Immagine dell'autore.

Sull'Autore

Lance Dodes, MD, is assistant clinical professor of psychiatry at Harvard Medical School in the Division on Addictions. He has been director of the substance abuse treatment unit of Harvard's McLean Hospital and director of the Boston Center for Problem Gambling. He has been elected a distinguished mostra altro fellow of the American Academy of Addiction Psychiatry. mostra meno

Comprende il nome: Lance Dodes

Opere di Lance M. Dodes

Opere correlate

The Dangerous Case of Donald Trump (2017) — Collaboratore, alcune edizioni275 copie

Etichette

Informazioni generali

Data di nascita
1946
Sesso
male
Nazionalità
USA
Attività lavorative
training and supervising analyst
assistant clinical professor of psychiatry
Organizzazioni
Boston Psychoanalytic Society
Harvard Medical School
Premi e riconoscimenti
Harvard Medical School. Division on Addictions "Distinguished Contribution"
American Academy of Addiction Psychiatry Distinguished Fellow
Breve biografia
Lance Dodes, MD, is a Training and Supervising Analyst Emeritus at the Boston Psychoanalytic Society and retired Assistant Clinical Professor of Psychiatry at Harvard Medical School. He is the author of many articles, book chapters, and books describing a new understanding of the nature and treatment of addiction. He has been honored by the Division on Addictions at the Harvard Medical School for “Distinguished Contribution” to the study and treatment of addictive behavior, and elected a Distinguished Fellow of the American Academy of Addiction Psychiatry.[adapted from The Dangerous Case of Donald Trump (2017)]

Utenti

Recensioni

Standard alcoholism is not a disease, but my method is a cure.

Cites the expert on Chinese Philosophy Fingarette, and that no genetic allele have been found, which they have.
 
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wwj | Jun 14, 2019 |
Questa recensione è stata scritta per Recensori in anteprima di LibraryThing.
This book looks at the AA movement and whether or not 12-step programs are truly effective. It's long been known in the psychology field that generally, AA is not effective for most people who try it, but it's so ingrained in the substance disorders field that it's difficult to find a program that doesn't use AA principles. Dr. Dodes provides a summary of some of the empirical evidence for the efficacy, or lack thereof, of the 12-step program, and also some background about the program and how it has gained the power that it currently holds in the field. He decries the fact that so many programs use a program that fails to provide evidence that it works. There is actually good evidence that around 50% of people who get and stay sober, do so without any treatment at all, while AA has only about a 5-10% success rate, indicating that it's no better than not getting any treatment. The book does a good job of presenting evidence about AA and also that debunks the disease model in general, but one thing that I found fascinating, and hypocritical, is that he also presents a model of the etiology of addiction, that it's the result of "displacement" and addicts feeling helpless, without presenting even one scientific study that supports this assumption! This may be his theory about why people become addicts, but it is far from established fact, nor is it even the prevailing etiological theory. I think he does a very good job of making a case against the current state of rehab programs in this country, but he hurts his own credibility by then presenting his pet theory without any empirical support to back it up.

If you are interested in getting a wider view of rehab as an industry, and exploring the background of AA and how it became so popular, in spite of it having no real basis in science and there being little evidence that it's very helpful for most people, this book is a good place to start.
… (altro)
½
 
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drsyko | 10 altre recensioni | Jan 24, 2016 |
Questa recensione è stata scritta per Recensori in anteprima di LibraryThing.
A very good book about really bad science methodology and accountability. The author is swimming against a strongly ingrained sociological tide, but he is a recognized expert inside the field who backs his proposals with accessibly presented, peer-reviewed research from numerous sources as well as powerful patient testimonials. Should be mandatory reading for all judiciary members, NIH staff members, social workers, substance abuse counselors and therapists, and loved ones of those currently attending AA/GA/NA and/or struggling with addiction issues. Thank you to Early Reviewers for bringing this book to my attention.… (altro)
1 vota
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dele2451 | 10 altre recensioni | Jun 17, 2015 |
Questa recensione è stata scritta per Recensori in anteprima di LibraryThing.
(an Early Reviewer review)

Six-word review: Angry indictment based on mistaken assumptions.

Extended review:

Debunking the bad science behind anything that claims false credentials sounds like a good idea. But is that the case with Alcoholics Anonymous?

Let's imagine for a moment that someone tells a friend, "I've started taking yoga classes, and already I'm losing weight."

The friend decides to try a yoga class too, attends two or three sessions, and then complains: "I've been doing yoga, and I haven't lost any weight. Yoga doesn't work." This person then goes on to blame yoga for not being an effective weight loss program and, moreover, for preventing her from losing weight by not teaching her about diet and exercise, much less giving her diet pills. It's yoga's fault that the complainer hasn't lost ten pounds. Never mind that yoga was developed for another purpose entirely and that there is no such coherent entity as "yoga" to be making any claims about its own efficacy; somehow she considers it a system that's to blame for the fact that it doesn't provide weight-loss success for everybody who tries it.

Absurd, right?

How many times more absurd would it be, then, if a disappointed weight-loss seeker--or perhaps a disappointed weight-loss seeker's parent--published a book "debunking the bad science" behind yoga as a weight-loss treatment, and tackled the weight-loss industry as a predatory taker of advantage of people's weakness because profit-making weight-loss clinics incorporated yoga into their programs?

That is a fair parallel of what we have here in this book.

Disclosure: I couldn't read this book without bias, and I can't review it without bias. It's also hard for me to think of someone's choosing to read it who doesn't already have some history with the topic and therefore also a probable bias. So it seems best to me to go ahead and expose my bias and let my comments be viewed in that light.

On the one hand, I have a fair amount of direct and indirect experience with twelve-step programs, from long association with a sober 30-year member of AA, from attending AA meetings as a visitor, and from attending Al-Anon meetings (for family and friends of alcoholics) for several years myself. I've gained some knowledge and understanding that have been helpful to me.

On the other, I have no appetite for God-talk and no place in my life for magical thinking. I'm always going to favor a rational approach. But other people don't have to believe what I believe, any more than I have to surrender my brains to their credulity. Something might work for another person even if it's not the same for me; yoga for weight loss, for instance, or religion as an antidote to life's stresses.

So. This book takes up what I regard as an extremely important topic, namely, how we as a society (American, implicitly) respond to alcoholism, what addiction is, and what methods of recovery are effective. Included is the question of whether the prototypical twelve-step program is religious in nature and consequently whether it is or is not right for judges to prescribe attendance at AA (or NA) meetings for people convicted of alcohol-related (or drug-related) charges.

However: the first-person author (Lance, according to the preface) not only exhibits a considerable bias of his own but frequently uses loaded language, making it apparent that his findings are tinged by, if not guided by, his emotions--principally indignation. To me his tone sounds more like the bitter, scornful voice of a disaffected ex than that of a balanced, objective man of science, never mind a Harvard professor of psychiatry. Does sarcasm belong in a book that claims to be a sober application of scientific principles?

Given the way addiction works psychologically, it could be possible that some decreased biological tolerance of certain emotions could lead to a variety of symptoms, including addiction. But nobody in human history has ever walked into a bar because a gene told them to. (page 89)

Consider: Chapter 4 is titled "The Business of Rehab and the Broken Promise of 'AA-Plus'." Think "broken promise" sounds like weighted language? How about the fact that this chapter title is the only mention of "AA-plus"? The only mention in the entire book. The expression simply isn't used or explained (and it certainly isn't AA terminology). So--broken promise of what, then? Broken or unbroken, what promise? The authors don't substantiate this accusatory language; it just sits there, coloring the reader's perception.

And there's plenty more accusing going on, much of it sounding kneejerk and irrational to me. The book
• accuses AA of being based on bad science when it doesn't claim to be based on science at all
• blames AA for copycat twelve-step programs and for the fact that rehab programs too are typically based on a twelve-step model
• accuses it of not working for everybody (because we are all alike?) while in the same breath complaining that it doesn't individualize treatment (because we are not all alike?)--even though it never says it will work for everybody and in fact doesn't represent itself as "treatment" at all
• acknowledges that AA works for those it works for--which, yup, is all it does--so? The same goes for, let's say, yoga as a way to fitness and weight loss; is it the fault of yoga that not everybody who comes to a few yoga classes will get fit or lose weight? It's like writing about the "bad science" behind Zen meditation: Zen claims nothing, but that wouldn't prevent someone from attributing claims to it and then "debunking" them.
• blames AA for its popularity and thus for crowding out other solutions, as if it were somehow a matter of competing for market share
• confuses AA's practice and self-description with studies of AA done by others, as if AA were responsible for researchers' findings about it
• scorns the efficacy of free volunteer-run programs that meet in church basements and then asks: "[W]hy do people spend a fortune for programs that aren't fundamentally different from what they could find for free in a church basement?" (page 61)
It's almost as if the authors were so mad that at any given point they just want to say something derogatory or sarcastic right then, whether or not it's consistent with remarks made elsewhere.

Note that the authors repeatedly fault the AA program for being based on irrational premises. That may be so, but AA doesn't claim to be rational, whereas they do. You can't debunk something that doesn't make any claims. There's a reason why the twelve steps say "we" and use the past tense ("We admitted we were powerless," etc.)--it's not prescriptive. It's about what the founders did, their own story, which they then went on to share with others, together with testimonials of many who had followed their path. They're describing the path and posting markers, not taking hostages and dragging them down it.

It's not that there aren't fair questions that can be asked about AA and its view of recovery. For some people it's the only way, and for others it's simply not. Significantly, for some, it is the way that worked for them (or, rather, that they worked successfully--and that's an important difference), and it seems to me both pointless and destructive to try to invalidate that somehow. Reasonable questions--is alcoholism really a disease in the same sense that diabetes or pneumonia is a disease? should the court require offenders to attend a spiritual program?--are swallowed up in bile.

This book won't hurt AA at all or take anything away from people who have found help in the program. Perhaps it will encourage some who have not found recovery in one way to seek other solutions, and that's fine. But why spend all that effort trying to tear something down--especially through misdirection, such as trying to hold AA accountable for its imitators and those who make a profit from treatment facilities--when there is so much necessary and positive work to be done in the field of addiction and chemical dependency? If treating addiction as a compulsive behavior that's amenable to therapy is a more effective solution--and I'm not arguing against that; maybe it is--won't it prove itself? I can't escape the feeling that there is some personal disappointment, such as perhaps a failed recovery attempt in a friend or loved one, lurking behind all the highly colored rhetoric and that its taint impairs the very credibility that the authors are trying to establish.

It makes no sense at all to criticize AA for not doing this or that--for not having a medically based treatment program, for not systematically integrating newcomers, for not doing follow-up studies. You might as well criticize a spoon for not being a fork. There's no structural hierarchy, no formal management of groups, no set of rules governing conduct toward members or newcomers. There's just a bunch of folks with their steps and traditions and slogans, trying to get their lives straight, putting in volunteer time and effort to sustain the group, setting up chairs and making coffee, working on their own recovery and extending a hand to others. They strive for progress, not perfection. If it works for them, who are Lance Dodes and Zachary Dodes to say they're doing it wrong?
… (altro)
12 vota
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Meredy | 10 altre recensioni | Jun 6, 2015 |

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Statistiche

Opere
3
Opere correlate
1
Utenti
163
Popolarità
#129,735
Voto
4.0
Recensioni
13
ISBN
10

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