Abstract

Although alcohol use disorder (AUD) is a serious and complex mental disorder, it is still surrounded by numerous doubts, misunderstandings, lack of support and lack of empathy from the environment and the health profession, because most people consider that the individual caused it on their own. The purpose of this narrative literature review is to answer the research question regarding empathy towards AUD and the psychodynamic understanding of patients with AUD by using the database literature (Web of Science, PubMed, and Google Scholar) published in the last 60 years. The contemporary psychodynamic understanding of AUD based on the ego and self-psychology of development of the individuals with this disorder is presented, as well as a psychodynamic explanation for the lack of empathy provided by healthcare professionals and the society, despite it being an accepted medical model of understanding addiction. Contemporary psychoanalytic understanding of AUD is linked to suffering, which is opposite from pleasure seeking (especially according to neuroscientists) and the earlier psychodynamic formulations (pleasure seeking or motives for self-destruction), because seeking relief from alcohol is mainly a consequence of the addicted individual’s inability to regulate their emotions (anxiety, depression), selfesteem, interpersonal relationships and behavior, especially their self-care. From a clinical perspective, it is important to understand the construct of empathy towards patients with AUD, as well as AUD from a psychodynamic aspect, in order to understand the psychological background of addictive behavior and increase empathy in the treatment of addictive disorders by combining psychotherapeutic, behavioral-sociotherapeutic and pharmacotherapeutic approaches.