Book Review: The Globalisation of Addiction: A Study in Poverty of the Spirit

Book Title: 
The Globalisation of Addiction: A Study in Poverty of the Spirit
Bruce K. Alexander
Book Publisher: 
Oxford University Press. 2008. £34.95 (hb). 396pp. ISBN: 9780199230129
Ed Day, Senior Lecturer in Addiction Psychiatry
British Journal of Psychiatry (2009, 195, pp. 92-93).

Several years ago I was asked to participate in a Royal College of Psychiatrists’ debate for young people. I was proposing the motion that ‘we are all a nation of addicts’, and a show of hands before the debate started revealed a strong majority in my favour. Unfortunately, an articulate description of the ICD–10 definitions of dependence by the opposition allowed the audience to re-evaluate their excesses as falling below the ‘addictive’ threshold defined by scientific medicine, and the motion was soundly defeated. Had I read this scholarly and extremely entertaining book before this debate, the result might have been different.

Here the term ‘addiction’ is reclaimed from its current use in reference to alcohol and drugs and instead defined as an ‘overwhelming involvement with any pursuit whatsoever that is harmful to the addicted person and his or her society’. This change of emphasis is crucial, as the author then goes on to present a thesis every bit as bold as his title suggests. His central argument is that ‘psychosocial integration’ is a ‘profound interdependence between individual and society’ that ‘reconciles people’s vital needs for individual autonomy and achievement’. An enduring lack of such psychosocial integration is called ‘dislocation’ and is both individually painful and socially destructive. Free-market society undermines this and ‘addiction’ is a way of adapting to this dislocation, thus explaining why huge numbers of people are addicted to destructive habits in the 21st century.

The author is a psychologist with many years experience in the addictions field and has drawn on an impressive array of materials to support his theory. Evidence from clinical and scientific sources is supplemented by historical and anthropological studies, case histories of historical figures (J. M. Barrie, Adolf Eichmann and St Augustine, among others) and the author’s interviews with various individuals, as well as case studies of communities as diverse as the Canadian ‘Orkneymen’ and Maoist China. It all amounts to a well-reasoned and illuminating read that will challenge many people’s views on the world that we live in, as well as providing a refreshing alternative to a clinical view of addiction dominated by genetics and neuroscience. My only concern was that the solutions offered to tackle dislocation in the final two chapters seemed lightweight in comparison with the rest of the book.