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
A clearly delineated guide to finally eradicate poverty in America.
A thoughtful program for eradicating poverty from the Pulitzer Prize–winning author of Evicted.
“America’s poverty is not for lack of resources,” writes Desmond. “We lack something else.” That something else is compassion, in part, but it’s also the lack of a social system that insists that everyone pull their weight—and that includes the corporations and wealthy individuals who, the IRS estimates, get away without paying upward of $1 trillion per year. Desmond, who grew up in modest circumstances and suffered poverty in young adulthood, points to the deleterious effects of being poor—among countless others, the precarity of health care and housing (with no meaningful controls on rent), lack of transportation, the constant threat of losing one’s job due to illness, and the need to care for dependent children. It does not help, Desmond adds, that so few working people are represented by unions or that Black Americans, even those who have followed the “three rules” (graduate from high school, get a full-time job, wait until marriage to have children), are far likelier to be poor than their White compatriots. Furthermore, so many full-time jobs are being recast as contracted, fire-at-will gigs, “not a break from the norm as much as an extension of it, a continuation of corporations finding new ways to limit their obligations to workers.” By Desmond’s reckoning, besides amending these conditions, it would not take a miracle to eliminate poverty: about $177 billion, which would help end hunger and homelessness and “make immense headway in driving down the many agonizing correlates of poverty, like violence, sickness, and despair.” These are matters requiring systemic reform, which will in turn require Americans to elect officials who will enact that reform. And all of us, the author urges, must become “poverty abolitionists…refusing to live as unwitting enemies of the poor.” Fortune 500 CEOs won’t like Desmond’s message for rewriting the social contract—which is precisely the point.
A clearly delineated guide to finally eradicate poverty in America.Pub Date: March 21, 2023
ISBN: 9780593239919
Page Count: 288
Publisher: Crown
Review Posted Online: Nov. 30, 2022
Kirkus Reviews Issue: Jan. 1, 2023
BOOK REVIEW
PERSPECTIVES
PERSPECTIVES
SEEN & HEARD
A master class in how gender has been weaponized in support of conservative values and authoritarian regimes.
A deeply informed critique of the malicious initiatives currently using gender as a political tool to arouse fear and strengthen political and religious institutions.
In their latest book, following The Force of Nonviolence, Butler, the noted philosopher and gender studies scholar, documents and debunks the anti-gender ideology of the right, the core principle of which is that male and female are natural categories whose recognition is essential for the survival of the family, nations, and patriarchal order. Its proponents reject “sex” as a malleable category infused with prior political and cultural understandings. By turning gender into a “phantasmatic scene,” they enable those in positions of authority to deflect attention from such world-destroying forces as war, predatory capitalism, and climate change. Butler explores the ideology’s presence in the U.S., the U.K., Uganda, and Hungary, countries where legislation has limited the rights of trans and homosexual people and denied them their sexual identity. The author also delves into the ideology’s roots among Evangelicals and the Catholic Church and such political leaders as Donald Trump and Viktor Orbán. Butler is particularly bothered by trans-exclusionary radical feminists (TERFs), who treat trans women as “male predators in disguise.” For the author, “the gap between the perceived or lived body and prevailing social norms can never be fully closed.” They imagine “a world where the many relations to being socially embodied that exist become more livable” and calls for alliances across differences and “a radical democracy informed by socialist values.” Butler compensates for the thinness of some of their recommendations with an astute dissection of the ideology’s core ideas and impressive grasp of its intellectual pretensions. This is a wonderfully thoughtful and impassioned book on a critically important centerpiece of contemporary authoritarianism and patriarchy.
A master class in how gender has been weaponized in support of conservative values and authoritarian regimes.Pub Date: March 19, 2024
ISBN: 9780374608224
Page Count: 320
Publisher: Farrar, Straus and Giroux
Review Posted Online: Dec. 5, 2023
Kirkus Reviews Issue: Jan. 1, 2024
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