Relapse into Addiction as an Expression of the Collapse of the Ground of Experience

Although addiction is a topic that has been studied widely in Gestalt therapy, the specific issue of relapse into addiction is not explored enough, both in theoretical and clinical works. Referring to neurobiological aspects, the authors support the hypothesis that relapse into addiction expresses a “collapse” of the ground experience; they describe this phenomenon as based on a disturbance of the id and personality functions of the self in a difficult field. A peculiarity of addiction is the risk of relapse even years later due to a neuro-functional modification sustained by craving. Relapse could be the outcome of a complex process involving the neurobiological, emotional, relational and situational dimensions. It is the expression of a difficulty in finding support in one’s own physiology, in the system of contacts that are taken for granted, and in the redefinition of the self that runs through every addiction treatment pathway. In these situations, a “collapse of the ground” can occur: it is about the loss of those certainties that guarantee stability and security for the addicted patient. In the therapeutic field with these patients, we contact a failure history in the wish to belong, and failure of relational recognition, with neuropathological and psychological consequences. Implicit in the therapeutic work with addiction is the work on the ground experience, the support system that comes from the spontaneous physiology and the complex of self-definitions in the different situational systems. A short clinical case shows how in relapse the functions of the self may collapse regressing to primal modes of adaptation and reducing the integrative capacity of the self. Relapse prevention aims at co-creating a relational field that promotes support for the ability to make contact through the discounted contact system and the re-sensitised body, and through a new self-definition on the identity, relational and social level. Relapse prevention focuses on the creative reconstruction of a safe ground that has been desensitised by addiction experiences. A fundamental part of this prevention work is the identification and management of possible activating stimuli (triggers). The authors draw on an extensive scientific literature on the subject of relapse in addiction and a view that does not blame the patient.

Keywords: ; relapse; addiction; functions of the self; ground experience; Gestalt therapy; relational recognition

Beatrice Petrosino, Giancarlo Pintus, La ricaduta nell’addiction come espressione del “crollo dello sfondo” in "QUADERNI DI GESTALT" 2/2024, pp 11-31, DOI: 10.3280/qg2024-2oa18194