현대 사회에서 일중독 증세가 있는 사회 구성원들이 많아지고 있다. 이것은 성과주의라는 가치가 시대적인 삶의 흐름이 되어가고 있음을 의미할 수 있다. 인간이 자유롭고 독립적인 주체로 살아가는 데 일은 하나의 중요한 요소이지만, 지나치게 성과주의에 집착하여 일이 자신의 존재를 구속하게 된다면 인간은 자유로운 주체로 살아가기가 힘들 것이다. 마르틴 하이데거(M. Heidegger)는 그의 주저인 『존재와 시간』에서 인간 실존이 ‘비본래성’(Uneigentlichkeit)으로부터 ‘본래성’(Eigentlichkeit)을 찾을 방법을 제시한 바 있다. 누군가가 “무엇을 찾고 있다.”라는 것은 찾고 있는 대상을 잃어버렸다는 것을 의미한다. 즉 본래적 자기를 찾는다는 것은 본래의 자기를 잃어버렸음을 말한다. 이 (...) 논문에서 필자는 일중독을 본래적 자기 존재를 스스로 상실한 채 살아가고 있는 현대인의 비본래적인 모습 중에 하나로 파악할 것이다. 또한 필자는 일중독 증세를 가진 내담자가 처해있는 세계를 분석하고, 철학상담을 통해 내담자가 스스로 본래적 자기를 찾아갈 수 있는지를 살펴보고자 한다. (shrink)

Recent research highlights the positive effects of organizational CSR engagement on employee outcomes, such as job and life satisfaction, performance, and trust. We argue that the current debate fails to recognize the potential risks associated with CSR. In this study, we focus on the risk of work addiction. We hypothesize that CSR has per se a positive effect on employees and can be classified as a resource. However, we also suggest the existence of an array of unintended negative (...) effects of CSR. Since CSR positively influences an employee’s organizational identification, as well as his or her perception of engaging in meaningful work, which in turn motivates them to work harder while neglecting other spheres of their lives such as private relationships or health, CSR indirectly increases work addiction. Accordingly, organizational identification and work meaningfulness both act as buffering variables in the relationship, thus suppressing the negative effect of CSR on work addiction, which weakens the positive role of CSR in the workplace. Drawing on a sample of 565 Swiss employees taken from the 2017 Swiss Public Value Atlas dataset, our results provide support for our rationale. Our results also provide evidence that the positive indirect effects of organizational CSR engagement on work addiction, via organizational identification and work meaningfulness, become even stronger when employees care for the welfare of the wider public. Implications for research and practice are discussed. (shrink)

This article attempts to point out the main problem in research on workaholism, namely over-use of the term workaholism when describing symptoms or constructs which are not related to work addiction. Workaholism has one, negative pathological/dysfunctional form and can be differentiated from the healthy forms of over-engagement. Based on the analysis of one example of research results, this article explains that the nomenclature of „workaholic“ is not applicable to the case of over-engaged employees with healthy symptoms. The second (...) aim of the article is to argue that the invalid conceptualisation and measurement of workaholism can result in conclusions which do not really regard work addiction. (shrink)

Individuals in managerial and professional jobs now work long hours for a variety of reasons. Building on previous research on workaholism and on types of passion, the results of three exploratory studies of correlates of work-based Passion and Addiction are presented. Data were collected in three samples using anonymously completed questionnaires: Canadian managers and professionals, Australian psychologists, and Norwegian journalists. A common pattern of findings was observed in the three samples. First, respondents scoring higher on Passion and (...) on Addiction were more heavily invested in their work. Second, respondents scoring higher on Passion also indicated less obsessive job behaviors, greater work satisfactions, and higher levels of psychological well-being. Third, respondents scoring higher on Addiction indicated more obsessive job behaviors, lower work satisfaction, and lower levels of psychological well-being. (shrink)

This paper aims to explore the complex manner in which Martin Amis defines the state of addiction–as the sustained collapse of objectivity and subjectivity for any inhabitant of a social system–as well as how the systemic patterns of life impose, imprint, and perpetuate themselves upon the individual.

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)

Background: Recent literature on addiction and judgments about the characteristics of agents has focused on the implications of adopting a ‘brain disease’ versus ‘moral weakness’ model of addiction. Typically, such judgments have to do with what capacities an agent has (e.g., the ability to abstain from substance use). Much less work, however, has been conducted on the relationship between addiction and judgments about an agent’s identity, including whether or to what extent an individual is seen as (...) the same person after becoming addicted. Methods: We conducted a series of vignette-based experiments (total N = 3,620) to assess lay attitudes concerning addiction and identity persistence, systematically manipulating key characteristics of agents and their drug of addiction. Conclusions: In Study 1, we found that US participants judged an agent who became addicted to drugs as being closer to ‘a completely different person’ than ‘completely the same person’ as the agent who existed prior to the addiction. In Studies 2-6, we investigated the intuitive basis for this result, finding that lay judgments of altered identity as a consequence of drug use and addiction are driven primarily by perceived negative changes in the moral character of drug users, who are seen as having deviated from their good true selves. (shrink)

In this article in a form of a review I analyze at length A. Pruss’ book One Body, pointing at where I agree with him and stressing several flaws in his arguments. The general line of thought, which is exploring the biblical metaphor of “being one body,” is ultimately sufficient for me from the theological, but not the philosophical point of view.

Substance addiction has been historically conceived and widely researched as a brain disease. There have been ample criticisms of brain-centred approaches to addiction, and this paper aims to align with one such criticism by applying insights from phenomenology of psychiatry. More precisely, this work will apply Merleau-Ponty’s insightful distinction between the biological and lived body. In this light, the disease model emerges as an incomplete account of substance addiction because it captures only its biological aspects. When (...) considering addiction as a brain disorder, it will be shown that research fails to account for the contextual, functional, and emotional aspects inherent to subjective health. It is concluded that, while the disease model is fundamental to our understanding of what happens in the brain, its brain-centred approach is cure-oriented. Instead, we suggest a care-orientated approach, which understands and treats the psychological feel as bodily experience situated in an environment, allowing for a more encompassing therapeutic perspective. (shrink)

There are many ways of interpreting the behaviours related to substance misuse and addiction, which can be sort out as three basic models: biomedical, legal, and social. They are corresponding to approaches built in different epistemic and professional frameworks, such as medicine, law, and social work. Confronted with the experience of addiction, these models appear as pre-determined by a specific scientific or professional ideology; they presuppose a pre-understanding of the phenomena. I directed, therefore, my investigation on those (...) phenomenological paths that might lead to, and circumscribe the experience of addiction and I propose an analytical framework based on three major phenomenological perspectives: descriptive, genetic, and inter-relational. This paper argues in favour of defining addiction without making reference to a form of failure, psycho-somatic or existential. On the contrary, it concludes that there is a need to adopt a definition of addiction which holds at its core the idea of empowering addicted persons, of re-constructing their capacity to take decisions about their own lives. (shrink)

Addiction: A Philosophical Approach CHAPTER ABSTRACTS “Introduction: Dismantling the Catchphrase” by Candice Shelby Shelby dismantles the catchphrase “disease of addiction.” The characterization of addiction as a disease permeates both research and treatment, but that understanding fails to get at the complexity involved in human addiction. Shelby introduces another way of thinking about addiction, one that implies that is properly understood neither as a disease nor merely as a choice, or set of choices. Addiction is (...) a phenomenon emergent from a complex dynamic system that is at once physical, psychological, social, and more. “A Philosophical Analysis of Addiction” by Candice Shelby Shelby brings much-needed clarity to the discourse surrounding the topic of addiction. Arguing that addiction can neither properly be understood as a disease nor as merely a set of choices, Shelby exposes the weaknesses of both approaches. She shows that addicted persons do not exhibit the elements characteristic of compulsion, nor does an account of addiction in terms of weakness of will, or irrational choosing, provide a satisfying explanation. Instead, by replacing traditional substance ontology with process ontology, and accepting the reality of emergent entities, a coherent account of persons, minds, and addiction can be provided. A fundamental philosophical shift is necessary to see that bodies, minds, values, and addictions are all part of the natural world. “Addiction at the Individual Level” by Candice Shelby Shelby discusses the most influential accounts of addiction as it is understood at the purely individual level. From hedonic theories to incentive sensitization, to habit theories of addiction, to behavioral theories and the ego depletion theory, Shelby considers a variety of approaches to understanding addiction in individuals, as framed in both psychological and in neuroscientific terms. She notes some important caveats that should be considered before accepting the research regarding addiction at the individual level, namely that the scanning studies that are so popularly used to characterize addiction in neurobiological terms are ambiguous, and rely on numerous assumptions that may be false, and that certainly mislead. Shelby provides much-needed critique of both disease and choices models as they characterize addiction at the individual level. “Addiction and the Local Environment” by Candice Shelby Shelby argues that human addiction cannot be understood without serious consideration of the individual’s local environment, her home and family. From the gestational environment to interactions with caregivers during post-natal development to the adult environment in which people become addicted, Shelby shows that no one becomes an addict in a vacuum. Stress is a major influence in the environment throughout life, and has serious consequences for addictive vulnerability. Genetic influences as well are important to addictive vulnerability, but genes always express in interaction with their environment. Social acceptance or rejection is another particularly important factor in the local environment with respect to both coming to be addicted and transitioning out of it. “The Relation Between Addiction and Culture” by Candice Shelby Shelby provides a groundbreaking analysis of the relation between addicts and the cultures that breed them. In this cultural critique, Shelby shows that addictions to certain substances have historically been both the solution to the problem of how to grow economies and control people, and a problem for economic productivity and controlling citizens. Not all cultures have even the concept of addiction, while others, such as the contemporary Western world, and the U.S. in particular, seem to foster it. Shelby shows that addiction is both a cultural construct and, from another way of thinking about it, the result of conditions created by particular cultures. Social inequities, alienation, driving capitalism, and in particular the power of pharmaceutical companies, all contribute to the spiraling endemic of addiction. “Addiction and Meaning” by Candice Shelby Shelby provides a unique argument that understanding how meanings work is essential to a complete analysis of addiction. Individuals experiencing addiction and those who care about and for them often utterly fail to communicate. This is because their respective systems of meanings come to be significantly different. Meanings are not, Shelby argues, best understood in the symbolic terms that characterized the theory of language in the 20th century, but are better apprehended as emotion-rich prototypes carved from repeated interaction with the world. Becoming addicted essentially changes one’s entire system of meanings. Requisite to transitioning out of addiction is a Gestalt-type shift in one’s system of meanings. This holistic way of understanding meanings also provides one level of explanation of what happens when an addict relapses. “The Phenomenology of Addiction and its Implications” by Candice Shelby One way of judging theories of addiction is by how well they capture the phenomenal descriptions that addicts give of their own experiences. Shelby considers variations on 5 basic patterns of addictive experience through the eyes of particular individuals who lived through addictive periods, and shows how even the most influential theories of addiction fail to capture all of them. She argues that an important implication of taking the details of individuals’ addictive stories seriously is that addiction must be understood as a personal phenomenon emergent from a particular complex dynamic system. As her theory of addiction would lead one to expect, no two addicts are the same, and no single-focus theory can explain why not. “Possibilities for Transitioning Out of Addiction” by Candice Shelby Shelby provides numerous strategies for transitioning out of addiction. Given that the vast majority of addiction treatment programs currently available are 12-step based and only successful about 5-8% of the time, it is essential that other approaches be undertaken. Shelby canvasses a variety of options for helping addicted individuals to make the transition out of their troubled pattern of thinking and behaving. From direct brain interventions to drugs to trauma therapy to exercise and nutrition to habit reformation to use of narrative and changing one’s social context as ways of redefining the self, Shelby shows that the possibilities for transitioning out of addiction are legion. Perhaps the best approach is to understand addiction treatment in terms of providing physical, psychological, and social tool kits. “Addiction Emerges from a Complex Dynamic System” by Candice Shelby Shelby considers whether there truly exists such a thing as “an addict” or “addictive thinking” in the universal sense. She concludes that within the context of disruptive substance use or repetitive engagement in certain activities, ordinary human cognitive biases and behavior patterns are categorized as addictive. Addiction, she argues, is best understood as an irreducible human reality, emergent from a sufficiently complex dynamic system (an organism with self-awareness, within a particular cultural milieu) that is both shaped by and contributes to the shaping of its environment. Attempts to simplify addiction into one or a few dimensions may create a solvable problem, but by doing so they fail to solve the real one. (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)

Researchers working on drug addiction may, for a variety of reasons, want to carry out research which involves giving addicts their drug of choice. In carrying out this research consent needs to be obtained from those addicts recruited to participate in it. Concerns have been raised about whether or not such addicts are able to give this consent. Despite their differences, however, both sides in this debate appear to be agreed that the way to resolve this issue is to (...) determine whether or not addicts have irresistible cravings for drugs – if they do, then they cannot consent to this type of research; if they do not, then they can. This I will argue is a mistake. Determining whether or not addicts can say 'No' to offers of drugs will not help us to make much progress here. Instead we need to look at the various ways in which different types of research may undermine an addict's competence to give consent. What we will find is that the details of the research make a big difference here and that, as such, we need to steer a course between, on the one hand, painting all addicts as being unable to consent to research which involves providing them with drugs, and, on the other, maintaining that there are no problems in obtaining consent from addicts to take part in such research. (shrink)

Drug use and drug addiction are severely stigmatised around the world. Marc Lewis does not frame his learning model of addiction as a choice model out of concern that to do so further encourages stigma and blame. Yet the evidence in support of a choice model is increasingly strong as well as consonant with core elements of his learning model. I offer a responsibility without blame framework that derives from reflection on forms of clinical practice that support change (...) and recovery in patients who cause harm to themselves and others. This framework can be used to interrogate our own attitudes and responses, so that we can better see how to acknowledge the truth about choice and agency in addiction, while avoiding stigma and blame, and instead maintaining care and compassion alongside a commitment to working for social justice and good. (shrink)

While pornography addiction currently circulates as a comprehensible, diagnosable, and describable way to make sense of some people’s ostensibly problematic relationship with pornography, such a comprehensive description of this relationship has only recently been made possible. The current analysis makes visible pornography addiction as situated within a varied history of concerns about pornography, masturbation, fantasy, and technology in an effort to bring to bear a conceptual critique of the modern concept of pornography addiction. Such a critique in (...) turn works to offer an alternative to treating the study of pornography addiction as the discovery of a new disease, instead conceiving it as the propagation of old forms of knowledge under a new moniker. (shrink)

Recent studies reveal some of the neurophysiological mechanisms involved in drug addiction. This prompts some theorists to claim that drug addiction diminishes responsibility. Stephen Morse however rejects this claim. Morse argues that these studies show that drug addiction involves neither compulsion, coercion, nor irrationality. He also adds that addicted people are responsible for becoming addicted and for failing to take measures to manage their addiction. After summarizing relevant neuroscience of addiction literature, this chapter engages critically (...) with Morse to argue that a subgroup of addicted people does meet plausible criteria for compulsion, coercion, or irrationality; that few addicted people are fully responsible for becoming addicted; and that some addicted people can be at least partly excused for failing to manage their addiction. Pickard and Lacey’s “responsibility without blame” approach is also suggested as a fruitful basis for future work in this field. (shrink)

Addiction is widely taken to involve a profound loss of self-control. Addictive motivation is extremely forceful, and it is remarkably hard to abstain from addictive behaviors. Theories of addiction have sought to explain how self-control is undermined in addiction. However, an important explanatory factor in addictive motivation and behaviors has so far been underexamined: emotion. This paper examines the link between emotion and loss of control in addiction. I use the concept of affective scaffolding to argue (...) that drug use functions as a form of emotion regulation that, especially in certain psycho-socioeconomic conditions, can escalate into what I term addictive affective dependence. Addictive affective dependence is extremely motivating of drug use, and in this way contributes to the agent losing control. An upshot of the paper is that it predicts something that is known to be true about addiction treatment and recovery: strategies that address psycho-socioeconomic conditions are particularly successful in bolstering agency in addiction. Furthermore, my view explains why these strategies work. Thus, the view provides a conceptual framework for existing effective methods of addressing addiction. (shrink)

Addiction is a widespread problem affecting people from different regions, generations, and classes. It is often analysed as a problem consisting in compulsion or poor choice-making. Recently, however, integrated analyses of compulsion and choice have been called for. In this paper, I argue that the capability approach highlights the well-being loss at stake in cases of addiction, whether they are described as stemming from compulsion, poor choice-making, or some combination thereof. The relevant capabilities obtain when combinations of individual, (...) socio-political, and environmental factors jointly facilitate abstention. On this complementary evaluative analysis, people’s capabilities to abstain are shown to be undermined by how different kinds of factors interact with each other. The upshot is that without committing to an empirical view of the nature of addiction that must capture each case, the capabilitarian analysis helps highlight a central goal of addiction-related well-being policy-work, namely to promote people’s genuine opportunities to abstain. (shrink)

This article critically interrogates contemporary forms of addiction medicine that are portrayed by policy-makers as providing a ‘rational’ or politically neutral approach to dealing with drug use and related social problems. In particular, it examines the historical origins of the biological facts that are today understood to provide a foundation for contemporary understandings of addiction as a ‘disease of the brain’. Drawing upon classic and contemporary work on ‘styles of thought’, it documents how, in the period between (...) the mid-1960s and the mid-1970s, such facts emerged in relation to new neurobiological styles of explaining and managing social problems associated with drug abuse, and an alliance between a relatively marginal group of researchers and American policy-makers who were launching the ‘War on Drugs’. Beyond illustrating the political and material conditions necessary for the rise of addiction neuroscience, the article highlights the productivity of neurobiological thought styles, by focusing on the new biological objects, treatments and hopes that have emerged within the field of addiction studies over the last several decades. (shrink)

The conflict between drug and conventional rewards leads to a paradox: Sanctions against drug use decrease access to conventional rewards and push drug users toward drug abuse, whereas increased access to the rewards of family, friends, and work may help reduce drug abuse. Lack of control is not specific to drug addiction and is unlikely to yield to a shift in bookkeeping.

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)

In our target article, we proposed that addiction could be envisioned as misperformance of a decision-making machinery described by two systems (deliberative and habit systems). Several commentators have argued that Pavlovian learning also produces actions. We agree and note that Pavlovian action-selection will provide several additional vulnerabilities. Several commentators have suggested that addiction arises from sociological parameters. We note in our response how sociological effects can change decision-making variables to provide additional vulnerabilities. Commentators generally have agreed that our (...) theory provides a framework within which to site addiction and treatment, but additional work will be needed to determine whether our taxonomy will help identify and treat subpopulations within the addicted community. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Trauma, Addiction, and Temporal Bulimia in Madame BovaryElissa Marder (bio)Lisez, et ne rêvez pas. Plongez-vous dans de longues études. Il n’y a de continuellement bon que l’habitude d’un travail entêté. Il s’en dégage un opium qui engourdit l’âme [Read and do not dream. The only thing that is continually good is the habit of stubborn work. It emits an opium that numbs the soul].—Gustave Flaubert to Louise (...) ColetMadame Bovary I daresay is about bad drugs.—Avital Ronell, Crack WarsIf Flaubert’s Madame Bovary remains so timely, it is because its heroine, Emma, suffers from the quintessential malady of modernity, the inability to incorporate time into experience. Emma’s missed encounter with her own life, her inability to “get a life,” as we say now in America, renders her our contemporary in the strangest sense of the word. She is our contemporary not because we live in the same time but because her failure to live in time has come to define our own. Paradoxically, Emma Bovary has been so well preserved (she is, in some sense, “more alive” now than ever) because she incarnates and inaugurates a modernity that can be defined by the erosion of the possibility of living in time. In Flaubert’s minute and meticulous descriptions of the particular temporal disorders that afflict Emma (as we shall see, she can neither bear witness to an event nor remember one, she can neither live in the present nor project a future, she is incessantly subject to bouts of involuntary forgetting even as she is preoccupied by obsessive rites of recollection, she attempts simultaneously to conjure up time and to stop it), we can read the prophetic traces of a depiction of the temporal structure of the many forms of trauma and addiction that have come to define contemporary American culture.But before turning to Flaubert’s prescient and powerful analysis of how Emma Bovary suffers from a “temporal disorder,” let us take a brief look at how the notions of trauma and addiction have been described in a contemporary analysis of modern culture. In his recent book On Flirtation, the British child psychoanalyst Adam Phillips redescribes ordinary neurosis as a traumatic response to an inability to live in time. He writes:People come to psychoanalysis when there is something they cannot forget, something they cannot stop telling themselves, often by their actions, about their lives. And these dismaying repetitions—this unconscious limiting or coercion of the repertoire of life stories—create the illusion of time having stopped (or [End Page 49] rather, people believe—behave as if they have stopped time). In our repetitions we seem to be staying away from the future, keeping it at bay.[153]Phillips goes on to explain that “[f]or Freud these repetitions are the consequence of a failure to remember.... Whatever cannot be transformed, psychically processed, reiterates itself. A trauma is whatever there is in a person’s experience that resists useful redescription. Traumas, like beliefs, are ways of stopping time” [153–54]. Phillips’s argument rings with a seductive simplicity: neurosis is defined as a temporal disorder, and the contemporary psychoanalytic “cure” does nothing less than promise time. It presumably offers the subject the option of accepting the contingencies of living in time over the pleasure and pain that attend the attempt to stop it.Nonetheless, Phillips’s claim, that contemporary neurosis can be expressed as an attempt to stop time, should perhaps make us pause. Stopping time, in the time of Balzac, Gautier, Baudelaire, and Flaubert, was once conceived of as part of the privileged domain reserved for art and the artist. We might have naively assumed that in the realm of the “real world,” for “real people” time remains an implacable fact of life. The task of falling out of time, after all, would seem to necessitate either an accident of enormous magnitude (a trauma in the traditional sense) or the reliance upon an external substance—hashish, opium, alcohol, or cocaine—one of those mind-altering substances that so preoccupied the nineteenth-century advocates of paradis artificiels. So what is surprising and particularly suggestive... (shrink)

Leading bioethicist Gregory Pence demystifies seven foundational theories of addiction to reveal how they must work together to build more comprehensive solutions. Concerned citizens, individuals suffering from addiction, their families, and those who devote their lives to fighting addiction will find this new perspective a hopeful call to arms.

This introduction sets the stage for the Special Issue and the manuscripts that follow. Interest in work hours, work intensification and work addiction has grown over the past decade. Several factors have come together to increase hours spent at work, the nature of work itself, and motivations for working hard, particularly among managers and professionals. The introduction first reviews some of the known causes and consequences of long work hours and the intensification of (...) work. A case is then made as to why individuals, families, organizations and society should care about hours spent at work and work addiction. Individuals and organizations have some choice here. Most employees would in fact prefer to work fewer hours though few actually realize their preferences. This collection lays out these choices and hopefully encourages thought and discussion of their merits. Long work hours and work addiction harms individuals and their families and does not make organizations more effective. The introduction concludes with a brief summary of the diverse contributions of an international group of leading researchers in this area. (shrink)

With the fantastic features of smartphones, smartphone addiction is a prevalent phenomenon. However, there is a lack of theory-based understanding of how smartphone addiction affects employees’ personal and work lives. The purpose of this study is to investigate the role of smartphone addiction in reinforcing techno exhaustion and life invasion and the final effects of these factors on job performance, and this study applied stress–strain-outcome (SSO) as the foundation of the model. In total, 475 responses were (...) obtained from office and service workers in Iran by a survey. Our findings show that smartphone addiction leads to enhancement in job performance, whereas it significantly strengthens life invasion and techno exhaustion, and thereby life invasion and techno exhaustion dramatically reduce job performance. Our findings indicate the two-sided role of direct and indirect effects of smartphone addiction. Implications for both organizations and employees are discussed. • Stressor-strain-outcome framework is utilized to examine smartphone addiction. • Smartphone addiction leads to enhancement in job performance. • Smartphone addiction significantly strengthens life invasion and techno exhaustion. • Life invasion and techno exhaustion dramatically reduce job performance. • The negative indirect effects of smartphone addiction are more powerful than its positive direct influence. (shrink)

This article uses Marc Lewis’ work as a springboard to discuss the socio-political context of the brain disease model of addiction. The claim that promotion of the BDMA is the only way the general public can be persuaded to withhold blame and punishment from addicts is critically examined. After a discussion of public understandings of the disease concept of addiction, it is pointed out that it is possible to develop a scientific account of addiction which is (...) neither a disease nor a moral model but which the public could understand. Evidence is reviewed to suggest that public acceptance of the disease concept is largely lip-service and that the claim the BDMA removes stigma among the public and professionals is unsupported by evidence. Further, there is good evidence that biogenetic explanations of mental/behavioural disorders in general have been counterproductive in the attempt to ally stigma. A model of addiction as a disorder of choice may attract special problems in public-facing communications and risks being misunderstood. However, ways of presenting this model to the public are suggested that may avoid such risks. Lastly, the claim that the BDMA is the only way of ensuring access to treatment and of maintaining research funding for addiction is disputed and a way in which these benefits can be retained under a disorder-of-choice model proposed. The article concludes by enthusiastically endorsing Lewis’ call for a third stage in the governing image of addiction. (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)

Mortality rates for middle-aged whites in the U.S. are rising due to drugs, alcohol, and depression. Unique to our country, these “deaths of despair” disproportionately occur among the under-educated, who are at particular risk for dying young. At one time, less-educated persons aspired to work in the same factory as their parents, at union wages, with benefits. Those jobs, and the sense of community and prosperity and security they allowed, are evaporating. Many former workers suffer from chronic pain, which (...) underlies America's ongoing opioid overdose epidemic. The pain is not only physical. It is psychic, spiritual, and economic. (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)

Alcohol addiction can lead to health and social problems. It can also affect people's emotions. Emotion plays a key role in human communications. It is important to recognize the people's emotions at the court and infer the association between the people's emotions and the alcohol addiction. However, it is challenging to recognize people's emotions efficiently in the courtroom. Furthermore, to the best of our knowledge, no existing work is about the association between alcohol addiction and people's (...) emotions at court. In this paper, we propose a deep learning framework for predicting people's emotions based on sound perception, named ResCNN-SER. The proposed model combines several neural network-based components to extract the features of the speech signals and predict the emotions. The evaluation shows that the proposed model performs better than existing methods. By applying ResCNN-SER for emotion recognition based on people's voices at court, we infer the association between alcohol addiction and the defendant's emotion at court. Based on the sound source data from 54 trial records, we found that the defendants with alcohol addiction tend to get angry or fearful more easily at court comparing with defendants without alcohol addiction. (shrink)

James Baldwin writes that "I underwent, during the summer that I became fourteen, a prolonged religious crisis."1 Baldwin dealt with this crisis in his literary works through the strategic use of Christian theological themes and imagery to make compelling critiques of bourgeois cultural and Christian values. So "prolonged" was his "religious crisis" that Christian theological themes permeate Baldwin's immense literary corpus.2 Baldwin thus both was influenced by Christianity and critiqued it in his works. Considering these two points, I think it (...) appropriate to begin this essay with a biblical reference to the Christian narrative of the "fall" of humanity. I choose this biblical starting point not only because of .. (shrink)

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)

Addresses the place of addiction in modern art, literature, philosophy, and psychology, including its effects on the works of such thinkers and writers as Heidegger, Nietzsche, DeQuincey, Breton, and Burroughs.

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 collection of thirty yoga and mindfulness tools will help support those in recovery from addiction of all kinds. Thirty accessible, pointed teachings offer inspiration, comfort, and solidarity in the moment, helping us cultivate a powerful and purposeful life in recovery, and to create a new design for living. Each chapter focuses on a quality-such as vigilance, acceptance, accountability, among others-and delves into how to manifest it in your recovery journey. Brian Hyman, a yoga teacher and recovery activist, understands (...) deeply what people need to maintain sobriety and strengthen recovery-and knows that those who struggle with addiction also often need support with other mental health challenges, like obsession, anxiety, depression. He uses yogic philosophy, mindfulness teachings, personal anecdotes, and secular wisdom to illuminate each quality and the role it plays in helping us create the life we want. The practices--which include inquiry questions, meditations, awareness exercises, breathing practices, yoga nidra, among others--will quiet the mind in difficult moments, support us as we establish meaningful relationships, and reinforce the power that recovery offers us. Hyman offers resources and additional reading suggestions in the back matter. Based on Hyman's popular online course, this book is essential reading for people of all ages in recovery-along with their family members and friends, and anyone in a health care profession who works with those struggling with addiction of any kind. Hyman includes a list of recovery organizations and a reading list in the back matter. (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)

In lieu of an abstract, here is a brief excerpt of the content:Hume Studies Volume XXII, Number 1, April 1996, pp. 23-48 Fantastick Associations and Addictive General Rules: A Fundamental Difference between Hutcheson and Hume MICHAEL B. GILL The belief that God created human beings for some moral purpose underlies nearly all the moral philosophy written in Great Britain in the seventeenth and early eighteenth centuries. David Hume attacks this theological conception of human nature on all fronts. It is out (...) of these attacks that Hume develops his own "science of man" based solely on "experience and observation."1 Francis Hutcheson is often taken to be the most important positive influence on Hume. And there can be no doubt that Hume does take on board several crucial Hutchesonian elements. But Hutcheson's moral theory, like that of most of his contemporaries, is grounded in a theological conception of human nature to which Hume is adamantly opposed.2 In this paper I will examine how Hume's disagreements with Hutcheson embody the anti-theological purpose that defines Hume's work as a whole. I will look, in particular, at Hume's and Hutcheson's different positions on the principles of association. I hope to show how Hume's use of these principles in the Treatise advances his larger goal of placing "the science of man" on "a foundation almost entirely new" (T xvi). I will proceed, first, by explaining Hutcheson's conception of human nature and his use of the principles of association; second, by sketching in broad outline how Hume's accounts of the origins of justice and natural virtue undermine crucial components of Hutcheson's conception of human nature; and third, by elucidating in more detail an aspect of Hume's associationism that is particularly revealing of his distance from Hutcheson. Michael B. Gill is at the Department of Philosophy, Purdue University, 1360 Liberal Arts and Education Building, West Lafayette IN 47907 USA. email: [email protected]. 24 Michael B. Gill I. Hutcheson and Association Hutcheson discusses the mind's tendency to associate in all of his writings, but his most extensive treatment of the matter comes in his Essay on the Passions.3 Hutcheson begins the Essay by telling us that something is good if and only if the perception of it "Causes, or Occasions" a pleasurable feeling, and that something is evil if and only if the perception of it causes or occasions a painful feeling (EP 2). Crucially, Hutcheson denies that all of our pleasures and pains are of the same type (EP 1-8).4 He holds, rather, that there are at least five distinct types of pleasures and pains and that each of them grounds a different irreducible type of good and evil. There are, first, the pleasures and pains caused by things we perceive through the external senses of taste, touch, smell, etc.; things that cause such pleasures are called naturally good, while things that cause such pains are called naturally evil. Second, there are the "Pleasant Perceptions, arising from regular, harmonious, uniform Objects" (EP 5); the things that cause these pleasures are called beautiful.5 Third, there are the pleasures and pains we feel upon perceiving the happiness or misery of other human beings; the things that cause these pleasures are called public goods while those that cause the corresponding pains are called public evils. Fourth, there are pleasures and pains, usually called approval and disapproval, that we feel upon perceiving the actions of others; the actions that cause approval are called virtuous or morally good, while those that cause disapproval are called vicious or morally evil. Finally, there are the pleasures and pains we feel upon perceiving others' moral perceptions of our own actions; the pleasure of perceiving others' approval of one's actions is called the feeling of honor, while the pain of perceiving others' disapproval is called the feeling of shame. For Hutcheson, then, natural goodness, beauty, the public good, virtue and honor are all defined by our pleasures and pains. He does not think, however, that these are defined by just any of our actual or occurrent pleasures and pains. He holds, rather, that they are defined by the pleasures and pains we feel under certain privileged... (shrink)

The success of deep brain stimulation (DBS) for movement disorders and the improved understanding of the neurobiologic and neuroanatomic bases of psychiatric diseases have led to proposals to expand current DBS applications. Recent preclinical and clinical work with Alzheimer's disease and obsessive-compulsive disorder, for example, supports the safety of stimulating regions in the hypothalamus and nucleus accumbens in humans. These regions are known to be involved in addiction and overeating associated with obesity. However, the use of DBS targeting (...) these areas as a treatment modality raises common ethical considerations, which include informed consent, coercion, enhancement, threat to personhood, and manipulation of the reward center. Pilot studies for both of these conditions are currently investigational. If these studies show promise, then there is a need to address the ethical concerns related to the initiation of clinical trials including the reliability of preclinical evidence, patient selection, study design, compensation for participation and injury, cost-effectiveness, and the need for long-term follow-up. Multidisciplinary teams are necessary for the ethical execution of such studies. In addition to establishing safety and efficacy, the consideration of these ethical issues is vital to the adoption of DBS as a treatment for these conditions. We offer suggestions about the pursuit of future clinical trials of DBS for the treatment of addiction and overeating associated with obesity and provide a framework for addressing ethical concerns related to treatment. (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)

In lieu of an abstract, here is a brief excerpt of the content:Welcome To The Pharmacy: Addiction, Transcendence, and Virtual RealityAnn Weinstone (bio)1. The Question of Addiction and TranscendenceIt has become a truism to say that virtual reality (VR) is addictive. Case, the protagonist of William Gibson’s Neuromancer, dreams of connection to the net like a junkie jonesing for a fix. In Jeff Noon’s novel Vurt, you get to cyberspace by tickling the back of your throat with addictive, (...) government-produced feathers. Verity of Kathleen Ann Goonan’s Queen City Jazz sports nanotechnology implants that compel her to enter virtual worlds into which she sinks with feelings of deep bliss. As in Vurt, in Pat Cadigan’s Synners, everything’s an addiction: cyberspace, people, rock and roll.But let’s move away from fiction. Graphic cyberartist Nicole Stenger, a self-professed neo-Platonist, writes, “[a]nd what if the passage to a new level of humanity actually meant abolishing indeed the natural one, or at least some part of it?... Will it not require immense effort to recover from this enhancement of the senses, from this habit of perfection? [Stenger 57]. Michael Benedikt, editor of Cyberspace: First Steps, deems VR “a new and irresistible development in the elaboration of human culture and business under the sign of technology” [1; my emphasis]. Ad copy for “Origin,” a VR game, reads, “You must die to learn how to live.... Death is not an option. It’s an addiction.” And an article in the New York Times titled “The Lure and Addiction of Life on Line” displays a graphic of a bespectacled male, tapping away at a computer located inside of a panopticon-sized rendering of a globe to which the avid user is happily chained [see Asciu]. From advertisements to scholarly texts, it is difficult to find any writing about VR that does not engage in and, as I will argue, rely upon the rhetorics of addiction. William Gibson dubbed cyberspace a “consensual hallucination.” That was 1984. In 1996, critic Robert Markley rechristened VR “a consensual cliché” [56]. Surely, the “addictiveness” of cyberspace contributes to the sense of tired familiarity. My question is this: Why does cyberspace have to be addictive? What work is addiction doing in discourses of virtual reality?In this essay, I’m concerned with the production of what might be called hyper-real transcendence. Jean Baudrillard, in his influential schema “three orders of simulacra,” identifies a first, “natural” order in which “a transcendent world, a radically different universe, is portrayed... in contrast to the continent of the real” [309]. I propose that a third-order, hyper-real, transcendence has survived the collapse of the distance between the model and the original. This transcendence relies on rhetorics of disembodiment, [End Page 77] immortality, and extra-human reproductive and generative powers within virtual spaces. Such spaces include scholarly and technical essays about VR or cyberspace, science fiction, advertisements for VR games, VR game narratives, and other advertising copy that borrows from current discourses of virtuality. My discussion takes place in a field crowded with talk of the death of logocentrism and the end of phonocentric culture. 1 Derrida has written that “scientific language [e.g. computer code] challenges intrinsically and with increasing profundity the ideal of phonetic writing” [Grammatology 10], the logocentric relation of voice to mental experiences. Baudrillard writes mournfully that the “third-order” world of simulated simulacra, of hyper-reality, leaves “no room for any kind of transcendentalism” [310]. Baudrillard and Derrida write with differing affects of the same effect—the waning or death of the foundation of Western notions of transcendence. In this tradition, transcendence commences with the penetration of the self by a supra-enlivened Other, whether that other be a king, a god, nature, the voice of logos, the Law, or an abstracted version of vitality itself. Particularly, I question the persistent coupling of rhetorics of transcendence with rhetorics of addiction. My initial point will be that following the established Western logocentric tradition, rhetorical relationships of addiction between VR users and VR narratives are the “software” with which hyper-real transcendence is produced and sustained. In other words, VR demands, as the price of transcendence, that the user become of the medium... (shrink)

Addictions are commonly accompanied by a sense of shame or self-stigmatization. Self-stigmatization results from public stigmatization in a process leading to the internalization of the social opprobrium attaching to the negative stereotypes associated with addiction. We offer an account of how this process works in terms of a range of looping effects, and this leads to our main claim that for a significant range of cases public stigma figures in the social construction of addiction. This rests on a (...) social constructivist account in which those affected by public stigmatization internalize its norms. Stigma figures as part-constituent of the dynamic process in which addiction is formed. Our thesis is partly theoretical, partly empirical, as we source our claims about the process of internalization from interviews with people in treatment for substance use problems. (shrink)

Central to philosophical practice is the application of philosophers' work by philosophical practitioners to inspire, educate, and guide their clients. For example, in Logic-Based Therapy (LBT) philosophical practitioners help their clients to find an uplifting philosophy that promotes guiding virtues that counteract unrealistic and often self-defeating conclusions derived from irrational premises. I will present the argument that Simone de Beauvoir’s existentialist ethics can be applied as an uplifting philosophy as per LBT methodology, and therefore has utility for philosophical practice. (...) Additionally, I will propose that Beauvoir’s existentialist ethics, as an uplifting philosophy, may act as an antidote for ideological obsession and ideology addiction. I will also suggest that LBT may be a suitable intervention when challenging the unrealistic conclusions derived from illogical premises in practical reasoning that contribute to ideological obsession, because it can contest irrational beliefs in a way that could mitigate the fragmentation anxiety that often arise when individuals relinquish maladaptive self-object organizations. (shrink)

The neuropsychoanalytic approach solves important aspects of how to use our understanding of the brain to treat patients. We describe the neurobiology underlying motivation for healthy behaviors and psychopathology. We have updated Freud’s original concepts of drive and instinct using neuropsychoanalysis in a way that conserves his insights while adding information that is of use in clinical treatment. Drive (Trieb) is a pressure to act on an internal stimulus. It has a motivational energic source, an aim, an object, and is (...) terminated by the satisfaction of a surge of serotonin. An instinct (Instinkt) is an inherited pattern of behavior that varies little from species to species. Drives are created by internal/ventral brain factors. Instincts require input from the outside that arrive through dorsal brain structures. In our model unpleasure is the experience of unsatisfied drives while pleasure if fueled by a propitious human environment. Motivational concepts can be used guide clinical work. Sometimes what had previously described psychoanalytically as, “Internal conflict,” can be characterized neurobiologically as conflicts between different motivational systems. These motivational systems inform treatment of anxiety and depression, addiction in general and specific problems of opioid use disorder. Our description of motivation in addictive illness shows that the term, “reward system,” is incorrect, eliminating a source of stigmatizing addiction by suggesting that it is hedonistic. Understanding that motivational systems that have both psychological and brain correlates can be a basis for treating various disorders. Over many papers the authors have described the biology of drives, instincts, unpleasure and pleasure. We will start with a summary of our work, then show its clinical application. (shrink)

The Handbook of Implicit Cognition and Addiction features the work of an internationally renowned group of contributing North American and European authors who ...

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)

In recent years, anthropologists have built a rich body of ethnography on the experience of addiction, including important cultural critiques of treatment systems. Yet little has been written from the perspective of those who work in the everyday to help others recover from substance abuse. In this article, I reflect on my labor as a clinical social worker providing therapy for homeless women and men who struggle with addiction. Building on the eloquence of those who seek to (...) recover, recovery poets, I demonstrate how the work of a team of frontline workers operates in a particular intersubjective realm that creates different conditions for understanding addiction and recovery than does anthropological fieldwork. By detailing the labor of recovery as I performed it using different evidence-based therapies to permit the emergence of a new consciousness, I aim to bring to center stage the complex labor of frontline workers so that their working conditions will be taken into account more often in anthropological work on addiction and treatment. (shrink)

People struggling with addiction are neither powerless over their addiction, nor are they fully in control. Lewis vigorously objects to the brain disease model of addiction, because it makes people lose belief in their self-efficacy, and hence hinders their recovery. Although he acknowledges that there is a compulsive state in addiction, he objects to the claim that this compulsion is carved in stone. Lewis argues that the BDMA underestimates the agency of addicted people, and hence hinder (...) their recovery. Lewis’s work offers us a very much to be welcomed neurobiology of recovery. It offers addicted people a hopeful and respectful narrative for their recovery that treats them as agents rather than as damaged brains. However, I argue that overestimating people’s agency can also result in people losing belief in their self-efficacy. Lewis’s strong focus on the agency of addicted people might not match their experiences of struggle, hence reinforcing their feelings of guilt when they fail to control their use. I propose to replace the notion of addiction as a disease with a notion of a disease-like stage in addiction. I call this stage the duress stage in addiction, in which the addictive behaviour is largely impervious to the agent’s values and to available techniques of self-control. However, the agent can overcome this stage by developing new techniques of self-control, by building on their self-concept and belief in self-efficacy, by changing their environments and habits, and by engaging in projects that are meaningful to the agent. (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)