Neuropsychoanalytic notes on addiction

In other words, during development masturbation is normally replaced by adult sexual satisfaction, but where it is not it may be substituted by (another) addiction. These are quintessentially Freudian claims, museum-quality examples of the type. For that reason, perhaps, they are all too easily dismissed by addiction researchers today. If readers are willing to suspend judgment for a moment, though, and permit us to unpack the meaning of these claims and reconsider them in the light of contemporary neuroscience, their patience will be amply repaid. For all of his failings, Freud had an uncanny ability to identify the essence of a psychological problem. The fundamental problem of addiction exposed by the parallel that Freud drew with masturbation is that substance abuse (like masturbation) is an affectively rewarding activity that serves no biological purpose. Substance abuse generates hedonically positive affects in the brain (or reduces negative ones; for full discussion of this ‘opponent process’ issue in addiction research, see Khantzian, 2003) but does not sustain reproductive fitness. In fact, it does the opposite. Addiction therefore cannot be an evolutionarily proper use of the brain mechanisms in question, but it is psychologically compelling nonetheless.