The Biology of Desire

May 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.

June 1, 2015
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.

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June 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, Bibliotheque et Archives nationales du Quebec

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