Abstract
In Addiction and the Captive Will: A Colloquy between Neuroscience and Augustine of Hippo, Rev. Cynthia Geppert, M.D., Ph.D., provides a rigorous and comprehensive medical and theological analysis of addiction. Drawing upon her extensive clinical expertise and employing a thorough theological method, Geppert compellingly argues that through the lens of theological anthropology, modern discussions on the nature of addiction parallel Augustine’s conception of the captive will. To build her case effectively, the book is organized into three parts, with each section advancing her argument in a specific and constructive way.
The first section of the book is largely summative as it offers a comprehensive engagement with the field of addiction medicine as well as outlining competing philosophies and models of addiction. The book’s three-part structure begins with an introductory chapter that outlines the methodology and establishes the framework for the discussion. Chapter 2 provides a comprehensive overview of the current state of the field, distinguishing between models and theories to set the stage for subsequent analysis. Chapters 3, 4, and 5 delve into three prominent perspectives on addiction: the moral model, the disease model, and the brain disease model of addiction (BDMA), respectively. Chapter 6 complements chapter 5 by addressing the criticisms and pushback against the BDMA, presenting a balanced and nuanced examination of this perspective. Together, Chapters 5 and 6 form a crucial pairing that underscores the book’s core theological contributions to dialogue on addiction.
Section two of the book moves beyond the clinical and engages directly with exegeting Confessions phenomenologically. Chapter 7 examines Books 1 through 4 of Confessions, defining three types of knowledge—empirical, psychological, and theological. Geppert traces Augustine’s empirical observations of childhood as precursors to adult conduct, identifying parallels with modern understandings of addiction. Chapter 8, which engages with Books 5, 6, and 7, follows Augustine’s intellectual conversion, highlighting his evolving understanding and its implications for internal transformation in the context of addiction. Chapter 9 explores Books 8 and 9, discussing Augustine’s concept of the divided will and its relation to addictive behavior, as well as the process through which the will is redirected toward moral uprightness. Finally, chapter 10 analyzes Books 10 through 13, focusing on Augustine’s conversion of memory. Geppert draws a compelling connection between Augustine’s insights and modern addiction frameworks, particularly the BDMA and learning models of addiction, to demonstrate the transformative potential of the will.
The final section of the book is highly synthetic, combining the substantial amount of material outlined in section one and Geppert’s engagement with Confessions from section two, culminating in an insightful dialogue, all in a theological register. The third part of the book extends the discussion by integrating philosophical and theological insights into the modern discourse on addiction. Chapter 11 evaluates Aristotle’s concepts of akrasia and habit, examining their relevance to Augustine’s notions of habit, the captive will, and the interplay between freedom for and freedom from behaviors. Chapter 12 engages with existing theological accounts of addiction, situating Augustine’s thought within the broader landscape of theological discourse on the subject. Chapter 13 focuses on the transformative role of grace in addiction, offering a nuanced analysis of how grace operates within each prevailing model of addiction. The section concludes with chapter 14, a summative colloquy between Augustine’s thought and contemporary addiction studies. Here, Geppert provides conclusive insights and ventures provocative conjectures about how Augustine might contribute to modern conversations on addiction.
Even as the argument of the book is undergirded by the thoroughness of material and engagement, as exemplified in the outline provided above, there are points in Geppert’s work that could benefit from a sharpening or expansion of the argument itself.
First, Geppert makes significant efforts to be precise in qualifying Augustine as a person with addiction. At times, she is decisive in characterizing Augustine’s actions or behaviors as indicative of addiction, while at other moments, she articulates Augustine’s experiences as having strong resonance with addictive actions or behaviors. While this particularity underscores the strength of Geppert’s work—eschewing broad categorizations and overgeneralizations—it may leave readers, particularly those external to clinical addiction work, wondering why Augustine’s behaviors and actions receive differing qualifications at various points. Greater clarity could be achieved by explaining why certain elements are described as resonances without being fully classified as addictive behaviors or actions.
The second element where the book could be improved is closely related to the first critique. Because Geppert differentiates between behaviors and actions that are defined by addiction and those that resonate with addiction, an exploration—whether clinical, theological, or theoretical—could have been offered to examine the space between actions and behaviors that resonate with addiction and those that occur because of addiction. Augustine frequently speaks of longing, both in his own experiences and in those of others mentioned throughout the book. What distinguishes an experience because of addiction from one that merely resonates with the experience of addiction?
Finally, Geppert is dismissive of 12-step programs, particularly those within an ecclesial context. In less than a page she gives little substantive consideration to these programs as necessary elements of addiction treatment. However, based on Geppert’s exegesis of Augustine’s conversion and his personal engagement with addictive behaviors, Augustine appears to offer an early paradigm of the 12-step program. He undergoes an intellectual transformation but ultimately realizes that this alone is insufficient. Only through the spiritual transformation of encountering life with God does Augustine become fully reoriented from addiction. While not fully analogous, Augustine’s journey reflects the general structure of many 12-step programs offered in churches (e.g., see Owen Flanagan, ‘Phenomenal Authority: The Epistemic Authority of Alcoholics Anonymous’, in Addiction and Self-Control: Perspectives from Philosophy, Psychology, and Neuroscience, ed. Neil Levy, Oxford University Press, 2013). A more critical engagement with how Augustine’s approach substantively differs from such programs would strengthen Geppert’s overall argument.
Though the three aforementioned points would enhance the overall argument of the book, they should not be taken as an indication of a lack of quality or persuasiveness. Geppert has written a foundational theological work that will endure as a cornerstone text at the intersection of theology, medicine, and addiction. The following three qualities highlight the book’s strengths. First, Geppert is exceptionally thorough in engaging with prior theological material on addiction. By directly addressing the works of Linda Mercadante, Christopher Cook, and Kent Dunnington, she provides the most comprehensive analysis of where the field of theology currently stands in relation to addiction. Furthermore, her careful use of resources lends the book an authoritative tone in both the fields of addiction studies and theology. Second, and related to the first point, this book significantly advances theological inquiry into addiction. Few works push a topic as far as Geppert does here. Finally, Geppert’s ability to write a book that is accessible to clinicians, academics, and pastors alike is remarkable. The book is highly accessible and written for all three audiences in a way that few authors manage to achieve.
Conclusively, Cynthia Geppert writes from her expertise as a theologian, pastor, and physician, resulting in her book, Addiction and the Captive Will: A Colloquy between Neuroscience and Augustine of Hippo, persuasively articulating Augustine’s Confessions as a productive dialogue partner for modern conceptions of addiction. In doing so, she not only successfully brings theology and science into conversation but does so in a way that allows both fields to substantively benefit from the perspectives of the other. While such an argument might initially seem esoteric, the opposite is true; Geppert presents her case in an accessible manner, enabling both scholars and practitioners to benefit from her work.