The Captive Imagination: Addiction, Reality, and Our Search for Meaning

Psychiatrist and scientist Elias Dakwar presents a groundbreaking yet simple framework for understanding and addressing addiction as a confusion from which we are all, addicted or not, working to find freedom.

Addiction is a crisis affecting millions of Americans every year. As rates of addiction and overdose deaths surge across the country, physicians, mental health professionals, and researchers scramble to help. While the prevailing model--addiction as a brain-based disease--has destigmatized addiction, it hasn't solved the problem. Instead, as pioneering psychiatrist and researcher Elias Dakwar shows, it may be making things worse.

Drawing on his research with hallucinogenic compounds and meditation-based treatments, fifteen years of clinical experience, and recent findings from neuroscience, Dakwar frames addiction as the fixed "reality" to which the imagination become captive. In a bold repudiation of the brain-disease model, he approaches addiction, not as a physical problem, but as a crisis of the creative imagination in which our all-too-human attempts to alleviate suffering and make sense of the world leads to a locked-in conception of things that only confuses things further. Addicted individuals therefore suffer acutely from what afflict us all - the fictions we create and mistake for reality.

In this beautifully written and often startling exploration, Dakwar reveals how the journey towards freedom is not unique to addiction, but a passage we must all make as we work towards greater understanding, fuller relationships, and more profound peace. He makes an urgent plea for scientists to consider consciousness and meaning-making when approaching addicted individuals, and combines cutting-edge research with clinical narratives to pose and address the existential, relational, and philosophical questions that are at the heart of addiction. A leading researcher in the use of ketamine in addiction treatment, he examines how psychedelics, in combination with other practices, might be helpful clinically, and how they can also shed light on the broader systemic and cultural shifts that are needed to alleviate suffering, beginning with the most vulnerable among us.