A Psychodynamic View of Addiction

By Steve K.

I recently spent some time listening to someone who suffers from an alcohol use disorder describing their internal struggle, triggered by anxiety and stress, that takes place before they start drinking again after a period of abstinence. As they were describing their experience Freud’s model of personality came to mind, which is represented by the id, ego, and superego. This model can be used to compliment Bill Wilson’s view of addiction outlined in the books ‘Alcoholics Anonymous’ and ‘The Twelve Steps & Twelve Traditions.’

In these books basic human instincts are identified as our needs for emotional and material security, social approval and acceptance, and the need for sexual relations. These are the natural instincts and desires that drive human behaviour and insure our survival as a species.

These primitive needs in relation to our basic human nature can be excessive and distorted by childhood developmental difficulties, trauma, neglect and abuse. Unmet needs and desires can direct us unconsciously, and often unethically at times. When our thoughts, feelings and behaviour are unethical or against our conditioned values, we operate unconscious psychological “defences” to reduce anxiety and protect our self-concept or ego.

We operate defense mechanisms such as repression, denial, and rationalisation to protect ourselves from the anxiety, shame and guilt that accompany our unacceptable motives for behaviour.

Defense mechanisms are associated with Freud’s model of personality structure noted above. The id, often referred to as the ‘pleasure principle’, represents our unconscious instincts and desires and is unconcerned with morality. The superego, often referred to as the ‘morality principle’, is concerned with social rules and morals and informs our conscience or “moral compass”. The superego is largely unconscious in its workings. The ego is the rational, pragmatic part of our personality and operates on both a conscious and unconscious level. The ego, often referred to as the ‘reality principle’, balances the demands, stress, anxiety and shame created by the conflict between the id and superego in the practical context of reality.

When the ego feels threatened or overwhelmed by the struggle between the unmet desires of the id and a critical superego, it employs psychological defences such as denial and rationalisation to cope with these powerful and stressful forces.

The process of addiction, in all its expressions, can be viewed through Freud’s model of personality. Addiction fuels and enables our instinctual desires and unmet needs (the id) to become uninhibited by impairing the ego’s rational choice and decision-making ability and censoring (via defenses) our superego. The result is often moral corruption and further damage to an already diminished self-esteem. The more punishing an individual’s superego is (the critical parent within the Transactional Analysis (TA) model), the greater the sense of shame, anxiety and guilt felt when coming out of addictive and hedonistic behaviour.

The structure of the human brain is another way of understanding our conscious and unconscious processes. The brain stem (reptilian brain) and limbic system (emotional brain) are responsible for our instinctual and emotional responses and operate at an unconscious level. The neocortex is our reasoning and decision-making brain (pre-frontal cortex) and where our conscious activity takes place. Contrary to popular belief, most of our behaviour is directed unconsciously by the instinctual and emotional centres of the brain. Brain science suggests that our conscious cortex tends to rationalise and justify our unconscious desires and motivations.

When thinking about my own previous inner struggle in relation to active addiction Freud’s model of the id, ego, and superego makes sense. I have suffered with low self-esteem, insecurity and anxiety throughout my life, and a sense of inner emptiness and isolation. These are classic characteristics of someone who is prone to addiction and fit with the psychodynamic view of addiction as a dysfunctional strategy of emotional self-regulation. The id with its need for pleasure, instant gratification, and relief from emotional distress represents addiction and its insatiable cravings. These overwhelming desires are often too powerful and anxiety provoking for a developmentally weakened ego to resist, and so it employs various defense mechanisms which corrupt its reasoning and silences the moral objections of the superego critic.

Conscious Awareness Through Cathartic Self-Disclosure

A fundamental aspect of 12-Step recovery is the emphasis upon taking a moral inventory and sharing it honestly with another person who understands the process. Step Ten is the regular practice of this self-reflective inventory. Sharing openly with others the thoughts, feelings, and behaviours that cause anxiety, shame, and distress are regularly practiced as part of the 12 Step process. This often leads to greater self-awareness and insight into the various ego defense mechanisms and harmful patterns of thought, emotion, and actions they permit.

The same process happens within psychodynamic therapy, where the client is encouraged by the therapist to self-disclose in an uncensored way (free association) with the aim of bringing the unconscious into consciousness. Both processes result in a strengthened ego and sense of self-acceptance which is better able to manage the conflicting demands of the irrational id and the guilt and shame inducing judgemental superego. The suggestion of strengthening the ego may seem contrary to the philosophy of 12 Step recovery, but it’s important to differentiate between an over-inflated ‘big ego’, which is in effect weak, fearful, and insecure, and a ‘strong ego’, which is secure, humble, and ‘right-sized’.

The recovery journey, whether it’s through the 12 Steps or psychotherapy, is largely a process of gaining greater self-awareness and self-acceptance. This then allows us to make healthier and more honest choices in relation to our instinctual and emotional needs through a conscious and secure sense of self. A more self-aware, self-accepting (humble), balanced and resilient ego is better able to emotionally self-regulate without the need for harmful defensive strategies, including addictive behaviour. It’s also better able to challenge the often overly critical superego and the anxiety, shame and guilt that it creates.

The natural sense of shame all healthy human beings possess can become toxic in those suffering from addiction and cause the denial of natural needs and desires for connection and intimacy, resulting in a sense of isolation and disconnection. These feelings then create a vicious cycle of addictive relief and further toxic shame and suffering. Recovery from addiction promotes the development of a healthy relationship with our instinctual needs and desires and ultimately more satisfying, enduring, and ethical ways of meeting them.

The above post is an adapted version of an earlier essay titled, ‘Instincts, desires, and Ego Defenses’. By Steve K.