The Craving Brain: The Biobalance Approach to Controlling Addiction

By Dr. Ronald A. Ruden, with Marcia Byalick
ISBN 0060186984

Reviewed by Katy P.


The mystery of alcoholism and addiction is one that has plagued us for years. Is it a disease? Is it a choice? Physiological or psychological? Experts and researchers have published various theories and thoughts on the subject, some easier to understand and digest than others. Those of us seeking answers to these questions are left to consider all possibilities and draw our own conclusions based on personal opinions and experiences. In Dr. Ronald A. Ruden's book "The Craving Brain," the scientific theory of biobalance is introduced as a key to understanding and treating substance abuse. Applying scientific explanations to the questions of addiction and alcoholism is nothing new. But Ruden is able to break his theory down and present medical and scientific concepts in a simple, non-threatening style. We're still left to draw our own conclusions on the issues, but Ruden gives us something attainable and cogent to mull over.

The title of the book comes from Ruden's handle for what society has historically referred to as alcoholism and addiction. He says these are "craving disorders" of the brain, caused by a "craving response" to life experiences and environment. A craving brain is a brain chemically out of balance, and the solution is to put it back into balance, or "biobalance." Along with alcohol and drug abuse, Ruden applies his theory to all addictions, including overeating, gambling and sex.

In the first section of the book, Ruden examines the brain and how this complicated organ works. The author keeps his explanations clear and palatable. He starts with defining survival instincts as they apply to the human brain, and goes on to describe how and why the brain releases certain chemicals, or neurotransmitters, to accommodate our human urges and needs. The two main chemicals Ruden refers to are dopamine and serotonin. He says these two work together to both regulate our urges and satisfy our needs.

Ruden goes on to explain his theory of where addictive behavior comes from. Depending on our early experiences, and the god-given layout of our brain, the neurotransmitters may not release correctly, and what is normally a self-regulating system is now disrupted. This could happen for any number of reasons, but the author cites experiencing "inescapable stress" for a prolonged period of time as one possibility. In this case, the landscape of the brain has been altered, sometimes permanently, and cannot balance itself. The person is now left to balance his or her brain manually, i.e. with substances or behaviors that stimulate the neurotransmitters.

If all of this sounds confusing, trust that Ruden does an excellent job of presenting these theories in a graspable, step-by-step manner. The author also uses bold type for words and phrases that may need further explanation, and he includes a glossary in the back of the book.

With his theory now uncovered, Ruden explains that an addict's craving response, the abuse of a substance or behavior, becomes the automatic response. This, he says, accounts for the "I can't stop myself" feelings most addicts experience. According to Ruden, if our brain landscape is severely primed for craving, no social or moral constraints will stop us. But the author makes it clear that once we understand these responses, and understand the landscape of the craving brain, we can then learn to balance the brain (biobalance) by adopting healthy, serotonin-boosting habits.

Ruden offers several methods for arresting the craving response. He gives brief explanations of ideas behind Buddhism, 12 step programs, rehabilitation centers, and drug therapy. Ruden says each of these possible solutions can offer the craving brain a new method of producing the correct amount of serotonin to interact with dopamine and achieve biobalance. According to the author, the brain is a primitive system designed to ensure survival. One of the ancient survival instincts humans are known to possess is the need to "herd," or come together with a close community of people for comfort, safety and support. Support groups, or "herding," can produce the needed chemicals for biobalance. Similarly, this can be achieved through the Buddhist approach of liberation from the self and from desire, and other spiritual teachings. Ruden also mentions service to others as a means of boosting good feelings and balancing the brain.

The section on drug therapy in treating the craving response is the one troubled section of this book. Ruden includes information on the now illegal diet drug Fen-Phen, along with personal accounts from food addicts who have used it. This was obviously published before the dangers of the drug were publicized. Ruden also quickly glosses over antidepressants, and addiction-specific drugs such as Antabuse, Naltrexone, and Methadone. But compared to the rest of the work, this section falls short in facts and explanations.

The final section of the book includes an extended bibliography that not only cites Ruden's sources, but also "offers (the) reader a glimpse into the scientific process and explanations that led to this new understanding."

Overall, Ruden's work makes an impressive argument for the physiological rationale behind alcoholism and other addictions. His thoughts are organized and clear. The work is peppered with personal accounts from addicts, which helps take the edge off the scientific nature of the book and adds some personality to the work. Throughout his theorizing, Ruden maintains that no one method of achieving biobalance is the right method, but that there is hope for every person with a craving brain to find a solution that will work. With a simplified presentation of his theory and a realistic opinion on how to achieve recovery, this book is an enjoyable, thought-provoking read.

The Booze Merchants - The Inebriating of America

By Michael Jacobson, George Hacker, & Robert Atkins
ISBN 0893290998

Reviewed by Katy P.


There's no clouding of the issues in this 1983 report from the Center for Science in the Public Interest. The authors take a clear stance from start to finish: most marketers of alcohol are underhanded, deceitful, and act with ill intent. While there is sound evidence in the form of reports from the Federal Trade Commission, examples of print and television advertisements, and facts and figures from various studies, the report is a bit overkill. Published in 1983, over two decades ago, the information is somewhat stale and the reader is never sure if the stated problems are still problems today. The book does, however, raise a relevant point in any day and age -- advertising entices the public. People should, at the very least, be aware of that. This report serves as a good reminder to not buy in to everything you read and see.

The forward was written by Nicholas Johnson, a former Federal Communications Commissioner. Johnson doesn't pull any punches in his introduction of the topic. He sets the tone for the entire report by stating his opinion unequivocally: he proposes a ban on all advertising of alcohol in the U.S. The reader can expect the rest of the report to be colored with this proposition in mind.

The book goes on to discuss alcohol as the number one drug problem in America. It cites numerous studies from several advocacy groups to back its claims. The authors argue that alcohol industry advertising and marketing is mostly to blame for the epidemic. They say children, problem drinkers, and women are targeted by industry ads and are hypnotized, lured into regular drinking habits and pushed to drink more.

The research is thorough and the points are well thought. The report builds its arguments conclusively. The problem arises when facts and figures are augmented with statements of opinion and slanted adjectives. Throughout the report, the authors include copies of alcohol advertisements to punctuate their stance. Some of these ads are captioned with descriptions from the authors. For example, one ad description reads, "Dignity is thrown out the door by the makers of "Wild Irish Rose" in this sexually suggestive ad." The ad in question is a photo of young ladies in shorts and tank tops holding bottles of wine. The phrase "dignity being thrown out the door" seems a bit dramatic and exaggerated, considering the tame content of the ad.

The report is, overall, filled with interesting facts and insights, but it's a dry read (no pun intended.) Written as a report, it has the same matter-of-fact posturings as a report, with a few harsh criticisms thrown in here and there. If you have interest in the subject and can brave it, you'll most likely find thought-provoking arguments. It does allow the reader to give more thought to the questions; Are alcohol marketers trying to get more people to drink, and are they trying to get drinkers to drink more? The report calls for a ban on alcohol advertising as part of a comprehensive, coordinated attack on our society's alcohol problem. I'm not so sure it's that simple, but akin to the tobacco wars, it's a point not to be discounted.

A Million Little Pieces

By James Frey
ISBN 0385507755

Reviewed by Katy P.


As addicts and alcoholics, we’re prone to getting stuck in the victim role. It’s what thwarts our recovery in many cases, holding us back from taking action in our lives, from making decisions and choices to live better, stop using and drinking. For anyone who has struggled with the “poor me, I can’t change” syndrome, James Frey’s book “A Million Little Pieces” might just help snap you out of it.

There has been quite a bit of hype over this book since its April 2003 release. This being Frey’s first literary work, he’s a rookie who came out of the dugout swinging away. Media interviews abounded. He was quickly dubbed a “literary bad boy” because of his no nonsense responses to questions, his profane vocabulary, his rejection of Alcoholics Anonymous, and his completely unapologetic stance regarding his zealous ambitions in the literary world. Marketed as an addiction memoir, the book has attracted both positive and negative feedback. Adversaries call it exaggerated, repetitive, cliché, and some have even called Frey’s accounts of his addiction and experiences in recovery outright lies (see anesthesia-less root canal passage.) Proponents of the work, however, find his lack of adherence to standard writing rules refreshing, the overt gore with which the withdrawal experience is described honest, and his short, repetitive and choppy prose engaging and addictive.

My perspective as a recovering addict: this isn’t your usual addiction memoir. That much is true. If you think you’ve read it all and heard it all, and this book could only elicit yawns, I challenge you to crack it open. The prose is painfully vivid, pointed, and evocative. Almost any addict will relate to Frey. And the one thing all the hype has gotten right is that Frey has his own style of writing—he does away with style all together. Rules of grammar, punctuation, capitalization, are ignored. The author hits his mark with this one—it’s addictive. The reader is drawn and pulled into Frey’s saga, his thoughts, his mental rants and anguish like a runaway train is pulled downhill. The lack of grammatical structure removes pauses and breaks in thoughts and dialogue and leads you further and further down the rabbit hole into the story. And it’s a wild ride.

As far as exaggerated accounts go, I can see how those who haven’t struggled with substance abuse could be skeptical of Frey’s story. But those of us who have been in active addiction know how easy it would be to shock others with honest descriptions of how much of our drug we consumed over a given period of time. I even shock myself sometimes when I think of my own using experiences. The question is, why would we want to retell these tales? For some of us, at one time, it made us feel better about ourselves. “Look how cool I am, I used to drink this much.” But those of us who are seriously changing our lives and our ways find bragging is pointless and empty, an old behavior that doesn’t bring us any glory or self-respect. I believe Frey was merely painting a picture of the person he used to be to illustrate how low he had sunk. It’s clear from his writing that he’s neither proud nor validated by his drug and alcohol use and the violent, destructive person that emerged as a result. The guy is just telling his story from his perspective.

The most important thing about this book for me was the simple message: you don’t have to use if you choose not to. The book got through to me. It doesn’t matter who you are, how far down you’ve gone in your addiction, how weak or strong you think you are or how much damage you’ve done in your life. You don’t have to use, and it’s not about steps or a Higher Power or a sponsor. It’s about making a choice and living differently and taking responsibility for your own life and actions. What Frey taught me in this work is that it doesn’t matter how many “experts in their field” tell you you’re going to fail and why. If you take some control of your life, take responsibility for past actions and choices, and make an honest, concerted effort to do better, you can. People can tell you you’ll fail all day. It’s ultimately your choice. And I love this book for that message of personal strength and triumph alone. My advice: read this book now!