Follow the Bird—A Story of Survival in the Treatment of Addictions Commentary on Paper by Lisa Director

Abstract

Lisa Director proposes a relational model with an emphasis on enactment for the treatment of chronic drug and alcohol use. She illustrates her thesis with an extensive case report. The story of her patient's addiction, and of the embroiled analytic developments, is engaging, disturbing, and rewarding. I suggest that the telling of this inspiring story, and the narration of her theoretical framework, is a response to the devastation involved in the encountering of addictions and that this story unintentionally obscures some basic issues about addiction and the psychoanalytic treatment of it. I believe that the survival of patient and analyst was achieved with the help of three underemphasized factors: Director is an expert in the assessment and treatment of chemical dependency problems, and her patient, Helena, knew this; despite her chronic addiction, Helena brought exceptional resources for survival to the analysis; and the authority of the analyst was used for leverage to help replace Helena's reliance on drinking and drugs.