Ebook The Biology of Desire: Why Addiction Is Not a Disease
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The Biology of Desire: Why Addiction Is Not a Disease
Ebook The Biology of Desire: Why Addiction Is Not a Disease
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Audible Audiobook
Listening Length: 7 hours and 40 minutes
Program Type: Audiobook
Version: Unabridged
Publisher: Gildan Media, LLC
Audible.com Release Date: July 21, 2015
Whispersync for Voice: Ready
Language: English, English
ASIN: B0128B4HX4
Amazon Best Sellers Rank:
I have read Lewis' other book and follow his blog, and find his arguments among the most clear and comprehensive out there. He is not to be dismissed based on the title alone, which other reviewers seem wont to do. I'm giving this book 5 stars because it taught me things I did not know, despite having read hundreds if not thousands of peer-reviewed articles on drug use and addiction. Anything that makes me think differently about my own field of research deserves 5 stars.Lewis manages to synthesize a large body of literature that a layperson (which I am when it comes to the neurobiology of addiction) cannot do on one's own. I've always wished I could have a conversation with an addiction neuroscientist who had not blindly accepted the disease model, and that is essentially what this book is. However, his disagreements with others such as Nora Volkow are actually quite subtle and sophisticated, and I wonder if readers will miss the subtlety, chalking it up to mere semantics. For instance, “hijacking†of the brain’s natural reward system is the metaphor often used in the brain disease model, which some might argue is not that different from Lewis’ notion that addiction is an “accelerated†or “deep†form of the developmental learning our brains are meant to do. However, I think one crucial difference is he’s challenging the notion that the DRUG is the key point on which to intervene. The disease model needs a vector or pathogen, which the drug becomes, and this turns our attention away from what the person is experiencing and the meaning attached to that experience. Rather, Lewis argues, we have a natural motivation toward powerful emotional experiences, and drugs can provide a particularly powerful experience that we more quickly learn to seek out than other, less powerfully motivating experiences (nonlinear dynamics here being critical). Over time, people who are addicted (and not just to drugs) become trapped in the moment-to-moment experiences and disconnected from their past and future. The question becomes, how does the perspective change such that the meaning attached to the experience drugs provide is less powerful? (Understanding this also can help us to understand why most people who try drugs, even heroin, do NOT become addicted...for whatever reason the experience was not as powerful or as meaningful for them.)When we turn our attention away from the big, bad drug, it really does change how we intervene. In particular, we have a lot more to learn in exploring Lewis’ theories around ego fatigue, the addict’s perspective on time (linear v circular), and "social scaffolding." What might drain some people’s willpower more than other people’s? What are the effects of stress, inequality, oppression, and poverty on one’s ability to avoid ego fatigue, or on one’s ability to envision a better future? More importantly, what causes one to shift perspective, and can social scaffolding precipitate and not just take advantage of these shifts in perspective?
Near the end of Lewis’ valuable book on addiction and the misguided addiction treatment industry, the following quote appears:"Addicts experience something breathtaking when they can stretch their vision of themselves from the immediate present back to the past that shaped them and forward to a future that’s attainable and satisfying."He’s making a good point about how self-awareness, identity, and belonging to a caring community contribute to recovery (a word, by the way, he doesn’t like).Problem is, this point comes too late in the book to do much good. I imagine thousands of readers having given up way beforehand. Lewis himself has stated in an ill-advised diatribe against at an Amazon reviewer, the book is meant for the layperson, but that statement is hard to square with his chronic and often confusing references to brain parts that govern craving, “now thinking,†and all the other emotional and physiological factors that make addiction so baffling. He does include a little brain map near the beginning, but that didn’t help me much—and I read this book carefully.Not that his brain mapping, and frequent references to the Ventral striatum, the Amygdala, et al isn’t valuable—it is just presented in too disorganized a manner to be easily understood.Worse, I kept waiting for him to explain how this information could help an addict grow beyond his addiction. He sort of gets to this point at the very end—and his advise comes off as a bit suspect, even if it is well-intentioned. He mentions Peter Sheath’s Reach Out Recovery in the city of Birmingham, England, which is designed to enlist the community in a campaign to help addicts when they decide they want help. Great idea, but it’s unproven (and sounds Utopian). In any case, the final chapter, “Developing Beyond Addiction,†which should be the meat of the book, comes off more as an after-thought.On the plus side, he makes a strong argument—both biological and philosophical—against the disease model, arguing that addiction carves out the same neural canals as growth and learning.Memo to Marc Lewis (from a reader who’s no stranger to this problem): rewrite your book, or write another one, this time with a talented editor who can organize your strong material into something stronger.
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