What do you think?
Rate this book
Heart of Addiction A New Approach to Understanding & Managing Alcoholism & Other Addictive Behaviors
For more than twenty years, distinguished psychiatrist Dr. Lance Dodes has been successfully helping people master their addictions -- alcoholism, compulsive gambling, smoking, sexual addiction, and more with a radical approach. Dr. Dodes describes how all addictions have, at their heart, unrecognized emotional factors that In this refreshing book filled with compelling case studies, Dr. Dodes debunks several such widely accepted myths
Unknown Binding
First published January 1, 2002
114 people are currently reading
421 people want to read
About the author
Lance Dodes
7 books16 followersLance Dodes, MD, has been treating people with addictions for more than three decades. He is the author of The Heart of Addiction and Breaking Addiction. He is a Training and Supervising analyst emeritus with the Boston Psychoanalytic Society and Institute and recently retired assistant clinical professor of psychiatry at Harvard Medical School. He lives in Southern California.
Ratings & Reviews
Friends & Following
Create a free account to discover what your friends think of this book!
Community Reviews
Displaying 1 - 20 of 20 reviews
March 9, 2019
I'm not sure how to rate this book. Dr. Lance Dodes says that his model of addiction contradicts the general formulation of addiction, but I'm not too familiar with that since this is the first book on addiction I've ever read and I've never sought out treatment with a professional. Also, I have yet to see if it will help me with my problems. I think it will, but the back of my mind isn't so sure. It really wouldn't be Dodes's fault. I don't expect any writer, even a psychiatrist who works at Harvard, to be a miracle worker. But how else do you rate a book like this other than by referring to how much help it is to you.
I've been dealing with an addiction for some time now. I've actually read an article online by a psychiatrist that said you can't be addicted to what I think I'm addicted to and that it's more of a compulsion. But according to Dodes's model of psychology, I think I do have an addiction. (He actually says, "I have concluded that there is no fundamental distinction between addictions and most compulsions" (p. 184).) Over the many years that I have had it, I have never given it up for an entire week. About a month and a half ago, I was in a position where it was simply impossible for me to indulge my addiction for about 6 days. I hoped that that would be a good springboard for a longer streak of abstinence. But, as I had predicted with dread in the back of my mind, once I was in a position to indulge again, I did almost immediately. Since then, it became a daily occurrence, until about a week ago, when I became so irritated with myself that I decided once more to stop and I picked up The Heart of Addiction, which I had bought half a year ago, because I decided the psychological factors had to be dealt with.
Just so you know, I'm saying this all matter-of-factly, just to state where I'm coming from, not in a self-pitying way or anything.
I will say that reading this book was a positive experience. It gave me a lot of insight into my own psychology and made me think about how past experiences have influenced my addictive behavior. And it made me realize that, in addition to the one thing that I had considered an addiction, I was also doing other things that could be considered addictions themselves(or at least compulsions). Kind of like an extension of my central addiction.
I will admit to relapsing after 4 days of abstinence. But Dodes does say that relapses, while not desirable, are kind of to be expected while still figuring out your subconscious motivations. And I'm certainly still doing that. As of the writing of this review, I've been abstinent for more than 1 day, and I'll have to see how long it'll last. (He actually says that counting your days of sobriety is generally bad for most people to do, and maybe he's right, but I find it a little helpful.)
I wonder if Dodes is a bit too forgiving. He's against the Alcoholics Anonymous method, mainly because it's a generalized solution that doesn't delve into individual addicts' psychologies, but also because it can be harsh. Maybe a little harshness is necessary. I've also read some other people argue that physiological factors are more important than Dodes says they are, but I'm no expert in this area so I'm not sure what to say about that. Personally, though I don't have a scientific background, I wouldn't have minded if the book were bit more technical in places.
I'll give the book 4 stars for now. Maybe after rereading parts of it and applying what Dodes has to say to a greater extent, I'll raise the rating to 5/5. Even if I don't absolutely banish the problem, I honestly do think that, with what I've learned from this book, I won't sink to the depths I've been through at various points of dealing with my addiction.
I've been dealing with an addiction for some time now. I've actually read an article online by a psychiatrist that said you can't be addicted to what I think I'm addicted to and that it's more of a compulsion. But according to Dodes's model of psychology, I think I do have an addiction. (He actually says, "I have concluded that there is no fundamental distinction between addictions and most compulsions" (p. 184).) Over the many years that I have had it, I have never given it up for an entire week. About a month and a half ago, I was in a position where it was simply impossible for me to indulge my addiction for about 6 days. I hoped that that would be a good springboard for a longer streak of abstinence. But, as I had predicted with dread in the back of my mind, once I was in a position to indulge again, I did almost immediately. Since then, it became a daily occurrence, until about a week ago, when I became so irritated with myself that I decided once more to stop and I picked up The Heart of Addiction, which I had bought half a year ago, because I decided the psychological factors had to be dealt with.
Just so you know, I'm saying this all matter-of-factly, just to state where I'm coming from, not in a self-pitying way or anything.
I will say that reading this book was a positive experience. It gave me a lot of insight into my own psychology and made me think about how past experiences have influenced my addictive behavior. And it made me realize that, in addition to the one thing that I had considered an addiction, I was also doing other things that could be considered addictions themselves(or at least compulsions). Kind of like an extension of my central addiction.
I will admit to relapsing after 4 days of abstinence. But Dodes does say that relapses, while not desirable, are kind of to be expected while still figuring out your subconscious motivations. And I'm certainly still doing that. As of the writing of this review, I've been abstinent for more than 1 day, and I'll have to see how long it'll last. (He actually says that counting your days of sobriety is generally bad for most people to do, and maybe he's right, but I find it a little helpful.)
I wonder if Dodes is a bit too forgiving. He's against the Alcoholics Anonymous method, mainly because it's a generalized solution that doesn't delve into individual addicts' psychologies, but also because it can be harsh. Maybe a little harshness is necessary. I've also read some other people argue that physiological factors are more important than Dodes says they are, but I'm no expert in this area so I'm not sure what to say about that. Personally, though I don't have a scientific background, I wouldn't have minded if the book were bit more technical in places.
I'll give the book 4 stars for now. Maybe after rereading parts of it and applying what Dodes has to say to a greater extent, I'll raise the rating to 5/5. Even if I don't absolutely banish the problem, I honestly do think that, with what I've learned from this book, I won't sink to the depths I've been through at various points of dealing with my addiction.
August 13, 2021
ALthough the books seems to go extremely against the well known norms of addiction, it seems to offer really sound psychological inspection of the addiction as a state of human condition without any morals attachment to it. At first I was a bit skeptical about whether those ideas are real, especially arguing that physical addiction is not by any means a primary cause. I've been through an experience with a friend while reading this book that demonstrated exactly what the book is trying to prove.
I love how Dr Lance writes in non-offensive way when he directs the book once in general as a discussion of addiction and once to you directly with a nice tendecy to always have a IF statment to whether you have an addiction or not. Dr Lance is well aware of the misconceptoin and the moral, or demoral, values assigned with addiction. He is carefully tip-toeing to provide a comprehensive advice in a no-offence manner.
I love how Dr Lance writes in non-offensive way when he directs the book once in general as a discussion of addiction and once to you directly with a nice tendecy to always have a IF statment to whether you have an addiction or not. Dr Lance is well aware of the misconceptoin and the moral, or demoral, values assigned with addiction. He is carefully tip-toeing to provide a comprehensive advice in a no-offence manner.
August 1, 2017
The claim here is that addiction results primarily from feelings of powerlessness and helplessness and that the addictive act is a displaced act of trying to regain control of one's life. Gaining control of addiction therefore can happen from gaining control of the emotional foundation and cause of this helplessness.
The sense of agency and control that Dodes sees in human action is powerful here. He doesn't subscribe to the powerlessness that's inherent in the very first step of AA. He takes the control of the addiction away from the substance itself and turns it back over to the human. The idea is knowing yourself, examining yourself and realizing that the key to solving addiction is internal not external. Some would say that's where "the higher power" spoken of in AA might reside anyway.
He also doesn't subscribe to the disease theory of addiction that is preached in AA and believes that it's primarily a matter of resolving emotional and mental issues.
From personal experience in seeing addiction up close, it's complicated. Dodes will say this too, but I don't believe it's one way or the other - I mean that each individual human mind is different. It's impossible to know what one person feels or is driven towards without actually being inside their head. How are we to truly understand those addictions that seem to defy all psychological classification? Who's to say that it isn't a disease for some or simply the way their brain is wired? On the other hand, who is to deny the power of individual human agency?
It's an important read though for the questions and perspectives it raises (ones that aren't given enough credit in addiction treatment) and I'd recommend reading it alongside The Sober Truth which is a more in-depth look at 12-step programs.
The sense of agency and control that Dodes sees in human action is powerful here. He doesn't subscribe to the powerlessness that's inherent in the very first step of AA. He takes the control of the addiction away from the substance itself and turns it back over to the human. The idea is knowing yourself, examining yourself and realizing that the key to solving addiction is internal not external. Some would say that's where "the higher power" spoken of in AA might reside anyway.
He also doesn't subscribe to the disease theory of addiction that is preached in AA and believes that it's primarily a matter of resolving emotional and mental issues.
From personal experience in seeing addiction up close, it's complicated. Dodes will say this too, but I don't believe it's one way or the other - I mean that each individual human mind is different. It's impossible to know what one person feels or is driven towards without actually being inside their head. How are we to truly understand those addictions that seem to defy all psychological classification? Who's to say that it isn't a disease for some or simply the way their brain is wired? On the other hand, who is to deny the power of individual human agency?
It's an important read though for the questions and perspectives it raises (ones that aren't given enough credit in addiction treatment) and I'd recommend reading it alongside The Sober Truth which is a more in-depth look at 12-step programs.
June 26, 2009
I want to find this guy and spend years in therapy with him. Just reading his book changed my perspective on things. If you struggle with any type of addiciton, this is a must read!
February 4, 2016
A good one. Focuses on taking you right inside the moment when the addict says, "forget it, I'm gonna go get high" and strategizes around that. Needless to say this is a very useful approach.
June 28, 2010
The Heart of Addiction reexamines common myths and provides new recommendations aimed at helping anyone with an addiction, be it to gambling, alcohol, or prescription medications. Rather than focusing on the specific object of addiction, he challenges us look at the common desires and emotions present in anyone with addiction issues.
There is a pattern behind addiction--a pattern of anger, helplessness, and shame, coupled with a desire for immediate escape from these feelings. He shows repeatedly that addiction is more than an uncontrollable desire for the substances; it is a behavior pattern with deeply emotional roots. He explains the differences between physical tolerance, abuse, and addiction. He also has a questionnaire that focuses on the underlying reasons for drinking, rather than the more traditional one that covers specific amounts and methods. Separate chapters discuss particular issues of teens and couples, and special recommendations for seeking treatment are also included.
He dispels the notion that people are addicted to the things that are addictive and that "addicts" should always be treated by someone who also has the addiction. Through realistic case examples, this new approach challenges the thinking in professional practice while explaining why people feel an impulse to engage in unproductive addictive behavior and what they can do about it.
It was easy to read and written in a way that the general audience can understand it.
There is a pattern behind addiction--a pattern of anger, helplessness, and shame, coupled with a desire for immediate escape from these feelings. He shows repeatedly that addiction is more than an uncontrollable desire for the substances; it is a behavior pattern with deeply emotional roots. He explains the differences between physical tolerance, abuse, and addiction. He also has a questionnaire that focuses on the underlying reasons for drinking, rather than the more traditional one that covers specific amounts and methods. Separate chapters discuss particular issues of teens and couples, and special recommendations for seeking treatment are also included.
He dispels the notion that people are addicted to the things that are addictive and that "addicts" should always be treated by someone who also has the addiction. Through realistic case examples, this new approach challenges the thinking in professional practice while explaining why people feel an impulse to engage in unproductive addictive behavior and what they can do about it.
It was easy to read and written in a way that the general audience can understand it.
December 8, 2017
New insights for people with compulsions and addictions
Incredibly helpful and new, to me, ideas about why we have addiction and compulsions to do something that is harmful to us - because we are trying to deal with our rage and helplessness and because we can't do what we really want to do.
This book has opened my eyes to why I compulsively overeat and I have to agree with a lot of what the doctor says.
The book does not have a treatment plan and I believe that is a separate book which I intend to read.
Incredibly helpful and new, to me, ideas about why we have addiction and compulsions to do something that is harmful to us - because we are trying to deal with our rage and helplessness and because we can't do what we really want to do.
This book has opened my eyes to why I compulsively overeat and I have to agree with a lot of what the doctor says.
The book does not have a treatment plan and I believe that is a separate book which I intend to read.
November 1, 2016
I really appreciated getting to read a psychoanalytic or psychodynamic take on addictions. I began reading it to offer another model or approach to one of my supervisees, to what currently exists in the culture. I quickly began thinking about my resounding resonance to its precepts, and began discussing it with my other supervisee as well, and thinking about its application to multiple patients. Was thrilled to have spent the time with it. Well worth my and our attention in this field.
August 6, 2018
Are people addicted to things because the things themselves are addictive? Do you have to 'hit bottom' before you can get well? If you have an addiction, are you by definition self-destructive? Do you need to 'surrender'? Can you only be helped by someone else with an addiction? Is addiction a disease and a problem of brain chemistry? Is there such a thing as an addictive personality?
May 1, 2018
Disputes the social construction of addiction-as-disease that has been touted for decades. Links addiction to psychological displacement that has occurred during formative years. Contains brief case studies to highlight types of experiences that may contribute to a person becoming an addict. A compelling read
November 10, 2020
This book has fundamentally changed my life. His straight forward explanation of powerlessness and hopelessness as a driving factor towards addictive behavior is refreshing and highly insightful. This book should be required reading for every psychotherapist, psychiatrist and addiction counselors.
November 8, 2018
Excellent cornerstone work
I find that this work “rings true” to addiction and treatment. I have begun using this approach with my own clients and I see progress being made within their treatment.
I find that this work “rings true” to addiction and treatment. I have begun using this approach with my own clients and I see progress being made within their treatment.
June 4, 2019
Very compelling theory about what lies at the heart of addiction. I will be putting this book to use.
May 12, 2020
Lance Dodes is a very smart man, who concisely and clearly explains a lot of psychological phenomena that lead to addiction issues in one's life.
Read
September 15, 2023highly recommend
October 1, 2016
Helpful and insightful.
November 10, 2015
This book offers an unorthodox look at approaching addiction and its treatment. It offers a way to view addicts in our society sans the moralistic ethos that seems to be hammered into our collective consciousness on the regular. Dodes is a psychiatrist with years of experience and his approach offers a tremendous amount of value. Highly recommended reading for just about anyone.
April 3, 2015
A very useful perspective on a national health crisis.
April 14, 2015
Provides brilliant insight into why we perform seemingly irrational behaviors, and why the standard Alcoholics Anonymous and other 12 step programs don't work.
April 25, 2017
Lance Dodes has some interesting insights into why various addictive behaviors--which seem so irrational--serve a rational function: "Virtually every addictive act is preceded by a feeling of helplessness or powerlessness. Addictive behavior functions to repair this underlying feeling of helplessness. It is able to do this because taking the addictive action (or even deciding to take this action) creates a sense of being empowered, of regaining control--over one's emotional experience and one's life." He also does a good job of explaining why 12-step programs have such an abysmal success rate.
Displaying 1 - 20 of 20 reviews