Tag: Freud

Find the Switch — 3

Jean Strobel introduced me to the the “dry drunk syndrome” years ago and it has guideded my work ever since. A well-known pamphlet on the subject states, “Being dry is not the same as contented sobriety.”1 Bev Lemaniak, another important mentor, said it best: There’s more to recovery than sobriety.”

Dick Solberg, the pamphlet’s author, notes:

Dry drunk refers to attitudes and actions that poison our well-being. We keep acting "drunk," even when we're "dry." What's more, these attitudes and actions often show up after we've been sober for a while. They're a sure sign that we're experiencing discomfort in our lives.2

I’d argue that the attitudes and actions are generally present before struggles with alcohol and other drugs develop. They represent the driver or “switch” (and here) for addiction.

Solberg explored some “obvious traits” of those with substance use disorders including grandiosity, judgmentalism, intolerance and impulsivity.3 Some in recovery refer to these are “character defects.”4 From a clinical standpoint, we think in terms of attachment patterns, personality structure, irrational beliefs,5 and so forth. Treatment involves targeting these underlying issues. ✸

  1. R.J. Solberg. The Dry Drunk Syndrome, Revised Edition. Center City, MN: Hazelden, 1993, p. i
  2. Ibid., pp. 1–2; emphasis in the original
  3. Ibid., pp. 3–8
  4. Alcoholics Anonymous, 4th ed. New York: Alcoholics Anonymous World Services, 2001, pp. 58–71, 72–88 (Step 6)
  5. Irrational beliefs, or iBs, are a core feature of rational emotive behavior therapy (REBT), a form of cognitive behavioral therapy. Those with substance use disorders often address awfulizing, frustration intolerance and self-downing by “chemical coping”

Endnote. According to Hazelden, Solberg’s pamphlet was initially published in 1970. It was revised in 1983 and 1993. There have been many different covers over the years and pamphlets are often undated. The copy that Jean Strobel gave to me appears to be a later printing of the first edition (publishing mark: dry drunk is hyphenated).

Solberg also authored The Dry Drunk Revisited, which was published in 1980 and is now out of print.

Many thanks to Chuck B. for helping me understand the publication history.

Series Installments
Find the Switch
Find the Switch — 2
Find the Switch — 3
Find the Switch — 4

Find the Switch — 2

In an earlier post, I stressed the importance of finding the driver for symptoms and behaviors— the “switch,” as Freud called it. Kyle VanBlaircom referenced this post in a recent podcast and we discussed it for a bit.

I keep this vintage postcard in my consultation room and use it for patient education.

What might the driver or switch be? Typically early attachment experiences that coalesced into personality patterns — patterns that keep showing up in the present and cause suffering.

Finding the driver takes time. According to Drs. Jonathan Shedler and Enrico Gnaulati, “Meaningful change began at about the six-month mark, and clients who stayed in therapy for a year did substantially better. Those who stayed for two years improved still more. There [is] an unmistakable dose-response curve […].” ✸

Series Installments
Find the Switch
Find the Switch — 2
Find the Switch — 3
Find the Switch — 4

Find the Switch

I’ve been fascinated with indirect procedures1 ever since Brian McCullough introduced me to F.M. Alexander.

Consider a toddler with a fever. Administering Advil or Tylenol would be a direct approach to treatment. This might tamp down the fever for a few hours but won’t resolve its underlying cause. Moreover, that strategy might prove dangerous if something like meningitis or cancer is the cause of the fever. In contrast, treating an ear infection (driver for fever) with antibiotics resolves the fever indirectly and permanently.

I keep this vintage postcard in my consultation room and use it for patient education. Please see Endnote.

So, too, in mental health and addiction treatment. One can target symptoms and behaviors directly with medications and certain forms of psychotherapy. By and large, however, this doesn’t resolve root causes.

Freud [...] sometimes used a picture postcard of the most ordinary kind for making his point. A picture showed, for instance, a hillbilly in a hotel room trying to blow out the electric light like a candle. Freud explained: "If you attack the symptom directly, you act in the same way as this man. You must look for the switch."2

Do I use direct approaches? Yes — they are often necessary to stabilize patients. But I generally try to shift to indirect procedures that uncover and resolve root causes. ✸

Postscript. In the case of addiction:

Our liquor was but a symptom. So we had to get down to causes and conditions.3
[Y]our problem is not drinking in spite of what anyone has told you or in spite of the conclusion you may have reached yourself. Forget all that stuff. It's a lot of bunk and probably has you so confused you can't look at yourself with any objectivity. I repeat——drinking is not your problem. [...]

Drinking in your case is a symptom of something wrong. If you can make yourself realize this you may be thankful for your drinking at a future date. Why? If it were not for the particular effect that liquor has on you, you might never search for the underlying trouble.4
  1. Slides 26–39
  2. Theodor Reik. The Need to Be Loved. New York: Farrar, Straus and Company, 1963, p. 271
  3. Alcoholics Anonymous, 4th ed. New York: Alcoholics Anonymous World Services, Inc., p. 64
  4. Charles Clapp, Jr. Drinking’s Not the Problem. New York: Thomas Y. Crowell Company, 1949, p. 17 [emphasis in the original]

Endnote. I contacted the Freud Museum in 2024 to see if it had any postcards in its collection. A research manager replied: “Thank you for your email—what an intriguing question. Good old Theodore Reik! I’ve had a search through and can’t find any postcards matching that description. My guess would be that the postcard that was used for this demonstration wasn’t part of the material that came to London from Vienna—but if you ever are able to track it down—do let me know!”

Series Installments
Find the Switch
Find the Switch — 2
Find the Switch — 3
Find the Switch — 4