Based on an understanding of the psychological vulnerabilities of addicts, the MDGT model addresses the modifications in psychodynamic technique that are necessary for addicts' needs. It focuses on four main areas of difficulty involving self-regulation; affect, self-esteem, relationship, and self-care problems. Both supportive and expressive, the approach helps group members identify, process, and modify the characterological traits that mask addict's vulnerabilities.

Viewed from a contemporary psychoanalytic perspective, drug dependency can best be understood by examining how such a person’s ego organization and sense of self serve or fail the individual’s attempts to cope.

Reductionistic formulations which consider such problems as substance (drug and alcohol) abuse, and other forms of self-neglect in terms of explicit pleasure-seeking and/or unconscious self-destructive motives fail to consider adequately how these problems are just as often a result of deficiencies or failure in ego functions.

A summary of a conference in 1976 on psychoanalytic theory and its
relevance for understanding opiate addiction. We are convinced that psychoanalytic theory continues to be the most enabling and useful depth psychology at our disposal to understand the human mind and behavior, including addictive behavior.

To help understand addictive vulnerability, I have proposed a triad: the person, the pain, and the drug and how these three factors interact. I have adopted an overarching paradigm of substance abuse as a self-regulation disorder.