Breaking Addiction by Lance Dodes, MD: My Book Review

I’ve been reading the book Breaking Addiction: A 7-Step Handbook for Ending Any Addiction by Lance Dodes, MD recently. I have highlighted many parts of this book because there are lots of key insights about addiction that I want to pass along to you.

As an eating disorder recovery coach, I’m always interested in learning new techniques or processes from people in the area of addiction, habits and neuroassociative conditioning. These are all fascinating to me and I find value in picking up books like Dr. Dodes book because if I can learn one new thing that helps me help someone else on their path to lasting recovery it’s totally worth it.

General Review of Breaking Addiction

My overall take on the book is it’s an easy read filled with a nice combination of practical steps for understanding and recovering from addiction mixed with case studies, or stories, of patients he’s worked with to explain the processes.

I really like this approach because it’s one thing to have him explain something, but I found it very helpful to read a real-world example that I could relate to. As a former food addict I could totally related and. I also saw examples where my clients from different walks of life have their struggles which often vary from my own journey.

Lance Dodes, MD is a psychiatrist and psychoanalyst and assistant clinical professor of psychiatry at Harvard Medical School. He’s part of the substance abuse treatment unit at Harvard’s McLean Hospital.

Pretty impressive credentials, right?

His bookl is very straight forward, easy to get through and provides how to processes with some simple steps to ending any addiction. None of the people in the book had bulimia or anorexia, but one story was about overeating. I found the stories easy to relate to what I personally experienced at times during my 20 years with bulimia.

Dr. Dodes being a clinician and professor does present the material very matter of fact. I find that both helpful and hindering to his being able to relate to what goes on inside the mind and emotions of an addict. All in all I enjoyed the book and want to share some of what I learned from this book with you.

Key Insights from Breaking Addiction

Dr. Dodes does a nice job of calling attention to key points in the book. I’d like to share them with you here and do my best to summarize what he talks about in the book.

INSIGHT #1:

“Addiction is a behavior intended to reverse a profound, intolerable sense of helplessness. This helplessness is always rooted in something deeply important to the individual.”

Said another way: an intolerable sense of helplessness leads to addictive behaviors.

Wow. That IS a key insight into addiction!

I started applying that to my coaching clients immediately. It hit me so square in the eyes having spent many years with that overwhelming urge; being that out-of-control-crazy person I would turn into before I would binge and purge. It could definitely say I often felt “an intolerable sense of helplessness” before my binges.

Now what makes each of us feel helpless is different. For some, it’s trying to please others and when we can’t we feel helpless. It can be feeling not good enough. Not loved. The usual list of reasons and situations we that leave us with unmet needs (think six human needs – certainty, uncertainty, significance, love/connection, growth and contribution).

He goes on to say that the moment of decision to follow through with our addictive pattern or habit (for bulimics it would be compulsive overeating) is when we begin to feel relief from that sense of helplessness. The moment we decide we’ll “give in” we feel a little better. The pressure starts to release. We let a little air out and feel the internal helplessness start to subside. As a former food addict, I remember the moments of shoveling countless calories down also had a numbing effect. It took me away from whatever problem I was feeling helpless about.

I have to agree with this insight from Dr. Dodes. Addiction is often created by feeling helpless. I can also say there are other triggers that can lead to triggers. I have a client right now who will not meaningfully overeat, but get caught up in the process of eating and feel she’s eating too much, feel guilty and purge it afterward. That crazy-making sense of helplessness may…may…have been there behind the overeating, but I know it’s quite a different experience from that rush, or pressure-building feeling, when external situations and stresses cause us to feel helpless.

Food feels like the only relief.

INSIGHT #2:

“The drive in addictive behavior is rage at helplessness. It is this particular kind of rage that gives addiction its conspicuous characteristics of intensity and loss of control.”

…and…

INSIGHT #3:

“Addictions are all substitute (or displaced) actions. They take the place of a more direct response to feelings of helplessness in a particular situation.”

Our addictive behaviors cause us to do things to relieve the pressure of the rage induced helplessness. We sort of have to take it out on something. We have to release that feeling and for those of us with bulimia pounding down the calories is the way we avoid those awful feelings of helplessness.

Dr. Dodes calls it helplessness and I’d like to translate that into the terms I’d most often feel myself and hear from my clients are…anxious, angry, frustrated, lonely, sad, or stressed. Maybe a few others but the top two seem to be anxious or stressed out.

How to Know if You Have an Addiction

I like the section of the book where Dr. Dodes helps you understand the distinctions between habits and addictions. There was a great part where he talked about addictions as compulsions. He says…

“Compulsions…are basically identical to addictions. They are behaviors that are strongly driven, repetitive, and difficult to stop even if you wish you could…compulsions are so common, in fact, that they are often taken for granted, or are at worse a source of good hearted humor.”

He goes on to explain that everyone in mainstream society suffers from compulsions. We label these compulsions, like bulimia, with such stigma that those of us who suffer from these compulsions are labeled in a way that it’s like a straight jacket when you try to get out of those patterns.

I like thinking of bulimia as a compulsion. It helps take the severe weight of the behaviors out of the realm of “disease”. Disease seems so permanent or difficult to cure. Let’s just stop calling it that, ok!?

More Insights From Breaking Addiction

I’d like to circle back to a few remaining insights Dr. Dodes shared in his book.

INSIGHT #4:

“The key moment in addiction is when the thought of it first comes to mind. This may be hours or even days before the addictive act occurs.”

Which leads very nicely into…

INSIGHT #5:

“The key moment in the chain of thoughts, feelings, and acts leading to an addictive behavior may be a decision to take an action that brings you closer to the addictive behavior, rather than a conscious thought about the addictive act itself.”

There was so much in this section I have LOTS of highlights. It’s so true!

I liken when he’s saying here to what Abraham-Hicks often talks about the power of momentum (video). Abraham talks about how our emotions build momentum with attention on them – or focus.

A story Abraham tells about how our emotions build momentum is to imagine a car on the top of a hill in San Francisco. If you nudge that car (think a negative thought) and then run out in front of it (realize you’re thinking/focusing on what you don’t want) and stop it, you’ll only feel a slight bump on your legs. However, if you let that momentum build – or push the car and let it roll down the hill – and don’t do anything to shift your focus or manage your emotions that car will run you down if you get out in front of it at the bottom of the hill.

This is the classic frustration of recovery and relapse!

I can’t tell you how many clients work so hard on stopping their addictive behaviors or overeating in the moment they’re worked up. That’s really not the ideal moment to work on it. I agree with Kathryn Hansen, author of Brain Over Binge, that you can ride the emotional wave of the helplessness, the addictive urges, and stop them.  But oh man that’s the hard way of going about it! And many people struggle trying to solve their problems head on this way.  That’s not how I did it.

The methods and insights that Dr. Dodes talks about and Abraham teaches are about getting momentum going in the direction you want and noticing the urge when it’s tiny. The first moment you have a thought about overeating – or negatively focused on your body or self esteem issues – that’s when you are your most powerful self and can have a better opportunity to break the momentum before it’s too powerful. Before it turns to anxiousness or stress.

Dealing With Emotions

Dr. Dodes says later in the book that…”people have habitual ways of dealing with anxiety, sadness, fear, anger and other feelings. These emotional defenses are pretty much permanent aspects of their personalities – techniques settled upon early in life to deal with emotions.”

It’s my experience that we have traumatic, or just long term struggles, with something in our life and we develop defenses to not feel the pain of the emotions that are created by those struggles. It’s sort of an emotional self-defense mechanism. We create patterns to survive when the world makes us sad or angry or upsets us.

I wrote an article a long time ago that I called The Hole in The Soul. I used to feel like I overate to fill a void in my heart that felt empty. So empty. I go into greater details in that article, but the short of it is that I felt such emptiness of love from my parents and so disconnected from Source, or God, that I felt nothing in my heart. It was empty and I used food as a way to fill me up and keep from feeling that emptiness.

Get to Know Your Defenses – Your Unique Patterns

I would like to take an opportunity to share one final thing here and I expect I’ll need to write another post to share Dr. Dodes techniques for recovery with you. In a future post…

For now, I want you to know that he talks about each of us having defensive styles we use when we’re faced with something uncomfortable. If we can document our patterns by journaling and taking notes about the things going on in our lives each day we’re more likely to see things jump out at us by noting them down.

He says that our addictive brain will keep us from seeing the destructiveness head on. Sometimes we have to get past ourselves by writing down our thoughts, feelings and focus for a week or more to see the things we do routinely to avoid that feeling of helplessness.

Studying yourself like as if you were an experimental case study is a good way to get more aware of yourself. If you wanted to see the way things you’re doing are impacting your life and look for new routines to replace those negative patterns with documenting your daily life is an approach to consider. After reading his section on noticing patterns I wrote down:

What causes ME to feel helpless? What response do I have when I feel helpless?

If you can notice your moments of helplessness either in the moment or look back over the past few days/weeks and pay attention to the situation and your response to it you could very well uncover the patterns that you’ve ignored to this point.

Please share your comment below about Breaking Addiction.  Do you think bulimia or any other addictions are a rage against helplessness?  Is that how it feels for you?

With love and light,

Polly