Breaking Addiction: A 7-Step Handbook for Ending Any Addiction – An Alternative to Alcoholics Anonymous Guide to Understanding Emotional Root Causes and Lasting Recovery

by Lance Dodes

“Dr. Dodes’s approach runs directly counter to the paralyzing, but standard, message of ‘powerlessness’—a mes­sage that reinforces the sense of helplessness that is at the root of addicts’ life predicaments! Many psychiatrists recognize that this is where we must head, but Dr. Dodes is one with the guts to shine a beacon in the right direction.” —Stanton Peele, PhD, author of 7 Tools to Beat Addiction and The Life Process Program of Treatment   The follow-up to his groundbreaking volume The Heart of Addiction, Dr. Lance Dodes’s Breaking Addiction is a step-by-step guide to beating addiction of any kind—from drugs and gambling to alcoholism, overeating, and sex addiction. By recognizing and understanding the emotional forces underlying addictive behaviors, Dr. Dodes says any dangerous, life-destroying obsession can be overcome. Including special bonus sections for both families and health-care professionals, Breaking Addiction is the new handbook for those suffering from addiction—a valuable resource that addresses addiction’s root causes and serves as an alternative to Alcoholics Anonymous and similar recovery programs.

Genres: Psychology, Nonfiction, Self Help, Addiction, Health

221 pages, Paperback

First published March 1, 2011

About the author

Lance 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.

Reviews

[Morgan Blackledge · Rating 4 out of 5]

According to Dodes:

• Addictive behavior essentially amounts to indirect (and therefore, ineffective) responses to feelings of helplessness, typically stemming from formative early life events.

• Episodes of addictive behavior have identifiable Key Moments i.e. definite instances (often occurring well in advance of the behavior) when the pivotal decisions to use are made.

• Identifying the Feelings of Helplessness, and Key Moments associated with the addictive behavior pattern is critical to effective intervention.

• This type of honest behavioral analysis can be difficult for the individual to perform, depending on the individuals Defensive Style i.e. the individuals particular psychological strategies (often unconscious) for denying or distorting reality in order to maintain an acceptable self-image.

• Overcoming addiction entails (a) gaining clarity into the afore mentioned mechanisms of the addictive behavior, and (b) adopting effective long and short-term strategies for taking ongoing, effective direct action to address the actual problem.

Before I go on, I should mention that I am a masters level clinician in training at an addiction treatment facility. I provide this disclaimer, not as some kind of declaration of expertise (I'm not an expert, I'm a trainee). But rather, as a clarification of my particular needs as a consumer of this book. In other words, I'm basing my review of this book on weather or not it provides me with information and techniques that I can use to help my clients recover from addiction. That being said, I have mixed feelings about this book.

Dodes acknowledges that addiction involves biological, psychological and social factors. That being said, he emphasizes emotional factors (taking a more or less psychodynamic approach) and deemphasizes, even to the point of dismissal, the neuroscience (brain disease) approach. He makes some valid points regarding the emotional drivers of addiction, but misses the opportunity to construct a more integrated model by playing the "emotions are everything, physical dependence is inconsequential" angle so insistently.

I think I would have given Breaking Addiction three (as opposed to four) stars, were it not for Dodes' amazingly rich and instructive case study examples. Wow! This book shines in this department. Dodes is masterful at providing compelling examples of (a) how addiction presents in "ordinary lives", (b) how addiction is problematic, and (c) how (exactly) his interventions can be applied to change the problematic behaviors.

Breaking Addiction is frequently mentioned in association with to two other recent books on the same subject: (1) In The Realm Of The Hungry Ghosts by Gabor Mate, and (2) Clear by David Shiff. Although Breaking addiction is a very good book, I'd say it is the weakest of the bunch.

The Science Of Addiction by Carlton Erickson is another good book to add to the A list. It's much more technical than the others mentioned above. But if you really want a detailed understanding of the issue from the biological perspective, this book delivers a lot of information in a concise, well researched and written form.

[Sarah · Rating 2 out of 5]

Not too long ago, I finished reading and reviewing The Sober Truth, Dodes’ book about the science (or lack thereof) behind Alcoholic’s Anonymous and associated 12-step treatment. Because I enjoyed that book and thought it particularly insightful, I picked up this one by the same author. I’m sad to say it was a bit of a disappointment.

The content of Breaking Addiction is unfortunately quite repetitive and overly simplified. Dodes makes sweeping generalizations about those struggling with addictions, disregards physiological components of addictive behavior, and offers solutions and interventions that seem easy and straightforward on paper but are incredibly challenging to implement in real life.

In my experience as a therapist, for example, recognizing triggers and what Dodes refers to as “key moments” is frequently not enough to end the addictive cycle. It is a change in action that facilitates health and that is often incredibly difficult for those struggling with addiction. Moreso than Dodes would have you believe, that is.

Granted, Dodes does mention that it takes the development of insight to accomplish sobriety via identifying the source of addictive behaviors, he simply does a poor job of describing the intensity and challenges associated with subsequently altering ones literal actions.

I do agree with some of Dodes’ assertions however, particularly his description of addiction as a compulsion rather than a disease. This does, to some extent, ignore the physiological changes to a person’s brain and subsequent physical addiction, which is not inconsequential. That said, the idea that addiction is a disease can often distract from the emotional underpinnings of addictive behavior and cause a further sense of helplessness for someone who’s already feeling out of control.

Overall, I wouldn’t recommend this book. Stick with The Sober Truth.

[John · Rating 5 out of 5]

So simple and yet so profound.

The stories and questions are amazing.
There are many ways addiction can express itself (far beyond alcohol, drugs, pornography), such as excessive cleaning, working out, video games, etc.

A profound and straightforward look at healing what is behind the outer symptoms of addiction.

[Patricia Joynton · Rating 2 out of 5]

Made addiction too simplistic. He claims the addiction surfaces when one feels powerless. That's when the gallons of ice cream come out for gorging, or the casino looks just right for a win, or alcohol is consumed to soften the blow. Maybe within all this there was a complexity that I did not come close to appreciating. I never understood how one could identify that "key moment" he claims exists when the addict could "turn it around." While feelings of rage and helplessness could make you want a drink or to lose yourself in internet shopping, I just don't think the story stops there. I am more comfortable with the disease model for addictions.

[Peytie · Rating 5 out of 5]

I recommend this book to everyone, regardless of whether or not you or someone close to you has an addiction. You may realize that you are using/doing something in an addictive way once your definition of addiction is expanded by the author. There's also great information about how to handle feelings of helplessness and suppressed rage that stem from one's psychological patterns that's useful for anyone. An accessible, helpful, enlightening read.

[Jack · Rating 4 out of 5]

Interesting and useful take on the mechanisms behind and treatments for addiction. The writing itself is decidedly bland, and the editing was inexcusably sloppy, but those objections mean little when bearing in mind the help this will lend those in struggle.

[Megh · Rating 5 out of 5]

I really enjoyed the options explored in this book, and respect the accepting, supportive tone taken throughout. Excellent read for anyone who struggles or has a family member who struggles. Particularly for those who feel that traditional options have not worked for them and are losing hope.

[Julie · Rating 5 out of 5]

Highly readable, sensible & practical.

[Sally Smith · Rating 4 out of 5]

This is a short but fascinating book on insights into addiction and its treatment. He oversimplifies things, I believe, but his insights into the nature of addiction are fascinating.

[Idiot Watson · Rating 5 out of 5]

Great read and not intellectually over head of the layman reader. I think this is a more accurate theory of combating addiction then traditional "12 step" programs or things of that nature.

[Saeed]

This is an interesting book on addiction that focuses primarily on and around this idea:
“Addiction is a behavior intended to reverse a profound, intolerable sense of helplessness. This helplessness is always rooted in something deeply important to the individual.”

I read Part One (how addictions work) and Part Two (individual steps in the mastery of addiction—from the beginning to the end of the process). I skipped Part Three (a guide for family members and loved ones of people with addictions) and Part Four (for professionals who treat addiction).

Below are my notes from this book:

“The drive in addictive behavior is rage at helplessness. It is this particular kind of rage that gives addiction its most conspicuous characteristics of intensity and loss of control.”

“Addictions are all substitute (or displaced) actions. They take the place of a more direct response to feelings of helplessness in a particular situation.”

“But when people do understand the way addiction works, they usually can find some more direct action to deal with their helplessness. When they do, they have become the master of their addiction rather than its slave.”

~ 7 steps to end an addiction ~

Step 1: How to Know If You Have an Addiction

“If you wonder whether your behavior (or the behavior of someone you love) is an addiction, see if the pattern of behavior looks like a habit. Habits are linked with familiar situations, like the time of day or a regular activity.”

“If the behavior in question is routine, not associated with any emotionally meaningful events, and—most important—if it’s the result of simply liking a behavior, and not feeling that one must do it, then the behavior may just be a habit.”

Step 2: How to Think about Yourself If You Have an Addiction

“The study revealed that practically none of the subjects were normal; nearly everyone had psychological problems, as defined by the study, in one measure or another. Since an addiction is no more and no less than a psychological symptom—just one of many human mechanisms for dealing with emotional life—having an addiction places you squarely in the mainstream of humanity.”

“Because addictions are efforts to deal with the most important emotional issues of your life, it is impossible to understand them without understanding yourself as a person.”

Step 3: Recognizing the Key Moment in Addiction

“Focusing on the effects of addiction is not helpful either for yourself or somebody you care about. Too often, it results in more shame for the person with addiction and more estrangement between that person and whoever is doing the “reminding.” ”

“The key moment in the chain of thoughts, feelings, and acts leading to an addictive behavior may be a decision to take an action that brings you closer to the addictive behavior, rather than a conscious thought about the addictive act itself.”

Step 4: How You Keep Yourself from Seeing the Addiction ahead of You

“We can see that Karen’s binge eating was precipitated by her depressing interview with Professor Campbell. She had felt attacked, devalued, and finally despondent about her chances at the school. Her anxiety about her career plans was far higher after the interview than before. This all could have been a clear sign to her that she was at risk of repeating her addictive behavior. But she didn’t see it. Her feelings during and after her meeting with Professor Campbell were a jumble in her mind. She wasn’t even sure there was a problem. She was unprepared for her addictive act that soon followed.”

“Getting to know the defensive styles you use when faced with something uncomfortable can be extremely helpful in catching the key moment in your addiction. If you cast your mind back through your life you can probably notice the main ones. Do you try to push thoughts out of mind, like Marjorie? Do you try to out-tough problems rather than look into them, like Brian? Do you try to rationalize your problems away, like Steven? Do you turn emotions into intellectual problems to solve, like Kevin, or become unclear in your thinking when you are upset, like Karen? There are innumerable other ways to deal with uncomfortable issues.”

Step 5: Understanding What Is Happening at the Key Moment in Addiction

“The feeling at the key moment along the path to addictive behavior is helplessness or powerlessness. It feels like you are in a trap that you can do nothing about.”

“If you can learn to recognize that sensation of being trapped, that feeling of hopelessness and helplessness, then you have the chance to stop and scrutinize what is going on in your life and in your mind before you get close to acting on your addiction. Even if you are not aware that you are under stress, even if you are completely unaware of the main emotional issues that cause problems for you in your life, as long as you can pick up on your feeling of helplessness you have a chance to catch your addiction early. At that point you can think about your situation, and about whether it is the kind of position that in the past has led you toward your addiction. If you can do this, you will be turning the tables on your addiction. You will be making use of the central emotion of addictive behavior—the feeling of being trapped and helpless—as an ally. You will be turning it into a siren that warns you that the key moment on the path to addiction has arrived. And as we know, if you can catch the key moment in your addiction, you will know that your addictive act is around the corner.”

Step 6: Short-Term Strategies for Dealing with Addiction

“The solutions to the helplessness traps that lead to addiction are just the direct actions that would have automatically come to mind if there were not some emotional factor preventing you from acting directly.”

“When seeking alternatives to addictive behavior, you don’t need to come up with the best possible alternative. You only need to come up with an action that addresses your predicament more directly than the addictive act.”

“The “helplessness trap” at the heart of addiction can be relieved by almost any action that restores some sense of power, thereby reducing the pressure to repeat an addictive act.”

How to find short-term solutions:
- Just go away. One option available in many situations is to simply leave—to walk away. Naturally this won’t always work, since leaving a predicament could very well increase feelings of helplessness. But sometimes it’s a perfectly good and simple way to manage your helplessness trap.
- Do what you like. Leaving a situation can also mean freeing yourself to have something you like; doing what you really want to do is a good way to reverse feelings of being forced into doing something you don’t want to do.
- It’s never too late. Another way to act more directly when you’re not prepared to fully address your helplessness is to act after the fact. There is often an opportunity later to say or do something you wish you had said or done at the time.

“Focus on your feelings rather than the external facts. The end of a relationship or the loss of a loved one is not the only sort of loss beyond one’s control. The events that set off the addictive process might be the loss of a job or even a career. It could be a move from the place you love, the loss of an opportunity, or a serious injury. It could be any disappointment that is deeply meaningful to you. These would all be situations in which there is no practical way to reverse the problem; you are truly helpless over the reality. In all these cases the approach would be the same: take time to sit back and focus on your feelings rather than just the external facts.”

“Because it is so valuable to recognize the key moment—the earliest point at which you begin to think about performing your addictive act—you can help yourself by imagining this moment yourself. You can do this by anticipating the circumstances in which it would occur.”

Step 7: How to Deal with Addiction in the Long Term

“Four ways that being an expert on yourself enables you to deal with addiction forever:

1. Predicting recurrence. As we have seen, identifying the common emotional theme behind your overwhelming feelings of helplessness is essential to predict its recurrence. Once you identify this theme, you are able to anticipate “high risk” situations that make you feel trapped and lead to addictive urges.
2. Stepping out of the trap in key moments. By identifying the common emotional theme behind your feelings of helplessness, you can see how this theme makes you prone to experience events as repetitions of old painful problems, whether the situation realistically warrants it or not.
3. Understanding your life. By understanding the emotions underlying your feelings of helplessness, you gain a greater perspective on your behavior not only in the present, but also in the past.
4. Turning the tables on your addiction: using it to become an expert on yourself. If you don’t know the central problematic issues in your life already, listening to your feelings and thoughts at the key moment of despair and rage will help you to discover them.”

[Rosemary Brown · Rating 2 out of 5]

Hi, this is Laura, Dr. Rosemary Ellsworth Brown's cowriter. Being pretty unfamiliar with the addiction literature, I read this to begin to compare Dr. Brown's work to what other people are thinking and doing.

I appreciate that Dodes crushes the "brain disease" model. Even before I started working with Dr. Brown, that never made sense to me when I contemplated the very broad spectrum of behaviors labeled as, and experienced as, addictive. And I found many bits of common ground with Dr. Brown's views:

"Having an addiction places you squarely in the mainstream of humanity": Yes! We're all engaged in addictive behavior to one degree or another.

"Because addictions are efforts to deal with the most important emotional issues in your life, it is impossible to understand them without understanding yourself." Yes! Self-knowledge is a big piece of Dr. Brown's step method.

"Don't focus on your addictive behavior itself." Yes! Addiction is the symptom, not the problem.

Dodes thinks that addictive behavior is driven by feelings of helplessness, and his ideas about the "key moment in addiction"—the first thought of acting out the behavior, which could occur days before you actually do it—make sense. In fact, Dr. Brown likes to say that one you think it, you've already relapsed in your mind. Yet learning to identify that moment and stop the behavior incident by incident, as you go, seems like tall order. Really, really tough. How long would it take to build that self-awareness?

Part of what Dr. Brown's step method does—and I've been through the process—is review your past experiences, to the full extent of your memory, to bring to consciousness the pattern that's underneath every one of those key moments. Namely, the complex of fear, control and manipulation, as Dr. Brown calls it. You filter all of those incidents through a new lens that is ultimately very empowering. You're sort of rehearsing, or installing, a new response to all such triggering feelings. Further, your perception of reality may change to the extent that you no longer experience the feelings in the first place. No more feelings of helplessness.

As I read it, Dodes's steps help you identify your feelings of helplessness and begin to respond to them in a different way. That's good, but how about going deeper—getting rid of the feelings of helplessness? Now you're talking!

[Chris · Rating 5 out of 5]

This is the best book on addiction I've ever read. (and I've read plenty) I hope it will ultimately lead me to breaking my eating addiction - it certainly leaves me hopeful that that is possible after so many years struggling. It just makes so much sense -- in fact it seems so simple it's hard to believe I missed the main point for so many years. This book is easy to read and the examples really help in showing the authors point -- the examples mostly come from alcohol/drinking -- and at least one does come from an eating disorder.
I'll come back and check in with this review after I've worked the suggestions in the book longer --- hopefully to report I've finally broken the sugar habit.

[Elisabeth Davies · Rating 5 out of 5]

Dr Lance Dodes does an excellent job demonstrating why people relapse into addictive behavior. He shows how using substances is an attempt to achieve a more tolerable state of mind. His extensive research on addiction is ground breaking in that it opens the readers mind to addiction having roots in a behavioral coping problem, rather than a disease.
I highly recommend this book to anyone struggling with addictive tendencies, as well as treatment providers who treat clients struggling with addictive behaviors.

[Camy · Rating 5 out of 5]

Exceedingly insightful!

Helps with any go-to behaviour, ultimately destructive albeit defensively implemented as the author illustrates. Shows how vital it is to discover why and when these behaviours are practised, helps with unearthing one's own whys and whens, and provides great tools to stamp out their inceptive points.

[Jonathan Schildbach · Rating 3 out of 5]

Definitely have mixed feelings about this book. There is a lot of good stuff in here about understanding addiction from different perspectives (as one suffering from addiction, the loved one of someone suffering from addiction, or as someone treating people with addictions). Dodes does a lot of work arguing against common myths and perceptions around addiction as well, which is definitely positive. He also challenges the model of treatment which attempts to separate drug treatment from mental health treatment, particularly the idea that one needs to complete drug treatment before moving on to address mental health concerns. I think the title is misleading, though, as it makes it sound like ending an addiction is a relatively simple business, and the 7-step plan itself is little more than recognizing why one might feel helpless, thus engaging in addictive behaviors, so that one can end the addictive behaviors by recognizing when those feelings arise and making a decision to do something else. Dodes lays out a number of 'case studies', but they all seem rather neat and tidy, with obvious 'triggers.' To be fair, Dodes has a number of 'disclaimers' about how ending an addiction is not easy work, and can have a great many obstacles, particularly the defense mechanisms of the person suffering an addiction which allows them to continue justifying the behaviors. As an introduction to addressing issues of addiction, it is definitely valuable, but not all one would need for an in-depth understanding or guiding comprehensive treatment.

[NE · Rating 4 out of 5]

This was a good book which I became interested in reading after reading another book he authored, The Sober Truth. I definitely preferred his other book, but this one had some very interesting points. Dr. Dodes actually refuses the mainstream belief of addiction as a disease. Although I disagree with this particular stance, I enjoyed many elements of this book. The majority of the book was built on the idea that people, generally, are fighting against feelings of helplessness in many ways. People with substance use disorders, specifically, use addiction to cope with feelings of helplessness.

I think the helplessness factor as a causative trigger for addiction was insightful.
I also liked how he asked his patients to "think back" to each time they "decided to use" the substance as a way to trace the causative emotion. As for its realistic applicability in practice, it seems his "steps" which have been hard-won through many years of practice, could certainly benefit people.

“Addictions are an attempt to preserve control over your feelings and your life and respond assertively to helplessness.”

"We already know that addictions are a solution to an internal problem, not an attempt to create external problem for oneself or others. There is an even more fundamental problem with spending your time and effort thinking about the effects of addiction. The more time you spend on that, the less time you spending doing something truly valuable: looking at the causes of addiction”

[Mark Manderson · Rating 3 out of 5]

My top takeaways:
Addiction isn’t primarily a moral failing or simply a “brain disease”; rather, Dodes argues it’s a psychological symptom — a compulsive attempt to reverse an intolerable feeling of helplessness.
The addictive act is not the root problem; rather, what precedes it — the “key moment” when the urge arises — holds the critical insight.
The 7-Step Framework
Identify whether you have an addiction – Recognize what qualifies as addiction in your life (substance, behaviour, etc.).


Re-think self-perception – Shift from the narrative of “I’m powerless” or “I’m broken” to understanding this as a psychological process.


Recognize the “Key Moment” – Notice when the thought or urge first arises (often long before the actual act).


Identify your defenses – Understand how you unconsciously block seeing that key moment (denial, rationalising, intellectualising).


Understand what’s happening emotionally at the key moment – Realise that the underlying feeling is often helplessness (and the rage against it).


Short-term strategies – Develop immediate responses when you experience that helplessness/urge, something more direct than the addictive act.


Long-term mastery – Work on the deeper emotional themes and patterns that create the recurring helplessness, so the addiction no longer holds power.

[Mahmoud Shehata · Rating 4 out of 5]

I skipped the last chapter based on the author's permission! :)

The book is very actionable. My biggest takeaway from this book is how important is our internal emotional life. The way Dr. Lance views addiction is certainly true. It makes sense that addiction levels are higher in low income countries where frustration and helplessness are way too often found. Although his other book was more enjoyable since it was about theory and pure psychology, this book holds more value as it helps you to see how addiction takes shape in different environments for different people.

Goodread indeed!

[Aman Reading · Rating 5 out of 5]

Dr. Lance Dodes has written a thoroughly insightful guide to breaking addiction. His approach reframes current wisdom regarding addictions and those who suffer from them in a helpful and approachable manner. His anecdotes help the reader fully grasp his empathetic approach to addiction, which, while more sympathetic to the sufferer, appears to be the precise way addiction can, over time, be cured and eliminated rather than merely translated into another compulsion.

I highly recommend this book to anyone who struggles with any form of addiction, their loved ones, and professionals in the field of addiction.

[patricio · Rating 5 out of 5]

Good book to understand the logic behind addictions

Maybe the book has too many examples but they are helpful and you can feel that you're experiencing one of them. I`ve learned what moves an addict person to do what he does. It is sometimes more complicated that it seems. The book can help you understand if you're an addict or not and how to overcome that situation by identifying the factors that trigger this kind of behaviour.

[kylajaclyn · Rating 2 out of 5]

...And what if your addiction doesn’t come from helplessness? My emotional eating is usually as a result of me being happy or sad. And this book was just padded with stories because he has no actual advice to give.

[Nazmus Salehin · Rating 5 out of 5]

A very good book for people who want to stay away from addiction . You can't eliminate something upright, what this book teaches is how to identify thought patterns preceding your addiction so that you can be aware and make necessary adjustments so that you don't go down that path. Highly recommend

[Dale · Rating 4 out of 5]

Solid practical advice.

[Marie Cristina · Rating 5 out of 5]

One of the best books I’ve read on the subject, with clear explanations and examples for ordinary people

[Taline Sirabian · Rating 3 out of 5]

3.5

[Pablo Sotomayor · Rating 5 out of 5]

Muy buena explicación de cómo funcionan las adicciones y cómo tratarlas.

[Bill · Rating 4 out of 5]

I thought this was a very well-written book. Dodes is clearly a thoughtful, intelligent, and compassionate psychoanalyst. I liked that he argued that people with addictions shouldn't be viewed as somehow abnormal. Addictions are compulsive behaviors, and most of us likely suffer from some compulsive behaviors. The only thing that bothered me about his approach (which probably shouldn't have, given the fact that he's a psychoanalyst) is his insistence that they only way to uproot the addiction successfully is if the afflicted individual seeks therapy. He never suggests that people can succeed in conquering their addictions without psychoanalysis. I don't know if I'm completely convinced that the addict needs to discover the central issue in his/her life that is causing the compulsive behavior in order to break their addiction.

[Gerardo Silva · Rating 5 out of 5]

What a great book. This book describes perfectly the cycle of addiction. It is easy to read and the examples really help in understanding how to tackle any addiction or dependency. The book won't resolve the addiction by magic, however it will give good hints about where to go. It should be a must for anyone, even though there is not a dependency or addiction to address. As a parent it is good to know in advance about this topic because you never know when you would need that knowledge to help a loved one. Moreover, it makes you aware of how our parenthood can affect our children.

[Sarah · Rating 3 out of 5]

Dodes provides an interesting alternate theory to the disease model of addiction. He feels that addiction is a behavioral response to feeling helpless, and regardless of the outlet used (drugs, sex, food) is simply a way to reassert control. This seems overly simplistic, and ignores the reality of physical addiction, but it does make sense, and might compliment other theories.