I found The Heart of Addiction really
interesting and worth reading.  Dodes is
a psychologist of the psychodynamic school (hope the phrase is right) who
reports his perceptions of what lies at the heart of addiction, backed up
copiously by personal stories from people he has worked with — I was going to
write "case reports" but he tells sensible illustrative stories about
real people and explains what he thinks about them, which I like much better.  

His view is that
addictive behaviors are a response to feelings of powerlessness and loss of
control and that the behaviors allow a person to establish his or her own area
of control of life.

"But
surely" was my first response, "addiction is all about being out of
control. Else why look for help?" 
That’s a very traditional 12-step view, and I think that Dodes
provides good reasoning why that view may be hard to support.  Although it’s a long time since I practiced
abusive drinking. I recall well the feeling that I was by God going to do what
I wanted to do, so here’s how, people! 
I was in charge (for a while)!

Dodes expands his propositions very well, presenting analysis of the
patterns of thought and habit associated with addictive forms of behavior that
is compelling and clear.  Chapters
include a series of illustrative case histories, a lucid explanation of the
nature of addiction, how one may distinguish between abuse and addiction, a
section on myths of addiction and some of the less mainstream addictions such
as internet, shopping and exercise.  His
comments on teens and couples I found particularly helpful and interesting.

His views on
other methods?  He is refreshingly frank
about some of the weaknesses in the 12-Step approach to addiction, giving
sensible reasons why it works for some people and is worse than useless for
others.  

Dodes casts a few
brickbats at the superficiality of behavioral methods.  I think his comments were so much "cast
in passing" that it’s hard to take exception, even though I have
personally found these methods very helpful.   
And indeed, one of my pet gripes on first acquaintance with Rational
Emotive Behavior Therapy was being told that digging into personal background
and history is pretty much a waste of effort, present behavior and changing it
is all that is important.   Dodes
presents quite a different approach, and I think he is right.  If a person is addicted and wants to change,
it seems only sensible to try to understand why, although it is also a pretty
good idea to desist from serious addictive behavior as soon as you can handle
it and regardless of whether you have the first set of answers.  

Among the many fascinating chapters in this book are
two about gambling and about sexual addiction. 
The opinions on whether these are true addictions can be fairly
vehement, but explained in Dodes’ terms I would say they have the
characteristics.  He also, almost
absent-mindedly, offers an explanation for some forms of compulsive behaviors
and their relationship to addictive behaviors which is another question that
anyone who’s met a few such people wants to understand.

Does he have
answers?  Well, no quick instant fixes,
that’s for sure.  I find this
reassuring.   A habit of mind that
someone’s taken a lifetime to acquire shouldn’t yield to a magic wand, in my
opinion.

Dodes is a clever man and he comes across as an
attractive and caring personality.  This
book is also really well written, which is a courtesy to the reader and a great
selling point.  

Who is it for? 
I expect professionals in the field would find it a fairly
non-confrontational starter, which might prompt them to deeper
investigation.   I think anyone
interested in addiction — addict, spouse, family, observer or whatever could
benefit considerably from reading it.  
As for me, I’m going back to read it again.

© 2003 Fred Ashmore

Fred Ashmore is a member of the
public with a strong interest in drugs, drink and addiction and how people
recover from them. He is active as a meeting host for the SMART Recovery® program, which offers
help for people who seek to modify harmful and addictive behavior.

Categories: Addiction, MentalHealth