The Biology of Desire: Why Addiction Is Not a Disease

by Marc Lewis

Overview

Through the vivid, true stories of five people who journeyed into and out of addiction, a renowned neuroscientist explains why the "disease model" of addiction is wrong and illuminates the path to recovery.

The psychiatric establishment and rehab industry in the Western world have branded addiction a brain disease, based on evidence that brains change with drug use. But in The Biology of Desire, cognitive neuroscientist and former addict Marc Lewis makes a convincing case that addiction is not a disease, and shows why the disease model has become an obstacle to healing.

Lewis reveals addiction as an unintended consequence of the brain doing what it's supposed to do-seek pleasure and relief-in a world that's not cooperating. Brains are designed to restructure themselves with normal learning and development, but this process is accelerated in addiction when highly attractive rewards are pursued repeatedly. Lewis shows why treatment based on the disease model so often fails, and how treatment can be retooled to achieve lasting recovery, given the realities of brain plasticity. Combining intimate human stories with clearly rendered scientific explanation, The Biology of Desire is enlightening and optimistic reading for anyone who has wrestled with addiction either personally or professionally.

Product Details

ISBN-13:	9781610397124
Publisher:	PublicAffairs
Publication date:	08/23/2016
Edition description:	First Trade Paper Edition
Pages:	256
Sales rank:	93,798
Product dimensions:	5.40(w) x 8.20(h) x 0.80(d)

About the Author

Marc Lewis, PhD, is a neuroscientist and professor of developmental psychology. Now at Radboud University in the Netherlands, he taught for more than twenty years at the University of Toronto. He has authored or coauthored more than fifty journal articles in neuroscience and developmental psychology. Presently, he speaks and blogs on topics in addiction science, and his critically acclaimed book, Memoirs of an Addicted Brain: A Neuroscientist Examines His Former Life on Drugs, is the first to blend memoir and science in addiction studies.

Table of Contents

Introduction ix

Chapter 1 Defining Addiction: A Battleground of Opinions 1

Chapter 2 A Brain Designed for Addiction 27

Chapter 3 When Craving Comes to Power: Natalie's Story 47

Chapter 4 The Tunnel of Attention: Brian's Romance with Meth 71

Chapter 5 Donna's Secret Identity 95

Chapter 6 Johnny Needs a Drink 117

Chapter 7 Nothing for Alice: The Double-Edged Sword of Self-Control 139

Chapter 8 Biology, Biography, and Addiction 161

Chapter 9 Developing Beyond Addiction 193

Acknowledgements

Notes 219

Index 225

Editorial Reviews

05/25/2015
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. According to Lewis, addiction is neither a choice nor an inherent malady; rather, it is innate to human behavioral biology, a natural adaptation that begins in the brain. After a section introducing Lewis’s theory, the bulk of the book shows the concept in action through detailed, intimate case studies. 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. The focus is primarily on drug dependency, to the extent that readers will wish Lewis had given more explanation of how behavioral addictions (those not tied to substances) fit into his theory. And while therapy is consistently shown as instrumentally restorative, Lewis devotes few pages to describing how the cycle of addiction is broken. Nonetheless, this book, written with hopeful sincerity, will intrigue both those who accept its thesis and those who do not. Agent: Michael Levine, Westwood Creative Artists. (July)

Publishers Weekly

Dr. Lewis — a former addict who recovered to become a distinguished neuroscientist and author — writes engagingly about the addictive experience, the recovery experience and the science behind them. 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. The scientific information is presented in the context of day-to-day behavior and the lives of individuals you will come to care about. You'll learn more about neuroscience (and human development and psychology) than you may have thought possible. 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, Ph.D., President of ABPP, Practical Recover, and SMART Recovery and author of Sex, Drugs, Gambling & Chocolate: A Workbook for Overcoming Addictions

Winner of the 2016 PROSE Award in Psychology

“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 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… [T]his work helps make sense of how addiction operates and is recommended for readers wanting to learn more on the topic.” —Library Journal

"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, given that what has been learnt can be unlearnt by harnessing the principles of neuroplasticity. 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, author of the International Best Seller, The Woman Who Changed Her Brain

"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

"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

“This is the real story of ‘this is your brain on drugs,' but one that provides a refreshing, convincing alternative to the widespread traditional disease-model view of addiction. Through compelling stories of real people who struggled with various addictions, Lewis lucidly makes the case for a new science-based understanding of what causes and sustains addiction. Most important, it offers far more positivity about ways out of addiction than those offered by traditional treatment, providing hope for those struggling as well as for their loved ones.” —Anne M. Fletcher, M.S., author of NY Times best-selling Sober for Good, Inside Rehab, and the Thin for Life Books. Recipient of the Research Society on Alcoholism Journalism Award and APA's Outstanding Contributions to the Understanding of Addictions Awards

“Highly readable and plausible illustration of current ideas about addiction from behavioural neuroscience and clinical perspectives by the use of vivid case histories." —Trevor Robbins, Professor of Cognitive Neuroscience and Experimental Psychology, Cambridge University

“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… [T]his book, written with hopeful sincerity, will intrigue both those who accept its thesis and those who do not.” —Publishers Weekly

“Armed with scientific data and plenty of case studies… Lewis enters the ongoing addiction nomenclature debate with an intellectually authoritative yet controversial declaration that substance and behavioral dependencies are swiftly and deeply learned via the "neural circuitry of desire."… Lewis introduces biographical testimonies of Americans struggling with addiction that both humanize and reinforce his standpoint. … A thought-provoking, industry-minded, and polarizing perspective on the neurocircuitry of human desire and compulsion.” —Kirkus Reviews

“A very readable, often touching, gateway into the universe of neuroscience and the shadowland of addiction.” —Sydney Morning Herald

“Marc Lewis's new book neatly links current thinking about addiction with neuroscience theory and artfully selected biographies. 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: Disorder of Choice

“Informed by unparalleled neuroscientific insight and written with his usual flare, Marc Lewis's The Biology of Desire effectively refutes the medical view of addiction as a primary brain disease. A bracing and informative corrective to 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

From the Publisher

06/15/2015
Neuroscientist Lewis (developmental psychology, Radboud Univ. Nijmegen, Netherlands; Memoirs of an Addicted Brain) 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. Lewis also wants to bring together for the reader the experience of addiction and the neurological mechanisms in action. 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. Lewis alternates these harrowing retellings with descriptions of the striatum and prefrontal cortex as well as important concepts such as ego fatigue, delay discounting, compulsion, and self-control. VERDICT Lewis makes a solid case that addiction can be part of a person's development if defined as a mental habit that involves desire and becomes compulsive. But more discussion regarding brain diseases (what are they?) and mental-health nomenclature like disorders and syndromes would have helped better grasp the disease model debate of addiction. Still, this work helps make sense of how addiction operates and is recommended for readers wanting to learn more on the topic.—Maryse Breton, Bibliothèque et Archives nationales du Québec

Library Journal

2015-05-14
An argument against classifying addiction as a chronic "brain disease." Armed with scientific data and plenty of case studies, developmental neuroscientist and former addict Lewis (Memoirs of an Addicted Brain: A Neuroscientist Examines His Former Life on Drugs, 2012) enters the ongoing addiction nomenclature debate with an intellectually authoritative yet controversial declaration that substance and behavioral dependencies are swiftly and deeply learned via the "neural circuitry of desire." The author blames the medical community for developing a disease-model juggernaut derived primarily from clinical data rather than biological and psychological research on brain changes and altered synapses. Lewis believes this conceptualization pegged the affliction as a disease instead of what he deems a "developmental cascade and a detrimental result of habitual behaviors." As increasing numbers of medical communities have embraced the addiction model this way, he writes, treatment methodologies often become ineffective as well. Lewis further criticizes the Alcoholics Anonymous strategy and its emphasis on an addict's ability to surrender to their "powerlessness" over a compulsion rather than promoting personal empowerment toward self-sustainability. Once past a somewhat overly clinical neuroscientific discussion on the brain's plasticity, Lewis introduces biographical testimonies of Americans struggling with addiction that both humanize and reinforce his standpoint. Awash in the separate throes of heroin, methamphetamine, opiates, alcohol, and binge-eating compulsions, the cases are complemented with uplifting updates on their sobriety efforts, which the author prefers to call a "developmental journey" toward recovery. Lewis' statement that addiction is "uncannily normal" likely stems from his experiences as a former narcotic addict who overcame a decadelong drug habit at age 30. While definite fodder for debate, the author remains firm in his belief that in order to fully process the addiction spectrum, we must "gaze directly at the point where experience and biology meet." A thought-provoking, industry-minded, and polarizing perspective on the neurocircuitry of human desire and compulsion.

Kirkus Reviews