Stanton Peele

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Stanton Peele (born January 8, 1946) is a psychologist, attorney, psychotherapist and the author of books and articles on the subject of alcoholism, addiction and addiction treatment. [1]

Contents

Career

Raised in Philadelphia, Pennsylvania, [2] Peele received his B.A. in political science cum laude on municipal and state scholarships from the University of Pennsylvania in 1967. Supported by a number of fellowships (including the Woodrow Wilson Fellowship), he went on to earn a Ph.D. in social psychology from the University of Michigan in 1975. From 1976 to 2012, he maintained a private practice and consultancy while based in Morristown, New Jersey. [3]

After earning his J.D. from the Rutgers School of Law – Newark in 1997, Peele was admitted to the New York and New Jersey bars. He maintained a concurrent law practice (including two stints as a pool attorney in the Morris County Public Defender's Office that offered vital insights into the workings of the American criminal justice system) [4] until 2012. As a psychologist and addiction specialist, he has held visiting and adjunct academic positions at New York University (adjunct clinical professor; 2003–2007), Bournemouth University (visiting professor; 2003–2010) and The New School (adjunct professor; 2004–2010). [1] He currently resides in Brooklyn, New York. [5] [6]

Peele inaugurated the Life Process Program (LPP) as a residential treatment program in Iowa from 2008 to 2011; LPP went online at that point and has been an international coaching service into the present (see the “Life Process Model of Addiction” [7] ).

Peele is the author of fourteen books, including Love and Addiction (1975), The Meaning of Addiction (1985/1998), Diseasing of America (1989), The Truth about Addiction and Recovery (with Archie Brodsky and Mary Arnold, 1991), Resisting 12-Step Coercion (with Charles Bufe and Archie Brodsky, 2001), 7 Tools to Beat Addiction (2004), Addiction-Proof Your Child (2007), Recover! Stop Thinking Like an Addict (with Ilse Thompson, 2014), Outgrowing Addiction: With Common Sense Instead of "Disease" Therapy (with Zach Rhoads, 2019), and his memoir, A Scientific Life on the Edge: My Lonely Quest to Change How We See Addiction (2021), as well as 250 other professional publications.

Addiction

He began his critique of standard notions of addiction when he published Love and Addiction (coauthored with Archie Brodsky). [8] According to Peele's experiential/environmental approach, addictions are negative patterns of behavior that result from an over-attachment people form to experiences generated from a range of involvements. He contends that most people experience addiction to some degree at least for periods of time during their lives. He does not view addictions as medical problems but as "problems of life" that most people overcome. The failure to do so is the exception rather than the rule, he argues. [9] This view opposes the brain disease model of addiction.

In his books on non-addictive child rearing, Addiction-Proof Your Child (2007) and Outgrowing Addiction (with child development specialist Zach Rhoads, 2019), Peele argues that the best antidote for addiction is raising independent children who are competent and who have pro-social, health-oriented values. These same profiles, along with socially privileged backgrounds, account for which young people are able to overcome whatever addictive episodes they have.

In a number of papers, as well as his 1989 book, Diseasing of America: Addiction Treatment Out of Control, Peele has argued that treatment— including as ideally administered in Project MATCH— is an inadequate, even iatrogenic, cultural response to addiction. This is particularly true, he finds, for disease treatments, since they diminish people's sense of themselves and their ability to change.

When it was published in 1975, Love and Addiction pre-dated by almost a decade the notion of sex addiction and codependency popularized by authors such as Patrick Carnes, whose Out of the Shadows, one of the earliest popular books to describe sex addiction, came out in 1983, and Melody Beattie, whose Codependent No More was published in 1986. Love and Addiction pre-dated the current popular use of the terms "sex addiction" and "codependency" to describe disorders of love attachment, as these terms were not part of Peele and Brodsky's nomenclature. However, because Love and Addiction was concerned with observing the same condition of addictive human attachments, it has been argued that this is the first book to be written on the subject of codependent relationships. [10]

In reviewing the legacy of Love and Addiction, psychologist Dr. Alex Kwee wrote:

"That experiences can be addictive was a prescient notion in 1975 as psychology now embraces the concept of the process (or behavioral) addictions such as pathological gambling, compulsive eating, and sex addiction. But it must surely be to Peele's dismay that instead of rethinking substance addiction as a medical illness, psychology has gone and classified the behaviors as addictions in the same medical sense and yielded the solution into the hands of the 12-Steps." [11]

Views on alcoholism

Peele maintains that, depending on the person, abstinence or moderation are valid approaches to treat excessive drinking. In a Psychology Today article which compared the Life Process Program with the disease model, [12] he also argues against the theory proposed decades ago by modern physicians, mental health professionals, research scientists, etc. that addiction is a disease. [13] In Diseasing of America (1989) Peele contested Dr George Vaillant's pro-disease treatise The Natural History of Alcoholism .

Peele has been concerned with identifying cultural factors (those differentiating Temperance from non-Temperance societies) in support of positive alcohol experiences, as well as medical and psychological benefits due to positive drinking practices. Primarily, he has found, such drinking occurs where alcohol use is socialized in young people in family and community settings. He has also sought to generalize this paradigm to drug use.

Views on 12 step/disease treatment

In a co-authored book, Resisting 12 Step Coercion (2001), Peele outlined his case against court mandated attendance of twelve-step drug and alcohol treatment programs. He argued that these treatment programs are useless and sometimes harmful, he presented research on alternative treatment options, and accused some addiction providers of routine violation of standard medical ethics, an accusation that is likewise often leveled at Peele by disease proponents. [14]

In The Truth About Addiction and Recovery (1991) and 7 Tools to Beat Addiction (2004) Peele laid out what he believes to be the elements of alternative treatment. He developed these ideas as the Life Process Program, which was the basis for a non-12 Step residential treatment program and is now offered as an online treatment resource by Dr. Peele and colleagues. [15]

Peele attributes the intensifying drug crisis in the US to the continuing acceptance and spread of the disease model of addiction in both its 12-step and brain disease forms since, he feels, the disease model undercuts the sense of self-efficacy that characterizes positive, controlled substance use.

Criticism

In a review of The Meaning of Addiction, addiction researcher Dr Griffith Edwards stated the following about Peele's work:

"With these and other issues treated in cavalier fashion, with referencing highly incomplete and crucial work often ignored, one begins to feel that this is a book where polemic and scholarship have become inextricably and unhappily mixed. ... Peele is not only a psychologist of distinction, but someone who can make use of sociological and biological ideas. ... So there's the dilemma."

— Griffith Edwards, Review of The Meaning of Addiction. [16]

Recognition

Stanton Peele has done as much as anyone to reveal the inadequacies, absurdities, and injustices of the idea that addiction is a disease and, specifically, that it is a disease of the brain. In a constant flow of influential books, articles, and blogs over more than forty years, he has persuasively extended the critique of the disease theory of addiction beyond the scientific community to the general public. When the disease theory is eventually replaced by a more rational and humane approach in the popular understanding of addiction, Stanton Peele will be first in line to receive the plaudits, and those of us who broadly share his view will owe him a profound debt of gratitude.

—  Nick Heather, PhD, Emeritus Professor of Alcohol & Other Drug Studies, Northumbria University, UK; co-editor, Evaluating the Brain Disease Model of Addiction.

Funding

Lindesmith Center (now the Drug Policy Alliance): grant to write an adolescent drug guide (1996).

The Distilled Spirits Council of the United States (DISCUS), and the Wine Institute provided unrestricted grants. [19]

Related Research Articles

Twelve-step programs are international mutual aid programs supporting recovery from substance addictions, behavioral addictions and compulsions. Developed in the 1930s, the first twelve-step program, Alcoholics Anonymous (AA), founded by Bill Wilson and Bob Smith, aided its membership to overcome alcoholism. Since that time dozens of other organizations have been derived from AA's approach to address problems as varied as drug addiction, compulsive gambling, sex, and overeating. All twelve-step programs utilize a version of AA's suggested twelve steps first published in the 1939 book Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism.

Rational Recovery was a commercial vendor of material related to counseling, guidance, and direct instruction for addiction designed as a direct counterpoint to Alcoholics Anonymous (AA) and twelve-step programs.

Pornography addiction is the scientifically controversial application of an addiction model to the use of pornography. Pornography may be part of compulsive sexual behavior with negative consequences to one's physical, mental, social, or financial well-being. While the World Health Organization's ICD-11 (2022) has recognized compulsive sexual behaviour disorder (CSBD) as an "impulsive control disorder", CSBD is not an addiction, and the American Psychiatric Association's DSM-5 (2013) and the DSM-5-TR (2022) do not classify compulsive pornography consumption as a mental disorder or a behavioral addiction.

Drug rehabilitation is the process of medical or psychotherapeutic treatment for dependency on psychoactive substances such as alcohol, prescription drugs, and street drugs such as cannabis, cocaine, heroin or amphetamines. The general intent is to enable the patient to confront substance dependence, if present, and stop substance misuse to avoid the psychological, legal, financial, social, and physical consequences that can be caused.

The life-process model of addiction is the view that addiction is not a disease but rather a habitual response and a source of gratification and security that can be understood only in the context of social relationships and experiences. This model of addiction is in opposition to the disease model of addiction. It was originated and advocated by Stanton Peele in his book The Truth About Addiction and Recovery.

<span class="mw-page-title-main">Alcohol dependence</span> Medical condition

Alcohol dependence is a previous psychiatric diagnosis in which an individual is physically or psychologically dependent upon alcohol.

<span class="mw-page-title-main">Problem gambling</span> Repetitive gambling despite demonstrable harm and adverse consequences

Problem gambling or ludomania is repetitive gambling behavior despite harm and negative consequences. Problem gambling may be diagnosed as a mental disorder according to DSM-5 if certain diagnostic criteria are met. Pathological gambling is a common disorder associated with social and family costs.

An intervention is an orchestrated attempt by one or many people – usually family and friends – to get someone to seek professional help with a substance use disorder or some kind of traumatic event or crisis, or other serious problem. Intervention can also refer to the act of using a similar technique within a therapy session.

Substance dependence, also known as drug dependence, is a biopsychological situation whereby an individual's functionality is dependent on the necessitated re-consumption of a psychoactive substance because of an adaptive state that has developed within the individual from psychoactive substance consumption that results in the experience of withdrawal and that necessitates the re-consumption of the drug. A drug addiction, a distinct concept from substance dependence, is defined as compulsive, out-of-control drug use, despite negative consequences. An addictive drug is a drug which is both rewarding and reinforcing. ΔFosB, a gene transcription factor, is now known to be a critical component and common factor in the development of virtually all forms of behavioral and drug addictions, but not dependence.

The modern disease theory of alcoholism states that problem drinking is sometimes caused by a disease of the brain, characterized by altered brain structure and function.

An addictive behavior is a behavior, or a stimulus related to a behavior, that is both rewarding and reinforcing, and is associated with the development of an addiction. There are two main forms of addiction: substance use disorders and behavioral addiction. The parallels and distinctions between behavioral addictions and other compulsive behavior disorders like bulimia nervosa and obsessive-compulsive disorder (OCD) are still being researched by behavioral scientists.

Drug addiction recovery groups are voluntary associations of people who share a common desire to overcome their drug addiction. Different groups use different methods, ranging from completely secular to explicitly spiritual. Some programs may advocate a reduction in the use of drugs rather than outright abstention. One survey of members who found active involvement in any addiction recovery group correlates with higher chances of maintaining sobriety. Although there is not a difference in whether group or individual therapy is better for the patient, studies show that any therapy increases positive outcomes for patients with substance use disorder. The survey found group participation increased when the individual members' beliefs matched those of their primary support group. Analysis of the survey results found a significant positive correlation between the religiosity of members and their participation in twelve-step programs and to a lesser level in non-religious SMART Recovery groups, the correlation factor being three times smaller for SMART Recovery than for the twelve-step addiction recovery groups. Religiosity was inversely related to participation in Secular Organizations for Sobriety.

<span class="mw-page-title-main">Maressa Orzack</span> American psychologist

Dr. Maressa Hecht Orzack was an American psychologist who was clinical associate in psychology at McLean Hospital; Coordinator of Behavior Therapy Affective Disease Program, also at McLean Hospital and assistant clinical professor of psychology, Department of Psychiatry at Harvard Medical School. She also held private practice at Newton Centre.

<span class="mw-page-title-main">Gabor Maté</span> Hungarian-Canadian physician (born 1944)

Gabor Maté is a Hungarian-Canadian physician and author. He has a background in family practice and a special interest in childhood development, trauma and potential lifelong impacts on physical and mental health including autoimmune disease, cancer, attention deficit hyperactivity disorder (ADHD), addictions and a wide range of other conditions.

<span class="mw-page-title-main">Love addiction</span>

Love addiction is a proposed model of pathological passion-related behavior involving the feeling of falling and being in love. A medical review of related behaviors in animals and humans concluded that current medical evidence does not have definitions or criteria on an addiction model for love addiction, but there are reported similarities to substance dependence, such as euphoria and desire in the stimuli, as well as anhedonia and negative levels of mood when away from the stimuli, intrusive thoughts on it, and disregard for adverse consequences. There has never been a reference to love addiction in the Diagnostic and Statistical Manual of Mental Disorders (DSM), a compendium of mental disorders and diagnostic criteria published by the American Psychiatric Association.

<span class="mw-page-title-main">Substance use disorder</span> Continual use of drugs (including alcohol) despite detrimental consequences

Substance use disorder (SUD) is the persistent use of drugs despite substantial harm and adverse consequences as a result of their use. The National Institute of Mental Health (NIMH) states that “Substance use disorder (SUD) is a treatable mental disorder that affects a person's brain and behavior, leading to their inability to control their use of substances like legal or illegal drugs, alcohol, or medications. Symptoms can be moderate to severe, with addiction being the most severe form of SUD”. Substance use disorders (SUD) are considered to be a serious mental illness that fluctuates with the age that symptoms first start appearing in an individual, the time during which it exists and the type of substance that is used. It is not uncommon for those who have SUD to also have other mental health disorders. Substance use disorders are characterized by an array of mental/emotional, physical, and behavioral problems such as chronic guilt; an inability to reduce or stop consuming the substance(s) despite repeated attempts; operating vehicles while intoxicated; and physiological withdrawal symptoms. Drug classes that are commonly involved in SUD include: alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, hypnotics or anxiolytics, stimulants, tobacco

<span class="mw-page-title-main">Addiction</span> Disorder resulting in compulsive behaviours

Addiction is a neuropsychological disorder characterized by a persistent and intense urge to use a drug or engage in a behaviour that produces natural reward, despite substantial harm and other negative consequences. Repetitive drug use often alters brain function in ways that perpetuate craving, and weakens self-control. This phenomenon – drugs reshaping brain function – has led to an understanding of addiction as a brain disorder with a complex variety of psychosocial as well as neurobiological factors that are implicated in addiction's development. Classic signs of addiction include compulsive engagement in rewarding stimuli, preoccupation with substances or behavior, and continued use despite negative consequences. Habits and patterns associated with addiction are typically characterized by immediate gratification, coupled with delayed deleterious effects.

Exercise addiction is a state characterized by a compulsive engagement in any form of physical exercise, despite negative consequences. While regular exercise is generally a healthy activity, exercise addiction generally involves performing excessive amounts of exercise to the detriment of physical health, spending too much time exercising to the detriment of personal and professional life, and exercising regardless of physical injury. It may also involve a state of dependence upon regular exercise which involves the occurrence of severe withdrawal symptoms when the individual is unable to exercise. Differentiating between addictive and healthy exercise behaviors is difficult but there are key factors in determining which category a person may fall into. Exercise addiction shows a high comorbidity with eating disorders.

About 1 in 7 Americans suffer from active addiction to a particular substance. Addiction can cause physical, psychological, and emotional harm to those who are affected by it. The American Society of Addiction Medicine defines addiction as "a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual's life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences." In the world of psychology and medicine, there are two models that are commonly used in understanding the psychology behind addiction itself. One model is referred to as the disease model of addiction. The disease model suggests that addiction is a diagnosable disease similar to cancer or diabetes. This model attributes addiction to a chemical imbalance in an individual's brain that could be caused by genetics or environmental factors. The second model is the choice model of addiction, which holds that addiction is a result of voluntary actions rather than some dysfunction of the brain. Through this model, addiction is viewed as a choice and is studied through components of the brain such as reward, stress, and memory. Substance addictions relate to drugs, alcohol, and smoking. Process addictions relate to non-substance-related behaviors such as gambling, spending money, sexual activity, gaming, spending time on the internet, and eating.

Nancy M. Petry was a psychologist known for her research on behavioral treatments for addictive disorders, behavioral pharmacology, impulsivity and compulsive gambling. She was Professor of Medicine at the University of Connecticut Health Center. Petry served as a member of the American Psychiatric Association Workgroup on Substance Use Disorders for the DSM-5 and chaired the Subcommittee on Non-Substance Behavioral Addictions. The latter category includes Internet addiction disorder and problem gambling. She also served as a member of the Board of Advisors of Children and Screens: Institute of Digital Media and Child Development.

References

  1. 1 2 3 "Curriculum Vitae Stanton Peele". www.peele.net.
  2. ↑ "My Fabulous Sports Career on the Mean Streets of Philadelphia". Psychology Today.
  3. ↑ "Love Can Be An Addiction". www.peele.net.
  4. ↑ "A DRUG-USERS' ADVOCATE" – via www.washingtonpost.com.
  5. ↑ Glaser, Gabrielle (July 3, 2014). "A Different Path to Fighting Addiction (Published 2014)". The New York Times.
  6. ↑ " @speele5 " on Twitter
  7. ↑ "Life-process model of addiction", Wikipedia, 2022-03-07, retrieved 2022-05-01
  8. ↑ "Love and Addiction". www.peele.net.
  9. ↑ "About Stanton Peele". www.peele.net.
  10. ↑ Kwee, Alex (2007). "Constructing addiction from experience and context: Peele and Brodsky's Love and Addiction revisited" (PDF). Sexual Addiction & Compulsivity: The Journal of Treatment and Prevention. 14 (3): 221–237. doi:10.1080/10720160701480535. S2CID   144242381 . Retrieved January 11, 2015.
  11. ↑ Kwee, Alex (2007). "Constructing addiction from experience and context: Peele and Brodsky's Love and Addiction revisited" (PDF). Sexual Addiction & Compulsivity: The Journal of Treatment and Prevention. 14 (3): 221–237. doi:10.1080/10720160701480535. S2CID   144242381 . Retrieved January 11, 2015.
  12. ↑ "Recovering from an All-or-Nothing Approach to Alcohol". www.peele.net.
  13. ↑ "Hungry for The Next Fix: Behind the relentless, misguided search for a medical cure for addiction". www.peele.net.
  14. ↑ Peele, Stanton "Resisting 12 Step Coercion" Book Online : https://web.archive.org/web/20170407233750/http://www.morerevealed.com/library/resist/
  15. ↑ "Online Program for Addiction Recovery | AA Alternative".
  16. ↑ Griffith Edwards. The Meaning of Addiction (book review). British Journal of Addiction, Dec85, Vol. 80 Issue 4, p447-448.
  17. ↑ "Rutgers Center of Alcohol Studies". www.peele.net.
  18. ↑ "Alfred R. Lindesmith Award for Achievement in Scholarship, Drug Policy Foundation". www.peele.net.
  19. ↑ "Exploring Psychological Benefits Associated with Moderate Alcohol Use: A Necessary Corrective to Assessments of Drinking Outcomes?". www.peele.net.
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