The first case presented shows the murderous and violent drives that are part of the addict's psychological make-up. The masochistic component in addiction is also related to a defense against the sadistic impulses that drive the addict to use drugs. When working with addicts, attention must always be paid to the unconscious communication of suicidal ideation and intent, as well as underlying psychosis. The use of drugs is often a manic defense against feelings of despair, hopelessness, and the fragmentation of the ego and internal world. In discussing addiction and deprivation, the author advises that addicts are often addicted to their mothers as idealized love objects. This occurs when the normal process of bonding and separation as well as the development of a healthy dependency have been damaged. Consequently, the child's capacity to grieve and mourn is also undeveloped, and thus manic defenses (drug abuse) are created in the face of loss and separation. A discussion of addiction transference includes a case study that shows how the therapist came to be seen by the patient as the addict and the drug in the relationship. In the concluding comment, the author notes that addiction is about extremes: good-bad, love-hate, and life-death. Addicts are excited by danger and risk, and they live in extreme isolation. The mania and the depression rise and fall in rapid succession.