Bringing the Pieces Together: Relational Psychoanalysis and Harm Reduction Therapy in Treatment with Substance Abusers

Abstract

For many years, there has been a rift between the fields of psychoanalysis and substance abuse treatment. Today, with the advent of a relational perspective in psychoanalysis and harm reduction therapy in addiction treatment, the two fields are coming together. This paper describes a relational psychoanalytic approach to treating addictions, defines harm reduction therapy, and elaborates how each can contribute to the other. Both harm reduction and relational psychoanalysis promote a context of mutuality and a collaboration between two fully functioning participants. With harm reduction as a background philosophy, relational psychoanalysis is ideally suited to the treatment of addictive disorders, especially in the ways relational analysts focus on process, self-states, and the use of transference, countertransference, and enactments. This paper elaborates the ways the analyst and patient can work together to recognize and integrate various dissociated self-states in the treatment.