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Product details
File Size: 1506 KB
Print Length: 349 pages
Publisher: St. Martin's Press (April 5, 2016)
Publication Date: April 5, 2016
Sold by: Macmillan
Language: English
ASIN: B014PF3P84
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As a recovery advocate and the father of someone in long-term recovery, I've read more books about addiction than I can count. When my son first started struggling with drugs, I made a vow to educate myself as much as I possibly could. Knowledge is power, and I wanted to know *everything* about addiction. I still do. So I read about it. A lot. And I can honestly say that Maia Szalavitz's "Unbroken Brain: A Revolutionary New Way of Understanding Addiction" is one of the best books I've ever read on the subject.Maia Szalavitz is a fabulous writer who has penned a wonderful, very forward-thinking book about addiction. She introduces us to some new theories about addiction, several of which may have people re-examining the way they've thought about one of the most prevalent and deadliest problems in America today.Szalavitz sets out to show that addiction isn’t a choice or moral failing. "But it’s not a chronic, progressive brain disease like Alzheimer's, either," she notes. “Instead, addiction is a developmental disorder--a problem involving timing and learning, more similar to autism, attention deficit hyperactivity disorder (ADHD), and dyslexia than it is to mumps or cancer." Yes, Szalavitz is blazing new trails here.The author contends that "addiction doesn't just happen to people because they come across a particular chemical and begin taking it regularly. It is learned and has a history rooted in their individual, social, and cultural development." She adds that the addicted brain is not "broken," as many other researchers and writers have suggested. Instead, she says, the addicted brain has "simply undergone a different course of development....addiction is what you might call a wiring difference, not necessarily a destruction of tissue."Looking at addiction as a learning disorder may seem strange to some, but Szalavitz states that doing so "allows us to answer many previously perplexing questions." And in "Unbroken Brain," Szalavitz--who is 25+ years in recovery from cocaine and heroin addiction herself--tells us how learning is a part of every aspect of addiction, oftentimes drawing upon her personal experience to illustrate her points.There are so many interesting and thought-provoking topics covered in this book. From the problems associated with waiting for someone to hit "rock bottom" to the myth of the addictive personality; and from the issues surrounding 12-step programs to why harm reduction isn't a bad thing. ("Harm reduction recognizes [the] social and learned components of addiction. It 'meets people where they're at,' and it teaches them how to improve their lives, whether or not they want to become abstinent." Amen to that.)If you or someone you love has been touched by addiction, or if you're just interested in this fascinating subject, I cannot recommend "Unbroken Brain" highly enough. This book contains a wealth of information, but Maia Szalavitz presents it in an organized manner while writing in a clear and understandable voice. Trust me: You will not be bombarded with a bunch of scientific language that you don't understand.Szalavitz writes in the introduction, "Only by learning what addiction is--and is not--can we begin to find better ways of overcoming it. And only by understanding addicted people as individuals and treating them with compassion can we learn better and far more effective ways to reduce the harm associated with drugs." That is definitely the approach we should be taking with addiction. Hopefully, Maia Szalavitz's innovative new book will be the catalyst for some positive change.
Because I'm a substance abuse counselor, people have often asked me to recommend a book about addiction. For thirty years, the only one I ever urged people to read has been the Big Book of AA, written eighty years ago, when we knew next to nothing about addiction. I’ll get into the reason why I recommended it in a minute. I’m happy to say that now there’s a better book for anyone interested in learning about addiction, drawing on the latest findings, written by an award winning journalist and recovering addict, Maia Szalavitz. Her book is Unbroken Brain.The central premise to Unbroken Brain, is that we’re in the middle of an epidemic of addiction and we are stuck in treating it ineffectively when there are better methods available. One in ten Americans are in the throes of some type of substance use disorder. That’s 23 million and doesn’t even count tobacco addiction and the myriad millions who have behavioral addictions to sex, gambling, shopping, etc; nor, one third of Americans who overeat and are said to be addicted to food. At the same time, pharmaceutical companies, tobacco companies, alcohol companies, agribusiness companies, casinos, lotteries, and every store at the mall all seem to know how to induce addiction for their purposes. We need some new ideas to help people, or, at least, stop recycling old ideas that don’t work.The first idea that doesn’t work is throwing addicts in jail. Think about it; addiction is defined as using, despite negative consequences. Why then would we believe that applying negative consequences would treat addiction? It makes no sense, but we do it anyway.I’ll tell you why we do it. AA taught us to. Yes, the Big Book of AA, that other book I told you about, the only one I ever could recommend, has taught us that addicts have to hit bottom, they have to lose everything and become totally humiliated before they will ever change. It’s this idea which justifies the drug war, mass incarceration of addicts, and many of the other degrading things we put addicts and their families through.This is where I give you the reason I have never been able to recommend any book other than the Big Book of AA. It’s because the field of addiction has been so dominated by it, that no one has been able to go further, or contradict, the ideas found there. Almost everything else that has been written about addiction is based on AA principles.When I began working in the addictions field, practically everyone else working as a counselor was a recovering addict. AA had saved their lives. They were consequently devoted to AA and, when they wrote books and designed what were supposed to be professional treatment programs based on science and best practices, they just repeated AA slogans and principles. That’s fine as long as AA works, but frequently it doesn’t work; actually, more often than not, it doesn’t. seventy percent of the people who try AA-like groups drop out within six months.If a doctor had a pill that 70% of her patients stopped taking before the course of treatment was complete, she’d conclude that the pill had serious side effects, instead of just blaming the patients for being uncooperative. In addiction treatment we blame the patients. We say they haven’t hit bottom yet. They have to hit bottom before they will get serious.I didn't enter the addictions field by first being in recovery. I entered it because I wanted to be a counselor and saw opportunities there. When I began, I found that the counselors were treating clients very differently than they way I was taught to treat them in school. I was taught to respect clients, offer them unconditional positive regard, and put them in the driver’s seat. What I saw was the opposite. Chemical dependency counselors were very directive; they told people when and how they were full of shit, and made decisions for them. They said a client’s best thinking got them in this mess; it was not able to get them out. They said that an addict is lying whenever his lips are moving. When I objected, I was told things had to be different in chemical dependency. Addicts would take advance of my naiveté. My education had not prepared me for the real world. An addict’s mind was broken, they said, we can’t expect it to work like everyone else’s.According to Szalavitz, they’re wrong and I should have believed what I was taught in school all along. Addiction does not break a brain, nor is it caused by a broken one. She characterizes addiction as a developmental disorder, like autism, ADHD, or dyslexia; which arises as an attempt to solve problems like trauma, interpersonal conflict, and sensitivity to stimulation, for which the person’s brain is not yet equipped; and one which resolves itself if the person is given the opportunity to learn from their mistakes. Indeed, the vast majority of addictions begin in adolescence and most end by the time the brain is mature around age thirty.If we treated others who have a developmental disorder as we do addicts, we would tell the kid with dyslexia, for instance, that nobody could help him until he came to the realization that he was powerless over his dyslexia. We would punish him whenever he spelled a word wrong and, if he continued to do so, would throw him out of school, and maybe into jail. Not only would we fail to teach him, but we would call anyone else who had patience for him codependent and enabling. That’s not what we do with dyslexics, not any more, anyway; consequently, most compensate for their dyslexia and learn to read.The concept of hitting bottom undermines AA’s other, more accurate, principle that addiction is a disease. It justifies the criminalization, discrimination, and humiliation of addicts. It spawns “tough love†approaches and the pathologizing of loved ones as codependent. It led to abusive methods in many other “therapeutic communities.†It leads to seventy percent of the people walking out.There are many more points Szalavitz makes in this quite comprehensive book about addiction. She reviews in detail the connection between our drug policies and racism. She gives us the the dope on dopamine. She describes the twin hooks of wanting and having. She gets autobiographical, revealing her own transit into and out of addiction. But, for me, it is the counterpoint she provides to the last great book about addiction that is most valuable. Read Unbroken Brain if you need to understand something about addiction.Keith Wilson writes on mental health and relationship issues on his blog, Madness 101
As a physician in recovery, I was excited to see the author expand on the idea of addiction as a developmental disorder, a view I share. I was quite disappointed, however, that the author uses these ideas to launch her personal attack on the 12 step recovery model. Though that model does not work for everyone, it has worked for many. She suggests that the model is akin to breaking patients down with "hours of spitting, shouting, name calling, and repeatedly listing every flaw of his character." She likens it requiring "a patient to sit facing a wall, carry humiliating signs or wear diapers." The author tells us that the 12 step approach "can be used to justify disrespectful and abusive tactics," and that "humiliating participants is acceptable." Her revulsion is understandably driven by her early treatment experience in a therapeutic community that was rather traumatic and would never be tolerated in a 12 step meeting or recovery group. As a youth, she was required to sit rigidly for hours on end while being subjected to emotional attack along with another girl who eventually sued the "treatment" program exposing the sexual, physical, and emotional abuse. As a fellow person in recovery, I relate to her struggle as well as her frustration with the current views the world holds on addiction. But I hardly find it necessary to debase a grass roots organization that, in my personal experience, has never offered anything other than love and acceptance and a way to begin healing from the trauma of addiction through personal development.
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