A review of the substance abuse literature in the 1980s focuses on deficits in self-regulating capacities, in self-care functions, and in other vulnerabilities of the self, such as an inappropriate use of defenses and problems in intimacy. Various models which attempt to explain these behaviors are described, as well as techniques of dynamic psychotherapy for substance abuse, which emphasize the building of ego functions and the internalization of self-preservation functions. Commonalities and differences of substance abuse with other intensely driven compulsive behaviors (e.g., pathological gambling or certain sexual behaviors) are also considered.