Research in the philosophy of addiction commonly explores how agency is impacted in addiction by focusing on moments of apparent loss of control over addictive behavior and seeking to explain how such moments result from the effects of psychoactive substance use on cognition and volition. Recently, Glackin et al. (2021) have suggested that agency in addiction can be helpfully analyzed using the concept of affordances. They argue that addicted agents experience addiction-related affordances, such as action (...) possibilities relating to drugs, drug paraphernalia, and drug-related activities, as aberrantly salient motivations for action. Building on this approach, we present a novel two-tiered affordance model of addiction. In doing so, we suggest that what is significant about the addicted person’s world is not simply what affordances are experienced as salient, but also the way in which the addicted person’s world is shaped by a dominant concern. It is not only that addiction-related affordances become more prominent as addiction progresses but that one’s plurality of concerns become monopolized by and funneled through addiction. Our model endorses Glackin et al.’s idea that addiction-related affordances become aberrantly salient, while proposing why they become and remain so. This way of viewing agency in addiction also brings to light important implications for recovery and treatment. For, if an addicted person adopts a new, even “socially approved”, dominant concern, there is a risk that the shape of addiction is preserved, even though the content changes, leaving an individual at the risk of addiction substitution or relapse. (shrink)

The problem of addiction to psychoactive substances, such as alcohol and other drugs, has been addressed in psychiatry traditionally from the perspective of a mechanistic-reductionist epistemological model, whose main focus in clinical care is to avoid or suppress the use of these substances, rather than understanding the meaning of a treatment and the meaning of the alterations of consciousness produced by these addictive substances. This paper attempts to contribute towards overcoming this epistemological perspective from the perspective of phenomenological psychopathology. (...) In the first part of the article, the main characteristics of phenomenology and its incorporation into the field of mental health will be presented. Then the issue of addiction will be analysed from two ways of understanding it: the mechanistic-reductionist model and the phenomenological dialectical model. Finally, the pragmatic consequences of the dialectical perspective of phenomenology, called Dialectical Phenomenology (DPh), which seeks to enrich the diagnostic process in the mental health clinic, allowing scientific diagnoses to approach the complexities of clinical reality, will be presented. (shrink)

Biomedical science has been remarkably successful in explaining illness by categorizing diseases and then by identifying localizable lesions such as a virus and neoplasm in the body that cause those diseases. Not surprisingly, researchers have aspired to apply this powerful paradigm to addiction. So, for example, in a review of the neuroscience of addiction literature, Hyman and Malenka (2001, p. 695) acknowledge a general consensus among addiction researchers that “[a]ddiction can appropriately be considered as a chronic medical (...) illness.” Like other diseases, “Once addiction has taken hold, it tends to follow a chronic course.” (Koob and La Moal 2006, p. ?). Working from this perspective, much effort has gone into characterizing the symptomology of addiction and the brain changes that underlie them. Evidence for involvement of dopamine transmission changes in the ventral tegmental area (VTA) and nucleus accumbens (NAc) have received the greatest attention. Kauer and Malenka (2007, p. 844) put it well: “drugs of abuse can co-opt synaptic plasticity mechanisms in brain circuits involved in reinforcement and reward processing”. Our goal in this chapter to provide an explicit description of the assumptions of medical models, the different forms they may take, and the challenges they face in providing explanations with solid evidence of addiction. <br>. (shrink)

The problem of addiction is one of the major challenges and controversies confronting medicine and society. It also poses important and complex philosophical and scientific problems. What is addiction? Why does it occur? And how should we respond to it, as individuals and as a society? The Routledge Handbook of Philosophy and Science of Addiction is an outstanding reference source to the key topics, problems and debates in this exciting subject. It spans several disciplines and is (...) the first collection of its kind. Organised into three clear parts, forty-five chapters by a team of international contributors examine key areas, including: the meaning of addiction to individuals conceptions of addiction varieties and taxonomies of addiction methods and models of addiction evolution and addiction history, sociology and anthropology population distribution and epidemiology developmental processes vulnerabilities and resilience psychological and neural mechanisms prevention, treatment and spontaneous recovery public health and the ethics of care social justice, law and policy. Essential reading for students and researchers in addiction research and in philosophy, particularly philosophy of mind and psychology and ethics, The Routledge Handbook of Philosophy and Science of Addiction will also be of great interest to those in related fields, such as medicine, mental health, social work, and social policy. (shrink)

Philosophers and psychologists have been attracted to two differing accounts of addictive motivation. In this paper, we investigate these two accounts and challenge their mutual claim that addictions compromise a person’s self-control. First, we identify some incompatibilities between this claim of reduced self-control and the available evidence from various disciplines. A critical assessment of the evidence weakens the empirical argument for reduced autonomy. Second, we identify sources of unwarranted normative bias in the popular theories of addiction that introduce systematic (...) errors in interpreting the evidence. By eliminating these errors, we are able to generate a minimal, but correct account, of addiction that presumes addicts to be autonomous in their addictive behavior, absent further evidence to the contrary. Finally, we explore some of the implications of this minimal, correct view. (shrink)

This article discusses various ethical and philosophical aspects of heroin addiction. It arose as a result of the plan by the Amsterdam city council to supply free heroin to drug addicts. The objective of treatment of heroin addicts is ambivalent because what is in fact a socio-cultural problem is transformed into a medical problem. The characteristics of this treatment are made explicit through a philosophical analysis which sees the medical intervention as part of a strategy aimed at achieving social (...) normalisation. The reason why such a social control function is practised by physicians is discussed, as well as the reason why heroin users in particular are the object of such a process. In this paper, heroin addiction is considered primarily as a cultural problem. The consequences of this for treatment and ethics form the conclusion. (shrink)

The concept of addiction is historically and culturally specific, becoming a common way of understanding experience first in early nineteenth-century America, This paper considers the relation to the concept of elements in current professional definitions of addiction (as dependence). Addiction concepts have become a commonplace in storytelling, offering a secular equivalent for possession as an explanation of how a good person can behave badly, and as an inner demon over which a hero can triumph.

Recent clinical trials show that psychedelics such as LSD and psilocybin can be given safely in controlled conditions, and can cause lasting psychological benefits with one or two administrations. Supervised psychedelic sessions can reduce symptoms of anxiety, depression, and addiction, and improve well-being in healthy volunteers, for months or even years. But these benefits seem to be mediated by "mystical" experiences of cosmic consciousness, which prompts a philosophical concern: do psychedelics cause psychological benefits by inducing false or implausible beliefs (...) about the metaphysical nature of reality? This book is the first scholarly monograph in English devoted to the philosophical analysis of psychedelic drugs. Its central focus is the apparent conflict between the growing use of psychedelics in psychiatry and the philosophical worldview of naturalism. Within the book, Letheby integrates empirical evidence and philosophical considerations in the service of a simple conclusion: this "Comforting Delusion Objection" to psychedelic therapy fails. While exotic metaphysical ideas do sometimes come up, they are not, on closer inspection, the central driver of change in psychedelic therapy. Psychedelics lead to lasting benefits by altering the sense of self, and changing how people relate to their own minds and lives-not by changing their beliefs about the ultimate nature of reality. The upshot is that a traditional conception of psychedelics as agents of insight and spirituality can be reconciled with naturalism (the philosophical position that the natural world is all there is). Controlled psychedelic use can lead to genuine forms of knowledge gain and spiritual growth-even if no Cosmic Consciousness or transcendent divine Reality exists. Philosophy of Psychedelics is an indispensable guide to the literature for researchers already engaged in the field of psychedelic psychiatry, and for researchers-especially philosophers-who want to become acquainted with this increasingly topical field. (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)

In this essay I explore the notion of philosophy as a way of life as a recovery pathway for individuals in addiction recovery. My hypothesis is that philosophy as a way of life can be a compelling, and legitimate recovery pathway for individuals in addiction recovery, as one of many recovery pathways. I will focus on logic-based therapy applied in the context of addiction recovery. The aim of presenting a case study is to show how (...) a client receiving LBT is provided with techniques and a worldview that can contribute to a philosophically oriented recovery program. In the case study the client was advised to apply the moral philosophy of Friedrich Nietzsche as an uplifting philosophical framework to counteract his unproductive worldview and fallacious thinking. Considering that there is an ostensibly low efficacy rate for the treatment of addiction, articulating the value of philosophy as a way of life as a recovery pathway provides a conceptual and methodological framework for the development of novel philosophically-based addiction treatment and recovery-oriented programs—thus expanding the treatment and recovery options available for those seeking recovery from addiction. (shrink)

Addiction theorists have often utilized the metaphor of the blind men and the elephant to illustrate the complex nature of addiction and the varied methodological approaches to studying it. A common purported upshot is skeptical in nature: due to these complexities, it is not possible to offer a unifying account of addiction. I think that this is a mistake. The elephant is real–there is a _there_ there. Here, I defend a dispositionalist account of addiction as _the (...) systematic disposition to fail to control one’s desires to engage in certain types of behaviors_. I explain this position, defend the inclusion of desires and impaired control, and flesh out the notion of _systematicity_ central to my account. I then illustrate how my dispositionalist framework can unify the disparate and seemingly incompatible accounts of addiction (and their respective methodological approaches). I close with a brief plan to extend and implement my account. (shrink)

Can addiction be credibly invoked as an excuse for moral harms secondary to particular decisions to use drugs? This question raises two distinct sets of issues. First, there is the question of whether addiction is the sort of consideration that could, given suitable assumptions about the details of the case, excuse or mitigate moral blameworthiness. Most discussions of addiction and moral responsibility have focused on this question, and many have argued that addiction excuses. Here I articulate (...) what I take to be the best argument for this view, based on the substantial difficulty that people with severe addiction experience in controlling drug-related behavior. This, I argue, may in some cases be sufficient to ground a mitigating excuse, given the way in which addiction undermines agents’ responsiveness to relevant moral reasons to do otherwise. Much less attention has been devoted to a second set of issues that critically affect the possibility of applying this mitigating excuse in particular cases, derived from the ambivalent nature of agential control in addiction. In order to find a fitting response to moral harm, the person with the right standing to blame must make a judgment about the extent to which the agent possessed certain morally relevant capacities at the time of the act. In practice, this will often prove tremendously difficult to assess. The ethical challenge for the person with the right standing to blame is fundamentally one of making a judgment about matters that seem underdetermined by the available evidence. (shrink)

It is both common and natural to think of addiction as a kind of defect of the will. Addicts, we tend to suppose, are subject to impulses or cravings that are peculiarly unresponsive to their evaluative reflection about what there is reason for them to do. As a result of this unresponsiveness, we further suppose, addicts are typically impaired in their ability to act in accordance with their own deliberative conclusions. My question in this paper is whether we can (...) make adequate sense of this conception of addiction as a volitional defect. In particular, I want to focus on some philosophical assumptions, from the theory of action, that bear directly on the very idea that addiction might impair the agent’s volitional capacities. Understanding this idea, I shall argue, requires that we start out with an adequate conception of the human will. Only if we appreciate the kinds of volitional capacities characteristic of normal agents can we conceptualize properly the impairment of those capacities represented by addiction, and assess the implications of such impairment for questions of responsibility. (shrink)

Zoey Lavallee attempts to offer a unified account of addictive craving that explain what craving is across all substance and process addictions. They think that their theory of craving, if true, “bolsters social and psychological views of addiction” and undermines neurobiological theories. My own view is that addictive carvings are a disunified hodgepodge and thus that it is not possible to corral cravings for one addiction type into a unified kind, let alone to do so across addiction (...) types. I also do not think that neurobiological and social and psychological theories of addiction need to be seen as competitors when it comes to the phenomenology of addiction. I’ll explain using Lavallee’s... (shrink)

This essay is framed by the work of Edward Sampson (1993), and is a sociohistorical analysis of the institutional vicissitudes in American history that have formed the ground of our current version of the “truth” about drugs, alcohol, the drug addict and the alcoholic. The drug and alcohol discourse has been used throughout American history to institute and maintain normative ideals. These ideals are contoured by Western individualistic understandings of human being. They revolve around a theme of freedom seen as (...) access to unlimited possibilities, which arises as a right for those individuals who are self-reliant. Alcoholics and addicts have been used as political identities, silently portraying the opposite and living out the underside of these normative ideals. As political identities they are used discursively to maintain mainstream illusions of self-reliance and to hide the falsehood of the capitalist promise of unfettered access to unlimited possibilities. Capitalist interests flourish through the maintenance of these illusions, and are able to disown responsibility via the silencing, through embodiment, of those who have been marginalized. This self-celebratory discourse is, hence, a monologue that undermines the possibility of hierarchical revolutions. Encapsulated in the embodiment of the alcoholic and addict are the covering over of political conflicts, the leveling down of difference, and the marginalizing of those who represent dialogical possibility. Twelve-step mutual help organizations participate in self-celebratory monologues that maintain the version of truth supportive of the agendas of the wealthy; however, they also offer an other-centered strategy by which dialogue again becomes possible. (shrink)

Mental conflict not always amounts to weakness of will. Irresistible motives not always speak of addiction. This book proposes an integrated account of what singles out these phenomena: addiction and weakness of will are both forms of secondary akrasia. By integrating these two phenomena into a classical conception of akrasia as poor resolution of an unnecessary conflict – valuing without intending while intending without valuing – the book makes an original contribution to central issues in moral psychology and (...) philosophy of action, including the relationship between responsibility and intentional agency, and the nature and scope of moral appraisal. In particular, the proposed integrated account is grounded in a general theory of responsibility and a related model of action as actualisation bringing together insights from both volitional and non-volitional conceptions, such as the intuition that it is unfair to hold a person responsible for things that are not up to her and the parity of actions and attitudes as legitimate objects of moral appraisal. Furthermore, the actualisation model supports a distinctive version of the Guise of the Good thesis which links valuing and intending in terms of success in action and explains why akratic actions and their offspring – addiction and weakness of will – are necessarily less than successful yet fully responsible. (shrink)

Philosophers and psychologists have long tried to understand people's irrational behaviour through concepts such as weakness of will, compulsion and addiction. The scientific basis of the project has been greatly enhanced by advances in cognitive psychology and neuroscience. However, some philosophers have also been critical of the more general conclusions drawn by the scientists. This is especially true when scientific researchers start making claims that go to philosophical issues, such as free will and responsibility. Conversely, some scientists have been (...) critical of philosophical approaches for not understanding the results of recent research. I examined some of the recent history of scientific claims about addiction, and the rise of the claims from scientists to have shown that addiction is a brain disease and that addictive behaviour is compulsive. Given the well-confirmed evidence that addicts can modulate their behaviour in response to rewards, punishments and context, it is clear that according to normal definitions of compulsivity the behaviour of addicts is not typically compulsive, suggesting that neuroscientists are making an error in their interpretation of data. Since philosophers have expertise in making distinctions between different kinds of action and categorising them as free, weak-willed and compulsive, we will achieve a better interpretation of the neuroscience of addiction when taking this philosophical work into account. Conversely, given the status of science in the modern world, philosophers have to grapple with the latest neuroscientific discoveries and show the compatibility of their philosophical theories with the data for their approaches to maintain credibility. (shrink)

This book brings cutting edge neuroscience and psychology into dialogue with philosophical reflection to illuminate the loss of control experienced by addicts, and thereby cast light on ordinary agency and the way in which it sometimes goes wrong.

In this paper, I argue that the thought and behavior involved in drug dependence is associated with a certain pre-theoretic conception of the self that finds philosophical expression as a grossly simplified form of materialism. Addicts tend not to take mentality seriously: They do not understand themselves as minded beings capable of self-awareness and development through intentional action. Recognizing the practical implications of accepting this philosophically unconvincing view, I argue, encourages a modification of self-conception that is instrumental to the process (...) of recovery from addiction. Using a combination of philosophical analysis and close reading of a trio of narratives that describe drug dependence and recovery, I pursue the possibility that rehabilitation may involve the clarification and alteration of self-conception in such a way that emphasizes autonomous agency and certain values that have not yet been embraced by twelve-step programs, namely, integration, apprehension, moderation, and self-discipline. The rich and substantial history of analytic–philosophical thought about the self is of immense practical value to people impacted by drug dependence and/or engaged in recovery from it; philosophy offers us a set of investigative tools, terms, and concepts that may help to map the different cognitive routes to successful self-rehabilitation. A philosophical consideration of the use of self-related words and ideas within the context of narratives of addiction and recovery may bear directly and significantly on the improvement of the lives of those persons who struggle to overcome drug dependence. (shrink)

_The Disordered Mind: An Introduction to Philosophy of Mind and Mental Illness, second edition_ examines and explains, from a philosophical standpoint, what mental disorder is: its reality, causes, consequences, and more. It is also an outstanding introduction to philosophy of mind from the perspective of mental disorder. Revised and updated throughout, this _second edition_ includes new discussions of grief and psychopathy, the problems of the psychophysical basis of disorder, the nature of selfhood, and clarification of the relation between (...) rationality and mental disorder. Each chapter explores a central question or problem about mental disorder, including: what is mental disorder and can it be distinguished from neurological disorder? what roles should reference to psychological, cultural, and social factors play in the medical/scientific understanding of mental disorder? what makes mental disorders undesirable? Are they diseases? mental disorder and the mind–body problem is mental disorder a breakdown of rationality? What is a rational mind? addiction, responsibility and compulsion ethical dilemmas posed by mental disorder, including questions of dignity and self-respect. Each topic is clearly explained and placed in a clinical and philosophical context. Mental disorders discussed include clinical depression, dissociative identity disorder, anxiety, religious delusions, and paranoia. Several non-mental neurological disorders that possess psychological symptoms are also examined, including Alzheimer’s disease, Down’s syndrome, and Tourette’s syndrome. Containing chapter summaries and suggestions for further reading at the end of each chapter, _The Disordered Mind, second edition_ is a superb introduction to the philosophy of mental disorder for students of philosophy, psychology, psychiatry, and related mental health professions. (shrink)

Addiction is almost universally held to be characterized by a loss of control over drug-seeking and consuming behavior. But the actions of addicts, even of those who seem to want to abstain from drugs, seem to be guided by reasons. In this paper, I argue that we can explain this fact, consistent with continuing to maintain that addiction involves a loss of control, by understanding addiction as involving an oscillation between conflicting judgments. I argue that the dysfunction (...) of the mesolimbic dopamine system that typifies addictions causes the generation of a mismatch between the top-down model of the world that reflects the judgment that the addict ought to refrain from drugs, and bottom-up input caused by cues predictive of drug availability. This constitutes a powerful pressure toward revising the judgment and thereby attenuating the prediction error. But the new model is not stable, and shifts under the pressure of bottom-up inputs in different contexts; hence the oscillation of all-things-considered judgment. Evidence from social psychology is adduced, to suggest that a similar process may be involved in ordinary cases of weakness of will. (shrink)

Impairment of self-control is often said to be a defining feature of addiction. Yet many addicts display what appears to be a considerable amount of control over their drug-oriented actions. Not only are their actions clearly intentional and frequently carried out in a conscious and deliberate manner, there is evidence that many addicts are responsive to a wide range of ordinary incentives and counter-incentives. Moreover, addicts have a wide variety of reasons for using drugs, reasons which often seem to (...) go a long way towards explaining their drug-oriented behavior. Many use drugs, for example, to cope with stressful or traumatic experiences. In this article I argue that some standard philosophical explanations of addicts’ impairment of self-control are inadequate, and propose an alternative. (shrink)

Examining the author’s own experiences of narcotics addiction reveals certain aspects of the addicted mentality that have strong ethical valence. In general, this shows that addiction is not a state fundamentally characterized by lack. The rudiments of this position are found in some contemporary philosophy of addiction; also, it is contrasted with a common widely held mistaken view. Addiction should instead be understood in continuity with and as illuminating the nature of human personhood and subjectivity. (...) Under a phenomenology specific to the author’s experience, addiction appears as a mode of experience that has an unmanageable overflow of narratives created as discourses concerning people, events, thoughts, and feelings. (shrink)

Friends since childhood, Anais Darnby and Lindsay Markham have long harbored a secret passion for one another. When they finally confess their love, their future together seems assured, sealed with their searing embrace. But when a debauched Lindsay is seduced by a scheming socialite, a devastated Anais seeks refuge in another man's bed while Lindsay retreats to the exotic East. There, he is seduced again--this time by the alluring red smoke and sinister beauty of opium. Back home, Lindsay's addiction (...) is fed by the vogue for all things Oriental--especially its sensual pleasures--in fashionable London society. In his lucid moments, Lindsay still lusts after Anais, who can neither allow him near nor forget his smoldering touch. Tortured by two obsessions--opium and Anais--Lindsay must ultimately decide which is the one he truly cannot live without. (shrink)

ABSTRACT This introductory paper raises, partly as a preparation for the other papers in this issue, questions about how philosophy ought to proceed in the light of knowledge we have in surrounding disciplines, with a focus on the case of addiction. It also raises issues about how addiction research might be enlightened by philosophical work. In the background for the paper are two competing approaches to the evidential grounding of philosophical insight. According to a widespread view, philosophical (...) knowledge rests on a set of intuitions. According to another, philosophy has no special evidential grounding. This paper resists the attractions of the first picture, and argues against the separateness of philosophy that it lends support. I try to make plausible that such a picture is harmful both for philosophy and for empirical science. We should replace it with a mild form of unity of science or unity of inquiry, in the spirit of the founder of this journal. (shrink)

The claim that addiction is a brain disease is almost universally accepted among scientists who work on addiction. The claim’s attraction rests on two grounds: the fact that addiction seems to be characterized by dysfunction in specific neural pathways and the fact that the claim seems to the compassionate response to people who are suffering. I argue that neural dysfunction is not sufficient for disease: something is a brain disease only when neural dysfunction is sufficient for impairment. (...) I claim that the neural dysfunction that is characteristic of addiction is not sufficient for impairment, because people who suffer from that dysfunction are impaired, sufficiently to count as diseased, only given certain features of their context. Hence addiction is not a brain disease (though it is often a disease, and it may always involve brain dysfunction). I argue that accepting that addiction is not a brain disease does not entail a moralizing attitude toward people who suffer as a result of addiction; if anything, it allows for a more compassionate, and more effective, response to addiction. (shrink)

I argue that addiction is not an appropriate category to support generalizations for the purposes of scientific prediction. That is, addiction is not a natural kind. I discuss the Homeostatic Property Cluster (HPC) theory of kinds, according to which members of a kind share a cluster of properties generated by a common mechanism or set of mechanisms. Leading accounts of addiction in literature fail to offer a mechanism that explains addiction across substances. I discuss popular variants (...) of the disease conception and demonstrate that at least one class of substances that fails to confirm a major prediction of each account. When no mechanism can be found to explain the occurrence of the relevant properties in members of a category, the HPC view suggests that we revise our categories. I discuss options offered by the HPC view, including category revision and category replacement. I then conclude that talk of addiction as a prediction-supporting category should be replaced with categories such as “S-addiction” and “T-addiction,” where S and T are substances or sets of substances of abuse, as these categories are genuine natural kinds. (shrink)

ABSTRACT Choice theorists such as George Ainslie and Gene Heyman argue that the drug-seeking behaviour of addicts is best understood in the same terms that explain everyday choices. Everyday choices, they claim, aim to maximise the reward from available incentives. Continuing drug-use is, therefore, what addicts most want given the incentives they are aware of but they will change their behaviour if and when better incentives become available. This model might explain many typical cases of addiction, but there are (...) hard cases that pose a problem. In these hard cases the addicted individual does not cease using drugs in the face of consequences that are so adverse it is implausible that they are unaware of more rewarding paths of action. These cases force the choice theorist into a dilemma: either these addicts? drug use does not count as action and so is best described by a neurobiological model, or reference to ?reward? in these cases means merely ?motivated? and so provides no explanatory power. We propose a different model of motivation that takes self-conception into account. We show how that can better explain the hard cases of addiction and also inform our understanding of recovery and self-control. (shrink)

Charland's article suggests that we need to think more about whether decision-making capacity is impaired in severe addiction, working from the idea that drug dealers rely on this understanding of addiction to draw in their clients. Charland argues that it is possible to make a choice without being in control (to make decisions without having decision-making capacity). I argue in support of Charland's ideas by examining the reasons supporting a medical model of addiction and its importance. (For (...) Charland's article and the full set of commentaries, please see the Research Gate link). (shrink)

The common conception is that philosophy is an armchair endeavour. For many (Žižek 2023), the task of philosophy is just to provide the right kinds of questions to the sciences upon which they can develop further tools etc. The research will aim to show that it is not just the right kind of questions that philosophy can provide, instead, it can provide practical solutions as well. The research paper will primarily aim to showcase a methodology for (...) class='Hi'>addiction recovery based on the philosophy of Advaita Vedanta, which can be broadly applied to most kinds of addiction. The biggest problem with most kinds of addiction treatment programmes is relapse. So, can we devise a methodology which not only cures the problem of addiction but also provides aid in refraining from subsequent relapse? (shrink)

ABSTRACT This article reports the result of a survey about causal beliefs, normative conceptions and moral evaluations of addicts and addiction in the general population. Specifically, we focused on four issues: To what extent are the normative conceptions of addiction current in the philosophical and scientific literature reflected in laypersons' conception of addiction? How do laypersons rate addicts on perceived responsibility? Which factors influence laypersons' responsibility attributions in the context of addiction? What feelings and attitudes (anger/sympathy/help-giving (...) intentions) do laypersons have toward addicts? We found that, although laypersons seem to assume a weakness view of addiction, their patterns of responsibility attributions vary depending on type of drugs combined with perceived severity of outcome, where the latter even overrides the attributional effects of the actor's perceived control over events. Some explanations of the data are suggested, and various consequences with respect to help-giving behavior, are discussed. (shrink)

The self is a common yet unclear theme in addiction studies. William James's model of self provides a framework to explore the experience of self. His model details the subjective and objective constituents, the sense of self‐continuity through time, and the ephemeral and plural nature of the changing self. This exploration yields insights into the self that can be usefully applied to subjective experiences with psychoactive drugs of addiction. Results of this application add depth to the common understanding (...) of self in addiction, acknowledge the importance of feelings and choice in the sense of self created in addiction experiences, and affirm the values salient to these interior experiences in addiction. These results suggest meaning derived from those values, and provide important background knowledge for the nurse interacting with these clients. (shrink)

This paper tries to show that the naturalistic view of addiction is mired in contradictions that stem from reducing the addict to a weak-willed subject who loses control over his or her body. From a phenomenological perspective, addiction reveals itself to be a habit which eventually becomes harmful, but has its primary sources in the embodied needs of a worldly subject. The aim of this paper is to uncover the dimensions of the lived addiction that are neglected (...) in the contemporary naturalistic discourse: the lived-body and the worldly context of the addict. Firstly, we try to do justice to the variety of addictions by underlying that their new and surprising forms are determined by the intersubjective tissue wherein the subject operates. Secondly, the loss of control in addiction, how the subject deals with the tendency to satisfy a need, is experienced as powerlessness, as expressed in the accounts of ecstasy addicts regarding altered states of mind. The last section of this paper will argue that this sense of powerlessness cannot be equated with a weakness of the will because a strong, forceful will engenders the same vertigo of being prey to strange powers. The embodied aspect of addiction and the spontaneous, bodily need it saturates will clarify further this claim. (shrink)

Indigenous understandings of consciousness represent an important inspiration for scientific discussions about the nature of consciousness. Despite the fact that Indigenous concepts are not outputs of a research driven by rigorous, scientific methods, they are of high significance, because they have been formed by hundreds of years of specific routes of cultural evolution. The evolution of Indigenous cultures proceeded in their native habitat. The meanings that emerged in this process represent adaptive solutions that were optimal in the given environmental and (...) social milieu. We argue that it would not be appropriate to handle these meanings as something that science considers to be wrong, or outdated relics of the human past. In contrast, Indigenous concepts and their meanings may be considered to be an important heritage of native human populations, but moreover, they are also an interesting material for analyses and inspiration for recent scientific debates. Furthermore, it is also necessary to mention another reason why the exploration of Indigenous concepts has been so topical recently. Thus far, much psychological theoretical development has been published in English as a result of research conducted in Western countries. The dominance of English and the superiority of research conducted by researchers from Western countries may be considered as a kind of barrier toward other ways of knowing. We argue that the traditional cultural knowledge coming from Indigenous societies may offer an interesting source of new thought for science. The weakening of the strong dependence of science on well-established academic circles dominated by Western theoretical perspectives may be beneficial for stimulating its further development (Sidik, 2022). Therefore, this special symposium of the Journal of Consciousness Studies aims to open the doors for other ways of knowing, For the knowing that emerged in native Indigenous cultures. We argue that the rich cultural heritage of these societies may stimulate the emergence of new analytical perspectives for scientific theorising about the nature of consciousness. For all these reasons, the Indigenous concepts of consciousness captured our interest, and we decided to start investigating them. In 2020 and 2021, we retrieved and analysed pieces of information from past ethnographical field evidence gathered in various Indigenous cultures. After removal of data about the cultures showing a high acceptance of influences from external religious traditions (e.g. Christianity, Islam or Buddhism), a comparative analysis of data from 55 Indigenous groups was conducted and published in the Journal of Consciousness Studies (Trnka and Lorencova, 2022). This primary project revealed many interesting results, but more importantly, it also showed many unexplored avenues that called for further exploration. This special symposium of the Journal of Consciousness Studies is a continuation and new development of research on the Indigenous understanding of consciousness. Past ethnographical evidence involved some valuable pieces of knowledge about Indigenous concepts of consciousness, but the relevant information was often fragmentary or even totally missing in some cases. Moreover, many authors of past ethnographic records applied a strong etic approach that clouded the understanding of native Indigenous thoughts. Therefore, the main goal of the recent symposium was to broaden the overall information basis for the analysis of Indigenous concepts of consciousness or closely related phenomena. In other words, the symposium aimed to bring more detailed knowledge of Indigenous concepts of consciousness, mind and body and their relations in various groups of Indigenous people. In 2022, we contacted potential contributors and were pleased by their positive reactions, which reflected the topicality of this research focus. The authors were asked to draft their papers with a special focus on (a) a cultural Indigenous understanding of the concept of consciousness, (b) a cultural Indigenous understanding of the mind-body differentiation (or consciousness-body differentiation) and (c) cultural metaphors and cultural beliefs related to consciousness, mind and body. Many of contributors were native members of Indigenous cultures that made the descriptions of Indigenous concepts more accurate and reliable. This enabled many truly emic, in-depth insights into the Indigenous concepts of consciousness and related phenomena to be gained. As a result, this issue of the Journal of Consciousness Studies introduces eight papers, each focused on a different geographical region/Indigenous groups: Nahua and Maya (Mexico), Guna (Panama), Mapuche (Chile), Maori (New Zealand), Telingit (Altai), Mongolian groups, Igbo (Nigeria) and Asabano (New Guinea). These papers are followed by one more general paper discussing magical consciousness on the case of an Aboriginal wise man (Australia). The symposium closes with our concluding editorial essay, which generalises the findings and introduces three theoretical models of understandings of consciousness inspired by the analysis of Indigenous concepts of consciousness. Aside from the importance for basic research, the exploration of Indigenous concepts of consciousness is also very important for informing practitioners from many applied spheres. Many current methods for treating addictions, traumatic life events, professional burnout and other mental health problems use features of Indigenous healing practices. A proper understanding of meanings related to mind, body and consciousness are quite important for Western psychotherapists to adapt the Indigenous practices to particular Western cultural milieus. Furthermore, a proper understanding of meanings related to mind, body, and consciousness is also important for treating ethnic, linguistic and culturally diverse populations (APA, 1990). For therapists, psychologists and physicians, understanding the meanings of these concepts may promote their own better care of their clients from various Indigenous ethnic groups. Last but not least, Indigenous concepts, meanings and languages are closely related to the continuation of the heritage of Indigenous people (United Nations, 2016). The world’s Indigenous languages have recently been under threat of disappearing; many Indigenous languages are endangered globally, and the rate of loss is high (United Nations, 2016). Importantly, recent research has also shown that the retention of Indigenous languages may be protective for the psychological and physical health of their speakers. All these areas represent fields for potential use of the findings presented in this symposium of the Journal of Consciousness Studies. As a concluding note, the editors of this symposium hope that this collection of papers will inspire academic scholars while also providing important information for practitioners from various spheres. (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)

Neil Levy argues that while addicts who believe they are not addicts are self-deceived, addicts who believe they are addicts are just as self-deceived. Such persons accept a false belief that their addictive behaviour involves a loss of control. This paper examines two implications of Levy's discussion: that accurate self-knowledge may be particularly difficult for addicts; and that an addict's self-deceived belief that they cannot control themselves may aid their attempts at self-control. I argue that the self-deceived beliefs of addicts (...) in denial and of self-described addicts differ in kind. Unlike the self-deception of an addict in denial, that of the self-described addict allows them to acknowledge their behaviour. As such, it may aid an addict to develop more self-control. A paradoxical implication is that this self-deception may allow an addict more self-knowledge. (shrink)

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 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 paper discusses alternatives of philosophical approach to addiction. While not denying the central position of problems of will or craving, it focuses on the broader anthropological context of addiction, using Heidegger’s existential analyses. It appears that addiction – in some cases, because an essentialist exposition is not viable here – is characterized by a defective pattern of the agent’s choice among possibilities and of temporality. The anecdotic observations can be synthesized into a treatise of addiction (...) as a normative disorder: a systematic inability of the addict to function within usual normative practices of various social contexts. The relevance of this perspective is testified also by therapeutic practice: addicts are treated not exclusively with respect to problems concerning will, but as persons who have to be re-socialized, i.e. led to a responsible attitude both towards themselves and society. (shrink)

Although the new ethical challenges posed by biotechnology and digital surveillance have been the focus of close attention and heated debate among Christian ethicists, comparatively little attention has been dedicated to far more ubiquitous technologies: the internet and our smartphones. Yet evidence is mounting among cognitive scientists, sociologists, and psychologists that the internet and related media technology are profoundly reshaping human thought, behavior, and sociality. This is surely a matter for ethical concern if there ever was one. This essay argues (...) that the medieval concept of the vice of curiositas is an apt diagnosis of the ways in which digital media can absorb and scatter our attention, often in pathological ways. I first offer a summary of what earlier Christian authors meant by curiosity, and I classify their concerns into a typology of seven forms of vicious curiosity. I then show how the phenomenon of online pornography addiction in particular and other forms of internet addiction more generally confirm the explanatory power of this older concept and especially Augustine's distinction of the "lust of the flesh" and "the lust of the eyes." I conclude by suggesting how the grammar of "vice" and "virtue" allows us to embrace the value of new technologies while consciously cultivating strategies of resistance to their harmful tendencies. (shrink)

Recent developments regarding the pharmacology of psychoactive substances are significant for treating depressions or opioid addictions. Current theories, hypotheses, and models of drug effects assume a cause–effect narrative, which is based on a stimulus/response mechanism. These narratives prioritize effects rather than conscious experiences. In this sense, drug experiences are quickly subsumed into common categories and codes of biological determinism. If subjective experiences are in the focus of the research, it quickly becomes a link to mystical, spiritual, or transcendental narratives. These (...) classifications lead to epistemological doublets (Gadamer). In this article, psychedelic experiences of drug users are analyzed in the frame of the pharmaco-analysis by Deleuze/Guattari. These framed psychedelic experiences are interpreted by means of a non-philosophical approach through philo-fictions (Laruelle), i.e., contradictory assumptions and hyperspeculations. In this respect, the aim of this article is to bring philo-fictions in relation to psychedelic experiences and to discuss them with models of information science, quantum mechanics, new materialism, and the philosophy of immanence. The result will be an open synthesis, with the assumption of further reflections on the agency, immanence, and the wholeness of matter. (shrink)

International media have reported cases of pregnant women who have had their children apprehended by social services, or who were incarcerated or forced into treatment programs based on a history of substance use or lack of adherence to addiction treatment programs. Public discourse on the biology of addiction has been criticized for generating stigma and a diminished perception of self-control in individuals with an addiction, potentially contributing to coercive approaches and criminalization of women who misuse substances during (...) pregnancy. We explored whether this is the case based on literature from social psychology, ethics, addiction research, science communication, and philosophy. The literature shows that the relationship between public discourse on biological aspects of addiction and issues such as stigma and perceptions of diminished self-control are unclear, largely due to the complexity of these phenomena. However, concerns about the biological approach are nevertheless legitimate given the broader social and policy context of women’s health. (shrink)

In this chapter I argue that there is a normative aspect to self-control that is not captured by the purely procedural account to be drawn from dual process theories of cognition – which we only uncover when we consider what self-control is for and why it is valuable. For at least a significant sub-group of addicts their loss of control over their drug use may not be due to a lack or depletion of cognitive resources. Rather it may be that (...) they have little confidence in their ability to exert control over their circumstances and shape the life they would value having and the person they would value being. (shrink)

Whatever its implications for the other features of human agency at its best — for moral responsibility, reasons-responsiveness, self-realization, flourishing, and so on—addiction is universally recognized as impairing autonomy. But philosophers have frequently misunderstood the nature of addiction, and therefore have not adequately explained the manner in which it impairs autonomy. Once we recognize that addiction is not incompatible with choice or volition, it becomes clear that none of the Standard accounts of autonomy can satisfactorily explain the (...) way in which it undermines fully autonomous agency. In order to understand to what extent and in what ways the addicted are autonomy-impaired, we need to understand autonomy as consisting, essentially, in the exercise of the capacity forextended agency.It is because addiction undermines extended agency, so that addicts are not able to integrate their lives and pursue a Single conception of the good, that it impairs autonomy. (shrink)

Addiction involves a chronic deficit in self-governance that treatment aims to restore. We draw on our interviews with addicted people to argue that addiction is, in part, a problem of self-narrative change. Over time, agents come to strongly identify with the aspects of their self-narratives that are consistently verified by others. When addiction self-narratives become established, they shape the addicted person’s experience, plans, and expectations so that pathways to recovery appear implausible and feel alien. Therefore, the agent (...) may prefer to enact her disvalued self-narrative because at least it represents who she takes herself to be. To recover, the agent needs to conduct narrative work, adjusting her existing self-narrative so that it better supports recovery-directed narrative projections. Reducing cravings, managing withdrawals, increasing self-control, and developing goals are all important for recovery but those approaches will often be in vain if the influence of self-narrative is ignored. If our analysis is correct, addiction treatment will typically be more effective if it incorporates support for self-narrative change. (shrink)

ABSTRACT Clinicians, researchers and the informed public have come to view addiction as a brain disease. However, in nature even extreme events often reflect normal processes, for instance the principles of plate tectonics explain earthquakes as well as the gradual changes in the face of the earth. In the same way, excessive drug use is predicted by general principles of choice. One of the implications of this result is that drugs do not turn addicts into compulsive drug users; they (...) retain the capacity to say ?no?. In support of the logical implications of the choice theory approach to addiction, research reveals that most addicts quit using drugs by about age 30, that most quit without professional help, that the correlates of quitting are the correlates of decision making, and, according to the most recent epidemiological evidence, the probability of quitting remains constant over time and independent of the onset of dependence. This last result implies that, after an initial period of heavy drug use, remission is independent of any further exposure to drugs. In short, there is much empirical support for the claim that addiction emerges as a function of the rules of everyday choice. (shrink)