Alcohol occupies a multivalent position across the depth-psychology corpus, functioning simultaneously as a psychosexual symbol, a neurobiological agent, a social pathogen, and a clinical challenge demanding pharmacological management. Karl Abraham's early psychoanalytic contribution frames alcohol as a mediator of repressed sexuality and masculine identity, tracing the differential relation of men and women to intoxication through the vicissitudes of libidinal economy and sublimation. Later voices, notably Addenbrooke drawing on Jungian clinical tradition, situate alcohol addiction within a broader psychology of addiction as defence against psychic pain, shadow identification, and the arrested development of the self. The neuroscientific strand—represented by Lovelock's interoceptive framework—reframes alcohol's hold on the organism through GABA, NMDA, and serotonergic receptor dynamics, insular cortex remodelling, and the disruption of body-state signalling that underlies craving and relapse. McPheeters and Antonelli represent the pharmacotherapy horizon, surveying naltrexone, acamprosate, baclofen, and topiramate as chemical responses to alcohol use disorder, now codified by DSM-5-TR criteria. Alexander and Hari contest the reductive disease model, embedding alcohol misuse in social dislocation and the iron law of prohibition. The corpus thus presents alcohol as a site of irreducible tension between intrapsychic, neurobiological, sociocultural, and clinical-pharmacological accounts.
In the library
18 passages
Men turn to alcohol because it gives them an increased feeling of manliness and flatters their complex of masculinity... The girl at puberty has no motive to turn to alcohol, for it would remove the effects of repression—the resistances.
Abraham argues that alcohol serves as a psychosexual surrogate for masculine potency and that the differential relation of men and women to drinking is structured by repression, libidinal economy, and gender-specific social sanctions.
Abraham, Karl, Selected Papers on Psychoanalysis, 1927thesis
Obscene wit, which according to Freud's brilliant analysis represents an exposure in a psychological sense, is inseparably associated with the enjoyment of alcohol... many brutal crimes are perpetrated in states of alcoholic intoxication.
Abraham links alcohol intoxication to the disinhibition of repressed sadistic and exhibitionistic component-instincts, connecting it to both wit and violence through psychoanalytic drive theory.
Abraham, Karl, Selected Papers on Psychoanalysis, 1927thesis
There are wide circles in which to be a hard drinker is looked upon as a sign of manliness, even as a matter of honour. Society never demands in this way that women should take alcohol.
Abraham establishes the socially sanctioned masculine coding of alcohol consumption as the sociocultural substrate upon which individual psychosexual motivations for drinking are built.
Abraham, Karl, Selected Papers on Psychoanalysis, 1927thesis
Alcohol-dependent individuals were found to have smaller insular cortex and ACC volumes which correlated with self-reports of impulsivity and compulsivity, as well as enlarged amygdala volume.
Lovelock presents neuroimaging evidence that alcohol use disorder produces measurable structural changes in interoceptive brain regions, linking habitual drinking to disrupted self-regulation and body-state processing.
Lovelock, Dennis F., Interoception and alcohol: Mechanisms, networks, and implications, 2021thesis
At higher doses of alcohol (e.g., ≥1.5 g/kg), GABAA agonists substitute to a lesser degree than NMDA receptor antagonists... because alcohol (2 g/kg) diminishes NMDA receptor function, it seems likely that the ability of alcohol to reduce NMDA receptor function gives rise to its interoceptive stimulus effects.
Lovelock maps the dose-dependent shift from GABAergic to NMDA receptor mechanisms as the neurochemical basis of alcohol's interoceptive stimulus properties, establishing the pharmacological foundations of dependence.
Lovelock, Dennis F., Interoception and alcohol: Mechanisms, networks, and implications, 2021thesis
Unhealthy alcohol use is the third leading preventable cause of death in the United States, accounting for more than 140,000 deaths annually... more than 28.3 million Americans 12 years of age or older met DSM-5 criteria for AUD in the past year.
McPheeters establishes the epidemiological scale of alcohol use disorder in the United States, framing it as a major public health emergency that remains dramatically undertreated despite available pharmacotherapies.
McPheeters, Melissa, Pharmacotherapy for Adults With Alcohol Use Disorder in Outpatient Settings: Systematic Review, 2023thesis
Chemogenetic silencing of the aIC→AcbC projections potentiated and produced 'alcohol-like' effects... silencing of this aIC→AcbC circuit decreased alcohol self-administration under baseline conditions.
Lovelock demonstrates that the anterior insular cortex to nucleus accumbens core circuit is a critical site of action for alcohol's interoceptive effects and self-administration, implicating cortical interoception in compulsive drinking.
Lovelock, Dennis F., Interoception and alcohol: Mechanisms, networks, and implications, 2021supporting
Serotonin receptors have also been implicated in alcohol interoceptive sensitivity as the 5-HT1B/2C agonist TFMPP was shown to fully substitute for 1 g/kg alcohol... substitution for alcohol with serotonin receptor agonists is specific to 5-HT1B receptors.
Lovelock extends the neurochemical account of alcohol's interoceptive effects to serotonergic systems, showing that 5-HT1B receptor engagement replicates low-dose alcohol stimulus properties.
Lovelock, Dennis F., Interoception and alcohol: Mechanisms, networks, and implications, 2021supporting
Women are more adversely affected by alcohol than men... A serious complication in pregnant women addicts is foetal alcohol syndrome. There is no agreement on safe limits of alcohol consumption for pregnant women.
Addenbrooke documents the sex-differentiated physiological consequences of alcohol, including fetal alcohol syndrome, and the psychiatric complications such as auditory hallucinations that attend chronic alcoholism.
Addenbrooke, Mary, Survivors of Addiction: Narratives of Recovery, 2011supporting
Alcohol also directly affects the brain cells adversely and this results in 'blackouts' in acute intoxication... This hypoglycaemia is the result of alcohol interfering with the metabolism of glucose and glycogen in the liver.
Addenbrooke provides a clinical account of alcohol's acute physiological harms, encompassing blackouts, hypoglycaemia, and neurological damage, situating these within an addiction medicine framework.
Addenbrooke, Mary, Survivors of Addiction: Narratives of Recovery, 2011supporting
Prohibition always narrows the market to the most potent possible substance. It's the iron law... Students are normally beer drinkers, but since alcohol is prohibited at the stadium, they sneak in a flask and become whisky drinkers.
Hari invokes the 'iron law of prohibition' to argue that restricting alcohol drives consumers toward more potent substances, applying the same logic to the wider war on drugs.
Hari, Johann, Chasing the Scream: The Search for the Truth About Addiction, 2015supporting
At any given time, you and I and everyone around us has access to a huge array of chemicals that could drive away our pain for a while, from vodka to valium. Almost all of the time, we leave them on the shelf, unused.
Hari argues that alcohol and other intoxicants are ubiquitously available but selectively used in response to psychosocial agony rather than mere access, repositioning addiction as a symptom of social dislocation.
Hari, Johann, Chasing the Scream: The Search for the Truth About Addiction, 2015supporting
Harmful use: A pattern of drinking that is causing damage to health. The damage may be either physical (e.g., liver damage) or mental/social (e.g., alcohol-induced depression).
McPheeters taxonomises the diagnostic categories of unhealthy alcohol use from DSM-5-TR and ICD frameworks, establishing the clinical vocabulary for measuring and treating alcohol-related harm.
McPheeters, Melissa, Pharmacotherapy for Adults With Alcohol Use Disorder in Outpatient Settings: Systematic Review, 2023supporting
Familial functioning is so essential that a clinical diagnosis of alcohol abuse can be assigned to an individual who consumes enough alcohol to disrupt major role obligations in the home.
Benda situates alcohol abuse within family systems theory, documenting its disruption of marital and household functioning and the clinical relevance of family therapy to treatment outcomes.
Benda, Brent B., Spirituality and Religiousness and Alcohol/Other Drug Problems: Treatment and Recovery Perspectives, 2006supporting
Social drinkers exposed to an acute social stressor prior to alcohol consumption report blunted subjective response to alcohol on ratings of 'cheerful', 'focused', and 'outgoing'.
Lovelock demonstrates that acute stress modulates the interoceptive experience of alcohol, complicating the hypothesis that stress uniformly potentiates alcohol's rewarding effects.
Lovelock, Dennis F., Interoception and alcohol: Mechanisms, networks, and implications, 2021supporting
Addiction: alcohol see alcohol addiction; ambivalence and 34, 35, 36, 38, 45, 87; avoidance of feelings as a root of 163, 164; being in love with the drug 44; as a defence against mental pain 19, 26, 45.
Addenbrooke's index encodes the Jungian-inflected framework of the book, identifying emotional avoidance and psychic pain as the psychological roots of alcohol addiction and flagging Jung's own understanding of the phenomenon.
Addenbrooke, Mary, Survivors of Addiction: Narratives of Recovery, 2011supporting
It takes some time for the liver to break down alcohol, so it can stay in the body for a while... Perhaps you could tell me some about how alcohol fits into your life, into an ordinary day.
Miller illustrates a motivational interviewing session in which a clinician non-confrontationally explores a client's relationship to alcohol, demonstrating the spirit and technique of MI as applied to drinking problems.
Miller, William R., Motivational Interviewing: Helping People Change, Third Edition, 2013aside
He was saddened by the death of his first landlord from alcohol-related problems. After coming to the UK, he had a Freudian analysis.
Addenbrooke establishes the biographical origins of Dr. Rathod's clinical vocation in an early encounter with alcohol-related death, contextualising the psychoanalytic tradition that frames the book's approach to addiction.
Addenbrooke, Mary, Survivors of Addiction: Narratives of Recovery, 2011aside