it might sound like a long shot in some instances, the idea provided by the researcher is unique and thought-provoking and can help resolve many issues related to addiction.
Another study supports the same idea of incorporating technology into the psychological treatment procedures for addiction. It was mentioned by Bickel, Christensen, & Marcsh (2011) that any treatment based around addiction needs to be computer-oriented to make sure that there is enough space for the treatment process to evolve with time and everything is not very bookish. The idea works best in the current global technological scenario, but one aspect that needs to be considered at this point is that the use of technology in psychoanalysis and other treatments for addiction sounds like a rational plan, but there is a cultural aspect that cannot be ignored. As Amartya Sen mentioned in his capability approach, not all people have access to the same type of facilities and opportunities, and that is what makes the living standards different across the globe. Keeping that in mind, the technology that a hospital in New York can afford might even be possible for a hospital in an African country where the situation of health, wealth, technology and capability is already weak. Hence, the idea is not applicable on a broader scale and only adheres to the needs of developing communities where the treatment procedures have already made enough progress CITATION Sza14 l 1033 (Szasz, 2014).
(b) Psychotherapy and counselling.
Many studies provide details on how psychoanalysis is done and how it affects the human mind. These research studies do not only put light on how the process has been developed in the past but also provide insights on how it can be improved in the improved in the future to treat the patients in the best possible way. According to Loewenthal (2012), other than the physical results of drug addiction, something that affects the patients the most is the sense of alienation they receive from the society. Since drug addiction is considered as a terrible habit, drug addicts are almost outcast from the society because people do not want to interact with them. The idea is supported by another study mentioned above in which Barry, McGinty, Pesocosolido, & Goldman (2014) collected people’s responses on the way drug addicts should be treated. A typical reaction among these people was inclined towards isolating these people since they are a terrible influence on the society.
When an addict gets that reaction from the society, there is a very good chance that he would feel alienated and isolated from the mainstream of his social circle. As a result, there is a shallow motivation for him at the very beginning to get rid of his addiction, and this is something that drags him into this even more. The first thing that psychoanalysis needs to do is to make these patients feel comfortable so that they embrace their situation and the possible ways of getting treated. It can be a very first step towards their healing process and is an excellent way to start the treatment which can boost up their motivation. On the other hand, addicts have to be mindful of the severity of their situation since this is a crucial factor in developing their cognitive stance on their addiction. There is still some space to analyze how the psychoanalysis process should and what are the checkpoints that need to be achieved that can lead to a healthy and faster healing process.
Elliott (2018) put some more light on the idea mentioned above and argue that the relationship a person has with his environment makes a huge difference in his drug addiction treatment. It is so because since societal factors and the company of the person are somewhat responsible for dragging him into drug addiction, they also can pull him out of it. However, the context in both situations is slightly different to some extent and how the therapy is contributing to the process is essential as well. While doing counselling for the patient or running a psychoanalysis test, it is the responsibility of the therapist to view the matter from the rational ego of the patient and look for pointers that can assist him in dealing with the process. In that regard, the conscious and unconscious efforts of the patient play a primary role in getting to the best possible solution.
There were various studies found on the intensity of impact psychoanalysis has on drug addiction, and a variety of them will be mentioned here. Fenichel (2014) narrated that drug addiction and excessive compulsion to use drugs that the patient knows are harmful to him is a kind of brain development. Since it is something that was developed in the human brain from scratch, a proper intervention has to be used to reverse the process. This theory links back to the idea provided by Foll, et al. (2014) when the intake of D3 receptors was considered to be helpful in helping the brain get rid of the compulsive thoughts so that the patient can stop using drugs. Nevertheless, the search for more effective medication for drug abuse still goes on and keep improving on a constant basis CITATION Mey17 l 1033 (Meyer, 2017).
(c) Brain and psychoanalysis.
.The human brain is very complicated and many aspects of it are still to be discovered by science. From drug addiction to its treatment, the human brain plays the most crucial part, and that is why psychoanalysis targets this part of the body to come up with solutions to resolve the issue. It is mentioned by Dayan, Bernard, Olliac, Mailhes, & Kermarrec (2010) that human brain can engage in anti-social behavior which later on, leads to drug abuse. An experiment was conducted on adolescents from 12-18 years, and young adults from 18-25 age range to see the tendency of drug abuse in them and analyze the role of brain development in that. It was mentioned that individuals in this age group are more likely to engage in drug abuse habits which eventually leads them to isolation and anti-social tendencies.
In this instance, another perspective to the study can be that the tendency of drug abuse and anti-social behavior works both ways. While drug abuse easily leads an adult to engage in anti-social behavior, already existant anti-social tendencies can be a reason for drug abuse as well which needs proper intervention to heal. Although both instances are equally dangerous for the physical and mental well being of an individual, the later is even more harmful since it is something initiated from the society when the person is being isolated and finds his last resort in drug abuse. Either way, psychoanalysis is designed to detect in which case it is for the patient so that treatment can be designed for him.
Analysts report that in drug addiction, the patient loses his ability to limit his drug intake which leads to abuse. At that stage, psychoanalysis helps the person to look deep down into his thoughts to see what are the things that are stopping him from quitting drugs or what is making him use it on an aggressive rate. It is argued that alcohol or other types of drugs automatically form a reinforcement mechanism for the patient which is to be broken by the mechanism of psychoanalysis. For instance, when the neurochemical elements of human brain a telling an addict to keep using the drug, psychoanalysis can assist in diverting his neurotransmission streams so that he can find another source of reinforcement which is different from drugs. Although the study provided enough details on brain functions and how the human brain can be designed to think a different way through psychoanalysis, more perspective could have been provided on behavioral motivators that could change the tendency of a drug addict on use of drugs for a long-term (Koob, 2011).
(d) Behavioral dynamics.There are several studies available that argue that drug addiction is a behavioral issue and there are several dynamics that explain it. Additionally, these behavioral dynamics of patients also play a role in the treatment process whether it is psychoanalysis, medication or any other treatment mechanism. It was mentioned by Uriely, Ram, & Pines (2011) that it is possible that some patient automatically active their defence mechanism when they are being treated through psychoanalysis which can have a negative impact on the analysis process. This idea is supported by the arguments provided by Elliott (2018) and many other arguing that personal motivation of the patient play an active role in helping him get rid of the addiction. In this instance, if the defence mechanism of the patient is activated and he starts behaving against the treatment process and his negative tendencies can negatively influence the psychoanalysis.
In this instances, theory paves the way for further research on how to detect the level of motivation of a patient before he starts therapy. It can help psychotherapists and healthcare providers treating drug addiction in determining what strategy needs to be implemented to treat the patient. If the therapist can detect that the person is still in denial and has lower motivation to be treated, other interventions have to be used to get him more involved. An idea supporting this theory was presented by Dare & Derigne (2010) who mentioned that it is common for drug addicts to be in the sense of denial about their drug addiction for a long time. In these instances, there is a need to construct a healthy and supportive environment for them so that they can figure out what is wrong with them. This stage is essential to maximize the effectiveness and results of the study because if the patient is in denial, there is no way that he will corporate throughout the treatment. Hence, the results of the treatment will not only come out slow, but their overall effectiveness will be way lower.
Drug addiction, in many instances, is a way of dealing with some other issues like anxiety, depression or even suicidal tendencies. It is argued by CITATION Pro11 l 1033 (Proudfoot, 2011) that drug abuse, especially the excessive use of alcohol is something that people use to overcome some other personal issues. Through personal interviews with some participants that were drug addicts, it was concluded that they used drugs because of some personal issue that they were going through like poverty, divorce, loss of a loved one or something, and the drug helps them get rid of the negative thoughts. These escape plans can lead to suicidal tendencies as well if the person does not find enough motivation in his surroundings to keep going through life CITATION Ker12 l 1033 (Kerberg, 2012). More extensive research is required on the way societies and psychoanalysis combined can make efforts to help drug addicts get rid of their compulsive tendencies as it will help answer some of the most basic yet intense questions about drug addiction and its treatment.
2.2.6 Complementary Therapies and Interventions(a) Pharma-therapy.
There are many other therapies and intervention methods suggested by healthcare providers that prove to be helpful for addiction. The literature available on these other options Is vast enough to explore to ensure that all corners of the discussion are covered, and alternative options are also scrutinized to be able to what is happening on these ends. Bouso & Riba (2013) suggested the use of ayahuasca which is extracted from the Amazonian plant tea to cure drug addiction. It is a purely medical treatment for addiction with a philosophical touch to it. However, there is proven success track of this intervention in the literature and practice field as well. It has been reported that therapy centre around the world offer this intervention to calm down the addictive behavior and is like a traditional way of treating a behavioral issue. Nevertheless, the area needs more research regarding what makes the treatment useful and what are the best ways to ensure its implementation. Additionally, there is a need to test the clinical capability of the treatment with the help of more systematic studies.
Another study that talks about the use of medication and traditional ways of treating addiction were presented by Bauer, Soares, & Nielsen (2015) who mentioned that antagonist treatments like naltrexone and methadone and things like cocaine vaccines are highly effective in treating drug addiction in chronic addicts. The reason this traditional yet advanced method is useful is that it targets the physiological reasons of a person being addicted to a drug and then caters to his personal and development needs to help him get rid of this spiral. These methods were proven to be helpful for a variety of drug addictions like alcohol, cocaine and opioids, etc.
Bozrth (2017) mentioned in his work that while treating a drug addict with medication, personal reinforcement properties have to be considered since they might provide a new dose design for the different patients. It is so because one patient can have the better reaction time to medication compared to another one. On the other hand, the reinforcements also vary from the medication perspective, and while one patient is more sensitive to one medicine, it is possible that the other has a better response to an entirely different medicine. While some of it is self-administration, the therapist and healthcare provider has to be in charge of the situation to determine how the reaction of the patient is forming a shape and how is it forming a pattern. This observation can go a long way when it comes to treating drug addicts with medication.
In their work, Foll, et al. (2014) provided a strictly physiological yet logical way of treating drug addiction. They reported that the limbic area in the human brain is responsible for promoting or controlling the thoughts of having an excessive amount of drug or craving for it to begin with. To treat drug addiction pharmaceutically, the use of D3 receptor ligands is an effective way to treat drug addiction and the compulsion to use something harmful to human body and brain. Although it sounds like a straightforward solution, empirical evidence provides proof that this medical way of treating drug addiction is useful. To make the process more efficient for the addict, this medical treatment can be incorporated with psychoanalysis so that the addict gets more physiological and mental therapy so that he can get out of the addiction faster than expected.
(b) Personal preferences.A unique perspective provided in the literature regarding treating addiction through traditional ways talks about the personal preferences these addicts have when it comes to getting treated. The idea might not sound very practical considering that every rational person would like to get rid of his compulsion, but logically speaking, it is entirely applicable to a significant portion of the contemporary society. Also, many studies support the idea that it depends on how intensely a patient wants to recover from his addiction and how far is he willing to go to do that. For example, according to Everitt & Robbins (2016), drug addiction, no matter how old it is in the patient, is necessarily a bad habit which can always be changed. It all depends on the addict and his level of realization about this habit. Once he can overcome his drug-seeking behavior and has moved on to the treatment-seeking one through stimuli, it all gets sorted in due time. However, the study lacks empirical evidence, and there is a need to provide more logical to the theory to understand the mechanism of drug addiction and its treatment CITATION Roa18 l 1033 (Roazen, 2018). One study that provides more context to this idea of habits was presented by Murray (2016) who mentioned that the help-seeking behavior of the addict matter a lot when it comes to observing the results of the intervention method. For example, if the patient has short-term goals and does not deliver a commitment to getting treated, there is a very fair chance that his addiction habit will resurface even if he gets pharmacological and treatment at the same time. On the other hand, patients with long-term goals and showing commitment to their treatment have a way lower chance of relapse.
This idea is supported by the theory of human cognitive experience presented by Varela & Thompson (2014) who argued that no matter the type of therapy and treatment a drug addict is going through, what matter is the cognitive perception of the patient about his treatment and how he is comprehending the whole process in his mind. Patients who are mindful of their habits and understand that drug addiction is an issue that needs to be resolved are better at resurfacing as good patients that positively receive the therapy. On the contrary, denial and a lack of mindfulness affect the therapy in a wrong way, and the patient might end up getting dragged into a more extended therapy because of how slow the results are for his transformation.
(c) Treating Addiction.
When it comes to saving someone’s life from getting ruined by addiction, healthcare providers are supposed to do everything that is in their power to drag the person out of the dark corners. It was mentioned by Mitchell (2015) that the influence a therapist has on his drug addict patient makes much difference in the overall outcome of the treatment process. The idea provided in the paper holds a crucial place when the healthcare provider is delivering more than just a pharmaceutical treatment to the patient and is also giving him counselling or psychotherapy for his issue. It is so because when the doctor is only providing some medicines to the patient, the effects might not vary a lot depending on the doctor, his approach to the treatment and relation to the patient. However, when the patient is getting therapy from his doctor for his addictive behavior, how the doctor is approaching the problem and what is being offered to the addict makes a considerable difference to the outcome.
In that regard, it is vital that the therapist be well aware of the current mental state and past experiences of the patient. For example, if the patient has had a terrible experience in the past and is still dealing with that trauma, there is a high chance that the patient will be very defensive in sharing anything with the doctor which eventually affects the outcome of the therapy. At this point, the timing of past experiences, their intensity and distance from the present can make a huge difference as well. The case of someone who just went through a traumatic event and went into drug addiction because of that will be very different from a person who had a traumatic experience a while ago that no connection to his drug addiction. Hence, there is a space for improvement in this area to understand how individual differences matter when drug addicts are getting treatment for their addiction.
It paves the way for better treatments and intervention programs for drug addiction since context matters a lot in this respect. It should be noted that treating drug addiction is almost like treating any other physical or mental disease because no matter how much difference the treatment processes are, the outcome is all the same which is to make the person get out of the spiral of physical and mental agony. For that purpose, the treatment model, no matter if it is composed of medication, therapy, counselling, psychoanalysis, family intervention or any other type of recovery model, all that makes a difference is how the recovering mechanism is designed for the patient and what needs to be done to address his personal needs. The idea of personal needs regarding medical treatments might not sound very rational. However, recent studies conducted and experiences designed suggest that individual differences and history of the person being treated matter a lot regarding the extent to which the intervention will work CITATION Cla181 l 1033 (Clark, 2018).
2.3 Summary of Literature ReviewIn this literature, a more significant number of studies was analyzed from what they think about psychoanalysis and its use for addiction. Some general studies were also scrutinized that talked about drug addiction in general, treatment processes for addiction, psychoanalysis and its progression and the use of other creative methods including the use of technology to treat drug addiction in patients. All the studies agree on the idea that drug addiction is a severe behavioral issue that should be dealt with on an urgent basis. It is argued that since drug addiction does not only impact the addict himself but people around him on the same level, many methods can be used as interventions for the addiction so that the person can be moved back living a healthy life as soon as possible. However, the idea depends on many factors that are personalized demographics of drug addicts in various societies. For instance, as Amartya Sen argued, people around societies have a different approach to capabilities, and some have more options in life than others. Therefore, one uniform treatment cannot be guaranteed for everyone. Additionally, the willingness of the patient and the level of denial in him determine his speed of recovery as well.
Regarding psychoanalysis, it is a proven successful method to treat a person’s addiction to any drug. The idea of psychoanalysis is to use human brain and help it understand how the addiction is ruining his life and assist him in overcoming the compulsion. The person also gets to take a peek into the events of his life for him to judge the moment or reason that got him into addiction. The extent of effectiveness of psychoanalysis for an addict varies person to person, and many factors determine its success. For instance, a person who is still in denial that drug is affecting him and the people around him might not take the treatment as positively as someone who is willing to get better and get rid of the addiction. Another idea that surfaces were that since the use of technology has transformed the world to a large extent, using technology and advanced methods of intervention for drug addicts is something that cannot be ignored in the field of psychology. Other than these methods, the use of medication, therapy and peer attention can help an individual get out of the spiral of addiction faster.
2.4 Search DesignThe purpose of this literature review was part to ensure that as many studies as possible can be incorporated so that no aspect of the topic is ignored. To fulfill that target, multiple search engines, platforms and methods were adopted to extend the available literature. Search was started by Google Scholar, and the date range was set to 2008. It was done to ensure that all studies conducted in the past decade on the topic are covered in the review, and no major work is ignored. It helped expand the database and see how the concepts of researchers and psychologists have improved and transformed over the past decade as well.
Other than Google scholar, three additional databases used for the study were ScienceDirect, Emerald and Jstore. Although just one of the platforms could have been used it is possible that one study is available on only one of the three platforms, so all three were used to avoid exclusion of any significant work in the field. The subject matter on all three platforms was filtered down to psychology, and date range was again narrowed down to starting from 2008 which helped cover the same time span that was being analyzed by Google scholar. During this process, any duplicates studies appearing on all platforms were entered only once.
The keywords used to search for papers included:
“Psychoanalysis” and “addiction.”
“Drug addiction” and “treatment.”
“Psychotherapy” and “addiction.”
“Drug addiction” and “intervention.”
“Treatment” and “psychoanalysis” and “addiction.”
The type of studies was kept as open as possible, and everything including peer-reviewed journal papers, conference papers, books, experimental studies, reports and another type of research studies were included in the search. All this work was conducted in the field of psychology and mental health which helped keep the literature review on track. In the end, most of the studies that were peer-reviewed journal articles or books made it to the final output. The review was then broken down into sub-sections to give proper attention to all studies included in the review. It helped in avoiding cluttering of ideas and made everything clear and relevant according to the section a study was put in.
2.5 Theoretical Framework2.5.1 Addiction, Theories and Dependency
There are many ideas on addiction and its behavioral dimensions in the addict. These studies help understand the behavioral aspects of addiction and dig deeper into the ways it can be controlled through a well-designed intervention. It was mentioned by Dare & Derigne (2010) that some of the widespread and most initial behavioral reaction to addiction is denial and withdrawal. Whenever a person starts getting addicted to something, his first start to hide it from others which is one of the earliest signs of addiction. It indicates that unconsciously, the person has realized that his habit is turning into something unhealthy and he needs to get rid of it. However, at this stage, since many people or sometimes nobody knows about the addiction, it is harder to stop someone at this earliest stage.
Before devising a plan to treat a drug addict, it is helpful to understand how he gets into this in the first place. For addiction, several stages are mentioned in the literature that assists in understanding how someone gets addicted to a drug which eventually needs medical and psychological assistance to recover. These stages assist in understanding both theoretical and practical aspects of getting into drug addiction and how a human body reacts when it develops a compulsion of something. The chart below indicates four stages of addiction as experimental use, regular use, daily preoccupation and dependency CITATION Jes181 l 1033 (Jesse, 2018).
Figure SEQ Figure * ARABIC 1: Stages of Drug Addiction
The first stage is when the person only uses a drug because of peer pressure when his peers force him to do it. In the beginning, he does not have any idea of how it will affect his long-term life and that he is most likely to get addicted to it. In most instances, peers that force someone to do drugs are already addicts, and there is a lower probability that these peers do not even use the drug in the first place. Most of the times, it is not planned and happens suddenly when someone is sitting with his friends, and someone takes out the drugs so everyone can be involved for fun. Generally, nobody knows that it is the start of a new journey that will be very harmful to everyone involved.
The second stage is when the person is past the nervousness of using the drug for the first time. After experiencing the drug, he likes the feeling and goes back to his peers that provided him with the drug in the first place CITATION Sel13 l 1033 (Selby & Smith, 2013). He seeks the same drug and experience out of some minor discomfort and reaches out to his friends. When provided with the drug, he realizes how easy it is to get the drug, and he can have access to regular supply through his friends. Even at this stage, most of the drug use is for fun, but pleasure and dependency start kicking in without the person realizing it.
After the regular use, there comes a stage when the person cannot stop using the drug and starts to need to use it on a regular basis. It is a stage when the regular life becomes a challenge for the addict because his mind is preoccupied with the idea of using the drug. He would reach out to his peers that supply the drug asking for more. At this stage, it is prevalent for these addicts to get blackmailed by the supplier of the drug because they also realize that the person is dependent on the drug now and will need it on a regular basis. It is a miserable stage when there is no turning back CITATION Kim18 l 1033 (Kimberly & Deabreu, 2018).
The final stage is a complete dependency on the drug when most people know and admit that they are drug addicts. At this stage, the person is entirely dependent on the drug and would do anything to get a supply. He is prone to get easily manipulated at this point because his suppliers know that he cannot live without using the drug. It also gives rise to other types of crimes including stealing or harassing others to get the drug. Immediate help is necessary at this stage before it is too late and the person loses his senses.
There is an addiction cycle mentioned in the theory that provides a more generic and precise idea about the stages a person goes through when he is developing an addiction to some drug. These stages are relevant after someone has already developed an addiction. Firstly, he gets hits with an emotional trigger and starts feeling withdrawn because of the physical and psychological impact the pre-craving stage develops for him. Secondly, he starts craving the drug and thinks about looking for sources to get the drug. Thirdly, he starts the ritual and officially looks for a source so he can get the drug at the earliest. When he gets the access, then comes the stage of using the drug. At this point, it is common for drug addicts to overdo the drugs depending on the availability. After they have gotten this over with, then comes the stage of guilt when the person starts regretting using the drug. He starts contemplating about ways he would use to avoid using the drug again and how he would bring his normal life back on track. However, it does not help that much, and he has that emotional episode again which leads him to the same cycle one more time CITATION Vei10 l 1033 (Veilleux, Colvin, Anderson, York, & Heinz, 2010).
Figure SEQ Figure * ARABIC 2: Addiction Cycle
2.5.2 Treating Addiction and Ideas on PsychoanalysisAnalysts argue in theory that addiction is something that starts psychologically before it starts in reality. That is so because whenever a person is emotionally vulnerable, he is in the best position to be attracted towards these habits of using drugs. The instances when a person is asked to do drugs, and he denies are also common because they are emotionally stable and are aware of the destructive effects of doing drugs which helps them stay away. However, it does not necessarily mean that everyone who does drugs is emotionally unstable or week. There is a possibility that he has more pressure compared to others which forces him to do drugs. Additionally, another aspect provided in the literature is the ecological factors leading to drug addiction. What sort of environment a person is a part of plays a substantial role in determining his dependency on drugs and the probability of him ruining his life from it.
The strong pre and post impact of the use of drugs leads psychologists and healthcare providers to suggest many ways of treating it. There are several theories and concepts provided in the use of psychoanalysis to treat drug addiction. According to the psychoanalytical theory, using personality development can assist in developing the personality of a person in a way that he can undergo personality refinement that assist him in getting rid of addiction CITATION Kha131 l 1033 (Khanna & Greeson, 2013). This idea is widely accepted in the literature since there is a proven track of the success of psychoanalysis of helping people heal from addiction.
Another theory provided by Freud is the theory of unconscious which suggests that everything a person does and believes in is a fabrication of his mind and unconscious. That is the reason that the same brain and unconscious can be used to bridge the gap between the conscious and unconscious of a human and help him overcome his emotional dependencies. In most instances of drug addiction, the person is going through a psychological conflict and doing drugs sound like the final resort for him to get rid of his emotional agony and that is why getting addicted is very easy for these types of people CITATION Fen14 l 1033 (Fenichel, 2014).
Humans, in general, have an anxiety and defense mechanism that assists them in getting rid of their emotional knots and assists in leading a healthy and happy life. Reduction of tension and anxiety is a different process for all individuals that also depends on their personal preferences and past experiences. In some instances, past experiences of someone can lead him to become dependent upon drugs because he does not seem to find any other way to do it. That is the reason psychoanalysis is helping in treating people with addiction because it targets the most inner emotions of people and provides them with a clear pathway to assess their behavior in a long-term. This reflection assists a person build moral code or redefine the ones he already has so that he can control his emotions.
Figure SEQ Figure * ARABIC 3: Addiction Recovery
There are five stages of psychoanalysis therapy for drug addiction that a person goes through when he gets the therapy. These stages are as follows:
Early recovery and
The first stage is when psychoanalysis helps the person looking into his inner emotions so that he can understand the intensity of the problem. It is one of the most crucial stages of the treatment process because it is common for addicts to be in denial when they do not admit the fact that they are addicted to something. After some time, he is in a position to realize that he has actually past that stage when drugs are only fun for them, and now they are addicted to it with a loss of ability to live a healthy life. Once a patient is passed this stage, the rest of the process automatically becomes easier since realization is the essential factor in the process CITATION Bar141 l 1033 (Barry, McGinty, Pesocosolido, & Goldman, 2014).
After the realization, the person develops a connection with the therapy and develops commitment which goes a long way. Once someone realizes the intensity of the issue, it is way easier to develop commitment compared to trying to develop commitment without any realization. One thing worth mentioning here is that all these stages of recovery from addiction are followed the way they are mentioned, and the order cannot be changed. After the relationship development, the third stage is to understand recovery options. Since the patient is already going through psychoanalysis, other options for him are medication, changes in his lifestyle, group therapy or peer reviews. At this stage, it is advised for the patient to leave the company of people who got him into the process at the beginning and try to keep his company as positive as possible. Group therapy at this stage is an option because some patients only want to do the psychoanalysis and medication while others feel comfortable talking about it in a group that has been through the same problem. Next stage is the early recovery the person starts his journey towards not using the drugs for short periods of time and also reduce the quantity being used. People who do not want to get involved in a group therapy prefer joining a support group at this stage since it provides them with moral support when the getting up after hitting rock bottom in drug addiction.
The final stage in the recovery is maintaining the change, and this is when it all depends on how willing the person is to sustain the therapy. At this point, psychoanalysis is very important because the person is in a vulnerable position and it is helpful to understand what emotional journey he is going through so that any loopholes can be identified. The factor of self-help is something that kicks in here since after all the therapies, group sessions, discussions and medication, it is now time for the person to assist himself and sustain all the positive habit he had developed during the therapy CITATION Kha131 l 1033 (Khanna & Greeson, 2013).
2.5.3 Linking the Theoretical Domains and Critical Analysis
Theoretical ideas revolving around therapy and addiction overlap each other in many instances since they are strongly interconnected. The fact that drug addiction is a global phenomenon and is responsible for ruining thousands of lives on a daily basis cannot be denied. A wide range of literature addresses the issues surrounding addiction, its causes and treatment. Considering the idea around stages of drug addiction mentioned above analysts argue that drug addicts do not only need to get help when they hit rock bottom, and there is a need to devise plans that help these people from the very beginning.
In that perspective, the idea of self-help also emerges that talks about how these drug addicts can help themselves to overcome their compulsion of using drugs. In theory, low-cost methods have also been suggested that help people overcome their addiction with costly interventions. These methods also include the use of technology and advanced medication that does not necessarily require many visits to the healthcare providers. When it comes to any therapy for drug addiction, the idea sounds easier said than done and many people would be hesitant to get help on their addiction. It is a practical scenario that cannot be ignored because of the scale of the problem. In these instances, the theory might not be as useful as possible because the patient himself is not interested in getting any help from healthcare providers. It is when other dimensions of the problems have to be analyzed to see how the patient can help himself with least contact with the therapist.
In a practical social setting, the idea makes complete sense since not everyone would be comfortable talking to others about his addiction. That is one of the reasons that most of the support groups for drug addiction are secretive and no information of the participants is shared outside of the group. On the other hand, there are also groups like NA (Narcotics Anonymous) that are primarily designed for these people who are willing to get rid of their addiction and then go live a healthy life without having any traces of their past chasing them. These groups are beneficial for most people since confidentiality is their primary motto CITATION New11 l 1033 (Newman, Szkodny, Llera, & Przeworski, 2011).
While therapy, psychoanalysis or medication sounds like a once and for all solution, it might not be the last resort for some people. Cases when the person goes clean and comes back to his addiction after some are not very uncommon. In these instances, it is to be ensured that the person does not only get one-time support but has a go-to place where he can contact any time he gets the compulsion surface again. For almost everyone, addiction is an emotional trigger that gets activated due to some personal reasons, and that is when they lose control of themselves. In these instances, the person is supposed to be taught to overcome the trigger and live a socially healthier life so he can avoid situations that drag him into that pool of destructive emotions (Du, Jiang, & Vance, 2010). Practically speaking, something that drug addicts and healthcare providers need to understand is that drug addiction and recovery from it is a change model that the patient has to adopt. A change model is shown in the figure below.
Figure SEQ Figure * ARABIC 4: Change Model
The first stage of change model is pre-contemplation. It is the stage when the person is contemplating about a problem that he is facing in his life and wants to bring change. However, at this stage, the person does not formally think about bringing change and only happens to get bothered by stuff that is uncomfortable for him. Translating this idea into the life of a drug addict, at this stage, the addict would only start realizing that his drug dose is getting out of control and his behavior is not very healthy. On the second stage, the person officially enters a realm when is starts thinking about the negativity in his life and wants to live a better life. For drug addicts, this is when they realize that they are addicted to drugs, and this is something that they need to overcome. For many people, this is a more like a stage of revelation when the person gets hits by reality and is determined enough to make some changes in his life. The third stage is when the person gets on the train to act on his thoughts and plans. It is when the strategy-making starts for the person, and he lists down all the things he needs to do to get back on track. Most drug addicts at this stage look for resources and people that can assist him in the problem and might also think about reaching out to a healthcare provider or a social worker.
The action is the second last stage of the change model, and this is when the action happens. Whenever a person is determined enough to bring a change in his life, this is the level when he does it. For instance, for someone who wants to lose weight, this stage will be when he cuts down on junk food and starts going to the gym. Similarly, for a drug addict, this is officially the first day he stops having drugs. The final stage is maintenance, and it is when a person has to sustain the action he developed in the prior stage. Several people find it as one of the hardest parts of the change model because although kickstarting something is more comfortable, sustaining the change in life is harder. It is because any change does not only bring a temporary physical change in a person; it also comes in with a lot of mental and emotional burden that not everyone is prepared to hold. Therefore, getting past this stage is one of the most crucial things to do in a change plan. For drug addicts, this is when their friends and family can help them in developing a positive attitude and stay away from drugs for as long as possible and seek healthy alternatives to avoid emotional distress (Stead, Bullen, & Boyce, 2012).
2.6 Strengths and WeaknessesThere are several strengths and weaknesses in the literature review and the models developed around the concept. Most of the studies included were based on primary data analysis or experimental studies that proved to be a strength of these studies. It is so because, in the field of psychology, primary data holds much importance compared to other fields because the domain is all about humans, their emotions and experiences. For all these studies, there was a fair number of participants included in the study that helped develop the theory in the end. The current study will follow the same pattern, and a relatively large number of participants will be included in the analysis to make sure that the results are generalizable on a larger group.
One aspect that these studies ignored was that if the analysis was based on experiment, the entire analysis went on following the experiment and no healthcare providers were involved in the study at all. On the other hand, some studies were purely based on interviews conducted with healthcare providers or psychologists and drug addicts never became the part of the study. It made these studies one-sided since only one aspect was covered at a time. One thing that can be made to make the studies more generic with a broader scope is to cover the aspect of psychologists and patients at the same time so both of their ideas about psychoanalysis and addiction can be gathered.
Although none of the studies under analysis denied the fact that psychoanalysis and psychotherapy helps in treating a drug addict, there was a lack of conviction seen in the studies. It might be due to the facts that some of these studies were not targeted to talk about the connection between addiction and psychoanalysis, to begin with, and the primary purpose was to talk about any particular intervention for drug addiction. This weakness will be covered in the current study by making the keywords, research questions, hypothesis and study design as comprehensive and straightforward as possible so that a final and vivid conclusion can be drawn from these results.
2.7 Summarizing Theoretical Framework
The entire section of the theoretical framework was targeted to understand how the concept of drug addiction and the role of psychoanalysis works in the theoretical and practical domain. It was observed that many theories talk about how drug addiction is developed and what are the stages a drug addict goes through when he develops this habit. It is mentioned in theory that the journey to drug addiction starts with fun or peer pressure when the person only wants to try it for fun. Later on, that fun turns into something that the person cannot control and becomes dependent on using the drug over and over again. For some people, the time when they realize that they area addicts come earlier while others might take their whole lives to figure it out.
To overcome addiction through any intervention, a person has to go through the change model where he decides to bring a change in his life. Psychoanalysis helps in this regard since Freud mentioned that the theory helps the person take a peek into his inner emotions and comprehend the factors that lead him to do drugs. After deciding to bring a change in his life, the person attempts to bring that change through therapy, medication or other interventions. There is a possibility that the person is hesitant to seek any help for his addiction and wants minimum contact with the therapist. In this instance, ecological factors can help the person as well since as long as the person stays away from destructive settings and emotions, it might be easier for him to bring a change compared to instances when he keeps the same destructive company that dragged him into this habit.
2.8 Research Gap
Although a significant amount of literature available on the topic of drug addiction and psychoanalysis, there is enough space in the logical domain to understand this relationship in a broader scale. As mentioned above in the weakness section, most studies analyze one side of the coin when they either include healthcare providers in the study or drug patients going through therapy. This gap can be filled by conducting a study that works with both healthcare providers and drug addicts to understand the idea on a broader scale.
Another gap identified in the literature is that studies that are conducted are mainly cross-sectional analysis and analyze the same group of drug addicts at a specific point in time. The idea is helpful as it assists in narrowing down the study to a uniform point in time in the lives of these addicts. However, an additional feature for this type of analysis can be turning the study into a panel data analysis and observe the same group of people at the same and the end of a psychoanalysis treatment. It can help monitor the change and see the extent to which the therapy has assisted these patients in overcoming their addiction. In this way, the factor of the willingness of these patients can also be incorporated to see how the theory of self-help applies to these addicts and their intervention program. It can not only make the study theoretically broader but will also provide more practical turn to it and help humanity on a broader scale.
Lastly, another aspect that can make the study extensive and fill a research gap is to include people from different age groups. Dividing the people by some basic demographics like age, gender, economic and social status and other similar aspects might provide some more insights into the effectiveness of psychoanalysis or any given drug intervention program and assist in understanding what needs to be done to make the process more efficient.
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