A complete account of the causes of drug use and abuse must consider at least three groups of factors: physiological, social, and psychological.

Furthermore, it must explain both grouped data (such as means and correlations between variables that are measured by normative tests) and individuals.

No one theory is capable of including all relevant factors at both group and individual levels.

Consequently, the research scientist or clinical diagnostician must be in a position to evaluate all possibilities, weighing each according to its probable significance for the problem at hand.

The theory of drug abuse presented here concentrates on psychological factors in chronic drug abusers.

It is personalistic in that it deals with individuals in all their complexity and uniquenesses. The ideas it contains are not “laws of behavior” but guides for understanding individual human beings.

This theory is also distinctive in that it calls special attention to the importance of the numinous aspects of human experience.

“Numinous” means, roughly, spiritual and refers to the universal human tendency to construe the world and oneself animistically.

In cases of drug use and abuse, numinous factors become most obvious when substances are assigned magical or mystical properties by their users, when drugs are incorporated into religious rituals, or when such substances are the means for producing transcendental experiences (which the commonly used term “euphoria” is hopelessly inadequate to describe).

Numinous factors operate in everyone’s life, and it is important that they be recognized and understood.

Since 1974, the Greater Kansas City Mental Health Foundation has been engaged in a program of research on the relationships between drug use/abuse and lifestyle.

The program uses the representative case method (Shontz 1965, 1976; Spotts and Shontz 1980) an approach to research that must not be confused with ordinary case-study techniques.

A representative case is not a sample of a population or a person of “unusual clinical interest,” but an exemplar of a variable or type of behavior that is of specific theoretical or practical concern.

For example, in a study of the effects and use of cocaine the ideal representative case is not a person who takes the drug occasionally for recreational use, but one who is a genuine expert on the substance, who is committed to its use and who has tried it at all dosage levels and by all forms of ingestion.

This person must epitomize cocaine use as clearly as possible and must be studied extensively and intensively, using both quantitative and qualitative means.

He must be treated not as a “subject” but as a “consultant” or, at the very least, as an equal partner in the scientific enterprise.

Research of this type can serve exploratory purposes, but it also provides a powerful tool for testing hypotheses that have been developed in large-scale studies but have not yet been validated in individuals (Spotts and Shontz 1980).

It is, perhaps, tempting to conclude that a method which advocates the study of “single cases” promises an easy or quick way to conduct research.

Nothing could be further from the truth. First of all, it should be obvious that truly exemplary cases can be extremely difficult to locate. Hundreds of candidates may have to be screened before the appropriate individual is found.

Second, data collection is long, arduous, and demanding because it involves not only days of intensive testing and interviewing but usually requires repeated evaluations over many months.

Third, data analysis is complex and time consuming. Each subproject of the Greater Kansas City studies required factor analyzing nine correlation matrices of 15 variables each, nine correlation matrices of 27 variables each, 18 analyses of variance, each involving a complex, mixed model design, consisting of five factors, crossed and nested in most unorthodox fashion--all this to analyze a single type of data (Q-sorts).

And these analyses constituted just a small part of what had to be accomplished to prepare the descriptions of each of nine representative cases. Finally, integration of cross-sectional and longitudinal, dimensional and morphogenic, qualitative and quantitative data, both within and between cases, poses a huge problem in data condensation, interpretation, and communication.

The research from which this theory was derived is based on the proposition that the intensive study of carefully selected individuals provides a unique perspective on the problems of drug abuse and, if properly conducted, yields as much information about specific drugs, their effects, dynamics and determinants of use, antecedents, consequences, and social correlates as more traditional methods.

This program of research has focused upon the intensive study of closely matched persons, each of whom had engaged in long-term use of cocaine, amphetamine or its congeners, narcotics, or barbiturates.

The men were chosen from among hundreds of candidates because each was an expert who could speak with authority about himself as well as about his drug of choice, its effects, and the factors associated with its use.

All were studied intensively and extensively with structured interviews and with dimensional and morphogenic tests.

Our theory draws heavily upon the germinal ideas of Carl G. Jung. It is appropriate that this be the case, for Jung derived his theory from the intensive study of individuals.

Like any theory, this one is anchored in the methodology from which it was derived. Therefore, it is almost certain to differ in significant ways from theories based upon other approaches, research methods, and data-collection procedures.

The theory has three parts: a conception of personal structure, a conception of how personal structure develops, and a framework for describing the drug experiences of chronic, heavy users of several substances.

PERSONAL STRUCTURE

Every person is a complex mediator between two realities: the external physical/social environment, on the one hand, and the internal psyche, on the other.

An investigator who observes or studies another person starts in the environment and first encounters that other person’s overt actions. By noting regularities of behavior, the observer draws inferences about the outermost layer of the observed person’s total structure, the ego.

The relationship between a person’s ego and the environment is that of figure and ground.

In the optimal state, the ego is clearly differentiated and maintains its integrity in relation to the environment. Too much expansion or contraction of the ego or too much effort either to transcend or to obliterate it is biologically maladaptive.

In addition to describing a person’s ego, the observer may draw inferences about deeper levels of the personal structure.

The first level below the ego is the lifestyle: the consistent and pervasive pattern, system, or organization of preferences, regularities, and orientations that underlies overt behavioral adaptation.

Lifestyle variables include those described in other theories by such terms as habits, traits, or defense mechanisms. However, the concepts of habit, trait, and defense mechanism do not take into account the patterning, organization, and hierarchic structuring that make the lifestyle a system rather than a simple conglomerate or profile.

At first glance, the lifestyle of a pimp obviously differs from that of a real estate agent. Yet at a deeper level, both pimp and real estate agent may share the same determination to be indomitable, to be the most successful at what they do.

We call the next level of basic organizing principles from which the lifestyle and ego derive their character life themes. In other theories, life themes might be called core conflicts, character structure, or dominant tendencies.

However, most theories that rely on such constructs are content to consider them to be wholly learned and to be the most fundamental level of personal structure.

According to this theory, neither is the case. For one thing, preprogrammed (archetypal) processes set the stage for learning of the life themes.

For another, relations with the psyche by way of the personal myth are more basic than the life themes.

We found that most of our consultant-participants could be described in terms of no more than four to six themes. For example, one drug user’s life is dominated by the determination to make a great scientific discovery that will justify his mother’s faith that he is a genius.

Another’s is pervaded by efforts to gain love and attention from a powerful but affectionless father, while yet another’s life is pervaded by the need to conquer women sexually in order to neutralize the power he feels they would otherwise have to emasculate him.

Finally, it became evident from our research that yet one more inferential step was necessary, for we discovered that, as Freud recognized in his concept of repetition compulsion (1929), each man seemed to be living out a destiny over which he had little control.

Thus, at the deepest level of inference lies the myth or numen that gives each person’s existence a fate-like, an entelechial, quality as if possessed by life-shaping forces over which personal control is not possible. In Jung’s terms, the myth is the kernel or core of an “autonomous complex,” a numinous, monadic formation that remains subliminal and operates according to its own inherent tendencies, independent of the conscious will.

A well-integrated myth may be expressed in creative work. Poorly integrated into the rest of the personal structure, it may cause maladjustment (Jung 1971). The myth serves a purpose in human life that is equally important to that served by the ego.

The function of the ego is to insure biological survival, and in modern society, that typically takes place by means of technological or economic achievement. The function of the myth is to insure wholeness or unity of the person.

Like Janus, the two-faced god, each individual faces both environmental and psychic realities. A balanced responsiveness to both is necessary if equilibrium is to be maintained (Larsen 1976).

In a person who is functioning well, the ego insures biological survival by adapting to environmental realities, while the myth insures wholeness through insuring the ego’s relatedness to psychic realities.

OPERATIONAL CONSIDERATIONS

Direct observations of behavior provide the basis for inferring ego structure. Psychological tests penetrate to at least the level of lifestyle.

Intensive interviews and projective examinations usually permit reasonable reconstruction of life themes.

However, discovery of another person’s numen or myth requires not only a knowledge of the person but some familiarity with mythology as well as personal empathic and intuitional freedom on the part of the investigator.

To insure reliability, therefore, it is desirable for the process of myth identification to involve more than one person.

NORMAL DEVELOPMENT

During the earliest years of life, the human infant is dominated by influences from the psyche, the most important of which is the image of the mother (a precursor of the anima archetype).

Although the newborn infant is not totally helpless, human beings are born unfinished, unready to meet the world, and the child must spend some time in the psychic atmosphere of the parents, in a second womb, as it were, where it must rely heavily upon others for safety, security, and survival (Campbell 1949).

This is the stage in which, at the level of myth, the elementary or nuturant mother predominates (Neumann 1972). After a year or so, ego tools (speech, ambulation, motor coordination) start to develop, and a stage of emerging individuality begins.

At this point the normal mother takes on the function of transformation by helping the child break away from her and become an independent person. The child’s first experience of the process of transformation is reminiscent of being born and is incorporated into the child’s myth as a prototype of the theme of rebirth that may be activated later in life during religious or quasi-religious experiences.

Normally, at least for boys, the father enters the picture at this stage and eventually becomes a model according to which the child’s personal myth is elaborated in relation to the animus, or archetype of masculinity.

If the father is absent or provides an unsuitable model, the transforming mother may assume this function and become, in effect, the animus of her own anima. The result is confusion over sexual identity in the child.

More typically, the transforming anima requires that the boy increase in competence to win her approval, while the father teaches the boy how to accomplish this and to displace the anima away from the biological mother to a more suitable woman.

During these formative years, the child’s life themes begin to take form. At adolescence, the boy becomes initiated into adulthood and begins developing his own lifestyle, the ways in which he chooses to express his life themes.

Adolescence contains an important danger point. At this time, tolerance for numinous experiences is diminishing, but the pressure from such experiences may not shrink sufficiently rapidly and the ego may not yet be strong enough to solve the problem realistically.

This is the so-called adolescent crisis, and it is the culmination of a condition that develops from early childhood (Edinger 1973, pp. 3-36). After this crisis is passed, growth is for several decades a process of ego development and gradual alienation from numinous psychic influences.

At mid-life another phase begins. The now overdeveloped ego may become so estranged from its mythical roots in psychic experience that the person begins to feel a need for spiritual wholeness, for a meaning in life.

During this period the person counteracts the growing sense of alienation by returning to inner experiences or spiritual and religious sources for support and reintegration (Edinger 1973, pp. 37-71). If he is successful, the result is the emergence of a new, more complete identity called the self.

This is the culmination of personal actualization; the process of self-development (called individuation) may continue for the rest of the person’s life.

PATTERNS OF DEVELOPMENT IN CHRONIC DRUG ABUSERS

In this section, we briefly describe the typical or modal developmental patterns that have emerged from our research with men committed to heavy or chronic use of amphetamine, cocaine, narcotics, or barbiturates.

Although the developmental patterns of these relatively “pure” drug-user types show striking differences among groups, explainable variations and even occasional reversals of these modal patterns also appeared.

This discussion does not concern individuals who use drugs only for social-recreational purposes. Unlike recreational drug users, chronic drug users do not take drugs merely for pleasure.

Individuals who are committed to the heavy, long-term use of drugs do so to--

1. Fill gaps in their personal structure and mediate serious breaks between their rational (ego) and psychic (mythical) lives;

2. Attain by chemical means, even if only temporarily, ego states they cannot attain by their own efforts; and

3. Cope with ego deficiencies that have a developmental origin and handicap them in their efforts to achieve individuation.

This theory does not assume that problems of adjustment can always be blamed on the parents. People do not react to their parents as they really are but to parental imagoes -- unconscious images that are heavily influenced by fantasies and archetypal contents.

Furthermore, in specific cases, a host of constitutional, social, and environmental factors also enter into a person’s decision to try or use drugs. Nevertheless, the theory does recognize the existence of certain modal patterns in drug users’ reports of their early developmental years.

Most typically, the chronic amphetamine users we have studied report that they grew up in families with relatively strong but highly manipulative mothers and passive or ineffectual fathers.

The mothers of these men emerge as devious, ensnaring women (“spider women”) who skillfully, though not always consciously, practice complex acts of deceit and deception to keep their men firmly within their web of control.

The controlling and potentially castrating mother handicapped the boy in developing a strong ego, and the absence of a strong father left the boy without a firm sense of masculine identity.

The solution commonly adopted by the boy was not only to deny feelings of helplessness and fears of impotence but to convert them into their opposites by assuming a phallic and hypermasculine posture toward life.

As adults, these men fear the feminine and view women as creatures to be conquered, overcome, used, or exploited. They take great pride in their sexual prowess, for it provides them proof of their manhood and emancipation from the “spider” mother of childhood.

Chronic amphetamine users tend to be driven, sometimes violent, but achievement-oriented men who are strongly reactive against threats of weakness or impotence.

Typically, they are unreflective action-oriented men who lack insight or rigidly deny the reality of their psychic lives. Nevertheless, they are subject to numinous influences that seem to be dragging them inexorably downward into the maw of the everthreatening maternal figure.

In contrast, narcotics abusers typically said they came from psychologically disabled families, in which one parent (often the father) was absent or was an overpowering tyrant, while the other parent (often the mother) was too weak or ineffectual to protect the son from the attacks or intimidations of the other.

As adults, the opiate users we studied were seriously disabled individuals who maintained tenuous and unstable adjustments. Their egos were poorly or weakly differentiated.

Although they showed greater overall personal disturbance than cocaine or amphetamine users, they did not display a distinctive set of symptoms. With few exceptions, the narcotics abusers were vulnerable people who relied on ego constriction as a primary defense.

Typically, they are isolated individuals who live quiet, lonely, and unambitious Iives. Unlike cocaine and amphetamine abusers, narcotics abusers do not seek stimulation but steadfastly avoid it.

They seek a tranquil, serene existence through ego constriction; they would rather withdraw from the problems of life than conquer them. The cocaine users we studied seemed to have progressed further along the developmental path than men in the other groups.

Most described early lives characterized by a rather high level of positive family feeling. Most described their mothers as warm and their fathers as strong and encouraging.

As adults, the cocaine users are ambitious, intensely competitive men who work hard to become successful. They like to take risks and live by their wits.

They have stronger and more resilient egos than men in the other drug-user groups. They display a more intense commitment and willingness to struggle to overcome their environment but are highly prone to symptoms of alienation from the psyche.

They think of themselves as self-directed, self-sufficient, competent people--proud, energetic men who live life to the full and are capable of carrying pleasure to its extreme. The key to understanding the cocaine users we studied is their intense counterdependency, their need to be completely self-sufficient.

They cannot lean on others, turn to other people for help, or admit weakness of any kind. They take cocaine to expand their egos and their selfconfidence. In addition, they report that the drug produces temporary psychological states that are so ecstatic that life and fulfillment seem complete, if only for a moment.

By contrast, barbiturate users seemed to grow up lacking meaningful relationships with either parent. Most described families with uninterested, neglecting fathers and timorous, dependent, and ineffectual mothers.

Most were reared in emotional wastelands and might have been better off psychologically if their parents had been openly rejecting. The typical son seems to have concluded that, if he could not gain recognition by pleasing his parents, perhaps he could make them acknowledge his existence by granting their apparent wishes and failing at everything.

Barbiturate abusers repeatedly perform acts which seemingly tempt fate to destroy them. They report an alarmingly high incidence of fights, car wrecks, accidents, and drug overdoses.

From an observer’s point of view, these men as adults seem actively to seek defeat. However, from their own point of view they seek escape from their personal distress, frustrations, and failures, and barbiturates provide them a vehicle which allows them to do it. It is not that these men enjoy defeat.

Each succeeding setback and reversal adds to the gradual disintegration of the self and increases the internal pressures and frustrations these men feel. They are like boilers about to explode, for their frequent failures and frustrations cause a rapid buildup of tension that they are unable to express in a controlled way.

For them, barbiturates precipitate the inevitable; by artificially reducing ego inhibitions, these drugs provide the counterfeit courage the men need to release pent-up destructive forces.

The drugs give the user a ticket to oblivion, thereby permitting him to get away from his sense of failure for a period of time, or they set the conditions which allow the user to release his tensions in arguments, brawls, and accidents, with no subsequent sense of guilt, responsibility, or even awareness of what happened.

DRUG-INDUCED EGO STATES

As indicated above, relations between ego and environment are like those between figure and ground in gestalt psychology.

These may vary along two major dimensions. The first is ego expansion versus ego contraction.

Ego expansion implies growth in the person’s figural ego, his sense of dominance or control over both self and environment.

Ego contraction implies reduction of ability to manage the environment; in contraction, the ego protects its integrity by limiting its figural relation with the ground of the surrounding world.

The second dimension is ego/self synthesis versus ego/self dissolution. Synthesis of ego and self occurs when transcendent experiences lead the person to believe that the bounds of ordinary reality have been surpassed and a mystical truth discovered.

In ego/self dissolution, all sense of personal continuity and responsibility is lost, so that the state is one of psychological oblivion.

Chronic drug users attempt to avoid the suffering that would be necessary to reestablish normal individuation.

They use pharmacological means either to escape their personal dilemmas or to achieve ego states that would in other persons be associated with increasing selfhood.

The states they achieve are actually counterfeit, because, while their practical effects are real enough, they produce no permanent change in personal structure and typically do not outlast the period of drug usage.

STIMULANTS

Our studies indicate that stimulants, such as amphetamines and cocaine, produce ego inflation or expansion, which is experienced by the user as an increase in bodily warmth, exhilaration and euphoria, enhanced self-awareness, feelings of supreme self-confidence, and a sense of mastery over fate and the environment.

With large doses and chronic use of these drugs, the figural ego becomes so grossly inflated that the normal ego-environment relationship is overbalanced. The bloated ego becomes threatened by impulses it can no longer control, and reality testing becomes impaired.

At this stage, the ego may implode, producing the well-known amphetamine or cocaine psychosis. Several differences exist between the expansive effects produced by these two drugs.

First, chronic cocaine users do not display the stereotypy or patterns of compulsive behavior that are found in amphetamine abuse. Second, cocaine abuse seems less conducive to direct violence than does amphetamine abuse.

Finally, cocaine produces less hyperactivity than amphetamine. The amphetamine-induced ego state mobilizes the user for action. The cocaine-induced ego state is not a means but an end. The user has no further goal. His only problem is that he must continue using the drug to stay where he is.

NARCOTICS

The ego states induced by narcotics are the opposites of those aroused by stimulants. Narcotics (i.e., opium, its derivatives, and semisynthetic substitutes) produce ego contraction: a disengagement from the environment and withdrawal into a quiescent state and detachment of concern.

Massive doses may induce a stuporous or comatose condition that could culminate in death due to respiratory arrest.

The euphoria that accompanies narcotics use is not the sort that is associated with conquest or achievement but with relief from tension or from engagement with worldly affairs. Although care is suspended, the typical user does not seek complete loss of ego relationships with the environment; even an addict who is on a deep and pleasurable nod may be provoked into activity by stimulating or irritating events.

Narcotics addicts seem to feel they have achieved an ethereal experience of peace, contentment, and serenity which makes normal activity, striving, or achievement unnecessary or trivial.

BARBITURATES

Despite the fact that barbiturates are classified as depressants and are thought of as having effects similar to narcotics, the two types of substances produce strikingly different ego states. In low doses, barbiturates produce mild sedation.

However, in chronic heavy use, the person becomes increasingly disabled, and a state of ego/self dissolution ultimately ensues. All ego functions are crippled; thinking and reality-testing decline, and visual-motor coordination, speech, memory, concentration, and judgment are impaired.

In the ego state induced by barbiturates the user abandons responsibility for and awareness of his actions; some fall into a comatose condition which can bring about death.

Others enter a disoriented state (similar, apparently, to that produced by heavy use of alcohol) in which they commit destructive acts with no concern for or awareness of consequences.

They become belligerent, quarrelsome, and abusive, and engage in fights, arguments, and other violent confrontations. They are frequently the victims of accidents. The psychological state induced by barbiturate abuse might well be called oblivion, because, while in it, the users are all but egoless.

PSYCHEDELICS

We have not studied persons with a commitment to psychedelic drugs (such as LSD-25). However, the literature suggests that such drugs induce a state of apparent transcendence, or synthesis of the ego and the self.

These drugs produce profound alterations in sensory experiences as well as mood. It is believed by some that psychedelics produce a religious or spiritual state in which the user feels outside ordinary reality, at one with the cosmos.

Some users report gaining insight into the nature of the universe and purpose of life, the oneness, brotherhood, and togetherness of all living things. However, since “bad trips” may also occur, it is likely that set and setting strongly influence responses to psychedelic substances.

AN INTEGRATING MODEL

Clearly, chronic use or abuse of differing classes of drugs produces radically different ego states. These transformations are diagrammed in figure 1. [See original article for diagram] 

This figure shows a matrix of dimensions that may be used to define the ego states induced by five major substances of abuse.

The horizontal axis represents ego contraction (minus) and ego expansion (plus). The vertical axis represents ego/self dissolution (minus) at the bottom and self/ego integration at the top.

As products of like signs, the upper right and lower left quadrants are labeled plus. They represent generally pleasant experiences, which differ mainly in that those in the upper right are active, while those in the lower left are passive.

The upper left and lower right quadrants are labeled minus and represent generally unpleasant, ego-alien, or disintegrative experiences. Those in the lower right are directed outward toward the environment either through projecton or direct physical attack, while those in the upper left are directed inward, arise from, and are contained within the psychological structure of the person.

The representation of two dark and two light quadrants indicates that the counterfeit states induced by abuse of various drugs can have both positive (or light) and negative (or dark) side effects. The top of the diagram is also labeled transcendence. It represents experiences that lead the user to believe that the bounds of ordinary reality have been surpassed and a mystical truth discovered.

The bottom of the diagram is labeled oblivion and represents the fact that, in this state, all sense of person-continuity is lost. The left side of the diagram is labeled disengagement to reflect the fact that ego contraction implies a reduction of personal contact with the environment; the weak or threatened ego retains its integrity by limiting its figural relation with the ground of the surrounding world.

The right side of the diagram is labeled engagement to reflect the fact that ego expansion implies an increase in the person’s sense of dominance or control over both the self and the environment; the figural ego swells, providing increased belief in one’s personal power and importance.

To the right of the vertical coordinate is a dimension that runs from ecstasy (which arises from achieving a near-transcendent state through one,s own efforts), to peace or serenity (which stems from the passive disengagement of ego concerns).

Next IS a dimension that runs from striving (which is oriented more toward conventional than spiritual achievement), to passivity and relaxation, or loss of interest in the normal activities of life Just below the horizontal coordinate on the right a dimension runs from paranoia, or projection of unconscious impulses outward, to emergence of the unconscious or the flooding of awareness with impulses of a psychic nature; some psychoanalysts might call this the “return of the repressed. ”

Finally, a dimension runs from violence, which usually consists of attacks on others but mav have self-destructive consequences as well, to sacrifice, which means opening up (disintegrating) the ego to the acceptance of psychic reality.

As used here, the term violence does not mean controlled violence, of the sort used by professional athletes or policemen, but an explosive, unthinking rage in which all sense of identity is lost.

As indicated, the ego states induced by chronic, heavy abuse of stimulants, narcotics, depressants, and psychedelic drugs fall into distinctive sectors of figure 1. The placements of different drugs are indicated by broken lines on the diagram. These reflect our current judgments regarding the states these substances produce in individuals committed to chronic heavy use of each substance.

For example, the placement of cocaine shows that, while it may produce paranoia, it does not typically precipitate the violence that is often associated with amphetamine or barbiturates.

Also, although it shares features in common with amphetamine, users report that cocaine produces a state of ecstasy that is apparently unique. Narcotics induce ego contraction, disengagement, or serenity.

However, especially in very large chronic doses, they may awaken terrifying phantasmagoric images (such as those that affected Thomas DeQuincey and Samuel Taylor Coleridge), which indicates that unmanageable unconscious material has broken loose and is emerging into awareness.

Barbiturates may produce some positive effects, like relaxation, but with heavy use, the dark side effects of violence, self-destructiveness, and loss of self-identity outweigh the pleasant ones. Indeed, heavy barbiturate use seems to yield more socially and personally destructive acts than any other form of drug abuse.

We have not studied alcohol abusers but feel that the ego state produced by alcohol is similar to that produced by barbiturates, though at a less intense level. We also believe that people who take psychedelic drugs regularly may do so in an attempt to achieve something akin to spiritual enlightenment.

However, psychedelic drugs are unpredictable, and there is always the danger of a bad trip, the emergence of chaotic material from the psyche into consciousness.

We have not studied long-term polydrug abusers, but it appears that attainment of a specific ego state may be irrelevant for these individuals. They seem to be willing to enter any drug-induced ego state, so long as it differs in strong or noticeable ways from the ego state which exists during abstinence.

These individuals may well be more disturbed and have fewer personal resources than any other group depicted in figure 1.

REASONS FOR DRUG CHOICES

The various groups of drug users we studied have each gravitated to substances that induce temporary states that help them cope with specific disturbances in ego/psyche relationships. Because of adverse developmental conditions, these individuals are unwilling or unable to pursue a normal course of individuation.

They seek shortcuts, a pseudointegration by means of counterfeit ego states produced by pharmacological agents. Amphetamine abusers have failed to develop the tender, compassionate sides of themselves and view women as terrifying creatures who threaten to render them impotent.

With the aid of amphetamine, these men attempt to live a precarious but hypermasculine existence. Cocaine abusers have similar traits but are somewhat more resourceful and better integrated; they fight for what they want and regard normal dependency as defeat.

They are subject to crises of alienation and feelings of emptiness and despair. Cocaine provides them a powerful, though counterfeit, substitute for the warmth and nurturance they need.

Narcotics abusers are poorly defended against the environment and their own psychic lives; they use drugs to help shrink their egos so that they can maintain limited personal integrity in the face of internal and external forces they cannot control. They seek serenity and an ally which will provide temporary relief from anxieties and help them function in a limited but more integrated way.

Barbiturate abusers are neglected individuals who believe they have received little love, attention, or respect in life. Drugs provide these men temporary release and escape from identities which mark them as perpetual failures in their own eyes. 

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From Monograph 30 - Theories on Drug Abuse: Selected Contemporary Perspectives