Mapping The Psychic Change

As various forms of addiction continue to plague today's society, Alcoholics Anonymous (AA) and subsequent 12-step programs have become one of the most popular solutions, becoming integrated into mainstream addiction treatment. While psychoanalysis has long since had difficulty in grappling with the question of addiction, it may yet have something new to add to the discussion. This study seeks to better understand the process of change inherent in working through the 12 steps, by means of a thorough application of psychoanalytic theory to the core texts of the 12-step model's founding program, Alcoholics Anonymous. Through an integrative literature review, I explore what psychoanalysis has produced thus far on addiction, revolving around the themes of narcissism and self-regulation. The process of working the steps is then explored in relation to theories of the structure of egoic identification implicit in Freud and Lacan, as rendered by Moncayo's (2008, 2018) registers of narcissistic identification. The result is an original theoretical formulation for the psychological transformation produced by the 12-step process, in which the structure of egoic identification shifts from the register of the ideal ego, to that of the ego ideal and the imaginary father. Following is an exploration of theoretical implications, including a more precise interpretation of the function of the state of intoxication, a new explanation for the possible cause of addiction, resulting clinical implications for the psychoanalytic treatment of addiction, and finally, a brief account of what psychoanalysis may have to offer the addicted subject beyond AA.