Lance M. Dodes, M.D.

Hi. I have recently completed Dr. Dodes book "The Heart of Addiction." I thought his insight that addictive action is a way of overcoming an experience of helplessness was a major breakthrough in the field of addiction studies, and a huge insight for me personally. I am wonder why he does not mention explicitly that trauma may be the mechanism wherein the addict first experienced an overwhelming sense of helplessness, and that the particular trigger(s) of each addict might therefore be related to the specific type of trauma(s) experienced. In a 1990 paper available on line entitled "ADDICTION, HELPLESSNESS, AND NARCISSISTIC RAGE" Dr. Dodes says the following:

"First, I would like to consider the role of addiction in managing omnipotence over one's own affective state. The central importance of being in control of one's affective state is highlighted
by the loss of this control in psychic trauma: i.e., the imposition of a state of helplessness on the ego when it is overwhelmed by an instinctual drive (affect) which it cannot manage without excessive anxiety (Freud, 1926)."

I am interested to know why trauma didn't make it into the book, as it may be a crucial part of understanding the root causes of addiction.

Thanks to all

Dear Mr. Bland,
Thank you for your comment. Your quote from my 1990 paper actually refers to the internal state of feeling overwhelmed rather than the event that produces it, but you are right that traumatic experiences are regularly a source of subsequent feelings of overwhelming helplessness. My only hesitation about using the word "trauma" is that most people associate it with a single major event. Such dramatic episodes are important, of course, but most significant early traumas in life are of the "strain" variety -- a drawn-out experience over time produced by chronic issues in the dynamics of a family or between a child and one or another parent or sibling. These traumas tend to be invisible to external observers or even the individual himself, making them even harder to identify as a source of adult difficulties.
Thanks again for taking the time to contribute to this discussion.