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Craving for Ecstasy and Natural Highs

Craving for Ecstasy and Natural Highs
A Positive Approach to Mood Alteration

First Edition

June 2009 | 496 pages | SAGE Publications, Inc

"This book is extremely useful for a broad range of readers. This book reflects the extensive scientific and clinical expertise of the authors and is compelling reading for anyone interested in addictive behaviors. It is one of the rare books that from page one immediately engrosses, educates and broadens your perspective."
Alex Blaszczynski, The University of Sydney, International Journal of Mental Health Addiction

"Psychologist Harvey Milkman and chemist Stanley Sunderwirth explore why our relentless search for pleasure sometimes leads to dangerous addictions and show us healthy ways to achieve happiness."

"Harvey B. Milkman and Stanley Sunderwirth have written a tour de force. Craving for Ecstasy and Natural Highs: A Positive Approach to Mood Alteration . . . is a beautifully written and organized book . . . a thrill ride through the most innovative and insightful perspectives that science and clinical experience have to offer . . . hip and artistic, reflecting a deep understanding of addiction . . . a major contribution to the field; it is must reading." 
—Howard J. Shaffer, PhD, CAS Editor, Psychology of Addictive Behaviors, Associate Professor, Harvard Medical School Director, Division on Addictions, Cambridge Health Alliance

"Reading this book is in itself and ecstatic experience! . . . a fascinating journey that explores the benefits and risks of pleasure and the universal desire to feel good . . . It's quite a trip."             
—G. Alan Marlatt, PhD, University of Washington

People from all walks of life often lose themselves in pursuing counterfeit pleasures—cigarettes, alcohol, drugs, thrill seeking, sex, food, gambling, and on-line fantasies to name just a few. How does the pursuit of pleasure result in compulsion and loss of control? Craving for Ecstasy and Natural Highs addresses this fundamental question and then explores positive ways to achieve lasting happiness and fulfillment. Readers will gain important insight on how to improve their own quality of life and will learn how to offer support to clients, students, family, and friends whose lives may be compromised by addiction.

Students of addictive behaviors and anyone interested in discovering healthy means to satisfy the drive to alter consciousness will find this book compelling. 

View Harvey Milkman's appearance on local Denver TV where he talks about addiction and his book at

Be sure to follow Harvey Milkman's blog on Psychology Today at

Reviews of previous work:

"The chemistry and psychology of addiction are described with considerable insight. . . . These authors know their stuff and make a compelling case." 
—The Los Angeles Times

"The authors provide a valuable service by placing into perspective a large array of behaviors that could be considered addictive." 

SAGE offers treatment and training programs for mental health providers that you can easily incorporate into your existing programs. Visit to learn more about these treatment and training programs.

Addiction Syndrome Disorders

Extent of the Problem

Positive Psychology and Natural Highs

Ch 1. Addiction to Experience
The Broad Scope of Addiction

Behavioral Addictions

The Addictive Personality

Who Is Most at Risk?

Acquisition and Maintenance of Reward-Dependent Behavior

Drugs and Activities of Choice

Beacons of Compulsion

Behavioral Excess and the Brain

Mismanaging the Brain

Society and the Deviant Career

Chapter Summary

Ch 2. Pleasure and the Brain
Neurochemistry 101

The Joy of Dopamine and the Reward Cascade

Genes and Drug Abuse - Choose Your Parents Carefully

Drugs to Fight Drugs

Chapter Summary

Overview: Seeking Safety and Comfort

The Chemistry of Calm

Ch 3. Hey, What's in This Stuff, Anyway?

Inheriting Alcoholism

The Addictive Quality of Alcohol

Neurotransmitter Regulation and Dysfunction

Harmful Effects on the Mind, Body, and Brain

Sobriety and the Brain: What if I Quit?

Coping With Cravings and Urges

Redeeming Alcohol: The Benefits of Booze

Hold the Press, What About Cancer?

To Quit or Not to Quit?

Chapter Summary

Ch 4. The Great Psychiatric Tavern
Who Shows Up and What Do They Do?

Surrogate Family Atmosphere

The "Regulars"

Chapter Summary

Ch 5. Self-Medication

Nicotine: The World's Antidepressant

Alcohol and Drug Abuse Among Women

Posttraumatic Stress Disorder and Self-Medication

Patients in the Street

Prescription Drug Abuse

Inhalants: How Stupid Can You Get?

Chapter Summary

Ch 6. Eating for a Change

Anorexia, Bulimia, and Binge Eating

Eating and the Brain

Why Chocolate?

Obesity Around the Globe

Obesity in America

Overeating and Psychoanalysis

Biology Versus Psychology

Chapter Summary

Overview: What a Rush!

Ch 7. Stress Hormone Highs

Wake Me Up! Caffeine Buzz

Stress Intoxication

Addiction: The Curse of Ecstasy

The Up and Down Game

Problem and Pathological Gambling

Shop 'Till You Drop

Autoerotic Fatalities

Am I a Speed Demon?

Chapter Summary

Ch 8. Rock Around the Clock: Methamphetamine, Cocaine, and the Club Scene

Methamphetamine - A Dopamine Blast

Methamphetamine and the Brain

Cocaine: Gift of the Gods

Cocaine and the Brain

Compulsion to Use

The Club Scene

Club Drugs

Chapter Summary

Overview: Imagination - The Quintessential Human Trait

Electronic Media Everywhere

The Child's Use of Fantasy

Religion and Myth

Science and Religion

Personal Fantasy

Overview Summary

Ch 9. Virtual Reality and Electronic Bogeymen
Introduction: The Evolution of Electronic Media

Massively Multiplayer Online Role-Playing Games

Online Game Addiction

Is the Internet Good or Bad?

Chapter Summary

Ch 10. Fantasy and the Drug Experience
Introduction: The "Trip" Begins

Hallucinogens and the Brain


Dissociative Drugs

Can Hallucinogens Heal?

Chapter Summary

Ch 11. Compelled by Fantasy

Shared Delusions

Facilitator-Assisted Fantasy

Schizophrenic Fantasy

The Terrorist Mind-Set

Armageddon: The Ultimate Fantasy

Terror Management

Chapter Summary

Overview: The importance of Human Connections

Ch 12. Love or Addiction
Infatuation and the Legend of St. Valentine

Neurochemistry of Romance

Love and Death

MDMA: Synthetic Love

Should I Try Ecstasy?

Chapter Summary

Ch 13. Marijuana--Reefer Madness Revisited
'Benefits' of Pot: Why Do So Many People Smoke?

Effects on the Brain


Effects on Cognition

Serious Mental Disorder

Marijuana and the Endocrine System

Marijuana and the Immune System

Long-Term Effects on Health

Medical Marijuana

Chapter Summary

Ch 14. Romantic Sex Fantasy
Who Attends and Why

'Intimacy' at the Gentlemen's Club

The Allure of Prostitution

Chapter Summary

Ch 15. The Voyage of Hardship and Suffering
Introduction: The Disease Concept of Addiction

Addiction and the Adolescent Brain

The Downward Spiral of Addiction

Capsules for Transport: Licit and Illicit Drugs

Behavioral Addictions

The Passenger Sleeps

Symbols of Change

The Robot Pilot

The Mutiny

A Guard Must be Posted

Improving the Odds

Chapter Summary

Overview: The Era of Self-Regulation and Natural Highs

Ch 16. The Cognitive-Behavioral Revolution: How to Manage Thoughts, Feelings, and Behaviors
Introduction: Evolution of the Cognitive-Behavioral Model

Contemporary Cognitive Therapy

Behaviorist Contributions

Combining Cognitive and Behavioral Theories

Working With Automatic Thoughts and Core Beliefs

The Trans-Ideological Power of Cognitive-Behavioral Restructuring

Cognitive-Behavioral Restructuring in Everyday Life

Chaper Summary

Ch 17. Maintaining Close and Intimate Relationships
Introduction: The Three Faces of Love

The Universal Need for Love

Secure Attachment: A Prototype for Successful Relationships

Healthy Love

Intimacy and Sexuality

Intimacy Versus Individuality

Optimizing Relationships

Chapter Summary

Ch 18. Relaxation, Mindfulness, and Meditation
Introduction: Meditation Comes of Age


Process Meditation

Does Meditation Work?

Meditation and Hedonic Dependencies

A Word of Caution

Science-Based Relaxation Techniques

Managing Stress in the Here and Now

Chapter Summary

Ch 19: Eating Yourself Fit
Introduction: Does Dieting Work?

The Natural Highs Alternative: Think Thin, Moderate, Workout!

Developing the Right State of Mind

Partial Fasting

What Is a Healthy Diet?

The Bottom Line

Chapter Summary

Ch 20. Exercise: The Magic Bullet

Exercise of Choice

The Chemistry of Working Out

Exercise for Body Trimming

Training for Physical Health

Running Away From Depression

Healthy Body, Healthy Mind

Runner's High: Fact or Fiction?

Make Life a Moving Experience

Chapter Summary

Ch 21. Meaningful Engagement of Talents
Introduction: Capitalizing on Abilities and Strengths

Integrating Models for Self-Discovery and Change

Self-Discovery in Everyday Life

The Personal Pleasure Inventory

Chaper Summary

Appendix I: The Personal Pleasure Inventory
Appendix II: Classroom Discussion Guides

"This book is extremely useful for a broad range of readers. This book reflects the extensive scientific and clinical expertise of the authors and is compelling reading for anyone interested in addictive behaviors. It is one of the rare books that from page one immediately engrosses, educates and broadens your perspective."

Alex Blaszczynski
The University of Sydney

Will place order to keep multiple copies in our university library.

Dr Timothy Ritchie
Department of Psychology, University of Limerick
July 20, 2012

book content was excellent, however, format did not align with the objectives and structure of this course

Dr John Finneran
Professional Studies Division, Keene State College
March 11, 2012

An interesting broad-spectrum book covering how we all crave pleasure and the ways we go about achieving this. Will broaden the student experience and challenge pre-conceptions.

Mrs Rachel Harrison
Interprofessional Studies, Winchester University
October 27, 2010

This book is a very good fit for the broad spectrum of addiction studies. It is both comprehensive and comprehensible.

Professor Marc Henley
Public Svc Soc Sci Dept, Delaware County Community College
December 11, 2009
Key features
  • Addiction as a syndrome
  • Interdisciplinary approach
  • Examination of four broad factors of hedonic dependencies: arousal, relaxation, fantasy and intimacy
  • Classroom discussions guides
  • Chapter Summaries
  • Artistic illustrations

For instructors

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