The Subject of Addiction

Psychoanalysis and The Administration of Enjoyment

Rik Loose

• Publisher: Routledge
• Year: 2018
• ISBN:
  9780429922367
• Edition: 1
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Drugs and drug use are an integral part of human culture. Yet we know hardly anything about drugs, at least not the kind of knowledge that would help us to understand how drugs affect people and how people beome addicted to drugs. This is most surprising in the light of the vast amount of knowledge accumulated in the sciences. Psychoanalysis might not be an obvious choice for the treatment of addiction. Nevertheless, it is in an excellent position to make a contribution to a problem that has so far defied much of our understanding. By inviting people to speak about themselves, psychoanalysis has established a unique way of collecting clinical material, a material that surely must be immediately relevant coming as it does from the horse's mouth. With addiction on the increase, this fact alone justifies the necessity for a different approach.Providing a theoretical foundation for the argument that psychoanalysis should be seriously considered, and where possible incorporated into the treament of addicts, this thoughtful and innovative book can serve as an orientation in the ongoing front-line battle with addicts and addiction.

Part I:
Classical Foundations for a Theory on Addiction: The Energetics of Libido and the Economics of Desire

Introduction

‘‘. . . why isn’t everyone a drinker?’’

de Mijolla and Shentoub, Pour une Psychanalyse de L’alcoolisme, 1973, p. 33

It is a remarkable fact that there is no substantial psychoanalytic theory of addiction, especially given that Freud had some clinical experience of working with addicts.¹ This fact is even more remarkable in light of the fact that one of Freud’s first attempts to cure someone was his clinical intervention with his friend and colleague, Ernst von Fleischl-Marxov. Freud had hoped that cocaine could help his friend to lose his addiction to morphine. This attempt failed and eventually von Fleischl-Marxov died from a cocaine addiction.² Surely these clinical encounters must have aroused Freud’s interest in the problem of addiction and provoked questions regarding its metapsychology? Freud’s theory and metapsychology were always developed on the basis of his clinical work with patients and, after all, his mind was uncommonly predisposed to curiosity. There are numerous interesting and important references to addiction in his writings, ranging from his pre-analytical period to the end of his life, but it is nonetheless strange that he never wrote an article dealing exclusively with addiction. Despite the many references, it is still possible to speak of a relative silence in Freud’s work with regard to the clinical problem of addiction. He developed elaborate theories on neurosis, perversion, and psychosis, so why is there no such elaborate theory on addiction in his work? Could it be that there were deep-rooted psychological motives in Freud himself that contributed to this neglect? These questions have been taken up by various authors and will not be dealt with here.³ It is well known that Freud’s relationship to drugs was ambiguous. When Freud came across cocaine in 1884 he was immediately fascinated by it, particularly its therapeutic properties and he used it himself sporadically for about 10 years. He was not really interested in alcohol and only occasionally drank wine. He was irritated by problems of addiction in his practice and social environment. He was hopelessly addicted to smoking and nicotine. He smoked about 20 cigars a day. He needed cigars to work and lack of nicotine plunged him into bad moods. When he was diagnosed as having cancer of the mouth he was informed that his smoking habit would kill him and on several occasions he was strongly advised by his physicians to stop smoking but, despite this medical advice, he was unable to stop (Gay, 1988, pp. 426–427). From Freud’s biographer, Ernest Jones, we know that for a long time Freud refused to take analgesics against the excruciating pain produced by the cancerous growth in his mouth. He likened taking drugs to embracing death. Freud’s personal and professional ambiguities toward addiction perhaps contributed to the fact that there is no proper theoretical development in relation to addiction in his work. One can therefore not depend on a coherent theoretical foundation in Freud in order to construct a psychoanalytic theory and clinic of addiction. Nevertheless an exploration of remarks on, and references to, addiction throughout Freud’s work show that there is a lot of material to work with and on which to reflect. Chapter 1 is devoted to his papers on cocaine. These papers are so central to the development of his work and so important for an understanding of a psychoanalytic approach to addiction, that they warrant a separate investigation. The aim in Part I will be to analyse in detail all of Freud’s remarks on addiction.

Chapters 2–4 on Freud all use the work of Yorke (1970), de Mijolla and Shentoub (1973) and Magoudi (1986). But I have opted to do a detailed analysis of the theoretical and clinical context in which Freud’s references to addiction occur rather than compile and review the written material, so my point of reference to the above writing is, largely, taken from where I depart from them. The choice for this approach was made for two reasons: firstly, to demonstrate the theoretical complexities and lack of uniformity involved in Freud’s thinking on what is often considered to be an uniform or relatively straightforward clinical problem, and secondly, to indicate that these clinical and theoretical complexities have been largely ignored by most post-Freudian writers.

Notes

1. For instance Peter Gay in his biography of Freud mentions that Freud analysed Jones’ mistress Lou Kann who was a morphine addict (1988, pp. 186–187). Also, the famous analyst Ruth Mack Brunswick, was addicted to morphine and a whole series of other drugs. Freud had understood that her addiction should be treated. She was in analysis with him, with interruptions, from 1922 to 1938.

2. For more details about this important period in Freud’s life see again Peter Gay (Ibid., p. 45).

3. In an article on Freud’s relationship to cocaine Ali Magoudi argues that factors and events which contributed to Freud’s ‘‘cocaine episode’’, as Jones called it, resulted in a theoretical position which led to a tendency in Freud and psychoanalysts after him, to exclude addicts from psychoanalytic treatment. Magoudi highlights the blind spots in Freud’s self-analysis and theory in order to show how they functioned as obstacles to analysis of addicts and addictions (1995). For a further exploration of these questions the reader is referred to the following two authors: Peter Gay (1988, op. cit., p. 427) and Didier Anzieu (1975, pp. 75 & 78).

Chapter One
The place of cocaine in the work of Freud

"This is the malady in them all for which law must find a pharmakon. Now it is a sound old adage that is hard to fight against two enemies at once—even when they are enemies from opposite quarters. We see the truth of this in medicine and elsewhere"

Plato, Laws, 919b

"There is no such a thing as a harmless remedy. The pharmakon can never be simply beneficial"

J. Derrida, "The Pharmacon", p. 99

A "side interest"

In An Autobiographical Study Freud described his involvement with the drug cocaine as "a side interest though it was a deep I one . . ." (Freud, 1925d, p. 14). In the short passage he dedicated to this period of his life, he referred only to the missed opportunity of discovering cocaine as a local anaesthetic. Freud seemed to marginalize this aspect of his work, as indeed others have as well. When it is not marginalized by others, it is often used as a way of denigrating his work. It has been argued, for instance, that Freud was addicted to cocaine and that the founding texts of psychoanalysis were a result of grandiose delusions that were induced by cocaine.¹ On occasions, serious studies of this period in Freud’s work have been done.² These studies insist on the importance of returning to this aspect of Freud’s work and conducting a thorough exploration. The aim of these works is to reassess the problematic relationship that existed between the addictions and psychoanalysis from the very beginning. A return is fruitful if we come back with something new. If not with new answers, at least with new questions concerning the ongoing problem of situating addiction within the theoretical and clinical field of psychoanalysis.

In this chapter a reading of Freud’s Cocaine Papers is proposed as the beginning of the Freudian adventure.³ A detailed exploration of his subsequent pre-analytic trajectory (till the so-called birth of Psychoanalysis with The Interpretation of Dreams from 1900) in Chapter 2 will allow us to establish a relationship between these papers by Freud and concepts such as the sexual toxins, libido and the actual neuroses.

Freud’s Cocaine Papers are interesting reading, but they become especially relevant when we read them in the context of his work; that is, not as a side interest of Freud’s, nor as an allotrion, which is the term he used to classify his interest in cocaine in a letter to Wittels. Allotrion is an interesting word. It can be defined as a rupture which consists of the introduction of a foreign idea amongst the body of ideas within a certain scientific discourse or doctrine. Geberovich makes the interesting observation that a closely associated French term allotriophagie signified the following during Freud’s time: "the deprivation of appetite due to the incorporation of non-alimentary substances" (Geberovich, 1984, pp. 158–159, my translation). Freud’s choice of words might not have been accidental, but motivated unconsciously. On the rare occasions he wrote about this episode in Freud’s life, Jones referred to his forgetfulness, his mistakes and his lapses (Byck, 1974, p. 200). We know that it is precisely parapraxes such as these which reveal an unconscious desire that has been unsuccessfully censored. In other words, it is possible that Freud had repressed something concerning this so-called "episode" in his life, as Jones called it. In seminar XI Lacan says: "The truth is perhaps simply one thing, namely the desire of Freud himself, the fact that something in Freud was never analysed" (Lacan, 1979, p. 12). He continues:

What I had to say on the Names-of-the-Father had no other purpose, in fact, than to put into question the origin, to discover by what privilege Freud’s desire was able to find the entrance into the field of experience he designates as the unconscious. It is absolutely essential that we should go back to this origin if we wish to put analysis on its feet (Ibid.).

On the next page, Lacan asserts that this question of Freud’s desire is not to be considered on a psychological level, that is, as a trait of his individual personality. Freud’s desire concerns desire in the position of an object and as caused by an object. This object is the unconscious and so, therefore, Freud’s unconscious. Freud’s life and his work cannot be considered as separate entities. One of the first objects of Freud’s interest was the drug cocaine. In fact, we know from certain letters he wrote to his then fiancee Martha, and from reading Über Coca (1984e; the first of these papers), that he was very passionate about cocaine.⁴ It seems reasonable to assume that Freud’s relationship to the drug cocaine could be one of the areas of research that might open the door to an understanding of his discovery of the unconscious, the nature of the object in psychoanalysis and, possibly, the virtual exclusion of the problem of addiction from this field of research.

At this point an observation will be introduced which seems to be paradoxical. In his post-script to The Question of Lay-Analysis, Freud wrote that he was never a doctor in the proper sense of practising medicine and that he was never aware of any craving to help suffering humanity, because his innate sadistic disposition was not strong enough. When prompted by fresh influences, he became interested in the neuroses, though he felt that his lack of medical temperament was no obstacle to the treatment of his patients; on the contrary . . . (Freud, 1926e, pp. 253–254).

However, in a letter from 25 May, 1884 to Martha Bernays, Freud referred to the role cocaine played in the discovery of his medical vocation. He wrote: "It is only now I feel like a doctor, because I have been able to help a patient and I hope to help others" (Byck, 1974, p. 7). In other words, Freud wanted to medically cure patients from their suffering and he hoped he had found a panacea in the form of cocaine with which he would be able to do this.

The difference between this earlier position and his later position is that in the later one his desire was to cure analytically via psychological methods and without depending on a pharmaceutical object, whilst in the former position he had placed all his hopes on the drug cocaine.

But there is more. Freud had also realized that a conscious wish to help can be the transformation of an unconscious sadistic impulse or desire. It might perhaps have been this unconscious impulse that played a role in his relationship with his friend and colleague, Ernst von Fleischl Marxov. He was Freud’s ego-ideal and great rival at the same time. Fleischl died of a cocaine overdose after Freud had intervened in order to wean him off a morphine addiction.

The real difference between Freud’s earlier and later positions is that, in the interim period, he had not only discovered unconscious desire, but also that the object which causes this desire is an object that is lost forever. This is the object of psychoanalysis as opposed to the object cocaine as a therapeutic instrument.

Vera Ocampo summarizes the consequences of Freud’s encounter with cocaine as follows:

The encounter with the drug awakens in Freud the desire not only to cure others but also to cure himself (his neurasthenic and neurotic symptoms), and from the beginning, these desires emerge as two sides of the same coin; the first other of this Freudian desire is an addict—Fleischl. The problematic nature of addiction gives rise to a therapeutic act which leads Freud to question his own desire for the first time and, further into the heart of his intellectual adventure, to address the question of desire itself. But if addiction is the first object of Freud’s desire to cure, it also constitutes his first obstacle and his first therapeutic failure (Vera Ocampo, 1989, pp. 115–116, my translation).

What was the consequence of Freud’s impasse, his failure with cocaine? In an attempt to answer this question some of Freud’s steps in his work on cocaine will be considered.

Having arrived at this crossroads, the choice has been made to explore Freud’s work, rather than take the path of investigating his personal life. As such, it is possible to avoid the risk of reducing the implications of the Cocaine Papers to a mere moment in Freud’s personal history, "The Cocaine Episode". As with all of Freud’s scientific moments, there has always been more involved than his personal history. That is why it is more rewarding to study his work than to study his personal life, if one’s aim is to follow Freud in the discovery and development of psychoanalysis as a science. Jean Allouch seems to suggest that when we consider Freud’s relationship to the drug cocaine as a symptom, then the necessity of this symptom will be reflected in his writings about it (Allouch, 1984, p. 28). Freud’s symptom "ceased to write itself"; he dropped his passionate relationship with cocaine and this opened up the possibility of other pathways. A detailed study of Freud’s writings on cocaine is therefore crucial to an understanding of these pathways.

The Cocaine Papers

The text Über Coca which came first in the series and was published in July 1884, is a curious mixture of objective scientific writing and subjective writing, which reflects a passionate belief in the magical properties of the drug cocaine. This text begins with a botanical description, an historical overview of its usage in Peru and its reception in Europe. It continues with a look at the effects of cocaine on animals and the human body before ending with the mention of several therapeutic possibilities. The properties of cocaine, which initially attracted Freud to the drug, were its ability to increase the capacity to work, to allow people to do without food for long periods, and to increase physical strength. He even wrote in response to Poeppig’s description of physical and intellectual decadence as a result of habitual cocaine use that ". . . all other observers affirmed that the use of coca in moderation is more likely to promote health than to impair it, and that the coqueros live to a great age" (Freud, 1884e, p. 52).

When Freud referred to experiments with cocaine on himself and others, he mentioned that individuals react differently to the drug. He realized that there was no uniform effect. Freud would come back to this in his other papers. In his last paper on cocaine, Craving for and Fear of Cocaine, he related these different effects of cocaine to individual variations in excitability and "a factor of individual predisposition." This lack of uniform effect will later come to shatter Freud’s medical–pharmacological fantasy of being able to find a universal panacea for human suffering. Initially Freud’s thinking was very much determined or influenced by physics, energetics, and thermodynamics.

Pharmacology relies on two related factors. Firstly, the predictability of the effects of drugs and secondly, the lack of difference in reaction to them between individuals and within individuals. Freud’s emphasis on the instability of the effect of cocaine contradicts the suggestion by the editor of the Cocaine Papers, Robert Byck, that one should read these as written by someone who was interested in the science of pharmacology and who could be considered as one of its founders (Byck, 1974, p. xvii). This is not to say that Freud was not interested in cocaine as a therapeutic instrument. This fact was referred to before when it was mentioned that the last section of Über Coca deals with the various therapeutic possibilities of cocaine. There he collated the various recommendations and these clearly show Freud’s interest in therapy and in cocaine as its instrument. Freud hoped to explain the "facts" of cocaine within the parameters set by the sciences of physics and energetics in order to guarantee scientifically that the effects of cocaine are uniform, predictable, and above all, good. Freud tried to locate a formal or scientific cause for the effect of cocaine. His interest in therapy would last. Concerning cocaine as an instrument for therapy, his very first scientific observations already subverted his personal and medical fantasy about cocaine being the ideal pharmacological instrument for therapy.

It will be shown that, through his own scientific work on cocaine, Freud continued to subvert his fantasy and that this "working-through" of the fantasy resulted in the abandonment of cocaine as an object. To do this it is necessary to follow Freud step by step through his writings on ...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Dedication
• ACKNOWLEDGEMENTS
• Contents
• FOREWORD
• PREFACE
• PART I: CLASSICAL FOUNDATIONS FOR A THEORY ON ADDICTION: THE ENERGETICS OF LIBIDO AND THE ECONOMICS OF DESIRE
• PART II: THE POST-FREUDIAN REDUCTION OF A FIELD AND THE FRUITS OF A CONFRONTATION
• PART III: ELEMENTS FOR A LACANIAN THEORY (AND TREATMENT) OF ADDICTION — THE ADMINISTRATION OF TOXICITY
• REFERENCES
• INDEX