Kept on Wikipedia:Lance Dodes
Lance Dodes is an American psychiatrist and psychoanalyst, best known for his innovative work in developing a new theory for understanding the nature and treatment of addiction.[1] He is the author of The Heart of Addiction (2002)[2] and Breaking Addiction: A 7-Step Handbook for Ending Any Addiction (2011), and the co-author of The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry (2014)[3]. He is retired from his position as Assistant Clinical Professor of Psychiatry at Harvard Medical School, and has been elected to Emeritus status as Training and Supervising Analyst at the Boston Psychoanalytic Society and Institute. He is currently on the Faculty at The New Center for Psychoanalysis in Los Angeles, California.[4][5]
Biography
Dr. Dodes is an alumnus of the Bronx High School of Science, Dartmouth College and Harvard Medical School. He has been the Director of Harvard’s McLean Hospital for substance abuse treatment, Director of the Alcoholism Treatment Unit at Spaulding Rehabilitation Hospital (now part of Massachusetts General Hospital), and Director of the Boston Center for Problem Gambling.[6]
Work on Addiction
Dr. Dodes has been a leader in advancing the view that addiction has been deeply misunderstood in both our culture and clinical practice. Rather than being a reflection of impulsivity or self-destructiveness, or a result of genetic or physical factors, he has described a novel view of addiction as a psychological mechanism that is a subset of psychological compulsions in general. Prior to Dr. Dodes' work, psychodynamic theories about addiction focused on specific emotional issues that might precipitate addictive urges. Dodes worked to create a unified theory that would explain all of these factors while simultaneously bring the understanding of addiction back into the mainstream of psychological thought, rather than being viewed as a somehow unique kind of psychological entity. Rather than seeing addictions serving a multitude of psychological needs, he suggested that the compulsion to repeat addictive behaviors is a response to feelings of overwhelming helplessness, of whatever source. By taking an action, however inappropriate, people no longer felt powerless, and Dodes described reversing feelings of overwhelming helplessness as the essential function of addiction. He emphasized that the factors that made certain experiences of helplessness feel overwhelming are specific for each person, hence requiring psychologically individualized treatment. This perspective also helped helping to explain the poor success rates for approaches based on encouragement, moral standards, limit-setting, or group support. Dodes found, in fact, that the issues which, when stimulated, produced a compulsive need to repeat an addictive behavior were always those that were central to the emotional lives of his patients. It followed from this that individual psychotherapy to work out the major issues of a person's life would work hand in hand with understanding and managing an addiction. By knowing and understanding the central themes of their lives, patients were able to predict in advance when their next addictive urge would occur. Even before working out these central issues, they could manage their addiction. Dodes also described the loss of control entailed in feeling overwhelmingly helpless as a kind of rage, called "narcissistic rage", which normally occurs when people feel utterly trapped. Narcissistic rage creates precisely the out-of-control, seemingly irrational loss of concern for effects of one's behavior on one's health and on others, that is a major characteristic of addictive action, and Dodes described this rage as the essential drive behind addictive behavior. Dodes' theory also provided an explanation for why people are able to shift addictions from one drug to another, or even from a drug to a non-drug activity like compulsive gambling, or eating, or even compulsive housecleaning. He proposed that addictive acts are all displacements, or substitutes, for taking a direct action to reverse helpless feelings. Drugs are particularly suited to serve as displacement since they alter one's emotional state, but he discovered that non-drug addictions worked in exactly the same way. Changing addictions, then, meant no more than shifting the displaced action to reverse feelings of overwhelming helplessness from one focus to another. Finally, since people commonly shifted their addictive focus from symptoms well-recognized as addictions to other compulsive behavior not usually called "addictions", he proposed that there is no fundamental difference between addictions and compulsions. This brought addictions back into the mainstream of psychological knowledge and meant that their treatment should be undertaken by skilled psychotherapists in the same way as for other compulsive symptoms, keeping in mind their psychological mechanism described above.[7][8]
Selected Publications
Journal articles
Dodes, LM. Addiction, Helplessness, and Narcissistic Rage. Psychoanalytic Quarterly, 1990; 59:398-419.
Dodes, LM. Compulsion and Addiction. Journal of the American Psychoanalytic Association, 1996; 44:815-835.
Dodes, LM. Addiction and Psychoanalysis. Canadian Journal of Psychoanalysis, 2003; 11:123-134.
Dodes, LM. Addiction as a Psychological Symptom. Psychodynamic Practice, 2009; 15: 381-393.
Dodes, LM, Dodes, J. The Case Study Method in Psychodynamic Psychology: Focus on Addiction. Clinical Social Work Journal, 2016; 45(3): 215–226.
Books
Dodes, LM. The Heart of Addiction; New York: HarperCollins (2002).
Dodes, LM. Breaking Addiction: A 7-Step Handbook for Ending Any Addiction; New York: HarperCollins (2011).
Dodes, LM. and Dodes, Z. The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry: Beacon Press (2014).
Other Media
Dr. Dodes appeared as an expert in two documentary films about addiction: "The 13th Step" (winner for Best Documentary at the 2015 Beverly Hills Film Festival), and "The Business of Recovery"; both have been screened in multiple venues.
External Links
Lance M. Dodes, M.D.: The Online Home For A New Approach To Addiction
References
- ↑ "Trump's Mental Health". msnbc.com. February 23, 2017. Retrieved August 26, 2017.
- ↑ Silverman, M. A. (2005-01-01). "THE HEART OF ADDICTION. By Lance Dodes, M.D. New York: Harper Collins, 2002. 258 pp". By Lance Dodes M.D. New York: Harper Collins, 2002. 258 pp.. Psychoanal Q.,. 74: 912–917.
- ↑ Flanagin, Jake. "The Surprising Failures of 12 Steps". The Atlantic. Retrieved 2017-01-09.
- ↑ "https://www.nytimes.com/2014/05/06/health/the-sober-truth-seeing-bad-science-in-rehab.html". nytimes.com. May 5, 2014. Retrieved August 26, 2017. External link in
|title=(help) - ↑ "Mental Health Professionals Warn About Trump". nytimes.com. February 13, 2017. Retrieved August 26, 2017.
- ↑ "Lance Dodes, MD". psychologytoday.com. Retrieved August 26, 2017.
- ↑ "With Sobering Science, Doctor Debunks 12 step recovery". npr.org. Retrieved August 26, 2017.
- ↑ "Does AA fail addicts?". macleans.ca. March 16, 2014. Retrieved August 26, 2017.
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