Drug-Induced Ego States. I. Cocaine: Phenomenology and Implications

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Abstract
The ego state experienced by chronic users of cocaine is described in terms of sensorimotor functioning, cognitive functioning, emotionality, spatiality, temporality, causality and materiality. At low use levels the state is pleasurable but at high levels fear, anxiety and paranoia increase, and ultimately reality contact breaks down. Q-sort, Semantic Differential and other data suggest that low-level users take cocaine to overcome personal insecurities and relieve boredom. Heavy users take it to support overvaulting ambitions and intense strivings for self-sufficiency. Psychotherapy with such persons must deal with their counterdependency, anger and despair, and with their underlying sense of betrayal. These persons have unacknowledged needs for spiritual experience that must be dealt with openly. A description of persons most vulnerable to heavy use of cocaine is provided, and recommendations for research and social policy are presented.

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