ABSTRACT This paper uses abduction to propose a theory of addictive desire that is based on a dual dysfunction in learning and motivation. The theory is termed the Coherent Dual Theory of Addictive Desire (CDT) because it proposes that a dual dysfunction lies at the heart of addictive desire. This paper first lays out CDT in psychological terms. It then focuses on how CDT coheres with both the neurobiology and phenomenology of addictive (...) class='Hi'>desire, granting the theory empirical support and more explanatory power. The paper concludes by addressing an objection from opponent process theory. The result is a theory of addictive desire that contains multiple abductive virtues: It is simple, general, testable, and coherent on the levels of neurobiology, psychology, and phenomenology. (shrink)

The author comments on the article “The neurobiology of addiction: Implications for voluntary control of behavior,‘ by S. E. Hyman. Hyman presents that addiction is a brain disease or a moral condition. The authors present that addiction is a strong preference, similar to appetitive preferences. They state that addiction is merely a form of pleasure-seeking. The authors conclude that the problem of addiction is the problem of the management of pleasure, not treatment of a disease. Accession Number: 24077914; Authors: Foddy, (...) Bennett 1; Email Address: [email protected] Savulescu, Julian 2; Affiliations: 1: University of Melbourne, Monash University, Australia; 2: University of Oxford; Subject: EDITORIALS; Subject: ADDICTIONS; Subject: HYMAN, S. E.; Subject: BRAIN -- Diseases; Subject: PLEASURE; Subject: NEUROBIOLOGY; Subject: BEHAVIOR; Number of Pages: 4p. (shrink)

This paper argues that the crucial feature of the drug-related desires experienced by addicted agents is not that they ‘push’ the agent with a force she cannot oppose, but that they are not easily undermined by things that normally have the ability to undermine desires —in other words, that they are extraordinarily recalcitrant. As a result, the disposition to experience these desires is very persistent over the long-term, manifesting itself in particular episodes of wanting to use drugs that recur with (...) great frequency. Both the persistence and the recurrence of these desires, it is argued, contribute to a diminished ability to respond to relevant reasons that speak against drug use. (shrink)

In this paper I set out to investigate the claim that addicts lack su cient control over their drug-taking and are thus not morally responsible for it. More speci cally, I evaluate what I call the Simply Irresistible Argument, which proceeds from the claim that addictive desires are irresistible to the conclusion that addicts are not responsible for acting on such desires. I rst propose that we have to disambiguate the notion of an irresistible desire according to temporal (...) criteria, and revise the original argument accordingly in two di erent ways; one involving proximally irresistible desires and one involving permanently irresistible desires. I propose that both versions of the Simply Irresistible Argument fail, and, as a result, that considerations about irresistible desires and control cannot extricate addicts from responsibility for their drug-taking. (shrink)

In this paper, we contend that the psychology of addiction is similar to the psychology of ordinary, non-addictive temptation in important respects, and explore the ways in which these parallels can illuminate both addiction and ordinary action. The incentive salience account of addiction proposed by Robinson and Berridge (1993; 2001; 2008) entails that addictive desires are not in their nature different from many of the desires had by non-addicts; what is different is rather the way that addictive (...) desires are acquired, which in turn affects their strength. We examine these “incentive salience” desires, both in addicts and non-addicts, contrasting them with more cognitive desires. On this account, the self-control challenge faced by addicted agents is not different in kind from that faced by non-addicted agents – though the two may, of course, differ greatly in degree of difficulty. We explore a general model of self-control for both the addict and the non-addict, stressing that self-control may be employed at three different stages, and examining the ways in which it might be strengthened. This helps elucidate a general model of intentional action. (shrink)

This paper traces the emergence of a new figure of the desiring subject in contemporary addiction science and in three other recent cultural developments: the rise of cognitive-behavior therapy, the self-tracking movement, and the dissemination of ratings. In each, the subject’s desire becomes newly figured as a response to objects rather than a manifestation of the soul, measured numerically rather than expressed in language and rendered impersonal rather than individualizing. Together, these developments suggest a shift in the dominant form (...) of the desiring subject in contemporary U.S. culture, one that breaks with the subject-form that Foucault theorized five decades ago. (shrink)

Does addiction to heroin undermine the voluntariness of heroin addicts' consent to take part in research which involves giving them free and legal heroin? This question has been raised in connection with research into the effectiveness of heroin prescription as a way of treating dependent heroin users. Participants in such research are required to give their informed consent to take part. Louis C. Charland has argued that we should not presume that heroin addicts are competent to do this since heroin (...) addiction by nature involves a loss of ability to resist the desire for heroin. In this article, I argue that Charland is right that we should not presume that heroin addicts are competent to consent, but not for the reason he thinks. In fact, as Charland's critics correctly point out, there is plenty of evidence showing that heroin addicts can resist their desire for heroin. These critics are wrong, however, to conclude from this that we should presume that heroin addicts are competent to give their voluntary consent. There are, I shall argue, other conditions associated with heroin addiction that might constrain heroin addicts' choice in ways likely to undermine the voluntariness of their consent. In order to see this, we need to move beyond the focus on the addicts' desires for heroin and instead consider the wider social and psychological circumstances of heroin addiction, as well as the effects these circumstances may have on the addicts' beliefs about the nature of their options. (shrink)

The validity of an argument depends on the soundness of its premises. In the recent paper by Steele et al., conclusions are based on the initial construction of definitions relating to ‘desire’ and...

This essay investigates the tensions produced by the categorization of different forms of excessive desire under the singular model of addiction, and it challenges the increasing acceptance of addiction as an all-purpose explanation for unruly desires through a comparison of the different forms of disordered desire in sex addiction and alcoholism. Moreover, it argues for a broad understanding of addictive processes to undermine the normative and moralizing assumptions of addiction discourses. Refiguring addiction as a kind of intimacy (...) is one way of making sense of the intense relationships people can develop with substances and with activities. (shrink)

I argue that addiction is not a chronic, relapsing, neurobiological disease characterized by compulsive use of drugs or alcohol. Large-scale national survey data demonstrate that rates of substance dependence peak in adolescence and early adulthood and then decline steeply; addicts tend to “mature out” in their late twenties or early thirties. The exceptions are addicts who suffer from additional psychiatric disorders. I hypothesize that this difference in patterns of use and relapse between the general and psychiatric populations can be explained (...) by the purpose served by drugs and alcohol for patients. Drugs and alcohol alleviate the severe psychological distress typically experienced by patients with comorbid psychiatric disorders and associated problems. On this hypothesis, consumption is a chosen means to ends that are rational to desire: Use is not compulsive. The upshot of this explanation is that the orthodox view of addiction as a chronic, relapsing neurobiological disease is misguided. I delineate five folk psychological factors that together explain addiction as purposive action: strong and habitual desire; willpower; motivation; functional role; and decision and resolve. I conclude by drawing lessons for research and effective treatment. (shrink)

“The addict” is a well-known figure in philosophy, but analytical attempts to define “addictive disorder” are rare. According to extant views, the “hallmark” of addiction lies in an individual’s inability or impaired ability to control the behavior the individual is addicted to doing. But how exactly are we to understand the relevant concept of (in)ability (or impaired ability) in the first place? Furthermore, what else is necessary for an individual to have an addictive disorder? I argue for a (...) definition of “addictive disorder” in terms of desire, tolerance and withdrawal, inability, and harm. The main focus of this paper is on the concept of ability. The view I propose integrates insights from the literature on abilities and develops them further as they are relevant to addiction. The resulting view offers a more differentiated perspective on questions about what individuals with an addictive disorder can and cannot do. (shrink)

Normative thinking about addiction has traditionally been divided between, on the one hand, a medical model which sees addiction as a disease characterized by compulsive and relapsing drug use over which the addict has little or no control and, on the other, a moral model which sees addiction as a choice characterized by voluntary behaviour under the control of the addict. Proponents of the former appeal to evidence showing that regular consumption of drugs causes persistent changes in the brain structures (...) and functions known to be involved in the motivation of behavior. On this evidence, it is often concluded that becoming addicted involves a transition from voluntary, chosen drug use to non-voluntary compulsive drug use. Against this view, proponents of the moral model provide ample evidence that addictive drug use involves voluntary chosen behaviour. In this paper we argue that although they are right about something, both views are mistaken. We present a third model that neither rules out the view of addictive drug use as compulsive, nor that it involves voluntary chosen behavior. -/- . (shrink)

This investigation develops in three steps. First, we seek to complexify the opioid crisis in a way that helps us to see how the issues of misguided desire and misplaced attachments are fundamentally important for a theological account of opioid addiction.1 Second, acknowledging the connections between pain and opioid addiction, we explore some of the ways in which our understanding of pain can influence our understanding of and responses to opioid use. Finally, we offer some tentative reflections on the (...) theological and ecclesial dimensions of the opioid crisis which hold the potential to influence the nature of a Christian response to the issues. Having laid out these steps, we argue for the church’s calling, where she complexifies the narratives about the opioid crisis and provides individuals suffering from opioid use “homeful” encounters with God and the community. (shrink)

It is common to think of addiction as involving behavior which in some sense is ?out of control.? But does this mean addictive actions occur because of compulsion or because of ordinary weakness of will? Many philosophers argue that addictive actions occur because of weakness of will, since there is plenty of evidence suggesting that they are not caused by irresistible desires. In fact, addicts seem, in general, to perform these actions freely in the sense of having the (...) ability to refrain from doing so. In this paper I argue, first, that it is not the addiction-as-compulsion view that is mistaken, but rather the view that irresistible desires are a defining feature of compulsion. Second, drawing on some results in addiction neuroscience, I construct and defend a new analysis of compulsivity that distinguishes addictive from weak-willed actions in a way that is consistent with the view that addictive actions are performed freely. (shrink)

In this two-part analysis, I analyze Marc Lewis’s arguments against the brain-disease view of substance addiction and for a developmental-learning approach that demedicalizes addiction. I focus especially on the question of whether addiction is a medical disorder. Addiction is currently classified as a medical disorder in DSM-5 and ICD-10. It is further labeled a brain disease by NIDA, based on observed brain changes in addicts that are interpreted as brain damage. Lewis argues that the changes result instead from normal neuroplasticity (...) and learning in response to the intense rewards provided by addictive substances, thus that addiction is not a brain disease and by implication not a medical disorder at all. I argue that even if one accepts Lewis’s reinterpretation of the brain evidence, his conclusions do not follow. Relying on my harmful-dysfunction analysis of medical disorder, I defend the view that substance addiction is in fact a medical disorder and a brain disorder. In Part 1, I identify five arguments Lewis puts forward against the brain-disease view and evaluate them as arguments that addiction is not a disorder: Addiction is not a chronic, relapsing condition; There is no clear boundary between addiction and other strong desires; Negative consequences are not unique to disorders; The brain disease model does not account for behavioral addictions; and, Addiction is like love. I argue that Lewis’s arguments are invalid because they fail to take account of the context of addiction and its relation to biological design. (shrink)

How should addictive behavior be explained? In terms of neurobiological illness and compulsion, or as a choice made freely, even rationally, in the face of harmful social or psychological circumstances? Some of the disagreement between proponents of the prevailing medical models and choice models in the science of addiction centres on the notion of “loss of control” as a normative characterization of addiction. In this article I examine two of the standard interpretations of loss of control in addiction, one (...) according to which addicts have lost free will, the other according to which their will is weak. I argue that both interpretations are mistaken and propose therefore an alternative based on a dual-process approach. This alternative neither rules out a capacity in addicts to rationally choose to engage in drug-oriented behavior, nor the possibility that addictive behavior can be compulsive and depend upon harmful changes in their brains caused by the regular use of drugs. (shrink)

Concepts We thank all three commentators for extremely constructive, insightful, and gracious commentaries. We cannot address all their valuable points. In this response, we elucidate and relate the concepts of addiction, disease, disability, autonomy, and well-being. We examine some of the implications of these relationships in the context of the helpful responses made by our commentators. We begin with the definitions of the relevant concepts which we employ: ¥? ? ? Addiction (Liberal Concept): An addiction is a strong appetite. ¥? (...) ? ? Appetites: An appetite is a disposition that generates desires that are urgent, oriented toward some rewarding behavior, periodically recurring, often in predictable circumstances, sated temporarily by their fulfillment, and generally provide pleasure. ¥? ? ? Disease (Naturalistic Concept): A disease is some biological or psychological state that results in subfunctioning of the organism in a given set of environmental and social circumstances, C. The reference class is a natural class of organisms of uniform functional design; specifically, an age group of a sex of a species. A normal function is a part or process within members of the reference class and is a statistically typical contribution by it to their individual survival and reproduction (Boorse 1977, 1997). ¥? ? ? Disability (Welfarist Concept): A disability is a relatively stable biological or psychological state that tends to reduce the amount of well-being that this person will enjoy in a given set of environmental and social circumstances (Savulescu and Kahane 2009; Kahane and Savulescu, 2009). ¥? ? ? Autonomy (Rationalist Concept): A person rationally desires or values some state of affairs if and only if he or she desires that state of affairs while (1) being in possession of all relevant. (shrink)

It is often claimed that the autonomy of heroin addicts is compromised when they are choosing between taking their drug of addiction and abstaining. This is the basis of claims that they are incompetent to give consent to be prescribed heroin. We reject these claims on a number of empirical and theoretical grounds. First we argue that addicts are likely to be sober, and thus capable of rational thought, when approaching researchers to participate in research. We reject behavioural evidence purported (...) to establish that addicts lack autonomy. We present an argument that extrinsic forces must be irresistible in order to make a choice non-autonomous. We argue that heroin does not present such an irresistible force. We make a case that drug-oriented desires are strong regular appetitive desires, which do not compromise consent. Finally we argue that an addict’s apparent desire to engage in a harmful act cannot be construed as evidence of irrational or compulsive thought. On these arguments, a sober heroin addict must be considered competent, autonomous and capable of giving consent. More generally, any argument against legalisation of drugs or supporting infringement of the liberty of those desiring to take drugs of addiction must be based on considerations of harm and paternalism, and not on false claims that addicts lack freedom of the will. (shrink)

Addicts often are portrayed as agents driven by irresistible desires in the philosophical literature on free will. Although this portrayal is faithful to a popular conception of addiction, that conception has encountered opposition from a variety of quarters (e.g., Bakalar & Grinspoon, 1984; Becker & Murphy, 1988; Peele, 1985 and 1989; Szasz, 1974). My concern here is some theoretical issues surrounding a strategy for self-control of potential use to addicts on the assumption that their pertinent desires fall short of irresistibility. (...) I offer no defense of this assumption; rather, I treat it as a point of departure for one approach to understanding addiction in action. I begin by sketching some conceptual and theoretical background and then turn to a proposal of George Ainslie's (1992) about temptation and self-control and to some reservations that Michael Bratman (1966) has expressed about it. I will argue that in some scenarios typical of addicts, Ainslie's proposal survives Bratman's objections. My guiding question is this: How can behavior exhibiting self-control or its contrary in addicts who are concerned to resist relevant temptations be accommodated in a general theory of human action that features a broad array of so-called "intentional attitudes" as important explanatory items? The attitudes that primarily concern me here are desire, intention, belief, and a species of evaluative judgment. (shrink)

Addiction is a phenomenon that usually offers challenges to theories of action. If we consider the standard causal theory of addiction, explaining addicts’ action in terms of their addictive desires leaves them without agency. If the compulsive desires bring about the action, despite the addicts’ views and attitudes toward their addiction, the desire just seems to force the addict to act accordingly. In light of philosophical studies, this is not a plausible way of understanding addicts’ action, as they (...) are agents in the sense that they are basically able to control their action and refrain from acting according to their addiction. Still it seems more difficult for addicts to act against the addictive desire. There has been empirical research that heroin addicts, for instance, have strong attentional bias to heroin-related cues and this feeds the strong desire they have for heroin. In the presentation, I will consider two ways in which the addictive desire may be understood as a source of difficulty that the agent may experience in their action. (shrink)

We aim to find a middle path between disease models of addiction, and those that treat addictive choices as choices like any other. We develop an account of the disease element by focussing on the idea that dopamine works primarily to lay down dispositional intrinsic desires. Addictive substances artifically boost the dopamine signal, and thereby lay down intrinsic desires for the substances that persist through withdrawal, and in the face of beliefs that they are worthless. The result is (...) cravings that are largely outside the control of the addict. But this does not mean that addicts are bound to act on such cravings, since they typically retain their faculty of self-control. The issue is one of difficulty not impossibility. Controlling an addictive craving is exceedingly demanding. (shrink)

Addicts sometimes engage in such spectacularly self-destructive behavior that they seem to act under compulsion. I briefly review the claim that addiction is not compulsive at all. I then consider recent accounts of addiction by Holton and Schroeder, which characterize addiction in terms of abnormally strong motivations. However, this account can only explain the apparent compulsivity of addiction if we assume—contrary to what we know about addicts—that the desires are so strong as to be irresistible. I then consider accounts that (...) invoke the phenomenon of “ego depletion,” according to which a person can resist temptation for a while, but not indefinitely. Implicit in this account is the assumption that addiction-related desires persist long enough to deplete the addict’s willpower. The balance of the paper argues that the persistence of the desire to consume drugs is a significant form of dysfunction in its own right, and that it makes an important and independent contribution to the compulsivity of addiction. I argue that addiction involves dysfunction in a mechanism that normally prevents a person from being tempted to do something that would invite disaster. (shrink)

There is an ongoing debate about loss of control in addiction: Some theorists say at least some addicts’ drug-directed desires are irresistible, while others insist that pursuing drugs is a choice. The debate is long-standing and has essentially reached a stalemate. This essay suggests a way forward. I propose an alternative model of loss of control in addiction, one based not on irresistibility, but rather fallibility. According to the model, on every occasion of use, self-control processes exhibit a low, but (...) non-zero, rate of failure due to error. When these processes confront highly recurrent drug-directed desires, the cumulative probability of a self-control lapse steadily grows. The model shows why the following statement—which has an air of paradox—can in fact be true: Each drug-directed desire the addict faces is fully resistible, but the addict nonetheless has significantly diminished control over eventually giving in. (shrink)

This chapter contains sections titled: References Further reading.

Popular and neurobiological accounts of addiction tend to treat it as a form of compulsion. This contrasts with personality disorder, where most problematic behaviours are treated as voluntary. But high levels of co-morbidity, overlapping diagnostic traits, and the effectiveness of a range of comparable clinical interventions for addiction and personality disorder suggest that this difference in treatment is unjustified. Drawing on this range of clinical interventions, we argue that addiction is not a form of compulsion. Rather, the misuse of drugs (...) and alcohol is like many of the problematic behaviours associated with personality disorder: it is typically a way of coping with psychological distress. We suggest that a satisfying explanation of why many addicts struggle to control their use can be given without departing from concepts employed in our basic folk psychological understanding of agency. In particular, we appeal to five rough-and-ready folk psychological factors to explain addiction: (i) strength of desire and habit; (ii) willpower; (iii) motivation; (iv) functional role; and (v) decision and resolve. (shrink)

Joining the debate over the roles of reason and appetite in the moral mind, In Praise of Desire takes the side of appetite. Acting for moral reasons, acting in a praiseworthy manner, and acting out of virtue are simply acting out of intrinsic desires for the right or the good.

In an earlier article in this journal I argued that the question of whether heroin addicts can give voluntary consent to take part in research which involves giving them a choice of free heroin does not – in contrast with a common assumption in the bioethics literature – depend exclusively on whether or not they possess the capacity to resist their desire for heroin. In some cases, circumstances and beliefs might undermine the voluntariness of the choices a person makes (...) even if they do possess a capacity for self-control. Based on what I took to be a plausible definition of voluntariness, I argued that the circumstances and beliefs typical of many vulnerable heroin addicts are such that we have good reasons to suspect they cannot give voluntary consent to take part in such research, even assuming their desire for heroin is not irresistible. In a recent article in this journal, Uusitalo and Broers object to this on the grounds that I misdescribe heroin addicts' options set, that the definition of voluntariness on which I rely is unrealistic and too demanding, and, more generally, that my view of heroin addiction is flawed. I think their arguments derive from a misunderstanding of the view I expressed in my article. In what follows I hope therefore to clarify my position. (shrink)

The target of Hanna Pickard's very erudite and thought-provoking article is compulsion. She argues that “addiction is not a form of compulsion” and that “addictive desires are not irresistible” (Pickard 2012, 40). However, I fear that compulsion as she presents it is ultimately a metaphysical straw figure, trapped in a false metaphysical dichotomy. What is lacking is a proper attention to specific individual clinical cases, examined over time. At the same time, Pickard's discussion is extremely important because of the (...) manner in which it highlights both the merits and the perils of philosophical inquiry into the nature of addiction... (shrink)

This paper examines the view that desires are beliefs about normative reasons for action. It describes the view, and briefly sketches three arguments for it. But the focus of the paper is defending the view from objections. The paper argues that the view is consistent with the distinction between the direction of fit of beliefs and desires, that it is consistent with the existence of appetites such as hunger, that it can account for counterexamples that aim to show that beliefs (...) about reasons are not sufficient for desire, such as weakness of will, and that it can account for counterexamples that aim to show that beliefs about reasons are not necessary for desire, such as addiction. The paper also shows how it is superior to the view that desires are appearances of the good. (shrink)

The author comments on several articles on addiction. Recent developments in neuroscience suggest that addicted individuals have substantial impairments in the cognitive control of voluntary behavior. The author differs on the observations that addicts either act on desires that are not conducive to rational action. The author also states that addiction seems to be a prime manifestation of akrasia, in which one fails to be motivated to act in accordance with what one judges ought to be done. Accession Number: 24077920; (...) Authors: Viens, A. M. 1; Email Address: [email protected]; Affiliations: 1: University of Oxford, Hertford College, Oxford, United Kingdom; Subject: EDITORIALS; Subject: ADDICTIONS; Subject: COGNITION; Subject: DECISION making; Subject: AKRASIA; Subject: NEUROSCIENCES; Number of Pages: 3p. (shrink)

Developments in the field of neuroscience, according to its proponents, offer the prospect of an enhanced understanding and treatment of addicted persons. Consequently, its advocates consider that improving public understanding of addiction neuroscience is a desirable aim. Those critical of neuroscientific approaches, however, charge that it is a totalising, reductive perspective–one that ignores other known causes in favour of neurobiological explanations. Sociologist Nikolas Rose has argued that neuroscience, and its associated technologies, are coming to dominate cultural models to the extent (...) that 'we' increasingly understand ourselves as 'neurochemical selves'. Drawing on 55 qualitative interviews conducted with members of the Australian public residing in the Greater Brisbane area, we challenge both the 'expectational discourses' of neuroscientists and the criticisms of its detractors. Members of the public accepted multiple perspectives on the causes of addiction, including some elements of neurobiological explanations. Their discussions of addiction drew upon a broad range of philosophical, sociological, anthropological, psychological and neurobiological vocabularies, suggesting that they synthesised newer technical understandings, such as that offered by neuroscience, with older ones. Holding conceptual models that acknowledge the complexity of addiction aetiology into which new information is incorporated suggests that the impact of neuroscientific discourse in directing the public's beliefs about addiction is likely to be more limited than proponents or opponents of neuroscience expect. (shrink)

Older people enter the final phases of their lives with well‐established habits and rituals, some of which might be or become substance abuse. This inquiry focused on the relationship between habits, rituals, and the compulsive addictive behaviours evident in older persons' substance abuse. Habits and rituals, examined as adaptive and limiting functions in older persons, revealed changes in autonomy, social inclusion, and emotional responses to such changes as older persons experience declining energy reserves and physical debilities. Older persons' ebbing (...) sense of control and passionate responses to change illustrate the perennial struggle between the will and emotions when habits and rituals transform to compulsive addictive behaviours. Two concepts, germane to this struggle both in older persons' addictive behaviours and nurses' response, emerged from this inquiry: temperance, a balance between the will's freely chosen actions and passionate desire, and discipline, the means to achieve such balance. The focused attention demanded in discipline can be realized in spiritual exercises and daily care of the soul. Disciplined actions engage the older persons' imaginative capacities to manage and abandon the self in goals consistent with end‐of‐life issues: meaningful fulfillment of human potential and the need for daily joy and pleasure in living the final years. (shrink)

Marc Lewis argues that addiction is not a disease, it is instead a dysfunctional outcome of what plastic brains ordinarily do, given the adaptive processes of learning and development within environments where people are seeking happiness, or relief, or escape. They come to obsessively desire substances or activities that they believe will deliver happiness and so on, but this comes to corrupt the normal process of development when it escalates beyond a point of functionality. Such ‘deep learning’ emerges from (...) consumptive habits, or ‘motivated repetition’, and although addiction is bad, it ferments out of the ordinary stuff underpinning any neural habit. Lewis gives us a convincing story about the process that leads from ordinary controlled consumption through to quite heavy addictive consumption, but I claim that in some extreme cases the eventual state of deep learning tips over into clinically significant impairment and disorder. Addiction is an elastic concept, and although it develops through mild and moderate forms, the impairment we see in severe cases needs to be acknowledged. This impairment, I argue, consists in the chronic automatic consumption present in late stage addiction. In this condition, the desiring self largely drops out the picture, as the addicted individual begins to mindlessly consume. This impairment is clinically significant because the machinery of motivated rationality has become corrupted. To bolster this claim I compare what is going on in these extreme cases with what goes on in people who dissociate in cases of depersonalization disorder. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Confronting Addiction Across DisciplinesAllison Mitchell (bio)Keywords(Anglo-American) analytic philosophy, scientific method, hyper-rationality, autonomous agency, externality, AugustinePatricia Ross's detailed and thorough response to my paper exemplifies some of those strengths and weaknesses typically associated with contemporary Anglo-American analytic philosophy. The development of her position involves the following representative moves: In the first stage of her discussion, she highlights the possible presence of an implicit, untested, and potentially false proposition underlying my (...) general argument, namely, that proper theorizing about ourselves and the world may provoke changes in our beliefs and any behaviors based on them. In the second stage of her project, she expresses a paradigmatically analytic mode of skepticism; this doubt concerns a "chain of events" implicit in the development of my position, and it takes the form of a set of questions that bear a strong family resemblance. First, Ross questions the very possibility or intelligibility of using fictional discourse and philosophical theory to explore the ways in which addicts conceive of themselves and their circumstances. Next, Ross turns to a more psychological (and intellectually profitable) line of questioning: Do people struggling with drug abuse and addiction have similar self-conceptions that, moreover, are meaningfully distinct from those expressed by nonusers? How might such idiosyncratic and shared modes of self-understanding instruct us about the disease of addiction? Finally, in what sense (if any) might certain alterations in our conceptual schemas have practical rehabilitative value? Having voiced uncompromising doubt concerning my pragmatic appropriation of philosophy and literature, Ross proceeds to an unlikely third step in her argument: She insists that my project is entirely theoretical, in the sense that I focus exclusively on truth-evaluable claims (about addicts' conceptions of self and world) that are garnered from literary narratives. Relatedly, she takes issue with my strong Wittgenstenian intuition about the presence of some intimate connection between linguistic self-expression and an individual's conceptual framework, insisting that I neglect "the degree to which the narratives are [not] honest, veridical expressions of self-conceptions" (228). Ross urges me to recognize that the language employed in narratives of drug abuse and addiction "might be said to reflect the addict's observations concerning his or her self-hood, or, alternatively, what the addict cares to portray about this conception, however truthful" (228). From her analytic-philosophical perspective, these features of language, combined with sensible intuitions about the practical limitations of theorizing, motivate a critique of my overall project. [End Page 233]A standard analytic response to Ross' commentary would typically involve certain moves: One might question the truth value of her claims, challenge the soundness and validity of her arguments, or take issue with her particular use of philosophical terms and concepts. Instead, I clarify further my project and its intended results, in such a way that opens up space for her analytic voice within the context of an interdisciplinary discussion. Ross and I agree on two absolutely central concerns: First, her description of the proper significance of the language under study is perfectly apt, if ultimately irrelevant as a criticism of my work. Of course, I concede the obvious point that the narratives I consider are not perfectly veridical, reliable, or honest. Yet far from being a problem, these rhetorical features make the narratives appropriate and fruitful objects of study. Through the use of philosophical tools and literary-critical practice, I seek primarily to develop an understanding of the ways in which addicts portray their subjectively informed, culturally conditioned, and selectively edited self-observations. Second, I would like to underline Ross' helpful reminder about the contingency of the hypothetical claims I develop through close reading and philosophical references. Our agreement about these fundamental points may reflect my own failure to describe clearly my procedure and desired results. The overarching aim of my project is simply to highlight the possibility that addicts conceive of themselves in distinctive ways that are describable in philosophical terms. Moreover, I would like to initiate an ongoing interdisciplinary discussion in which the truth, aptness, and practical relevance of my method and its results may be evaluated. Ross's remarks highlight the need for further clarification on three points: First, I do... (shrink)

Weakness of will has perplexed philosophers since Plato's time. This chapter places some of the literature on volitional disorders and addictions in a philosophical context dating back to Plato and Aristotle in an attempt to shed light on issues that a theorist who wishes to analyze the idea of a volitional disorder will face. Key here is the notion of the irresistability and resistability of pertinent desires, which is explored in relation to George Ainslie's work on the ability to make (...) and adhere to personal rules. (shrink)

This book addresses an epidemic that has developed on a global scale, and, which under the heading of “addiction,” presents a new narrative about the travails of the human predicament. The book introduces phenomenological motifs, such as desire, embodiment, and temporality, to uncover the existential roots of addiction, and develops Martin Heidegger’s insights into technology to uncover the challenge of becoming a self within the impulsiveness and depersonalization of our digital age. By charting a new path of philosophical inquiry, (...) the book allows a pervasive, cultural phenomenon, ordinarily reserved to psychology, to speak as a referendum about the danger which technology poses to us on a daily basis. In this regard, addiction ceases to be merely a clinical malady, and instead becomes a “signpost” to exposing a hidden danger posed by the assimilation of our culture within a technological framework. (shrink)

This article explores and defends the claim that addictive desires—for alcohol in particular—are partly explained by the motive of self-escape. We consider how this claim sits with the neurophysiological explanation of the strength of addictive desires in terms of the effect addictive substances have on the dopamine system. We argue that nothing in the neuroscientific framework rules out pluralism about the causes of addictive desire.

The history of ideas about addiction often comes down to a history of debates over the use and meaning of language. Nowhere is this more clear than in the interminable “Is addiction a ‘disease’?” debate. In Marc Lewis’ excellent Biology of Desire and in his paper that centers this issue, there is far more agreement between his work and mine than there is disagreement on the “disease” question. Here, however, I make a case for greater compatibility between the “disease” (...) view and learning models of addiction than Lewis does, because I think the nuance is worth exploring. Indeed, if addiction science and ethics paid more attention to nuance in general, the whole field would be far better off. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:On Concepts and Theories of AddictionLennart Nordenfelt (bio)Keywordsaddiction, disease, will power, autonomy, holistic view of healthThe article "A Liberal Account of Addiction" is a good piece of analytic philosophy applied to psychiatry. It is well-informed both with regard to empirical matters and philosophical conceptualization. The arguments are often—but, as I will show, not always—quite convincing. The conclusions of the paper also have crucial consequences for practice, for the treatment (...) of patients, and for social policy.The authors argue that current scientific understandings of the problem of addiction are fundamentally flawed. They distinguish between two main positions in science: The Disease View and the Willpower View. According to the Disease View, drug-seeking behavior is the direct result of some physiological change in the drug seeker's brain. According to the Willpower View, the addict is no longer rational; he or she uses drugs as a result of a fundamentally non-voluntary process.The authors dismiss the Disease View in the following way. They first note that drug addicts are in many ways rational planners. The addicts may have to think a lot to find the best ways to find the heroin, cigarettes, or alcohol, and they normally act according to this planning. They are not in any simple sense "caused" to act in a particular way. Moreover, referring to recent neurological literature, the authors note that the changes caused by drug addiction—which have to do with activating reward pathways in the brain—are identical with the outcomes of many other human activities that we do not call addiction. "In fact, any pleasurable experience causes dopamine to be released within the brain, activating these reward pathways" (Foddy and Savulescu 2010, 4). These experiences can be the result of coffee drinking, sexual activity, and physical exercise. Thus, the physical changes in the brain are not effects peculiar to the pharmacology of the drugs; they are instead the effects of the pleasure that the subject has experienced.The argument against the Willpower View is lengthy and more involved. The proponent of the Willpower View must argue that there is some flaw in the subject's autonomy. The drug addict is in some sense unable to avoid taking the drug. The authors of the present article scrutinize this idea on the basis of distinguishing between different senses of autonomy: Substantive autonomy and procedural autonomy. They state that we must here be talking about procedural autonomy, namely, autonomy regarded as dependent only on our capacity to process information and make choices in accordance with our preferences. We cannot, as in the case of substantive autonomy, require that the preferences themselves be reasonable. [End Page 27] In such a case, many of our ordinary actions would be judged non-autonomous.The most reasonable Willpower accounts rely on the idea that addicted people in some sense lack self-control. The authors cite different interpretations of the concept of lacking self- control and they conclude that "none of these … theories can say that addicts are necessarily lacking in self-control unless they also make unreasonable normative or false factual claims about the nature of drug- or pleasure-oriented choices" (Foddy and Savulescu 2010, 10). For instance, according to one interpretation the subject does not endorse his own desire for drugs, but takes the drug anyway. According to another interpretation, the addict regrets taking the drug after having done so. Against such claims the authors claim that many addicts indeed endorse their desires for drugs and many addicts do not regret their addictive behavior.So what is the positive account proposed by the authors? They put forward what they call a Liberal View. It contains three claims about addiction: First, we do not know whether an addict values anything more than the satisfaction of his addictive desires; second, we do not know whether an addict behaves autonomously when he uses drugs; and third, addictive desires are just strong regular desires.According to the Liberal View, one has to accept that the addicts may have drug taking as their highest priority and that they do not have any reduced procedural autonomy. The authors say: "Once we abandon normative bias, we must accept... (shrink)

Data from multiple sources point to the desire for revenge in response to grievances or perceived injustices as a root cause of violence, including firearm violence. Neuroscience and behavioral studies are beginning to reveal that the desire for revenge in response to grievances activates the same neural reward-processing circuitry as that of substance addiction, suggesting that grievances trigger powerful cravings for revenge in anticipation of experiencing pleasure. Based on this evidence, the authors argue that a behavioral addiction framework (...) may be appropriate for understanding and addressing violent behavior. Such an approach could yield significant benefits by leveraging scientific and public health-oriented drug abuse prevention and treatment strategies that target drug cravings to spur development of scientific and public-health-oriented “gun abuse” prevention and treatment strategies targeting the revenge cravings that lead to violence. An example of one such “motive control” strategy is discussed. Approaching revenge-seeking, violence, and gun abuse from the perspective of compulsion and addiction would have the added benefit of avoiding the stigmatization as violent of individuals with mental illness while also acknowledging the systemic, social, and cultural factors contributing to grievances that lead to violent acts. (shrink)

The claim that non-addictive drug use is instrumental must be distinguished from the claim that its desired ends are evolutionarily adaptive or easy to comprehend. Use can be instrumental without being adaptive or comprehensible. This clarification, together with additional data, suggests that Müller & Schumann's (M&S's) instrumental framework may explain addictive, as well as non-addictive consumption.

: We investigate the role played by bodily self-perception and social self-presentation in addiction to massively multiplayer online role-playing games. In this paper we will develop the hypothesis that, at least in some cases, the habit of role-playing can be interpreted as a response to gamers’ need to explore a different bodily self-identity. Players tend to become deeply involved in this kind of game, especially in the character identity creation process. Participants might see and seek reflections of their desired selves (...) in their avatars. We suggest that in some cases gaming can be considered an addiction associated with self-perception, social acceptance, and body-image distortion. We explore how the phenomenological duality of body can be useful for analyzing the creation of game identities preferred by players. On the basis of this analysis, we sketch some therapeutic suggestions, combining aspect from two specific therapies: Internet Addiction-Cognitive Behavioral Therapy and Body Image Cognitive Behavioral Therapy. We hope these suggested approaches will be of value to gaming addiction specialists. Keywords: MMORPGs; Leib/Körper; Bodily Self-perception; Game Identity; Addiction L’abitudine ai giochi di ruolo in rete multigiocatore di massa : una analisi fenomenologica della percezione corporea di sé nella dipendenza da gioco Riassunto: Intendiamo indagare il ruolo svolto dalla percezione corporea di sé e dalla autopresentazione sociale nella dipendenza da gioco di ruolo in rete multigiocatore di massa. In questo lavoro illustreremo l’ipotesi per cui, quantomeno in alcuni casi, la disposizione al gioco di ruolo può essere interpretata come risposta al bisogno dei giocatori di esplorare una diversa identità corporea di sé. Chi partecipa a questo tipo di gioco tende a un coinvolgimento profondo, specialmente nel processo di creazione dell’identità caratteristica. I partecipanti possono vedere e cercare riflessi dei loro sé desiderati nei loro avatar. Noi suggeriamo che in alcuni casi il gioco può essere considerato una dipendenza associata alla percezione di sé, alla accettazione sociale e alla distorsione della immagine corporea. Esploreremo come la dualità fenomenologica tra corpo vissuto e corpo possa essere utile per analizzare la creazione delle identità di gioco preferite dai giocatori. Su questa base offriremo alcuni suggerimenti terapeutici, combinando aspetti tratti da due terapie specifiche: la Internet Addiction-Cognitive Behavioral Therapy e la Body Image Cognitive Behavioral Therapy. Auspichiamo che questi approcci possano essere validi per chi lavora nel campo della dipendenza da gioco. Parole chiave: MMORPGs; Leib/Körper; Percezione corporea di sé; Identità di gioco; Dipendenza. (shrink)

Despite creating vast inequalities and propping up reactionary world regimes, capitalism has many passionate defenders—but not because of what it withholds from some and gives to others. Capitalism dominates, Todd McGowan argues, because it mimics the structure of our desire while hiding the trauma that the system inflicts upon it. People from all backgrounds enjoy what capitalism provides, but at the same time are told more and better is yet to come. Capitalism traps us through an incomplete satisfaction that (...) compels us after the new, the better, and the more. Capitalism's parasitic relationship to our desires gives it the illusion of corresponding to our natural impulses, which is how capitalism's defenders characterize it. By understanding this psychic strategy, McGowan hopes to divest us of our addiction to capitalist enrichment and help us rediscover enjoyment as we actually experienced it. By locating it in the present, McGowan frees us from our attachment to a better future and the belief that capitalism is an essential outgrowth of human nature. From this perspective, our economic, social, and political worlds open up to real political change. Eloquent and enlivened by examples from film, television, consumer culture, and everyday life, Capitalism and Desire brings a new, psychoanalytically grounded approach to political and social theory. (shrink)

This article provides the existential and phenomenological conditions for addiction by applying the concepts of lack, escape and ‘hypervirtuality’ in new ways to the subject matter. There are five sections. The first is a brief review of some of the most relevant literature. The second lists the main general characteristics of addiction, gleaned from the literature, as well as discussing a possible general definition, namely wants that have become (damaging) needs. The third provides the existential conditions required for addiction to (...) be understood as a human phenomenon to which we are all susceptible, albeit to greatly differing degrees and objects. Here I stress the ideas of transcendence, desire, lack and escape one finds in the early writings of Sartre and Levinas. The fourth fills this idea out with a key phenomenological notion of hypervirtuality, inspired by Husserl. This latter, fifthly and finally, explains the rising power of new technologies and how many are increasing and providing new opportunities for addictive behaviour. (shrink)

Rationalist accounts of self-knowledge are motivated in important part by the claim that only by looking to our reasons to discover our beliefs and desires are we active in relation to them and only thereby do we take responsibility for them. These kinds of account seem to predict that self-knowledge generated using third-personal methods or analogues of these methods will tend to undermine the capacity to exercise self-control. In this light, the insistence by treatment programs that addicts acknowledge that they (...) are addicts seems puzzling. I argue that because addicts—and perhaps ordinary akratics, to some extent at least, too—are vulnerable to losing control of their actions via losing control over their beliefs, advising them to look to their reasons for actions is counterproductive and facilitates loss of control. In contrast, an insistence on what I call impersonal self-knowledge, knowledge of some of one's states and dispositions generated by third-personal means, may help to reestablish control. (shrink)

"All men by nature desire to know"-this is the famous first sentence of Aristotle's Metaphysics. It is interesting to note how knowledge, at least since Aristotle, could be understood as a desire, as a mental craving, so to speak. When understood as a desire, knowledge necessarily goes along with a certain absence, a lack. Those who crave for knowledge are not yet fully in its possession, they are still on the search.

In this study, we investigate the use of narrative in online conversations among persons suffering from chronic opiate addiction and evaluate both its positive and negative uses. Illness narratives, as argued by sociologist Arthur Frank and psychiatrist/medical anthropologist Arthur Kleinman, enable patients to give order to life experiences and receive support from others. We wished to explore under what circumstances online support coalesces and breaks apart. The narratives we examined exemplify two topics frequently discussed on the message board: the recovery (...) process and what it means to be ‘clean’. To better understand these narratives from a theoretically based approach, we used the work of rhetorical theorist Kenneth Burke. Burke's description of two human motives, suffering and perfection, led us to an understanding of how unification and division happened within the online community. We found that the recovery narrative primarily embodied the author's suffering and, consequently, received support from other members of the message board. The second narrative centered on what it means to be ‘clean’ through a discussion of the author's desire to court temptation, revealing what Burke calls the rotten nature of perfection. As a result, the author of the narrative provoked disagreements and did not receive support. (shrink)

This chapter presents a reflective, critical position toward the author’s own addiction and toward himself as an addict. It presents the question of whether addressing addiction as a disease is useful; the idea of addiction as a disease seems less useful in describing “what it is like” for the author than to say that his being was physically, psychologically, and relationally disordered. Despite his desires, he could not find a way to regain order and harmony within himself. It was only (...) the phenomenological possibility of feeling and being better that kept hope alive. The solution to addiction is social; other people who cared for the author personally, together with those with professional knowledge, assisted him in regaining some control that he alone had either lost or could not find. (shrink)

ABSTRACT We frequently accuse heavy drinkers and drug users of self‐deception if they refuse to admit that they are addicted. However, given the ways in which we usually conceptualize it, acknowledging addiction merely involves swapping one form of self‐deception for another. We ask addicts to see themselves as in the grip of an irresistible desire, and to accept that addiction is an essentially physiological process. To the extent this is so, we, as much as the addicts, suffer from self‐deception, (...) and the responsibility for their state is in part ours. Conversely, since addicts are compelled to accept a self‐deceptive image of themselves, they are at least partially excused from blame for their self‐deception. (shrink)