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NEVER ENOUGH

THE NEUROSCIENCE AND EXPERIENCE OF ADDICTION

Illuminating reading for those seeking to understand the whos, hows, and wherefores of getting hooked.

What is it about our brains that causes us to crave things that are bad for us, and why are we experiencing an epidemic of addiction? The answers are joined—and, this book suggests, not always obvious.

Unusually among academic researchers, behavioral neuroscientist Grisel (Psychology/Bucknell Univ.) has had extensive experience with nearly every addictive substance imaginable; her account of her wayward early 20s, chasing one high after another, is harrowing. A lesson she learned early on provides the title: “there will never be enough drug, because the brain’s capacity to learn and adapt is basically infinite.” That is to say, feed the brain addictive substances, and that new normal yields an insatiable hunger for homeostasis. “The brain’s response to a drug,” writes the author, “is always to facilitate the opposite state; therefore, the only way for any regular user to feel normal is to take the drug.” The neurobiology of addiction is imperfectly and incompletely known, she writes; there is certainly a genetic component, while brain structures shape and reshape depending on what is passing through them. For instance, if cocaine is a kind of laser hitting a certain point, marijuana is “a bucket of red paint” that touches many neural centers with its feel-goodness. As for alcohol, suffice it to say that the “primary inhibitory neurotransmitter in the brain” gets caught up in the process, which helps explain some of the stupider things people do when drunk. It also explains why in moderate doses, anxiety is quelled while in greater doses it is activated, going back to that homeostasis model. Grisel writes clearly and unsparingly about both her experiences and the science of addiction—tobacco and caffeine figure in, as well—making plain that there is still much that remains unknown or mysterious about the brain’s workings. In the end, she notes, much of our present culture, which shuns pain and favors avoidance, is made up of “tools of addiction."

Illuminating reading for those seeking to understand the whos, hows, and wherefores of getting hooked.

Pub Date: Feb. 19, 2019

ISBN: 978-0-385-54284-5

Page Count: 256

Publisher: Doubleday

Review Posted Online: Nov. 10, 2018

Kirkus Reviews Issue: Dec. 1, 2018

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WHEN BREATH BECOMES AIR

A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...

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A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer.

Writing isn’t brain surgery, but it’s rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn’t enter the field of medicine, in which his father and other members of his family excelled. “But I couldn’t let go of the question,” he writes, after realizing that his goals “didn’t quite fit in an English department.” “Where did biology, morality, literature and philosophy intersect?” So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which “would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay.” The author’s empathy undoubtedly made him an exceptional doctor, and the precision of his prose—as well as the moral purpose underscoring it—suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. “The fact of death is unsettling,” he understates. “Yet there is no other way to live.”

A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.

Pub Date: Jan. 19, 2016

ISBN: 978-0-8129-8840-6

Page Count: 248

Publisher: Random House

Review Posted Online: Sept. 29, 2015

Kirkus Reviews Issue: Oct. 15, 2015

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THINKING, FAST AND SLOW

Striking research showing the immense complexity of ordinary thought and revealing the identities of the gatekeepers in our...

A psychologist and Nobel Prize winner summarizes and synthesizes the recent decades of research on intuition and systematic thinking.

The author of several scholarly texts, Kahneman (Emeritus Psychology and Public Affairs/Princeton Univ.) now offers general readers not just the findings of psychological research but also a better understanding of how research questions arise and how scholars systematically frame and answer them. He begins with the distinction between System 1 and System 2 mental operations, the former referring to quick, automatic thought, the latter to more effortful, overt thinking. We rely heavily, writes, on System 1, resorting to the higher-energy System 2 only when we need or want to. Kahneman continually refers to System 2 as “lazy”: We don’t want to think rigorously about something. The author then explores the nuances of our two-system minds, showing how they perform in various situations. Psychological experiments have repeatedly revealed that our intuitions are generally wrong, that our assessments are based on biases and that our System 1 hates doubt and despises ambiguity. Kahneman largely avoids jargon; when he does use some (“heuristics,” for example), he argues that such terms really ought to join our everyday vocabulary. He reviews many fundamental concepts in psychology and statistics (regression to the mean, the narrative fallacy, the optimistic bias), showing how they relate to his overall concerns about how we think and why we make the decisions that we do. Some of the later chapters (dealing with risk-taking and statistics and probabilities) are denser than others (some readers may resent such demands on System 2!), but the passages that deal with the economic and political implications of the research are gripping.

Striking research showing the immense complexity of ordinary thought and revealing the identities of the gatekeepers in our minds.

Pub Date: Nov. 1, 2011

ISBN: 978-0-374-27563-1

Page Count: 512

Publisher: Farrar, Straus and Giroux

Review Posted Online: Sept. 3, 2011

Kirkus Reviews Issue: Sept. 15, 2011

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