The author advises that psychiatric diagnosis is more important for an individual than focusing on his/her drug abuses or crimes. Further, cessation of drug or alcohol use is said to be a prerequisite for psychotherapy. In the author's approach, the patient's ability to acquire more mature transitional objects is a necessary condition for mental structure, which in turn fosters self-esteem. The patient remains in the first phase of treatment as long as his or her major emphasis is on others. One technique that is useful in dealing with the abuser's defenses and anger is to stipulate that the patient can't say 'I don't know' when asked about a problem or event. A second technique is to use what is offered by the patient. During the first phase, splitting of the personality and positive transference to the therapist are common. The middle phase for some patients consists of successfully facing a crisis, and for others, mourning over lost objects is the critical problem to be confronted. For some, the task of achieving a healthy altered state of consciousness is paramount. Effective psychotherapy requires the patient to use the session as a transitional substitute for drugs and criminal activity. In the terminal phase of therapy, the patient not only recognizes problems of the past, but experiences an inner security with his or her current life situation. The article includes 19 references.