When Russell Brand's and Peter Hitchen's “expertise” in addiction dominate the media discourse, complex issues become trivialised. Simple answers are inevitably wrong, but developing better theories and advancing public understanding is a challenge. Jim Orford's latest book is a thought-provoking endeavour that will be of interest to people working in the field of addiction as well as those touched by the experience of addiction. It should be required reading for politicians and policy makers.
The book brings together three key elements of Orford's academic work: the excessive appetites psychological model of addiction; the cross-cultural work on families and how they are affected and cope with addiction; and his writings on community psychology. As this range of knowledge indicates, Orford is interested in ideas that span the individual and social levels of explanation. And it is this multi-layered tour of theories and how they link across often separate and polarised academic boundaries that is most refreshing. It is one which sees the advancement of knowledge in addiction being the concern of a range of disciplines as opposed to the promotion of simple reductionist argument or falling back on the rather tired and overused biopsychosocial explanatory framework.
Orford uses the concept of power as the unifying element to the book. It starts with a summary of three fictional case studies illustrating problems with alcohol, illicit drugs and gambling. These individuals highlight the personal experience of powerlessness in the face of an overwhelming compulsion to engage in behaviours despite huge personal costs. They are also used to shine a light on the often-neglected consequences of these behaviours on family and friends and the extent of this problem worldwide, estimated at 100 million people. The case studies are the touchstone throughout the book, used to make connections across theories and to demonstrate how power exercised at many levels removed from individuals never the less shapes their lives and the choices they make. The chapters follow this route, starting with psychological models and moving on to social theories of power, the extent of the gambling and alcohol lobbying and the discourses that conveniently hide their influence.
In seeking a broader view of addiction than is currently in vogue, this journey does not shy away from difficult issues such as the extent to which addicted individuals can be considered responsible for their behaviour. Orford draws on philosophy and legal expertise to explore this issue and allows the reader to see the complex web of arguments and ideas. However, he also seeks to engage with issues such as why addiction is disproportionably manifest in deprived communities. The book takes in a diverse range of ideas and writings to build the arguments. These include the biographies of Sara Coleridge and Caitlin Thomas, both married to famous poets with addiction problems; the stories of George Best and Charles Kennedy; and brings in a range of political and academic heavyweights including Gramsci and Foucault.
Orford touches on treatment too, but perhaps wisely refrains from engaging with the current recovery debates in the UK. However, the arguments in the book are directly relevant to why it suits those in political power to promote the “responsibilisation” of individuals whilst simultaneously engaged in a full-scale assault on the social welfare system. The community psychology influence perspective is clearly visible and seeks to understand the problems and find solutions to them in wider social structures and influences.
This book is not one for people who want simple answers, yet if you want to be challenged by an engaging and theoretically diverse range of arguments from a man with clear and sound principles then this is the book for you.
