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
For Howard Zinn, long-time civil rights and anti-war activist, history and ideology have a lot in common. Since he thinks that everything is in someone's interest, the historian—Zinn posits—has to figure out whose interests he or she is defining/defending/reconstructing (hence one of his previous books, The Politics of History). Zinn has no doubts about where he stands in this "people's history": "it is a history disrespectful of governments and respectful of people's movements of resistance." So what we get here, instead of the usual survey of wars, presidents, and institutions, is a survey of the usual rebellions, strikes, and protest movements. Zinn starts out by depicting the arrival of Columbus in North America from the standpoint of the Indians (which amounts to their standpoint as constructed from the observations of the Europeans); and, after easily establishing the cultural disharmony that ensued, he goes on to the importation of slaves into the colonies. Add the laborers and indentured servants that followed, plus women and later immigrants, and you have Zinn's amorphous constituency. To hear Zinn tell it, all anyone did in America at any time was to oppress or be oppressed; and so he obscures as much as his hated mainstream historical foes do—only in Zinn's case there is that absurd presumption that virtually everything that came to pass was the work of ruling-class planning: this amounts to one great indictment for conspiracy. Despite surface similarities, this is not a social history, since we get no sense of the fabric of life. Instead of negating the one-sided histories he detests, Zinn has merely reversed the image; the distortion remains.
Pub Date: Jan. 1, 1979
ISBN: 0061965588
Page Count: 772
Publisher: Harper & Row
Review Posted Online: May 26, 2012
Kirkus Reviews Issue: Jan. 1, 1979
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A philosophically rich critique of state violence and mass apathy.
An Egyptian Canadian journalist writes searchingly of this time of war.
“Rules, conventions, morals, reality itself: all exist so long as their existence is convenient to the preservation of power.” So writes El Akkad, who goes on to state that one of the demands of modern power is that those subject to it must imagine that some group of people somewhere are not fully human. El Akkad’s pointed example is Gaza, the current destruction of which, he writes, is causing millions of people around the world to examine the supposedly rules-governed, democratic West and declare, “I want nothing to do with this.” El Akkad, author of the novel American War (2017), discerns hypocrisy and racism in the West’s defense of Ukraine and what he views as indifference toward the Palestinian people. No stranger to war zones himself—El Akkad was a correspondent in Afghanistan and Iraq—he writes with grim matter-of-factness about murdered children, famine, and the deliberate targeting of civilians. With no love for Zionism lost, he offers an equally harsh critique of Hamas, yet another one of the “entities obsessed with violence as an ethos, brutal in their treatment of minority groups who in their view should not exist, and self-decreed to be the true protectors of an entire religion.” Taking a global view, El Akkad, who lives in the U.S., finds almost every government and society wanting, and not least those, he says, that turn away and pretend not to know, behavior that we’ve seen before and that, in the spirit of his title, will one day be explained away until, in the end, it comes down to “a quiet unheard reckoning in the winter of life between the one who said nothing, did nothing, and their own soul.”
A philosophically rich critique of state violence and mass apathy.Pub Date: Feb. 25, 2025
ISBN: 9780593804148
Page Count: 224
Publisher: Knopf
Review Posted Online: Dec. 14, 2024
Kirkus Reviews Issue: Jan. 15, 2025
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