Phobic core in the addictions and the paranoid process.
A discussion of "Addiction and the Paranoid Process," by W. W. Meissner, M.D. Three major strata are  distinguished in the psychodynamic make-up of addicts: (1) a sociopathic-paranoid stratum, (2) a depressive layer, and (3) a phobic core. The last consists of a claustrophobic constellation, with claustrophobia seen as primary. Parallel to phobic neurosis, and in contradistinction to the personalized paranoid construction, compulsive drug use is seen as an impersonal condensation system. The drug effect is a type of counterphobic fantasy. While the paranoid character blames others and the depressive character blames himself, the phobic character compulsively avoids the claustrum on the outside and the addictive character both searches for it and destroys it.
D000328:Adult; D006801:Humans; D008297:Male; D009293:Opioid-Related Disorders / Q000523:psychology; D010259:Paranoid Disorders / Q000523:psychology*; D010698:Phobic Disorders / Q000523:psychology*; D011574:Psychoanalytic Theory; D011575:Psychoanalytic Therapy / Q000379:methods; D019966:Substance-Related Disorders / Q000523:psychology*