This excellent book gives the reader an authoritative update on current psychological thinking in the addictions. The central theme is that the dominant views of addictive behaviour, of which social learning theory is a prime example, fail to take account of automatic cognitions and, therefore, fail to account adequately for relapse situations. The problem with existing theories is that they make the assumption that humans are rational decision-makers; readers will know that this is often not the case. Moreover, it is in the nature of dependence on psychoactive drugs that rational decisions are overruled by the desire for instant gratification.

The essential proposition running throughout the book is that psychological theories of addiction need to take account of automatic cognitive processes, that is processes that are both uncontrollable and mainly unconscious. In one chapter this is nicely described in computing language as ‘drug related stimuli grabbing cognitive processing’. Evidence is presented for substance users having an attentional bias towards substance using situations, which in turn selectively brings to the fore related memories, reinforcing the addictive behaviour.

There are ten chapters. The first describes current psychological theories of addiction. The second and third chapters describe the evidence for automatic cognitive processes, notably attentional biases and automatic memories. Chapters four and five are on the more familiar clinical territory of motivational interviewing and understanding ‘loss of control’ from the perspective of automatic processes. Chapters six to eight cover special interest topics, namely genetics, opiate-specific cognitions and neurochemical processes. The final chapters bring together the implications for the psychological research described into clinical practice.

If there is a weakness, it is that the clinician will be left uncertain of the implications for day-to-day practice. The authors of the final chapters make a good attempt at answering this but, in truth, the point of the book is as much about laying down a challenge for practitioners as providing answers. The book deserves reading from cover to cover – stimulating, informative and well written.