I really enjoyed this interview and am looking forward to checking out the book. Steines has one of those stories that makes you question the utility of the word "addiction." I'm not a psychiatrist, but a lot of what she describes sounds closer to what I understand to be Obsessive-Compulsive Disorder. Thus I was really struck by your use of the term "Orthorexia." When I google that, it's all about food, but it sounded like you were using it in a more general sense, which seems more akin to OCD (again, from a total layman's understanding of that disorder). Though very interesting that for Steines the community aspects of 12-step were still so valuable. It made me wonder if community-based programs like AA also work for people with OCD.
Such a thoughtful comment, thanks Isaac. Yes I tend to think of orthorexia a bit more casually and metaphorically, "right behavior" or "right appetite," though I know some people are trying to propose it as a formal diagnosis. Interestingly there are other psychiatrists who view OCD as a kind of addictive disorder in that it involves impulsivity, reward learning changes, and impaired control. (Even tourette's has a volitional component, which Oliver Sacks wrote about beautifully.) My own perspective is we probably err on the side of viewing these types of problems is distinct essences, whereas when we look at the underlying processes the distinctions are not so acute.
I really enjoyed this interview and am looking forward to checking out the book. Steines has one of those stories that makes you question the utility of the word "addiction." I'm not a psychiatrist, but a lot of what she describes sounds closer to what I understand to be Obsessive-Compulsive Disorder. Thus I was really struck by your use of the term "Orthorexia." When I google that, it's all about food, but it sounded like you were using it in a more general sense, which seems more akin to OCD (again, from a total layman's understanding of that disorder). Though very interesting that for Steines the community aspects of 12-step were still so valuable. It made me wonder if community-based programs like AA also work for people with OCD.
Interesting stuff. Thank you.
Such a thoughtful comment, thanks Isaac. Yes I tend to think of orthorexia a bit more casually and metaphorically, "right behavior" or "right appetite," though I know some people are trying to propose it as a formal diagnosis. Interestingly there are other psychiatrists who view OCD as a kind of addictive disorder in that it involves impulsivity, reward learning changes, and impaired control. (Even tourette's has a volitional component, which Oliver Sacks wrote about beautifully.) My own perspective is we probably err on the side of viewing these types of problems is distinct essences, whereas when we look at the underlying processes the distinctions are not so acute.