In The Biology of Desire: Why Addiction is Not a Disease, Marc Lewis challenges the dichotomy of brain disease theories of addiction.  Unpacking the difficulties in definition and treatment provided by the disease model, and supporting his claims with recent neuroscientific findings, Lewis suggests that addiction is another natural instance of the brain reconfiguring its response to a salient desire, and engraining it as a complicated habit.   Using a series of addiction narratives, he shows how each individual develops an addiction in response to various internal and external factors. 

Of particular interest is Lewis’ ability to address why certain individuals seem to ‘mature out’ of addictive behaviours, and the centrality of desire in motivating behaviour.  Referencing the brain’s complex process of ‘deep learning’, he explains how the motivation of desire plays more of a central role in addiction than the actual experience of pleasurable reward, suggesting that addressing the brain’s learning process is key to understanding the addiction process.  Lewis is careful to provide a realistic view of this ‘re-learning’, and suggests that the process is facilitated through personal engagement coupled with a variety of forms of therapy.  He does not prescribe a ‘certain route’, which is refreshingly different in addiction literature, but rather illustrates how the restructuring of the personal narrative of the individual occurs at a neurological level.  

Lewis’ book presents a clearly articulated account of the neuroscience involved in desiring ‘addictive’ stimuli, making it accessible to a wide audience.  His findings develop a salient critique of the binaries involved in the disease model of addiction, while also offering a hopeful (and arguably quite realistic) response to permanent recovery as a result of new habit formation.   While at times Lewis does seem to gloss over particularly important philosophical questions (concerning identity, desire, etc.), it delivers informative and stimulating findings to a diverse audience.  Through the use of neuroscience and personal case study examples, Lewis illustrates the value in localising and addressing internal empowerment and re-structuring narratives to develop beyond the patterns of addiction.

© 2016 Anna Westin

Anna Westin, PhD candidate and visiting lecturer, Arts and Humanities, St. Mary’s University, Twickenham, London