How does pathological use of substances like cigarettes, alcohol, and gambling differ from socially acceptable consumption? How can those affected be helped? What are the intrapsychic motives of addicts? While Freud viewed addiction as an immature perverse pleasure, his successors have established the position that addiction serves to defend against an affect that originated early in childhood. Today's psychoanalysis recognizes different severity levels of addiction and various functions of substance use, such as the denial of neurotic inhibitions, the inflation of low self-esteem, relationship avoidance, or even the annihilation of a worthless self. This book presents the most important explanatory models and illustrates them with numerous case studies. Finally, the author provides insights for psychoanalysis.