…(A)ddiction is a developmental disorder—a problem involving timing and learning, more similar to autism, attention deficit hyperactivity disorder (ADHD), and dyslexia than it is to mumps or cancer. Maia Svalavitz, Unbroken Brain
According to journalist Maia Svalavitz‘s new book Unbroken Brain: A Revolutionary New Way of Understanding Addiction, the ages-old wisdom about addiction recovery is often off base.
Some of the ideas Svalavitz sees as myths:
- The addict has a “broken brain.”
- An individual becomes addicted because of his or her “addictive personality.”
- One type of addiction treatment fits all individuals.
Or as Dana Goldstein, Slate, eloquently points out on behalf of Svalavitz, the entire following scenario is suspect:
The narrative of addiction is familiar. A pleasure-seeking ‘addictive personality’ spirals out of control, ‘enabled’ by friends and family, and eventually hits ‘rock bottom’ in the form of arrest, divorce, or homelessness. She may then succeed in a 12-step program, where she’ll embrace a ‘higher power,’ receive ‘tough love,’ and accept total ‘abstinence’ from substances including antidepressants and drugs that ease withdrawal symptoms. Even if she gets clean, she’ll be an addict forever, and is more likely than not to relapse.
In long-term recovery herself (cocaine and heroin), Szalavitz “offers an alternate way of thinking about what addiction is: neither an illness nor a sign of an immoral personality, but a learning disorder.”
How does she define addiction? “Compulsive behavior despite negative consequences.” Why/how does this happen? The addict learns “that the problematic substance can help soothe some other problem in [one’s] life, such as depression, social anxiety, physical pain, or, in Szalavitz’s case, what she believes was an undiagnosed childhood autism-spectrum disorder.”
What This Means For Addiction Treatment
A few basic principles addressed in Unbroken Brain:
- Individuals can benefit significantly before hitting rock bottom.
- Not all substance abusers have to forego all substances. The harm reduction model can work well for many.
- Imprisonment usually doesn’t benefit the addict and often makes things worse.
Moreover, 12-step programs are only useful for some. Publishers Weekly: “Szalavitz may alienate otherwise sympathetic readers with her critiques of popular treatment methodologies such as 12-step programs. This study may not be for people who have recovered using such treatments, but it can help promote the importance of understanding—and working toward fixing—a persistent problem.”
Marc Lewis, author of The Biology of Desire: “Szalavitz catalogs the latest scientific knowledge of the biological, environmental and social causes of addiction and explains precisely how they interact over development. The theory is articulate and tight, yet made accessible and compelling through the author’s harrowing autobiography. Unbroken Brain provides the most comprehensive and readable explanation of addiction I’ve yet to see.”