Motivation is crucial to successful recovery from Substance Use Disorders. Fifteen DSM IV conditions reduce the motivation needed to bond with programs that assist in abstinence. Child abuse and neglect are frequent in substance abusers, and a conceptualization of its role in substance abuse is given. Therapy for sequelae such as schizoid personality, resentment, pessimism and others are described. with treatment of Axis I and II disorders accomplished, and the effects of abuse/neglect allayed, involvement with 12 step programs is more likely.