2020 Award Winner for the in the category of Addiction & Recovery. A new model of addiction that incorporates neurobiology, social relationships, and ecological systems. Understanding addiction is no longer just about understanding neurons or genes, broken brain functioning, learning, or faulty choices. Oliver J. Morgan provides a fresh take on addiction and recovery by presenting a more inclusive framework than traditional understanding. Cutting- edge work in attachment, interpersonal neurobiology, and trauma is integrated with ecological- systems thinking to provide a consilient and comprehensive picture of addiction. Humans are born into connection and require nourishing relationships for healthy living. Adversities, however, bring fragmentation and create the conditions for ill health. They create vulnerabilities. In order to cope, individuals can turn to alternatives, “substitute relationships” that ease the pain of disconnection. These can become addictions. Addiction, Attachment, Trauma, and Recovery presents a model, a method, and a mandate. This new focus calls for change in the established ways we think and behave about addiction and recovery. It reorients understanding and clinical practice for mental health and addiction counselors, psychologists, and social workers, as well as for addicts and those who love them.
Occam's razor (aka the law of parsimony) refers to a fundamental principle of the scientific method (and critical thinking more generally speaking) which in essence posits:
“entities should not be multiplied beyond necessity"
Stated more plainly (however less accurately) Occom’s razor can be reified as follows:
"the simplest, naturalistic explanation is usually the best one."
A common addendum (probably) comes from Einstein who (may have) said:
"everything should be kept as simple as possible, but no simpler."
Yass qween 👑
A ‘Wicked Problem’ (aka clusterfuck) is planning and policy term of art referring to a problem that is (nearly or utterly) intractable due to incomplete understanding, or seemingly contradictory information, and due to complex interactions between frequently invisible or as of yet undiscovered and/or constantly changing variables.
Addiction is a wicked problem.
There is an irreducible level of complexity that you need to understand before you can think about it realistically, and respond to it effectively.
Attempts to collapse the issue into a soundbite level slogan do more harm than good.
Common (well-meaning but ultimately misleading) slogans include:
Addiction is a choice.
Addiction is a matter of character.
Addiction is a special case of learning.
Addiction is caused by an evolutionary mismatch.
Addiction is a disease.
Addiction is a spiritual disease.
Addiction is a brain disease.
Addiction is a mental health disorder.
Addiction is a family disease.
Addiction is self-medication.
Addiction is a lack of connection.
Addiction is an attachment disorder.
Addiction is all about trauma.
Addiction is all about oppression.
Addiction is a matter of psychosocial dislocation.
Addiction is a public health crisis.
I could go on.
Every time I hear one of these I cringe.
Because all of them are true.
Some clearly MUCH more true than others.
But each of these perspectives has at least a kernel of validity.
Some of them are close to spot the fuck on.
But more to the point.
None of them are true without the others.
So often people (really well intending people) including scientists and addiction professionals, champion one of these perspectives, and either intentionally or inadvertently downplay or outright disregard some or all of these other “truths”.
And a Tower of Babel ensues, from which countless ineffective or incomplete interventions emerge.
And the tragedies multiply.
And the corpses pile up.
Why can’t we weave all of this together into a comprehensive theory of addiction that actually makes sense?
Well…
We kind of can, and we sort of do.
The bio-psycho-social model of addiction simply states that:
Addiction is a biological, psychological, social/systemic (i.e. relational, cultural, political, environmental) and spiritual (thrown in for good measure) issue.
And furthermore, effective addiction recovery entails a comprehensive and integrated whole person, individual, family, peer and environmental change plan implemented and sustained over the long-term.
This book is a very good and quite wholistic view of addiction from the biological, psychological and sociocultural-ecological perspectives, with sound advice regarding interventions occurring at the micro, mezzo and macro levels of organization.
I have to say it’s one of the best, most comprehensive, and most relatable books on the subject that I’m aware of.
That being said.
The book biases the trauma and social relational pieces of the puzzle.
And I can understand why.
If I had to pick one of the factors to favor.
Relational trauma and social factors would be the right move.
To reiterate:
Trauma (incontrovertibly) alters your nervous system in such a way as to put you at extreme risk for problematic substance use and overreliance on other maladaptive soothing behaviors.
And.
The social factors of addiction (i.e the impact that our relationships have on our sense of self, and more specifically the devastating impact that abusive or neglectful relationships) have an equally large and important impact on our addictive behaviors.
Putting an emphasis on trauma and social factors reduces the highly problematic shame that individuals in addition Recovery invariably feel, and focuses attention on processing the past and changing the family, relational, peer and social-systemic factors.
And yes.
All of that is very wise.
That being said.
I believe people are smart enough, and completely capable of understanding that:
Addiction is a bio-psycho-social issue.
This is the irreducible level of complexity that you need to arrive at in order to understand entry detection.
All of it matters.
Why do we need to favor one or two factors or perspectives over other equally valid and non contradictory factors or perspectives?
Furthermore:
The bio-psycho-social model is a very basic, and easily understood concept.
It’s absolutely common place in addiction studies.
Many addiction professionals understand this.
However, every single popularization of addiction champions one perspective over the other.
And (for me anyway) it’s endlessly crazy making.
That being said.
This book is about as good as it gets.
And these criticisms are frankly pretty minor compared to all of the amazing things this book does achieve.
So I’m moving forward and giving it a 4.9/5 stars (until something better comes along).
As others have said, it reads like a textbook. As an attachment oriented therapist who has read a few books on the topic, it wasn't earth shattering for me. However, I'd recommend it to beginner therapists or even seasoned therapists who don't know much about addiction and trauma. I also believe our world would be better if policy makers and CEOs were reading books like this. It would be neat to see a cliff notes version for families as well.
This fantastic book does a great job of interweaving different theories about addiction. Rather than saying that one thing absolutely describes addiction, Morgan looks at addiction from a systems point of view. He expounds on Johann Hari's book Lost Connections, with science to back up the theory that addiction is in part due to lost connections. According to Morgan, addiction is part nuerobiology, a way of coping with attachment and other traumas, part genetic, part learning, and part due to the social ecology including displacement, economic despair, and lack of community.
I love that a thread of the whole book is about attachment sensitive, trauma informed counseling to help people move from unhealthy use to recovery. I also love the focus on what we can do as a society, as family members, and as clinicians to promote recovery and help people with addictions re-integrate and reconnect with humans. The focus of addictions is not just on substance use, but also on gambling, internet, sex, power, and money addictions too. He describes any of these addictions as a person finding a substitute relationship.
All though there wasn't a lot of data, I really agree with the last few parts of the book about viewing addiction as spiritual poverty. The more we mine the earth and treat humans as commodities or cogs in the machine, the more despair, and addiction.
A quote from the end of the book does a good job summarizing: "Nothing less than a full transformation of human society will eradicate the problem. This is not cause for despondency. The magnitude of the task should not deter us. Imagine that we can begin-one decision at a time, one relationship at a time-to build a more humanized, caring, and compassionate world, a world in which no one is left behind. All of us, not just those who are struggle, will benefit. "
Absolutely fantastic book for anyone who wants to know more about the title areas (addiction, attachment, trauma, recovery). Written in accessible language with clear examples throughout, this book is great introduction to addiction through the perspectives of interpersonal neurobiology and social ecology. For those readers that already know a few pieces of this story, Morgan weaves together multiple academic perspectives and largely succeeds in developing a synthesis of where addiction and recovery research and practice are heading. Even for those who know all of this, Morgan's book is a great reference for what has been published in these areas in the past three years.
“The answer to the question they set for themselves was a resounding “yes” addiction does indeed result from broken attachment bonds. Early adversity, trauma and toxic stress set the conditions for requiring chemical and behavioral self soothing.”
This book isn’t written to entertain but more like a textbook and without a science background, it might take longer to get through. The author breaks down addiction, trauma, attachment and recovery very well. He dives into a slew of different theories about how the latter impact neurological processes and behaviors. He helps to bring an understanding to how the brain has been affected and the actions that will therefore result from that change.
I found it very smart and credible until suddenly 3/4 of the way in it started citing JD Vance and known plagiarist Johann Hari as experts, and now I fear it's thrown off my opinion of the whole book.
Wow this book! Really enjoyed this one. I appreciate the conversation around viewing addiction as more than just a disease, but a failing of connection and attachment as well. A really well grounded conversation and education without feeling overwhelming. Worth the read!!
Winner of 2020 Independent Press Award, category: Addiction & Recovery!
This amazing book offers a comprehensive view of addiction. Utilizing attachment perspectives and trauma experiences, Morgan suggests that addiction is more than we think. Rooted in coping with adversity, addiction is a substitute relationship with chemicals, behaviors, and pursuits that “have what it takes” to meet our needs. Recovery requires reestablishing connections with real living.
Norton Professional Series on Interpersonal Neurobiology.
There were a lot of mind blowing moments in this book. The narrator was just OK, a bit monologing but that was OK. Some of it was so mind blowing I had to play and replay sections a number of times just so it could really sink in.