What I’m struggling with in the book
Lembke makes a good case for a modern forms of abstinence and prohibition, whether she intended to or not. Her uncritical support for AA gives us much to think about. There are other recovery movements and organizations that she does not discuss. I don’t understand the science well enough to know if she is correct in agreeing with researchers who have found that “Compelling new evidence indicates that ADHD drug treatment is associated with deterioration in academic and social-emotional functioning” (p. 130). What are the answers to her questions that she posses on pages 132 and 133: “In medicating to adapt to the world, what kind of world are we settling for? Under the guise of treating pain and mental illness, are we rendering large segments of the population biochemically indifferent to intolerable circumstance? Worse yet, have psychotropic medications become a means of social control, especially of the poor, unemployed, and disenfranchised?” Last, I found her chapters to be organized in repetitive sequences that sometimes got in the way of my learning.
The paradoxes Dr. Lembke presents
Lembke makes the point that our relentless attempts to make ourselves feel better, to soothe or ameliorate pain, make us feel worse in the long run if we can’t balance pleasure and pain. She also makes the case that organizations with an internal strictness, such as AA and certain churches, have higher rates of social participation than organizations that are more relaxed or loose with their internal cultures and discipline. Her point that wealthy countries have higher rates of anxiety than poorer nations do needs context that Lembke does take up. She is dealing with problems that are tied to how capitalism is organized and how it functions, but she never quite gets there when it comes to naming the beast.
Some points that I either disagree with or take issue with
It’s presumptuous for me to criticize the work presented and the arguments made in this book, but here goes.
This is a middle-class and white view of the world. The logic of the cases made in the book for prosocial shaming and club goods can be used to argue for a revised Protestant work ethic, although I’m sure that Lembke did not intend this. There is no mention of generational trauma. A strong case is made for empathy, but there is no case here for solidarity. The discussion in the book on self-binding brings us to a slippery slope when it comes to the matter of particular religious garb for women. The discussion of work, class, and social wealth seem almost upside-down to me. Lembke evidently approves of Electroconvulsive Shock Therapy (ECT) in some cases. Her use of data from animal experiments, which are described in more detail than I was prepared for, gives this book a brutal edge. I felt so worn down by this brutality that I felt bullied near the end of the book when Lembke dares readers to “walk towards” and confront whatever it is that we’re trying to escape.
Lembke’s support for ECT and her talk of experiments on animals makes it difficult for me to recommend this book to others. The other points in the book that I disagree with or am struggling with will be found in any liberal delve into the principles of addiction and recovery, finding needed balance, and the science behind these, I imagine.
Anna Lembke On The Neuroscience of Addiction: Our Dopamine Nation on the Rich Roll Podcast
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