Freud Meets Bill W: A Model for the Dynamics of Alcoholics Anonymous

Charles      E. Goldberg

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Abstract

Historically there has been a lamentably wide gap between Alcoholics Anonymous (AA) and psychodynamic psychotherapy. Although each has a distinct language, they actually utilize parallel principles. This paper is an attempt to integrate the two fields, using clinical examples from an inpatient unit for chemically dependent adolescents. Each of the Twelve Steps is equated with a psychodynamic mechanism. For example, the First Step, admitting powerlessness, is equated with the defense mechanism of denial.

Keywords: Adolescents, substance use disorders, alcohol use disorders, therapy, residential treatment, psychoanalytic theory, defense mechanisms, Alcoholics Anonymous, psychodynamic psychotherapy, psychodynamic mechanism