The Captive Imagination by Elias Dakwar review

A psychiatrist’s fascinating quest to understand drugs and addiction – and to describe the indescribable

When reading a book, I like to understand something about the person who wrote it. The Captive Imagination is rich in words yet strangely elusive in overall meaning, and feels as though it has been written by several different people, at times interrupting each other. So who are these characters? Elias Dakwar is a professor and scientist in the US, but he is also a clinician specialising in the treatment of addiction, a philosopher, a lover of literature and language, as well as a human being striving to understand life’s great mysteries. There is a sense of yearning throughout the book, as if it is a quest to find something; Dakwar invokes the fictional strivings of Don Quixote and compares them with the obvious desperation of the heroin addict. But he also notes that his patients often say: “I just want to be happy”, and perhaps this is what he, too, is saying.

As a psychiatrist with the same specialism, I was drawn to Dakwar’s vivid stories of patients and their different histories of drug use. They are clear, informative and also modest; Dakwar acknowledges the difficulties we have in helping people, given our limited understanding of both addiction and the human mind. He writes lucidly of brain-based models of addiction, while making it clear that they cannot fully explain people’s experiences. I must admit to envying the time he was able to spend with individual patients, working in a very different system from the one we have here in the UK.