Despite it’s controversial marketing, Harvard psychologist Gene M. Heyman’s new book, Addiction: A Disorder of Choice, is not exactly a direct attack upon the disease concept of addiction. What it is though is a fairly technical analysis of voluntary behavior as it pertains to addiction and substance abuse- one that does not so much discount the disease model of addiction as it offers a vague comparative interpretation using history, study statistics, and first hand observations. The gist down and dirty, Heyman believes addiction is a disorderly or counterproductive decision making process that often realigns itself in time or can be corrected by treatment. Not exactly a condemnation of conventional wisdom, Heyman seems content just in offering his well documented but still ambivalent perspective
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What I liked about the book- he is not on a witch hunt or making wild unsubstantiated claims to make his point and sell more books. In fact, his in depth look at both genetics and especially OCD behavior and treatment could actually be interpreted as counterproductive to his conclusions, yet he still makes his case. More than anything I like the fact that he makes sure to emphasize that regardless of his definition of addiction, it remains an extremely serious problem that can be chronic in nature and treatment should always be promoted.
What I didn’t like about the book- much like Stanton Peele he does not differentiate very well between substance abuse, physical dependence, and addiction saying that most people just grow out of this “behavior” without help as they mature. Also I do not think he made a very good case for defining the difference between the return to making good choices and recovery itself… and the likelihood of long term relapse.
Overall- I cannot recommend the book not so much because I disagree with Mr Heyman, but because he neither takes a radically different view or fully engaged me through the power of his words. In other words, it was a yawner.
Yes, addiction is a disorder of choice… but it is also so much more.