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Lance Dodes has distinguished himself as one of the few recent contemporary psychoanalysts to apply his analytic and psychiatric training to exploring and explaining in depth what makes addictive behavior so compelling. His contributions have until now been valuable and well received. Particularly so has been his theory that addiction is at root motivated by feelings of helplessness and powerlessness, and that the repetitious features of addictive behavior are displaced attempts to deal with the rage such feelings engender; his conclusion is that addictions have all the characteristics of compulsive disorders and thus lend themselves to psychodynamic examination and treatment (Dodes 1996).
Given his valuable contributions to addiction studies, then, it is unfortunate that The Sober Truth, which Dodes has written with his son Zachary, a freelance writer, is so polemical in attacking Alcoholics Anonymous that it risks polarizing clinical psychodynamic approaches and twelve-step programs. Their arguments against twelve-step groups seem in fact a gift to hopeful debunkers of psychodynamic psychiatry, who would use the same tactics to discredit our work. Indeed, the Dodeses are so polemical that they are likely to alienate a group of potentially enthusiastic patients, students, and clinicians who might otherwise enrich our understanding and treatment of addiction.
The book has already drawn serious criticism from the community of addiction treatment providers. John F. Kelly and Gene Beresin, colleagues of Dodes at Harvard Medical School, for example, write the following on the website of Boston's National Public Radio station: “Dr. Dodes’ book and comments are so far off the track of scientific research that he doesn't realize that for the past several years, the addiction research field has moved beyond asking whether AA and 12-step treatment works, to investigating how and why they work.” Richard A. Friedman, Professor of Clinical Psychiatry and Director of the Psychopha