title: Long-term treatment of an addictive personality.
abstract: There is infrequent discussion of long-term psychotherapy of persons with addiction, particularly in the self-psychology literature. In addition, some question whether long-term psychotherapy can be helpful in severe psychiatric disorders. The author describes the treatment of a woman with multiple diagnoses, including bulimia and alcohol and drug addiction, which took place over a period of almost 7 years. These issues are addressed from a self-psychological perspective, with progression of the treatment from early facilitation of a selfobject transference to more intense selfobject transference-countertransference states. Behavioral interventions (e.g., recommendation of inpatient chemical dependency treatment) are also discussed. The author describes the patient's dramatic progress and subsequent regression. Finally, there is a discussion of the addiction from self-psychological and biological perspectives of this woman's particular developmental and treatment issues, as well as a discussion of the confrontation and limit setting in a self-psychologically oriented treatment.
authors.affiliation: Behavioral Health Unit, Mercy Hospital, USA. Seymour.Peter@ScrippsHealth.org
authors.forename: Peter M
authors.initials: PM
authors.lastname: Seymour
mesh_terms: D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D016739:Behavior, Addictive / Q000523:psychology / Q000628:therapy*; D003866:Depressive Disorder / Q000628:therapy; D017831:Diagnosis, Dual (Psychiatry); D001068:Feeding and Eating Disorders / Q000628:therapy; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D008134:Long-Term Care / Q000379:methods*; D009771:Obsessive-Compulsive Disorder / Q000628:therapy; D011369:Professional-Patient Relations; D011613:Psychotherapy / Q000379:methods*; D012008:Recurrence; D019455:Self Psychology; D016728:Self-Injurious Behavior / Q000628:therapy*; D019966:Substance-Related Disorders / Q000628:therapy
chemical_list: D018687:Antidepressive Agents, Second-Generation; D005473:Fluoxetine