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A profound, humane, and revolutionary new framework for understanding and addressing addiction. 

Addiction has been called a moral failing, a social problem, a spiritual crisis, a behavioral disorder, and a brain disease. It has also been called a class issue, a supply problem, a problem of learning, a memory disorder, and a result of trauma. And some propose that addiction is neither a disease nor a problem, but a transgressive expression of freedom, a maligned sub-culture, a therapeutic relationship. Even the term ‘addiction’ is open to question. There are few human phenomena so elusive and intractable; after decades of neuroscientific research, we aren’t much closer to understanding addiction, nor to addressing it effectively. 

This profusion of interpretations, meanings, and models reflects a hidden truth about addiction: that it is profusely generative of meaning itself. In this bold reimagining, pioneering psychiatrist Elias Dakwar examines addiction as a sustained creative act—and specifically as a process of personal world-building, complete with its own rituals, systems of value, modes of suffering, and sources of support. In this regard, addiction is something we all do. But there is a crucial difference. In the case of those of us suffering from addiction explicitly, this meaningful world keeps us in clear captivity, worsening the suffering and confusion we hoped it would console. And we remain stuck because we have trouble imagining it differently.

Drawing on vivid stories of his own patients, path-breaking research with meditation, psychotherapy, and psychedelics/hallucinogens, and decades of clinical experience, Dakwar explores this captivity at the heart of our addictions, and shows how we might move beyond its bounds to reclaim our freedom. He also relates addiction to our collective self-inflicted crises, from environmental destruction to militarism to social injustice, rendering this often stigmatized condition relevant to all of us. With fluid, rich, and often startling prose, The Captive Imagination offers a novel path for better understanding and overcoming addiction, as well as human suffering more generally.

“The Captive Imagination is a much-needed stabilizing force in the fraught public discourse on addiction, which relies heavily on tropes that dehumanize. Dakwar, an admirably unique psychiatrist who is first of all human, places the suffering of those afflicted with addiction in the larger context of human suffering…this book is a must read.” — Carl Hart, PhD, Mamie Phipps Professor of Psychology at Columbia University, author of Drug Use for Grownups

“With rich prose and radical originality, Elias Dakwar expands pragmatic yet thrilling insights about addiction into a far-reaching examination of meaning, authenticity, and reality, challenging persuasively how we define nearly everything. Clinical anecdotes reveal startling flashes of intense generosity and wisdom, then grow into powerful abstractions, creating a fractal spectacle as arresting, glowing, and brilliantly revelatory as those induced by the substances he studies.” — Andrew Solomon, New York Times bestselling author of The Noonday Demon and Far and Away

“A riveting, compassionate meditation that navigates philosophy, psychedelics, religion, biomedicine, neuroscience, critical theory, and contemporary culture with brilliant and understated insight, shedding new light on the role of fiction in addiction—a world knit into knots, narratively and chemically—as well as in our existence more fundamentally, while reminding us, with astonishing beauty, of the infinite plasticity of the self. Incredibly erudite and informed, this book forces us to reconsider the nature of desire and of our capacity to undermine our own fulfillment—while also offering a means of restoration, with a strange humility and grace.” — Patricia Dailey, PhD, Columbia University, author of Promised Bodies

“This seductively written, likely landmark book about addiction and its treatments asks important and haunting questions about what Coleridge (addicted to opium yet never in doubt of his creative freedom) called “the shaping spirit” of a strong imagination. Is even great art a condition of our endemic hunger for self-delusion? How to shape the world into our truest likeness? Dakwar offers brilliant insight, with a scientist’s originality, a physician’s profound experience.” — Joseph McElroy, author of Women and Men 

“The Captive Imagination is brimming with intuition. Learning, unlearning, and relearning Earth's language-creating, language-transcending spirit begins with acknowledging her profound understanding of us. May these words bring consciousness to the premeditated ignorance of humans and guide us to stop creating and repeating our atrocities. Wowas’ake kin Slolyapo wowahwala he e. Read closely and know now the power that is Peace.” — Tiokasin Ghosthorse, Itazipcola/Mnicoujou Lakota

"Provocative...Dakwar, a professor of psychiatry at Columbia, draws on his extensive clinical and research experience to offer what he calls 'a work of imagination' that reframes addiction as a complex and universal form of meaning-making. A potent, incisive reconsideration of a fundamental human behavior." — Kirkus Reviews