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The Biology of Desire: Why Addiction Is Not a Disease Paperback – August 23, 2016
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"Wonderfully readable . . . and accessible in the descriptions of complicated brain science. . . . One finishes The Biology of Desire with a greater understanding of the striata and an appreciation for the argument that we may be thinking about addiction all wrong." —The Washington Post
"Marc Lewis offers a unique perspective on how addiction is seen through the famously misleading distinction between nature and nurture, as though it must be one or the other, when in fact, like most aspects of human life, it is inextricably both." —National Post
"An insightful take on the interaction of mind and brain against the backdrop of the addict's life circumstances. . . . The Biology of Desire says a lot about the brain mechanisms underpinning addiction but, to its credit, does not stop there. With minor exceptions, we do not help addicts (and they do not help themselves) by ministering directly to their brains. As Mr. Lewis stresses throughout this unorthodox but enlightening book, people learn to be addicts, and, with effort, they can learn not to be addicts, too." —Wall Street Journal
"Neuroscientist Lewis (Memoirs of an Addicted Brain) presents a strong argument against the disease model of addiction, which is currently predominant in medicine and popular culture alike, and bolsters it with informative and engaging narratives of addicts' lives. . . . Even when presenting more technical information, Lewis shows a keen ability to put a human face on the most groundbreaking research into addiction. Likewise, he manages to make complex findings and theories both comprehensible and interesting. . . . This book, written with hopeful sincerity, will intrigue both those who accept its thesis and those who do not." —Publishers Weekly
"Neuroscientist Lewis delves into the functioning of the addicted brain. He intends to demonstrate that addiction (substance abuse but also behavioral addictions such as eating disorders, gambling, etc.) is not a disease. . . . This objective is met by the detailed life stories of five recovering addicts the author has interviewed. Their descent into the grips of addiction reads like passages of a junkie's memoir: terrifying and page-turning. . . . This work helps make sense of how addiction operates and is recommended for readers wanting to learn more on the topic." —Library Journal
"Informed by unparalleled neuroscientific insight and written with his usual flare, Marc Lewis' The Biology of Desire effectively refutes the medical view of addiction as a primary brain disease. A bracing and informative rebuke of the muddle that now characterizes public and professional discourse on this topic." —Gabor Maté, M.D., author of In The Realm of Hungry Ghosts: Close Encounters With Addiction.
"Whether you are looking for a foundation in the neuroscience of addiction, guidelines for recovery or just hope that recovery is possible, it's all here. Informed by this book, you'll see how neuroscience explains addiction as a part of life, rather than a mysterious entity only experts can understand." —Tom Horvath, PhD, president of the American Board of Professional Psychology, Practical Recovery and SMART Recovery, and author of Sex, Drugs, Gambling & Chocolate: A Workbook for Overcoming Addictions
"This is the real story of 'this is your brain on drugs' . . . one that provides a refreshing, convincing alternative to the widespread disease-model view of addiction. It offers far more positivity about ways out of addiction than those offered by traditional treatment approaches, providing hope for those struggling and their loved ones." —Anne M. Fletcher, MS, author of New York Times bestselling Sober for Good, Inside Rehab and the Thin for Life books
"Highly readable and plausible illustration of current ideas about addiction from behavioral neuroscience and clinical perspectives by the use of vivid case histories." —Trevor Robbins, professor of cognitive neuroscience and experimental psychology, Cambridge University
"Marc Lewis' new book neatly links current thinking about addiction with neuroscientific theory. . . . Ex-addicts, we learn, are not 'cured,' rather they have become more connected to others, wiser, and more in touch with their own humanity. This is a hopeful message that has, as Lewis demonstrates, the advantage of also being true." —Gene Heyman, author of Addiction: A Disorder of Choice.
"A very readable, often touching, gateway into the universe of neuroscience and the shadowland of addiction." —Sydney Morning Herald (Australia)
"So much nonsense is spoken about addiction and the brain. If you want to understand what's really happening, read Marc Lewis' clear, insightful and necessary book." —Johann Hari, author of Chasing the Scream
"A courageous and much needed voice in rethinking addiction—Lewis takes addiction out of a disease model and reframes it as a negative outcome of neuroplasticity—simply put, our brains' fundamental nature to change as a result of learning and experience. This model provides realistic hope. . . . Through his intimate personal and professional knowledge of addiction Lewis reframes our understanding of its mechanisms and nature in a way that is empowering." —Barbara Arrowsmith-Young, bestselling author of The Woman Who Changed Her Brain
"If you want to understand addiction—and why it matters how the brain actually learns to become addicted—read this book. In elegant and incisive prose, Marc Lewis expertly explains the neuroscience of desire, and how it shapes the paths of our lives." —Maia Szalavitz, author of Unbroken Brain
"Lewis has succeeded in explaining a complicated body of evidence and weaving it into an engaging narrative that will be informative and thought provoking for addiction specialists as well as lay readers." —Matt Field, Professor of Psychological Sciences, University of Liverpool
From the Hardcover edition. --This text refers to the MP3 CD edition.
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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?
"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.
Most Recent Customer Reviews
My respect to Mark Lewis PhD.Read more