Cocaine and Psychoanalysis (International Dictionary of Psychoanalysis)
Cocaine is an alkaloid extracted from coca leaves, which has been used in medicine for its analgesic and anesthetic properties. Cocaine dependency is an addiction to this narcotic. The relation between cocaine and psychoanalysis goes back to Freud's research in which he used the substance as an ophthalmic anesthetic.
Cocaine was first used as an anesthetic agent in Vienna in 1884. Freud conducted research into the physiological action of the drug with a view to using it for therapeutic purposes. It was nevertheless his colleague, Carl Köller, who continued this work and to whom we attribute the discovery of the anesthetic properties of cocaine, based on its use in eye surgery. Years later Freud described the situation in these terms: "A side interest, though it was a deep one, had led me in 1884 to obtain from Merck some of what was then the little-known alkaloid cocaine and to study its physiological action....I suggested, however, to my friend Köningstein, the ophthalmologist, that he should investigate the question of how far the anaesthetizing properties of cocaine were applicable in diseases of the eye" (1925d, pp. 14-15). Ernest Jones (1953) reports that in 1884 Freud administered injections of cocaine to his friend Ernst von Fleischl in order to wean him off his morphine addiction and to ease his terrible trigeminal neuralgia. One year later he observed that the massive doses of cocaine required by Fleischl had led to chronic intoxication. He thus discovered the toxicity of cocaine, which stood in the way of its being used medically. Coca leaves and cocaine had been used in the Americas as stimulants to fight fatigue and hunger, but their use led to neurochemical and physiological effects as well as severe addiction problems.
Psychoanalysis has studied the underlying dynamics and the unconscious fantasies that drive patients to seek out the chemical and physiological effects of cocaine in a compulsive manner. Cocaine addiction is normally difficult to cure. Classification of the pathological structures underlying cocaine addiction seems to suggest that a process of pathological mourning or manic-depressive behavior can be found in many patients. Patients sometimes seek out this toxic substance as a stimulant or an anti-depressant in order to conceal states of depression. Some drug addicts unable to work through their grief develop pathological mourning wherein they identify with the lost dead object(s), thus unconsciously putting their lives in grave danger. Their repeated risk taking allows them to feel as if they are conquering death and are being resuscitated. This fantasied resurrection represents success to these addicts, in whose mental state the psychological notions of danger, death, and suicide do not exist. The psychoanalytic interpretation therefore must direct itself to the uncovering and interpreting of their resurrection fantasies and thus lead them to give up living within a dead object or give up identifying with a dead person.
See also: Addiction; Alienation; Anorexia nervosa; Borderline conditions; Dependence; Fantasy (reverie); Indications and counterindications for psychoanalysis; Transitional object.
Freud, Sigmund. (1925d). An autobiographical study. SE, 20: 1-74.
Jones, Ernest. (1953). Sigmund Freud. Life and work. London: Hogarth.
Rosenfeld, David. (1992). The psychotic aspects of the personality. London-New York: Karnac Books.