Compulsion and Addiction

Supposing that addicts choose to act as they do, rather than being compelled to behave in particular ways, what explains the choices that they make? Hannah Pickard has recently pointed out that we can go a long way to answering this question if we can make sense of why addicts value the ends they pursue. She argues that addiction is a social identity that gives purpose and structure to life and that the choices that addicts make are valuable to them (...) as ways of sustaining this social identity. But if addicts freely make choices towards ends that they perceive as valuable in terms of a social identity to which they contribute, and therefore if addiction involves the deployment of quite considerable agential apparatus, how are we to hold on to the natural assumption that addictions are disempowering? In this paper I present an answer to this question. Drawing on the resources of the phenomenological tradition, I argue that some social identities give purpose and structure to life in a way that inhibits, rather than enables, the exercise of a capacity that is central to our form of life. I elaborate the hypothesis that paradigmatic cases of addiction involve this sort of disempowering social identity. (shrink)

According to Marshall et al. (2024), some of the patients who refuse to stay in observation after being resuscitated following an opioid overdose are likely not making an autonomous choice. While I do not intend to dispute this claim, it merits discussion what is the concept of autonomy at play in making this assessment. I contend that the concept at work is more substantive than Marshall et al. acknowledge—and more substantive, too, than the form of autonomy usually thought to underpin (...) the moral justification of the requirement of informed consent . (shrink)

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

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

We are consumers of drugs and news, and sometimes call ourselves addicts or junkies of one or both. I propose to take the concept of news – more generally, doxastic – addiction seriously. I define doxastic addiction and relate this type of addiction to echo chambers and religious belief. I show how this analysis directs attention to appropriate interventions to help doxastic addicts, and how it offers a new type of justification for limits on free speech. -/- .

Withdrawal involves emotional pain that motivates much addictive behavior. In this paper, I argue that the emotional pain of withdrawal compels much addictive behavior. Researchers have noticed this possibility but it is widely underappreciated. Among philosophers, only Hanna Pickard has discussed emotional compulsion in addiction, and the emotional aspect of withdrawal has been almost completely neglected. Accounts of emotional compulsion in the philosophical literature (from Tappolet, Elster, and Furrow) probably do not capture how the distress of withdrawal compels, so I (...) propose a more suitable account of “pathodoxastic” compulsion in addiction. On this account, the emotional pain of withdrawal compels when it undermines the ability to believe that one can continue to endure it, and therefore the ability to intend abstinence. (shrink)

Experiences of urges, impulses, or inclinations are among the most basic elements in the practical life of conscious agents. This article develops a theory of urges and their epistemology. The article motivates a tripartite framework that distinguishes urges, conscious experiences of urges, and exercises of capacities that agents have to control their urges. The article elaborates the elements of the tripartite framework, in particular, the phenomenological contribution of motor imagery. It argues that experiences of urges and exercises of control over (...) urges play coordinate roles in enabling an agent’s awareness of their impulses. (shrink)

Progress in addiction science is hampered by disagreements and ambiguity around its core construct: addiction. Addiction Ontology (AddictO) offers a path to a solution of the kind that has addressed similar problems in other areas of science: a set of clearly and uniquely defined entities to which terms such as ‘addiction’, addictive disorder’ and ‘substance dependence ’can be applied for ease of reference while recognizing that it is the construct definitions and their unique IDs that are central, not the terms.

A restrictive view of self-control identifies exercises of self-control with synchronic intrapsychic processes, and pictures diachronic and externally-scaffolded strategies not as proper instances of self-control, but as clever ways of avoiding the need to exercise that ability. In turn, defenders of an inclusive view of self-control typically argue that we should construe self-control as more than effortful inhibition, and that, on grounds of functional equivalence, all these diverse strategies might be properly described as instances of self-control. In this paper, I (...) take a fresh look at this debate by focusing on cases of addiction. I argue that addicted agents face a paradigmatic sort of self-control challenge, which makes addiction an important test case for theories of self-control. And I discuss evidence that highlights both the unreliability of synchronic intrapsychic strategies and the crucial role that is played by diachronic and externally-scaffolded strategies in successful attempts at achieving abstinence by addicted individuals. Abstaining addicts are a paradigmatic case of agents who successfully exercise self-control, and they mostly do so by relying on diachronic and externally-scaffolded strategies. This, I argue, lends further support to an inclusive view of self-control. (shrink)

In article I explore how Logic-based Therapy (LBT) can inform a philosophically oriented recovery pathway for individuals in addiction recovery. Considering that there is an ostensibly low efficacy rate for the treatment of addiction, there is significant value in highlighting the utility of LBT for the development of novel philosophically based addiction treatment and recovery-oriented programs, which would expand the treatment and recovery options. I propose that LBT may be a suitable intervention when challenging the unrealistic conclusions derived from illogical (...) premises in practical reasoning that contribute to addiction, because it can contest irrational beliefs in a way that could mitigate the fragmentation anxiety that often arises when individuals relinquish maladaptive self-object organizations. (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)

An important philosophical issue in the study of addiction is what difference the fact that a person is addicted makes to attributions of autonomy (and responsibility) to their drug-oriented behavior. In spite of accumulating evidence suggesting the role of emotional dysregulation in understanding addiction, it has received surprisingly little attention in the debate about this issue. I claim that, as a result, an important aspect of the autonomy impairment of many addicted individuals has been largely overlooked. A widely shared assumption (...) in the philosophical literature is that for addiction to impair a person’s autonomy it has to make them (in some sense) take drugs against their will. So-called “willing addicts” are therefore usually seen as exempted from the autonomy impairment believed to characterize “unwilling addicts”, the latter being those who ‘truly want’ to stop using drugs but find their attempts repeatedly derailed by failures of self-control. In this article, I argue that the association between addiction and emotional dysregulation shows why this assumption is false. Emotional dysregulation is not only consistent with the possibility that many addicts take drugs ‘willingly’, it supports the hypothesis that they use drugs because they truly want to. The article proposes an explanation for why emotional dysregulation should nevertheless be seen as an aspect of their loss of control and an important reason why they have impaired autonomy. I end by exploring some implications of this account for addict’s decision-making capacity when they are prescribed the drugs to which they are addicted. -/- . (shrink)

Since the dawn of the internet, pornography has effectively become ubiquitous, pervasive, and increasingly normalised. Study findings show remarkable similarities in how the brain reacts to pornography, and other known addictive substances, and indicate that consuming pornography is comparable to consuming other known addictive substances. Moreover, two of the biggest risk factors for addiction are the substance’s availability and its easy accessibility, particularly in the case of younger persons. To date, pornography addiction has been conceptualised as a behavioural addiction. However, (...) the body of research data on pornography addiction does not provide conclusive support for behavioural addiction. The aim of this thesis is to put forward the idea that pornography can, and should, be conceptualised as an addictive substance, and, that when pornography is consumed, an addictive substance is consumed. In order to support this claim, there are many factors that must be addressed. I first clarify what pornography entails by exploring how it is conceptualised, what pornography ‘does’, and what it means to be a pornography consumer. Secondly, I examine the conceptualisations of substances, substance consumption and addiction, respectively, as well as the subsequent difference between substance and behavioural addiction. Thirdly, I give an inclusive overview of pornography addiction by not only examining the most recent perspectives of researchers, but also of pornography consumers. I conclude by suggesting how we should go about conceptualising pornography addiction, and then propose how the set of diagnostic criteria for pornography use disorder should be formulated for a future iteration of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. I argue that, given the abundance of academic research on substance addiction, compared to the scarcity of research on behavioural addiction, conceptualising pornography as an addictive substance is more likely to create a sense of urgency for the future research of pornography addiction than would be the case if it is considered a potential behavioural addiction. Furthermore, I argue that the classification of pornography as an addictive substance, and the inclusion of pornography use disorder in a future iteration of the DSM, will raise awareness of the potential adverse effects of pornography consumption and, therefore, the harmful consequences of pornography use disorder. (shrink)

Addicts are often portrayed as compelled by their addiction and thus as a paradigm of unfree action and mitigated blame. This chapter argues that our best scientific theories of addiction reveal that, psychologically, addicts are not categorically different from non-addicts. There is no pairing of contemporary accounts of addiction and of prominent theories of moral responsibility that can justify our intuitions about the mitigation of addicts but not non-addicts. Two conclusions are advanced. First, we should either treat addicts as we (...) normally treat non-addicts (as fully culpable) or embrace the skeptical conclusion that everyone is less responsible than we thought—perhaps not responsible at all. Second, we should be doubtful that theorizing about responsibility will be advanced by focusing on particular kinds of psychopathologies. (shrink)

In “The Routledge Handbook of Philosophy and Science of Addiction” Robert West highlights a pervasive challenge for more conceptual clarity and consensus within the field of addiction studies. In an attempt to address the challenge I provide the conceptual building blocks or architectonic of a metatheory of addiction, referred to as the Integrated Metatheoretical Model of Addiction (IMMA). The IMMA is not a general theory of addiction, but rather an exploratory attempt at providing the architectonic of an metaparadigmatic heuristic, that (...) may potentially provide the conceptual scaffolding needed for developing a general theory of addiction. (shrink)

In this essay I address the notions of motivation and self-deception by exploring the value of philosophy in the context of addiction treatment. More specifically, 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 (LBT) 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)

In my presentation I argue for the utility of a philosophical counseling method, called logic-based therapy (LBT), in the treatment of addicted populations. In the context of addiction treatment LBT could be also classified as a philosophical psychotherapy. Philosophical psychotherapy can be understood as an umbrella term for interventions designed to treat mental health disorders, with theoretical foundations that are philosophical. Philosophical psychotherapy would be distinct from philosophical counseling, as the latter does not directly treat mental health disorders. I suggest (...) that LBT has utility beyond philosophical counseling and is a viable intervention in the treatment of certain mental health disorders, like substance use disorders. I provide a brief overview of LBT and then discuss a LBT case study with a client suffering diagnosed with a substance use disorder. 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 philosophical psychotherapies in the context of addiction treatment can assist in 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)

Deep Self views of moral responsibility have been criticized for positing mysterious concepts, making nearly paradoxical claims about the ownership of one’s mental states, and promoting self-deceptive moral evasion. I defend Deep Self views from these pervasive forms of skepticism by arguing that some criticism is hasty and stems from epistemic injustice regarding testimonies of experiences of alienation, while other criticism targets contingent features of Deep Self views that ought to be abandoned. To aid in this project, I provide original (...) naturalistic analyses of “Self” and “internality” that replace the view’s metaphorical language with common-sensical concepts that make clear their usefulness. (shrink)

On the moral model of addiction, addicts are morally responsible and blameworthy for their addictive behaviours. The model is sometimes resisted on the grounds that blaming addicts is incompatible with treating addiction in a compassionate and non-punitive way. I argue the moral model is consistent with addressing addiction compassionately and non-punitively and better accounts for both the role of addicts’ agency in the recovery process. If an addict is responsible for their addictive behaviours, and that behaviour is in some way (...) bad or wrong, then that addict is blameworthy. If not, then they are not. But, if their addictive behaviour or behaviour which contributes to and perpetuates their condition of addiction, is not bad or wrong, then addiction is not an issue of moral concern. Addicts are blameworthy, but attributions of blame need not be followed by harsh treatment or punishment. Because blame and harsh treatment or punishment can be separated, there is no good reason to reject the moral model of addiction. (shrink)

While some form of loss of control is often assumed to be a common feature of the diverse manifestations of addiction, it is far from clear how loss of control should be understood. In this paper, I put forward a concept of decrease in control in addiction that aims to fill this gap and thus provide a general framework for thinking about addictive behavior. The development of this account involves two main steps. First, I present a view of degrees of (...) control as the degree to which an agent would be responsive to potential or counterfactual sufficient reasons to do otherwise. Second, I sketch an account of the relevant control-undermining factors in addiction that is consonant with my proposed view of degrees of control. Being a high-level functional property, reasons-responsiveness is particularly well suited to frame an account of control-undermining factors that is doubly pluralistic: it encompasses the contribution of factors both internal and external to the agent, and it is consistent with various proposals as to the precise nature of the anomaly taking place in the psychology of addiction. (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)

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 addiction, apparently causally significant phenomena occur at a huge number of levels; addiction is affected by biomedical, neurological, pharmacological, clinical, social, and politico-legal factors, among many others. In such a complex, multifaceted field of inquiry, it seems very unlikely that all the many layers of explanation will prove amenable to any simple or straightforward, reductive analysis; if we are to unify the many different sciences of addiction while respecting their causal autonomy, then, what we are likely to need is (...) an integrative framework. In this paper, we propose the theory of “Externalist” or “4E” – for extended, embodied, embedded, and enactive – cognition, which focuses on the empirical and conceptual centrality of the wider extra-neural environment to cognitive and mental processes, as a candidate for such a framework. We begin in Section 2 by outlining how such a perspective might apply to psychiatry more generally, before turning to some of the ways it can illuminate addiction in particular: Section 3 points to a way of dissolving the classic dichotomy between the “choice model” and “disease model” in the addiction literature; Section 4 shows how 4E concepts can clarify the interplay between the addict’s brain and her environment; and Section 5 considers how these insights help to explain the success of some recovery strategies, and may help to inform the development of new ones. (shrink)

There have been several recent lawsuits in which problem gamblers (or those affected by problem gambling) have sued casinos or other gaming companies for damages relating to bankruptcies, suicides, and other negative consequences of compulsive gambling. Although the legal cases have been decided in favor of the gaming companies, it can seem as though there is a moral residue in some of these cases: perhaps some of the actions of the gaming companies, though legal, have been morally problematic. This case (...) invites students to explore this possibility by introducing them to the facts surrounding the lawsuits and highlighting some of the most salient moral considerations. Students will also be asked to reflect on the public policy implications, if any, of their findings. (shrink)

Addiction and certain varieties of interpersonal attachment share strikingly similar psycho-behavioral structures. Neuroscientists, psychologists, and philosophers have often adduced such similarities between addiction and attachment to argue that many typical cases of romantic love represent addictions to one’s partner and thus might be appropriate candidates for medical treatment. In this paper, I argue for the relatively neglected thesis that some paradigmatic cases of addiction are aptly characterized as emotional attachments to their objects. This has implications for how we should understand (...) the nature of addiction and for the ethics of attachment more broadly. (shrink)

In “Ontologies Relevant to behaviour change interventions: A Method for their Development” Wright, et al. outline a step by step process for building ontologies of behaviour modification – what the authors call the Refined Ontology Developmental Method (RODM) – and demonstrate its use in the development of the Behaviour Change Intervention Ontology (BCIO). RODM is based on the principles of good ontology building used by the Open Biomedical Ontology (OBO) Foundry in addition to those outlined in (Arp, Smith, and Spear (...) 2015). BCIO uses as its top-level ontology Basic Formal Ontology (BFO). The methods outlined in Wright, et al. are a valuable contribution to the field, especially the use of formal mechanisms for literature annotation and expert stakeholder review, and the BCIO will certainly play an important role in the extension of OBO Foundry ontologies into the behavioural domain. (shrink)

In this essay I argue that a comprehensive understanding of addiction and its treatment should include an existential perspective. I provide a brief overview of an existential perspective of addiction and recovery, which will contextualize the remainder of the essay. I then present a case study of how the six-step philosophical practice method of Logic-Based Therapy can assist with issues that often arise in addiction treatment framed through an existential perspective.

Reprint of an article that first appeared in Monash Bioethics Review (2018).

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)

In this article I address the question of what makes addiction morally problematic, and seek to answer it by drawing on values salient in the sub-Saharan African philosophical tradition. Specifically, I appeal to life-force and communal relationship, each of which African philosophers have at times advanced as a foundational value, and spell out how addiction, or at least salient instances of it, could be viewed as unethical for flouting them. I do not seek to defend either vitality or community as (...) the best explanation of when and why addiction is immoral, instead arguing that each of these characteristically African values grounds an independent and plausible account of that. I conclude that both vitalism and communalism merit consideration as rivals to accounts that Western ethicists would typically make, according to which addiction is immoral insofar as it degrades rationality or autonomy, as per Kantianism, or causes pain or dissatisfaction, à la utilitarianism. (shrink)

Currently there is such a cornucopia of conflicting theories in the field of addiction studies that it has become exceedingly difficult for treatment providers, therapists, and policymakers to integrate this vast field of knowledge into effective treatment. Since such a chaotic overabundance of treatment theories, styles, and definitions cloud the field of addictionology, many therapists claim their field is in need of a paradigm shift. In the last 20 years an integrative and compound model has emerged known as the biopsychosocial (...) model, but without a solid and comprehensive meta-framework, syncretistic confusion can result when therapists pick and choose techniques without direction or an overall rationale. To address this problem, Guy du Plessis applies integral theory as a conceptual framework for understanding addiction, as well as a meta-therapeutic framework for therapists. The integral foundation of addiction outlined in this book provides researchers, academics, treatment providers, policy makers, and therapists with a conceptual architectonic of addiction and its treatment that is integrative, inclusive, and practical. An Integral Foundation for Addiction Treatment belongs on the shelf of every addiction treatment therapist, and anyone else who is impacted or influenced by the topic. (shrink)

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

In his target article and recent interesting book about addiction and the brain, Marc Lewis claims that the prevalent medical view of addiction as a brain disease or a disorder, is mistaken. In this commentary we critically examine his arguments for this claim. We find these arguments to rest on some problematical and largely undefended assumptions about notions of disease, disorder and the demarcation between them and good health. Even if addiction does seem to differ from some typical brain diseases, (...) we believe contrary to Lewis, that there are still good reasons to maintain its classification as a mental or behavioral disorder. (shrink)

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

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

Current theories of addiction try to explain what addiction is, who experiences it, why it occurs, and how it develops and persists. In this article, I explain why none of these theories can be accepted as a comprehensive model. I argue that current models fail to account for differences in embodiment, interaction processes, and the experience of addiction. To redress these limiting factors, I design a proposal for an enactive account of addiction that follows the enactive model of autism proposed (...) by Hanne De Jaegher. (shrink)

I show that Pickard’s argument against the irresistibility of addiction fails because her proposed dilemma, according to which either drug-seeking does not count as action or addiction is resistible, is flawed; and that is the case whether or not one endorses Pickard’s controversial definition of action. Briefly, we can easily imagine cases in which drug-seeking meets Pickard’s conditions for agency without thereby implying that the addiction was not irresistible, as when the drug addict may take more than one route to (...) go meet her dealer. (shrink)

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

ABSTRACT In previous work I explored how Integral Theory can be applied as a metatheoretical and transdisciplinary framework, in an attempt to arrive at an integrally informed metatheory of addiction. There was an overemphasis on Integral Methodological Pluralism in that thread of research, without clarifying the ontological pluralism of addiction as a multiple object enacted by various methodologies. To arrive at a comprehensive integral metatheory and integral ontology of addiction, I believe it is necessary to include the conception of Integral (...) Pluralism and Integral Enactment Theory as posited by Sean Esbjörn-Hargens. Integral Enactment Theory highlights the phenomenon of addiction as a multiple and dynamic object arising along a continuum of ontological complexity; it adeptly points out how etiological models “co-arise” in relation to methodology (methodological pluralism) to enact a particular reality of addiction (ontological pluralism) while being mediated by the worldview of the subject (epistemological pluralism) applying the method. This article briefly explores the significance of including Integral Pluralism and Integral Enactment Theory in the quest of an integral metatheory and integral ontology of addiction. (shrink)

Addiction is one of the most significant problems facing contemporary society. Consequently many scholars, institutions and clinicians have sought to understand this complex phenomenon, as is evident in the abundance of etiological models of addiction in existence today. A literature review pointed that there is little consensus regarding the nature and etiopathogenesis of addiction, and integrative models have not yet been able to provide the sought-after integration. In addressing this problem, this study offers a theoretical analysis of the paradigmatic and (...) meta-paradigmatic suitability of Integral Theory in the design of an integrated metatheory of addiction. The data consisted of the most prominent etiological theories and models of addiction. The study focused on several essential features constituting the architectonic of any metatheory that attempts to provide conceptual scaffolding for the construction of a comprehensive metatheory of addiction. The criteria for the construction of a metatheory were conceptual integration, ontological span, ontological depth, empirical validity and internal consistency. Integral Theory was critically assessed in terms of each of the abovementioned criteria. The study suggests that Integral Theory is eminently suitable as a philosophical foundation for the development of an integrated metatheory of addiction. (shrink)

ABSTRACT In my previous work I explored how Integral Theory can be applied as a meta‐theoretical and transdisciplinary framework, in an attempt to arrive at integrally informed metatheory of addiction, yet indispensable aspects were overlooked. Moreover, an overemphasis was placed on Integral Methodological Pluralism, without clarifying the ontological pluralism of addiction as a multiple object enacted by various methodologies. I believe what is needed in an attempt at a comprehensive integral metatheory of addiction is to include Sean Esbjörn‐Hargens and Michael (...) Zimmerman’s Integral Pluralism and Integral Enactment Theory. Integral Enactment Theory highlights the phenomenon of addiction as a multiple and dynamic object arising along a continuum of ontological complexity. Integral Enactment Theory adeptly points out how etiological models “co‐arise”, in relation to methodology (methodological pluralism) and enacts a particular reality of addiction (ontological pluralism), while being mediated by the world view of the subject (epistemological pluralism) applying the method. This paper briefly explores the significance of including Integral Pluralism and Integral Enactment theory in the quest of an integral metatheory of addiction . (shrink)

In what sense is a person addicted to drugs or alcohol incompetent, and so a legitimate object of coercive treatment? The standard tests for competence do not pick out the capacity that is lost in addiction: the capacity to properly regulate consumption. This paper is an attempt to sketch a justificatory framework for understanding the conditions under which addicted persons may be treated against their will. These conditions rarely obtain, for they apply only when addiction is extremely severe and great (...) harm threatens. It will be argued also that to widen the measures currently in place in some jurisdictions, though philosophically well-motivated, would require very strong evidence of a set of conditions disposing a person to an addictive future. It is doubtful that any such currently available evidence is strong enough to justify coercive treatment. Nevertheless, coercive treatment of addiction is already a reality, with the potential for more, and so some discussion will be presented regarding the extraordinary safeguards necessary to prevent misapplication of such treatment policies. (shrink)

Prominent theories of the criminal law borrow heavily from the two leading theories of temptation—the evaluative conception of temptation, which conceives emotion and desire as essentially involving a kind of evaluation, and the mechanistic conception of temptation, which conceives emotion and desire as essentially involving felt motivation. As I explain, both conceptions of temptation are inconsistent with the possibility of akratic action, that is, action contrary to a person’s conscious better judgment. Both are inconsistent with the possibility of akratic action (...) because both are covertly inconsistent with a two-fold psychological assumption that undergirds common beliefs about human action and lies at the heart of the law of criminal responsibility: that resisting a powerful temptation is extremely difficult yet not ordinarily impossible. I reveal these inconsistencies and offer in place of the leading theories of temptation a theory of affective desire as primitive psychic attraction, an elemental psychological state typically accompanied by evaluation and motivation but not reducible to either one. I then show how this theory of desire is consistent with the possibility of akratic action, with the two-fold psychological assumption at the heart of the law of criminal responsibility, and, in particular, with the defense of provocation. (shrink)

Decision theory explains weakness of will as the result of a conflict of incentives between different transient agents. In this framework, self-control can only be achieved by the I-now altering the incentives or choice-sets of future selves. There is no role for an extended agency over time. However, it is possible to extend game theory to allow multiple levels of agency. At the inter-personal level, theories of team reasoning allow teams to be agents, as well as individuals. I apply team (...) reasoning at the intra-personal level, taking the self as a team of transient agents over time. This allows agents to ask, not just “what should I-now do?’, but also ‘What should I, the person over time do?’, which may enable agents to achieve self-control. The resulting account is Aristotelian in flavour, as it involves reasoning schemata and perception, and it is compatible with some of the psychological findings about self-control. (shrink)

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

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

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)