Relapse in alcohol dependence as an expression of the patient’s depression
Ewa Wyrzykowska

This article presents a case study on an alcohol dependent patient whose addiction can be understood as secondary to the depressive personality. The article presents the life story of the patient, her undertaken treatment of addiction and many relapses, understanding of the patient’s psychopathology as well as repeated relapses of alcohol drinking, from the perspective of psychodynamic theory. The patient has undertaken five alcohol treatments. She interrupted abstinence after treatment four times. From the perspective of psychodynamic theory, alcohol dependence and relapse can be treated as a form of self‑destruction (including the so‑called indirect self‑destruction), destroying herself, her own dreams and desires. She undertook higher studies several times, which she did not complete because of alcohol abuse. She had two children. The article also analyses the patient’s relationships with her immediate family and friends. The patient’s father was addicted to alcohol. In adolescence, the patient drank with him. The patient’s mother is mentioned by her as absent. She met her partner during the treatment of alcohol addiction. He did not maintain abstinence after many treatments, either. It seems that in interpersonal relationships the patient unconsciously repeated frustrating, unsatisfying relationships. It can be assumed that this was reflected in therapeutic relationships which the patient annulled through successive relapses. Analysis of the life history of alcohol use and relapse suggests that the development of dependence could be caused by deep deficits in depressive personality structure of the patient and by deficits in object relations.