Measurement of levels of narcissistic rage in methadone patients and the relationship between narcissistic rage and extracurricular drug use: a study of the psychodynamics of compulsive drug use

Leon Wurmser's (1974) formulation of the psychodynamics of compulsive drug use focuses on individuals with a core narcissistic disturbance, who are prone to suffering narcissistic crises, leading to narcissistic rage. If normal defense mechanisms prove ineffective, this rage may be expressed as hostility and aggression in order to force a change in the external situation. If these attempts also fail, individuals will be compelled to use mood-altering drugs as a means of regaining control over their internal state, thereby satisfying infantile needs for omnipotence.