In order to establish a new nosology of addictive disorders, the neurobiology of withdrawal and craving are reviewed, followed by a review of the psychoanalytic literature on addictive neuropsychodynamics.

Drug dreams are seen ubiquitously in the treatment of various addictions. Recent studies have shown that the ventral tegmental pathway stimulates both dreaming and drug craving.To investigate a possible clinical link between these two psychic phenomena, psychotherapy notes from the first six months of an addicted patient’s treatment were reviewed, together with verbatim notes from the four years of psychoanalysis that followed.

Three perspectives on addiction promulgated during the 1990s are reviewed, along with many earlier theories on addictive illness. It is suggested that these distinct yet overlapping formulations of the dynamics of addiction form a hierarchy for each patient suffering from an addiction.