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Rothschild, L. (1933). Clinical: Sandor Radó. 'The Psychoanalysis of Pharmacothymia.' The Psychoanalytic Quarterly, 1933, Vol. II, No. 1, pp. 1–23.. Int. J. Psycho-Anal., 14:401-402.
Psychoanalytic Electronic Publishing: Clinical: Sandor Radó. 'The Psychoanalysis of Pharmacothymia.' The Psychoanalytic Quarterly, 1933, Vol. II, No. 1, pp. 1–23.

(1933). International Journal of Psycho-Analysis, 14:401-402

Clinical: Sandor Radó. 'The Psychoanalysis of Pharmacothymia.' The Psychoanalytic Quarterly, 1933, Vol. II, No. 1, pp. 1–23.

Leonard Rothschild

Drug addictions are psychically determined, artificially induced illnesses. All types are varieties of one single disease. Certain drugs happen to be 'elatants' which either generate pleasure or prevent pain and afford the way out of a psychic situation which is characteristic of addiction. This is the 'tense depression' which is a special type of emotional alteration resulting from frustration. The drug then causes an elevation of mood and a sharp rise in self-esteem which causes a recrudescence of primitive narcissism. Interest in reality gradually vanishes. A cyclic course is the usual sequence. The transitoriness of the elation determines the return of the depression, the latter the renewed craving for the elation. The ego

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now has to maintain its self-regard by an artificial technique. There is a change from a realistic to a pharmacothymic régime. But this is subject to the law of diminishing returns.

Crucial alterations now occur in the sexual sphere. Genital pleasure is disregarded and pharmacogenic pleasure effect comes to be the dominant aim. Thus an artificial sexual organization is established which is autoerotic and patterned after infantile masturbation. The ego responds to this devaluation with castration anxiety which is perceived as fear of pharmacogenic failure. By withdrawing itself from social and sexual activities, the ego has delivered itself over to masochism until finally no elation can conquer the misery of the depression. This is the pharmacothymic crisis from which there are three exits—flight into a free interval, suicide or psychosis. The withdrawal of the drug deprives the ego of its protection against masochism and usually fails. Suicide is the result of self-destructive masochism. The psychotic episode has been chiefly studied in the alcohol deliria. These are characterized by anxiety over castration or sexual attack, wishes which gratify latent masochistic tendencies and are transformed into manifest ego terror phantasies.

Deep insight into the dynamics of homosexuality can be gained through a study of masochism in pharmacothymia. Erotism is driven from its active positions. In men the result of the combination of the genital aim of painless pleasure with the passive goal of masochism is a homosexual object choice. For homosexuality is more acceptable to the ego than masochism. Its advantage rests in its denial of castration for even the sexual partner possesses a penis. It represents an attempt at autotherapy viâ a return to the realistic régime with a new genital aim. Subsequently a further step toward masculinity is taken by progression from a passive homosexual to an active homosexual attitude. It is possible for the pharmacothymic to preserve some heterosexuality through other compromise formations. He may become passively oriented to women who are endowed with a penis and elevated to the rôle of the phallic mother. Or a surge of sadism may attempt to dispel castration anxiety. This results in a counterpart to the sadistic perversion characterized by unprovoked outbursts of hate or rage against women alternating with states of tender mollification. The former are the pharmacothymic's substitute for potency.

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Article Citation

Rothschild, L. (1933). Clinical. Int. J. Psycho-Anal., 14:401-402

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