ABSTRACT
Patients who come into psychoanalytic treatment while using drugs, drinking excessively, relating in repetitive, abusive patterns, or involved in destructive sexual behaviors need to be assessed in a certain manner. Particular questions must be answered. Do they need detox? Does the legal system need to intervene? Do they need to be encouraged to join a 12-step group of some sort? Do they need an inpatient or outpatient treatment program? Are psychiatric medications indicated? Is a medical checkup necessary? Are they in danger of killing themselves or harming others?
