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DOPAMINE NATION

FINDING BALANCE IN THE AGE OF INDULGENCE

A good education on addiction, fascinating case histories, and a sensible formula for treatment.

An addiction specialist discusses her patients’ problems and how she deals with them, and it’s an unsettling picture.

Lembke, medical director of the Stanford Addiction Medicine clinic, begins with a lesson in neuroscience. Nerves along brain pathways that process rewards (i.e., pleasure) use dopamine as a “neurotransmitter”—to deliver signals. The more dopamine an experience releases, the more we enjoy it. However, dopamine processes pain as well as pleasure, and a healthy brain maintains a balance. Most of us stop eating when we feel full. Coffee often provides all the stimulation we need. Gambling, drinking, shopping, or watching pornography are intermittent activities. Addiction, the mark of an unhealthy brain, is a compulsive behavior that continues despite the harm it causes, and it’s a worldwide epidemic. The biggest risk factor is easy access. History books proclaim Prohibition a failure, but it produced a big drop in alcoholism, public drunkenness, and alcohol-caused liver disease, which rose again after repeal. Today, it seems, all indulgences are accessible. Since around 2000, the rampant overprescription of narcotics has produced skyrocketing addiction and death. The internet allows us to engage in social as well as unseemly activities in private. Popular medical books rely on vivid case histories, and Lembke offers plenty. Her first is a lifelong masturbation addict who was ultimately able to achieve control. There follow accounts of other types of addicts, and she describes her treatment strategy based on the acronym DOPAMINE: data, objectives, problems, abstinence, mindfulness, insight, next steps, and experiment. Most readers will find it reasonable, and the author does not trumpet its success rate. Some of the most insightful passages involve lying, a malignant process in a cooperative society but essential to maintaining addictive behavior. Many people believe that honesty—unmasking our flaws—will drive people away, but it does the opposite.

A good education on addiction, fascinating case histories, and a sensible formula for treatment.

Pub Date: Aug. 24, 2021

ISBN: 978-1-5247-4672-8

Page Count: 304

Publisher: Dutton

Review Posted Online: June 15, 2021

Kirkus Reviews Issue: July 1, 2021

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BETWEEN THE WORLD AND ME

NOTES ON THE FIRST 150 YEARS IN AMERICA

This moving, potent testament might have been titled “Black Lives Matter.” Or: “An American Tragedy.”

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The powerful story of a father’s past and a son’s future.

Atlantic senior writer Coates (The Beautiful Struggle: A Father, Two Sons, and an Unlikely Road to Manhood, 2008) offers this eloquent memoir as a letter to his teenage son, bearing witness to his own experiences and conveying passionate hopes for his son’s life. “I am wounded,” he writes. “I am marked by old codes, which shielded me in one world and then chained me in the next.” Coates grew up in the tough neighborhood of West Baltimore, beaten into obedience by his father. “I was a capable boy, intelligent and well-liked,” he remembers, “but powerfully afraid.” His life changed dramatically at Howard University, where his father taught and from which several siblings graduated. Howard, he writes, “had always been one of the most critical gathering posts for black people.” He calls it The Mecca, and its faculty and his fellow students expanded his horizons, helping him to understand “that the black world was its own thing, more than a photo-negative of the people who believe they are white.” Coates refers repeatedly to whites’ insistence on their exclusive racial identity; he realizes now “that nothing so essentialist as race” divides people, but rather “the actual injury done by people intent on naming us, intent on believing that what they have named matters more than anything we could ever actually do.” After he married, the author’s world widened again in New York, and later in Paris, where he finally felt extricated from white America’s exploitative, consumerist dreams. He came to understand that “race” does not fully explain “the breach between the world and me,” yet race exerts a crucial force, and young blacks like his son are vulnerable and endangered by “majoritarian bandits.” Coates desperately wants his son to be able to live “apart from fear—even apart from me.”

This moving, potent testament might have been titled “Black Lives Matter.” Or: “An American Tragedy.”

Pub Date: July 8, 2015

ISBN: 978-0-8129-9354-7

Page Count: 176

Publisher: Spiegel & Grau

Review Posted Online: May 5, 2015

Kirkus Reviews Issue: July 1, 2015

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BEYOND THE GENDER BINARY

From the Pocket Change Collective series

A fierce, penetrating, and empowering call for change.

Artist and activist Vaid-Menon demonstrates how the normativity of the gender binary represses creativity and inflicts physical and emotional violence.

The author, whose parents emigrated from India, writes about how enforcement of the gender binary begins before birth and affects people in all stages of life, with people of color being especially vulnerable due to Western conceptions of gender as binary. Gender assignments create a narrative for how a person should behave, what they are allowed to like or wear, and how they express themself. Punishment of nonconformity leads to an inseparable link between gender and shame. Vaid-Menon challenges familiar arguments against gender nonconformity, breaking them down into four categories—dismissal, inconvenience, biology, and the slippery slope (fear of the consequences of acceptance). Headers in bold font create an accessible navigation experience from one analysis to the next. The prose maintains a conversational tone that feels as intimate and vulnerable as talking with a best friend. At the same time, the author's turns of phrase in moments of deep insight ring with precision and poetry. In one reflection, they write, “the most lethal part of the human body is not the fist; it is the eye. What people see and how people see it has everything to do with power.” While this short essay speaks honestly of pain and injustice, it concludes with encouragement and an invitation into a future that celebrates transformation.

A fierce, penetrating, and empowering call for change. (writing prompt) (Nonfiction. 14-adult)

Pub Date: June 2, 2020

ISBN: 978-0-593-09465-5

Page Count: 64

Publisher: Penguin Workshop

Review Posted Online: March 14, 2020

Kirkus Reviews Issue: April 1, 2020

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