The Insatiable Gorge: An Existentialist View of Opiate Addiction and its Treatment.
Article Type: Book review
Subject: Books (Book reviews)
Author: Sharma, Manoj
Pub Date: 12/01/2011
Publication: Name: Journal of Alcohol & Drug Education Publisher: American Alcohol & Drug Information Foundation Audience: Academic; Professional Format: Magazine/Journal Subject: Health; Psychology and mental health; Social sciences Copyright: COPYRIGHT 2011 American Alcohol & Drug Information Foundation ISSN: 0090-1482
Issue: Date: Dec, 2011 Source Volume: 55 Source Issue: 3
Topic: NamedWork: The Insatiable Gorge: An Existentialist View of Opiate Addiction and its Treatment (Nonfiction work)
Persons: Reviewee: Shoham, S.G.; Addad, M.; Kett, M.
Accession Number: 280092622
Full Text: Shoham, S. G., Addad, M., & Kett, M. (2010). The insatiable gorge. An existentialist view of opiate addiction and its treatment. Oshawa, Canada: de Sitter Publications. [ISBN # 978-1-897160-28-2; 180 pages; $85.99]

This book is based on the clinical experiences of a professor of criminology at Tel-Aviv University in Israel with rehabilitation of opiate addicts. He hypothesizes that there is a lacuna called "black hole" in the current treatment that consists of medical detoxification and the twelve-step training program of Narcotics Anonymous in treating patients suffering from addiction of opioids. He claims that with his approach the success rate is close to 40 percent. The target audience of this book are behavioral scientists involved in the rehabilitation of opiate addicts.

The book consists of a prologue and eight chapters. The first chapter is called personality and its disruption. The chapter describes the theory of personality as developed by the authors. According to the authors the personality consists of two core vectors: participation and separation. In this chapter the authors describe the process of disruption of this personality. The chapter has a total of 47 citations and most of these are works by the authors themselves. There is a need to integrate this model with other existing and current models which would lend more credence to what the authors have proposed. The chapter does not conclude with a summary and it have any box items that would have made this book more reader friendly.

The second chapter is called the philosophy of treatment. The authors take a stance that mental illnesses and disruption of personality that predisposes one to addiction are related to disruptions of interpersonal communication. In my opinion, this is a very simplistic interpretation of a phenomenon that is so complex that science has not yet been able to completely unravel the mystery behind mental illnesses and addiction. The chapter presents an existentialist approach to treatment that is aimed at assessing and supporting the patient's inner sense of being, reducing external threats, providing ways to comfort self, and cope with pressures of others.

The third chapter describes the method of treatment. The approach is group therapy which has three goals: dialogue between each patient and the group, discovery of patient's strengths, and resolution of conflict and tension between the patient and the group. The chapter is only nine pages long, and it would have been good to have more details of the method.

The fourth chapter is called, "The mythogenic scaffolding of the addict's personality." According to the authors a mythogene is a, "connecting structure between the individual and other human beings, as well as other life forms and inanimate objects" and scaffolding is "the sum total of mythogenes with which the individual builds his self-concept for presentation to the outside world." The chapter presents 12 case studies of this "mythogenic scaffolding" in addicts. The case studies are very brief, and it would have been good to include more details. The fifth chapter is called, "Black Hole." It once again revisits the 12 case studies presented in Chapter 4 and discusses the lacuna in the personality (black hole) of these addicts. The sixth chapter is about the addict and others and once again revisits the case studies of the 12 addicts in the context of their relationships. The seventh chapter is labeled, "The Cure" and discusses the treatment aspects of these 12 addicts. The treatment according to the authors occurs at three levels: biological (detoxification), psychological, and social interactional. The final chapter discusses the prognosis aspects of the 12 addicts in the case studies.

On the whole, this book presents an interesting approach worth more exploration. The whole area of treating opiate addicts is among the most difficult ones, and the method elaborated in this book could hold some promise. It would be helpful if more behavioral scientists read this book and explore some of the approaches presented in this book. The problem with this approach is that it merely presents qualitative evidence in the form of case studies. There is a need to empirically test this approach in quantitative designs. Perhaps this book would stir some interest in this area, and future scientists would systematically test the veracity of this approach.

Review by Manoj Sharma, University of Cincinnati
Gale Copyright: Copyright 2011 Gale, Cengage Learning. All rights reserved.