Психодинамична личностова организация и нарцистична регулация при пристрастяване към психоактивни вещества
Psychodynamic personality organization and narcissistic regulation in substance addiction

Summary/Abstract: This theoretical analysis explores the relationship between personality organization and the etiology of psychoactive substance addiction, transcending a purely symptomatic approach. The analysis focuses on the structural characteristics of borderline personality organization and pathological narcissism as specific terrain for the development of addictive behavior. Through a theoretical integration of Kernberg’s ego psychology of object relations and Kohut’s self-psychology, the study conceptualizes substance use as a rigid mechanism of narcissistic regulation and an attempt to restore psychic homeostasis. Core psychoanalytic mechanisms, such as splitting, projective identification, and deficits in affect symbolization, are examined. Special emphasis is placed on the function of the substance as a substitute for missing psychic structure and its role as an external regulator of self-esteem during intense experiences of shame, emptiness, and rage. The transformation of the substance into a specific self-object is discussed, serving the paradoxical function of protecting the self from disintegration while simultaneously impeding authentic emotional relatedness. The derived theoretical conclusions point to the necessity of a clinical strategy focused on restructuring personality organization and building the capacity for mentalization, rather than solely on behavioral symptom reduction.

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