Unbroken Brain: A Revolutionary New Way of Understanding Addiction by Maia Szalavitz (PDF)

Description

A NEW YORK TIMES BESTSELLERMore people than ever before see themselves as addicted to, or recovering from, addiction, whether it be alcohol or drugs, prescription meds, sex, gambling, porn, or the internet. But despite the unprecedented attention, our understanding of addiction is trapped in unfounded 20th century ideas, addiction as a crime or as brain disease, and in equally outdated treatment. Challenging both the idea of the addict’s “broken brain” and the notion of a simple “addictive personality,” The New York Times Bestseller, Unbroken Brain, offers a radical and groundbreaking new perspective, arguing that addictions are learning disorders and shows how seeing the condition this way can untangle our current debates over treatment, prevention and policy. Like autistic traits, addictive behaviors fall on a spectrum — and they can be a normal response to an extreme situation. By illustrating what addiction is, and is not, the book illustrates how timing, history, family, peers, culture and chemicals come together to create both illness and recovery- and why there is no “addictive personality” or single treatment that works for all.Combining Maia Szalavitz’s personal story with a distillation of more than 25 years of science and research,Unbroken Brain provides a paradigm-shifting approach to thinking about addiction.Her writings on radical addiction therapies have been featured in The Washington Post, Vice Magazine, The Wall Street Journal, and The New York Times, in addition to multiple other publications. She has been interviewed about her book on many radio shows including Fresh Air with Terry Gross and The Brian Lehrer show.

User’s Reviews

Reviews from Amazon users which were colected at the time this book was published on the website:

⭐In this book the author tries to weave her life story into a scientific narrative but she uses her own political leanings to guide her “truth” in a way that – at least to me – seems to be intellectually dishonest.->Conservatives didn’t “brainwash” Margaret Thatcher->Ronald Reagan didn’t “violently repudiate hippie ideals”-> Her political leanings are why she repeatedly mentions the “terrible laws” that were written to fight the drug crises that existed in the years that she was on the scene — but she makes no mention (no mention!) of the rampant crime that accompanied the drug crises and the many people who had their lives destroyed by those crimes. Crime trends during that 25 year period are the reason why the drug laws were written that stringently in the first place.->She for some reason just ignores that fact in order to play the ‘race’ game. The populations that were overwhelmingly affected by the drug trends are the same populations that are currently affected by the opioid crisis – they are the POOR people. Currently, opioids are rampant among the poor whites; back then crack and heroin were in the inner cities which also had much of the associated crimes. The laws weren’t wholly ‘racist’ – they were there for an obvious reason that she chooses to ignore. Revisionist history with convenient ignorance – she places her own suffering over the many more who were erased by those that she actually sympathizes with as victims. Whether these policies have hurt those populations more than they’ve helped them is anyone’s guess as those populations A) are in jail in exorbitantly higher rates B) have also been destroyed by self imposed violence at exorbitantly high rates. Teasing out the balance between the two is probably impossible; the only people who attempt to do that are the “activists” like herself who come in with so much of their own bias they just pick and choose what is relevant – and subsequently what is irrelevant – to include in the equation.->Ironically, she mentions that people with ASPD are heavily represented in the addiction “community,” does she know that there is no “formal treatment” for ASPD? Front line treatment for those people is actually incarceration – there is no ‘cure’ other than locking them out of the way of the populace that they damage. I know it sounds crazy – but go through medical training and then argue with the current DSM-V recommendations and guidelines (the DSM-V isn’t a very scientific document and there are many books on this website that attack it; I only mention it because she does).->As a self pronounced left-wing liberal she completely ignores the role of family in addiction and the current norm of children to be raised in broken homes and with single parenting. If addiction is a learning disorder that incorporates risk factors that occur during development, then shouldn’t our drug policy DEMAND stronger families and differing attitudes as to what is acceptable within family life and raising children? If our society currently sees a majority (65%!!) of children being raised in A) the foster system B) single parent homes C) divorced/broken homes — then shouldn’t policies regarding a failure of what she calls “learning,” acknowledge the significance of the family units where social and psychological learning have historically occurred? It’s questionable to me that she claims to have experienced bullying and social isolation throughout her schooling but she makes no mention of interventions her parents attempted to make to acknowledge what she was undergoing. From the time of her Adderall experiment as a small child to the time she was a full-blown heroin addict there seems to be no mention of her parental involvement in her life and struggles. Where was the parenting? And why isn’t that a greater subject in this book?-> She tries to give “neuroscientific” explanations for the various stages and conflicts that she had at different ages using evolutionary justifications. It’s preposterous to make arguments and rationalizations in this regard because the “scientific fields” of ‘neuroscience’ and ‘evolutionary neuroscience’ are at their infancy to the point of irrelevancy. There is no “evolutionary mechanism” for the “conflicts experienced in the 17 year old brain” as the “17 year old brain” has never existed before. Only in wealthy countries at this particular point in history does the “teenage” experience as we have it vis a vis “preparing for adulthood” actually exist. The “evolutionary” argument for something that has only existed in the human record for the last 100-150 years is borderline moronic; it reads well from a journalism perspective but science demands some form of critical thinking. 4.2 billion years of evolution didn’t ‘prepare’ her 17 year old brain for anything that only existed in the past .0000001% of the evolutionary record. The premise of evolution actually DEMANDS the time it takes for something to change into something else that is more refined for sustainability – it didn’t happen in an 100 year period.->It turns me off when she criticizes policy as being ‘unscientific’ and “not being supported by any science.” MOST POLICIES IN SOCIETY ARE NOT THE REFLECTION OF PURE AND UNADULTERATED SCIENCE. It is with regularity that academic and scientific journals produce articles that have differing results and conclusions. There are numerous ways of measuring, qualifying, interpreting and representing any given body of ‘data,’ and there are often many potential confounding variables that affect any given population set and the data collected from within them. A healthy skepticism is essential due to the norm of academic journals being REPLETE with articles full of differing data and differing conclusions. Attacking something as being “unscientific” when ‘science’ is often just the extension of socio-political influence and bias is preposterous arrogance. Little of anything that involves social policy is scientific – if science was at the point where it was that refined and universal then everyone would be approaching these social issues in exactly the same manner. It’s never going to happen because only the “hard” physical sciences are purely “scientific.” Her arguments and suggestions are no more “scientific” than anything she attacks.->I find it comedic that she criticizes AA for it lack of efficacy, does she actually believe that everything recommended in medicine is efficacious? Does she believe that there is a definitive scientific process from which evolved most of what is currently practiced? The phrase often used in medical education is “only 50% of what we do is evidence based, the problem is that we don’t know which 50% it is.” Until something else is studied and compared side by side with AA/support groups and those data are collected in a way that is “higher order” and published within reputable journals – it might as well not be true. What can and can’t be studied, published and used to effect change within a society is more political than scientific. ((It also takes astronomical sums of money to gather and study these sorts of data.))->Drugs don’t “fuel spiritual quests” – and while there are cultures and traditions that incorporate psychoactive substance use into their development, it’s done in a way that doesn’t even remotely resemble what she describes and it is but a minuscule fraction of drug use in this country. It would be the equivalent of her describing a sex act with a stranger that occurred in an alleyway behind a bar and equating it to “an act of compassion and love making.” It’s uncouth to equate one’s own baseless indulgence in sensuality to something of a more noble endeavor.->The opioid crisis is overwhelmingly among the middle aged and older – her ideas and explanations don’t cover this CURRENT CRISIS. The addictions and deaths are overwhelmingly among the poor which is a conserved statistic in every society where these data are measured. This is true both among the capitalists (US) and socialist. There is zero evidence that mental health counseling will effect change within this population and that legalizing drugs will help them more than it will hurt them. Let them stick to the current availability of cigarettes and alcohol. There is no “need” to add more to their arsenal. The dose/timing argument (provided that it can be proven in humans) can only work if the poor can afford the newly ‘legalized’ drugs in a regular and consistent fashion. There is no model that shows that this will actually happen with legalization.->What weed does to the brain is not good for people within our society. There is no shortage of data on this. While I can hear her arguments for the legalization of psychedelics as they aren’t used in the same fashion and with the same consistent regularity – pot is often used differently and the people who are using it in the way that it will destroy them are not getting any mental health counseling; this is true both in places where it is legal and illegal. I understand the populist appeal – but that’s it. Regular and consistent pot use among people with developing brains (teens who overwhelmingly will not seek out the mental health counseling that might be availed) would be catastrophic ((that is just an opinion)).I certainly learned a lot from this book and I hope to be able to implement parts of it into my eventual practice. However, there are numerous things in this book which make it difficult for me to take with full seriousness, I’ve shared here a few of them and I understand that these are just my opinions.Policy should be influenced by thinkers and scientists – but those people need to demonstrate humility and intellectual honesty. I don’t think that I see these in her writing.

⭐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

⭐Thoroughly enjoyed this book. Very insightful to the underlying causes of addiction. Having been addicted to various habits in the past (smoking, drinking, gambling – and now more positively, coffee), I can now see far more clearly as to the then mysterious reasons as to why I found myself ‘derailing’ off the tracks at certain ages and key moments in my life – it’s all about learning, and if you lay tracks on faulty foundations, well…To summarise, this book as well as others, has helped to uncover the ‘blind spots’ in my mind, by looking in the mirror at my general (negative) behaviour, to which I can now see, and regularly continue to improve on such behaviour as I continue to age, and of course, to learn and acquire new knowledge!I would have given this book 5 stars, however, my only dissapointment was the lack of diagrams (of the brain) to help give better visualisation and reinforce some of the key findings.

⭐A really good look at addiction treatment with the author’s story tying it all together. Highly recommended.

⭐Not for me

⭐In depth book on how the brain works being an addict

⭐I agree with some of the other reviewers that Szalavitz, perhaps, spends a little too much time on her own her own story that is less related to drug dependence (potentially undiagnosed Autism Spectrum Disorder), however this is single-handedly the most comprehensive book on substance misuse that I have read this far… and I’ve read a lot.It’s the first time I feel as if i could actually give up drinking and not feel like i’d be giving up a ton.But even if you don’t buy in to 100% of what she says, she also quotes AA: “Take What You Want and Leave the Rest”, which I think is good advice for any self help/ discovery book.

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