Great article by Dr Andrew Tatarsky Ph.D, explaining how recreational use of substances can spiral out of control, when the reason for using becomes blurred. Nobody sets out to become addicted or reliant on a substance or even process like gambling, eating etc

Home » Addiction » Great article by Dr Andrew Tatarsky Ph.D, explaining how recreational use of substances can spiral out of control, when the reason for using becomes blurred. Nobody sets out to become addicted or reliant on a substance or even process like gambling, eating etc

Addiction, Personal Meaning, and Understanding


Is a guy who goes out several evenings after work with friends and often gets drunk sharing a meaningful social experience?

Or is he killing time, zoned out to avoid dealing with the depressing emptiness of his life?

Is a college student who uses speed to cram for a test just using it to stay up later to get in more studying?

Or is she self-medicating ADD (Attention Deficit Disorder), or trying to make up for a semester of missed schoolwork because of paralyzing anxiety and insecurity about her intelligence?

Is a successful executive who smokes high potency pot most evenings just relaxing with music after work?

Or is he retreating to a private cocoon, safely insulated from a social world filled with the anxiety or sexual insecurity that often contributes to bouts of suicidal despair about the lack of intimacy in his life?

All of these people were patients of mine who appeared to be social recreational users, not evidencing any serious signs of abuse or dependency.

The substances of choice help in some way that is highly meaningful to them.

They are used not only for the pleasure they provide but also to cope with painful feelings and life circumstances.

These meanings and functions had to be clarified and addressed for them to successfully resolve their problem substance use.

Over a long career as a psychologist working with people with drug and alcohol problems, I have had an ever-growing conviction that recreational drugs are never the real problem.

Instead, it is the multiple meanings and functions that drugs, their physiological effects and the rituals associated with them take on for the user that determine whether drug use becomes a problem or not.

Just as with automobiles and video games, it is the reasons for using them and the way in which they are used that are at issue.

Thinking of the drug alone as the problem can reinforce a denial in the user and in society at large of the many factors that make drugs so desirable to some that they would risk everything to continue using them.

At the personal level, a disconnection from the reasons for using gives rise to the addictive process.

Instead of feelings being about oneself, one’s needs, wishes, or suffering – the pain or struggles are expressed in the desire for the drug; the problem is put “in the drug,” not in one’s self.

If we consider that the personal and social meanings of substances determine why and how use patterns become problems, we see that it is essential to identify and address the particular meanings that substances carry in order to bring about positive change.

Each person has a unique set of meanings and feelings that he or she gives to their own substances.

A great many Americans experiment with drugs and alcohol. Some of these experimenters find the initial experience desirable enough in some way to want to repeat it. Fifteen to thirty percent of casual users go on to develop patterns of use that interfere with, threaten, or damage some important aspect of their lives.

Why do some use safely and others develop serious life threatening problems? Drugs lead to dramatic and varied biochemical changes that result in shifts in body sensation and states of consciousness. These changes are not meaningful, pleasurable, or desirable to all people in the same ways.

Many people experiment with drugs and don’t like the way they make them feel, or don’t like them enough to use them with their attendant risks.  It is important to realize that the use of substances is experienced as desirable in relation to other aspects of one’s inner and outer life.

From this “bio-psycho-social” perspective, problem substance use is understood to result from the interaction of personal meaning, sociocultural, and biological factors – elements that are unique for each individual. With chronic use, substances may become increasingly relied upon for whatever functions they perform for each person – for example, interrupting the anxiety of dealing with intimacy or sexual performance.

Substance use can become intertwined with psychological functioning and lifestyle such that it becomes part of the fabric of the user’s experience and essential to psychic stability. It can be said that each user develops a highly personal relationship to drugs that reflects this complex interaction.

To best understand the troublesome aspects of drug use, a clarification of the highly personal meanings and functions of the drug is essential.

Since the true meanings and functions of the desire to use may be disguised from the user or out of awareness, exploration is often a central focus of psychotherapy.

Whether in psychotherapy or on one’s own, acknowledging that one’s relationship to substances is highly meaningful can open up many avenues worthy of personal attention; a healthy relationship to drugs or alcohol is a valuable goal.


Andrew Tatarsky, Ph.D. is a licensed clinical psychologist with a private practice in New York City who lectures internationally on the treatment of addictions.  He studies psychoanalysis at the New York University Postdoctoral Program in Psychotherapy and Psychoanalysis.

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