Alcoholism has both psychological and physical components. However, it is well known that resolving the physical aspects of a person's alcohol addiction, by detoxifying the individual, does not cure the underlying compulsion to drink.

This is where the psychological basis of alcoholism becomes important. Psychoanalysts have discovered a number of emotional factors that are important in addictions like alcoholism. These factors involve emotional functions and meanings of drinking that lead it to be such a driven activity for some people, rather than a rational choice.

For some of these people, drinking serves to modify painful feelings, so that whenever these feeling states arise there is a deeply felt desire to drink. Sometimes, this feeling has to do with self-blame or a punishing self-criticism that is relieved by drinking.

For others, drinking seems to temporarily "treat" feelings of disillusionment and depression, or to create a needed sense of being important. Other people appear to use alcohol as a substitute for people whom they have lost: finding the bottle to be the friend they seek. And some people seem to reverse a feeling of helplessness by having a drink; they feel empowered by being able to drink, as if to say, "I may be powerless, but I can't be stopped from drinking."

In general, psychoanalysts believe that alcoholics should be treated with the same respect and understanding as any other person suffering from psychological distress. Once physical safety is considered and dealt with, the next most important matter is to carefully listen to people with alcoholism in order to understand the emotional issues that are meaningful for them.

It is wrong to say that all alcoholics are alike or to ignore what alcoholics say. Likewise, it is wrong to feel that one treatment approach must apply to every person with alcoholism.

Some people with alcoholism will benefit from professionally-led group treatments, some from individual psychotherapy or psychoanalysis, some from self-help programs, and some will benefit from a combination of these.

What is most critical is that the person with alcoholism be carefully evaluated by a person who is both open-minded and knowledgeable about all of these many treatment possibilities.