Monday 25 December 2017

Book Review: Mastering the Addicted Brain

I have worked in the substance use disorder field for about forty years. It can be a contentious field at times, with varying factions proclaiming that their way for recovery is the only way.

Some go the denial-busting, “you must admit your an addict” route. Others focus more on the individual, seeking approaches to recovery that may work for them, whether that is harm-reduction, complete abstinence,  a life time of support group meetings, or something else.

Walter Ling, author of Mastering the Addicted Brain: Building a Sane and Meaningful Life to Stay Clean is a flexible pragmatist. He is interested in helping readers find what will work for them.

Ling is a professor emeritus of psychiatry and founding director of the Integrated Substance Abuse Programs at the University of California, Los Angeles. He holds board certifications in neurology and psychiatry, has conducted clinical trials of psychiatric medications, and has acted as a consultant to the World Health Organization. He also runs a private practice.

Ling is also an author, with his first book being an excellent tool for anyone seeking to overcome an addiction. Mastering the Addicted Brain is geared toward addiction to substances specifically, but the techniques can work for any compulsive behavior.

Ling describes the disease model of addiction as a framework, perhaps even the most useful framework, but notes that it will “probably be revised or even completely discarded one day.”

Ling describes the brain using the three-part reptilian, limbic, and cortical model.

“Keep it simple” is an often-used phrase in Alcoholics Anonymous (AA), and Ling gives a very straightforward and simple explanation of how our three-part brain becomes addicted.

He also differentiates between two types of happiness. Hedonia, or pleasure for the sake of pleasure, is the category that addictive behaviors fall under. Eudonia, on the other hand, is the feeling of satisfaction “from helping others and one’s community through meaningful actions.”

Each form of happiness functions in the brain differently, affects the body in opposite ways, and yields a different outcome. Too much hedonia leads to sickness, while eudonia has the effect of making you healthier. Ling returns to eudonia throughout the book.

According to Ling, recovery is moving from a hedonic frame in your life to a eudonic one. Why is it so difficult for a person to stay off drugs?

“Someone becomes addicted because of the drug’s effects, but the person stays addicted because they remember those effects with a changed brain,” Ling writes.

Ling takes what he has learned over the decades and gives readers a forthright way to change. He offers the information readers need to succeed.

He also gives readers the leeway to find what works for them. If support groups work, use them. If not, Ling encourages readers to find a mentor or someone they respect to learn from. This person does not even have to be real. Someone I knew long ago used a wise fictional character from the Star Trek series for guidance in thinking through decisions.

Ling also redefines the idea of getting back to square one. In the West, we talk about “going back” to square one as a regression. A native of Thailand, Ling uses the phrase “getting to Sanamluang” as a contrast. In Thailand, getting to Sanamluang is progressing, or making a new start. While the idea of going back can be discouraging, Ling helps readers to reframe a fresh start in a very positive way.

Ling draws from both eastern and western stories throughout the book. He also goes into depth about topics such as relapse prevention, the importance of taking care of your physical and mental health, how to live responsibly, and how to first rebuild the relationship with yourself before trying to rebuild relationships with others.

He encourages readers to become responsible members of their communities and to seek meaning. This pursuit shifts people from chronically seeking hedonia at any price, to becoming eudonic and balanced. He even draws a bit from Buddhism; his list for relapse preventions is made up of eight steps, just like the eightfold path.

Ling’s book is a blessing for anyone seeking straightforward, simple, thoughtful guidance on getting and staying clean and living a meaningful, balanced life. His style is informative and conversational. It felt like listening to a caring and wise guide with much experience on what works on the road to recovery.

Mastering the Addicted Brain: Building a Sane and Meaningful Life to Stay Clean
Walter Ling, MD
New World Library
August 2017
160 pages, soft cover



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