abstract
Extreme Risk Seeking Addiction (ERSA) is a behavioural addiction manifested as a repeated voluntary search for risk. This article introduces some theoretical reference points to discuss a clinical case study, a once-weekly psychotherapy which extended over more than ten years. The model followed assumes that ERSA is due to the feelings of excitement and ‘narrow escape’ which, if reiterated, bring about the construction of a pathological organization, a psychic retreat in Steiner’s terms. This organization is a part of the self which is tyrannical and falsely protective, and is able to create illusory feelings of invulnerability and all-powerfulness. Psychotherapy can offer a benevolent interaction which is sufficiently in tune with the ERSA-affected person to be able to favour self-reflective experiences promoting the mentalization of affect and, more generally, the skills which make it possible to recognize emotions in the self and in others, and to manage emotional states within relationships effectively and competently.