Choice of substance and psychic vulnerability. A study with the Rorschach test

AIM: The present paper reports a clinical study of a group of 30 comorbid substance abusers: 10 alcoholics, 10 heroin addicts and 10 consumers of cocaine and other activator substances. The subjects were investigated through the Rorschach test, in accordance with the method of the French School. This comparative study had two aims. The first was to highlight the role of the different substances in strengthening and promoting the defense styles structured, in particular organizations of personality. The second was to guide clinical interventions, making them more targeted in regard to the mechanisms that promote the choice of the substance. METHODS: Within a psychoanalytic interpretative framework, the Rorschach test allowed to study the premorbid personality in depth, in a distinct way from the changes triggered by the substance. RESULTS: The data analysis shows three critical areas: the fragility of the ego, the difficulty of managing the emotional components, and the intense depressive experiences. However, these weaknesses show themselves in different ways depending on the personological profiles which presumably guided the preference for a particular substance. CONCLUSION: In accordance with the starting hypothesis, the results show how the choice of the substance is influenced by the prevalent defense style: the substance seems to conform to the ways used to face suffering.