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	Since this article does not have an abstract, we have provided the first 114 words of the full text and any section headings.

In his Clinical Crossroads article about a patient who is addicted to cocaine, Dr Hyman¹ states: "For such a patient, exploratory or insight-oriented therapies should be avoided. There is substantial risk that such therapies will only provide additional rationales for his addiction." Hyman offers no reference to support this statement and, indeed, I am not aware of any evidence that would support this conclusion. By contrast, my colleagues and I have some experience treating addictions with insight therapy.^2-3 I also know that I could personally never reach the conclusions about this particular patient from the very limited history offered in this case presentation.

AUTHOR INFORMATION
This letter was shown to Dr Hyman, who declined to reply.—ED.

Arnold Goldberg, MD
Department of Psychiatry
Rush Medical College
Chicago, Ill

1. Hyman SE. A 28-year-old man addicted to cocaine. JAMA. 2001;286:2586-2594. FREE FULL TEXT 2. Goldberg AI. Being of Two Minds: The Vertical Split in Psychoanalysis and Psychotherapy. Hillsdale, NJ: The Analytic Press; 1999. 3. Goldberg A, ed. Errant Selves: A Casebook of Misbehavior. Hillsdale, NJ: The Analytic Press; 2001.

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2002;287:988.

RELATED ARTICLE

A 28-Year-Old Man Addicted to Cocaine
Steven E. Hyman
JAMA. 2001;286(20):2586-2594.
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