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Addictive States.

O'BRIEN, C. P., & JAFFE, J. H. Addictive States. Raven Press, 1992. Pp. xii + 291.

This fifteen-chapter multiauthored text is the result of a 1990 Conference held to discuss advances since 1966 in the study of addictive "states" discussed at a similar conference. In discussing the emotionality and complexity surrounding the issue, the editors of the present text noted that the preface to the report of the 1966 conference contained a call by Dr. Abraham Wikler for the "need to approach the study of addiction using the scientific method to explore mechanisms, rather than accepting glib jargon and circular reasoning." Sadly, with the notable exceptions of the introductory chapter by one of the editors and a superbly enlightening chapter by Reese T. Jones, this text reveals that this admonition has not been heard. The text does, indeed, present the best in recent research aimed at determining the biological basis of reinforcement, and the roles of genetics and learning in the development of compulsive behaviors. However, the interpretation of these results by the researchers, and the subsequent use of these results by therapist/practitioners, is marred by the unquestioning acceptance of the very "glib jargon and circular reasoning" so reviled by Dr. Wikler and, purportedly, the editors of this volume. For example, two authors present in this text an excellent summary of what is known about the effects of chronic stimulation of opiate receptors. However, the authors then waste many words trying to get their brilliantly acquired and valuable data to support their otherwise unsupported assertion of "the nearly permanent character of addiction in the human." Other authors similarly engage in the use of "glib jargon" as they make the assertion, again without reference to the published scientific literature, that "addiction is a chronic relapsing disorder similar in many respects to diabetes or heart disease." These same authors then go on to seriously distort the tenets of probalistic learning theory to support their unjustifiably rigid deterministic view of addiction.

Good science gives way to ideology in many examples throughout this text. Although the initial chapter makes clear that Dr. Jaffe is quite aware of this problem, such awareness does not reflect itself in an editorial requirement that authors of subsequent chapters avoid passing off unsupported assertions as facts, or ideologically motivated musings for scientific discourse. The final three chapters of Addictive States reveal the full scope of this editorial failure. In these closing chapters on the treatment of addiction, pharmacological determinism runs rampant and the autonomy of humanity is denied. Despite a frequently stated interest in the effects of patient motivation for treatment" upon therapeutic outcome, the authors nonetheless consider such barbarities as boot camps and shock incarceration without asking the important ethical and scientific question of how individuals forced by violence to abruptly halt their drug intake may view their enforced "treatment." Rather than considering the possibility that a return to drug use subsequent to such coercion might be the free and rebellious (albeit foolish) choice of an autonomous individual, the authors of one of these final chapters assumes that such "resistance" to "treatment" reveals evidence of the much sought after long-lasting neurological deficit presumed to underlie "addiction." In his otherwise superb introductory chapter to this book, Dr. Jaffe slurs Dr. Thomas Szasz as he argues that "we can ignore the rantings of those who dismiss all mental disorders as conspiratorial inventions designed to give psychiatrists control over the socially deviant." It would have been better had Dr. Jaffe and his fellow editor ignored the authors' writings of the final three chapters in this edited text, and instead invited Dr. Szasz to Conclude this book with his own critique of the treatment of addiction. (Arthur P. Leccese, Kenyon College)
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Author:Leccese, Arthur P.
Publication:The Psychological Record
Article Type:Book Review
Date:Mar 22, 1993
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