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

In this paper, 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)

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

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)

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 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)

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)

The addiction literature is fraught with conceptual confusions, stalled debates, and an unfortunate lack of clear and careful attempts to delineate the phenomenon of addiction in a way that might lead to consensus. My dissertation has two overarching aims, one metaphysical and one practical. -/- The first aim is to defend an account of addiction as the systematic disposition to fail to control one’s desires to engage in certain types of behaviors. I defend the inclusion of desires and (...) impaired control in the definition, and I flesh out the notion of systematicity central to my dispositionalist framework. I engage the so-called ‘disease vs. choice’ debate, criticizing its presupposition that we are dealing here with a dichotomy and arguing that the movement towards a middle ground is the right track to take. I explain how the dispositionalist account can capture this middle ground and how it serves to expand upon existing views, in particular by filling in the metaphysical details. -/- The second aim is to show how the account I defend can help to unify the extant views and disciplinary perspectives in the literature. Both the dispositionalist aspect of my framework and the methodology adopted (applied ontology and systematic metaphysics) can move the literature towards both substantive and methodological unification. This will help to clear up conceptual confusions, resolve (or sometimes dissolve) apparently intractable disputes, situate different research perspectives with respect to each other, facilitate interdisciplinary dialogue, and help to frame important questions about addiction. Finally, I offer the beginnings of an ontology of addiction, which will provide a terminologically well-structured guide to the addiction literature in a way that will facilitate more effective and efficient communication and data management across disciplines. (shrink)

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

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

Alex Rosenberg’s latest book purports to establish that narrative history cannot have any epistemic value. Rosenberg argues not for the replacement of narrative history by something more science-like, but rather the end of histories understood as an account of human doings under a certain description. This review critiques three of his main arguments: 1) narrative history must root its explanations in folk psychology, 2) there are no beliefs nor desires guiding human action, and 3) historical narratives are morally and (...) ethically pernicious. Rosenberg’s book reprises themes about action explanation he first rehearsed 40 years ago, albeit with neuroscience rather than sociobiology now “preempting” explanations that trade on folk psychological notions. Although Rosenberg’s argument strategy has not altered, the review develops a number of reasons as to why his approach now lacks any plausibility as a strategy for explaining histories, much less a successful one. (shrink)

Van Gordon et al. outline the classification of their Ontological Addiction Theory (OAT), including its aetiology and treatment. In this review article I will from an appreciative perspective question some of its fundamental assumptions by presenting an alternative view on the ontology of ‘the person’, as distinct from its presently assumed conventional conflation with a contracted separate egoic self. I will propose this view as structurally and ethically significant for the ‘embodied’ experience of a reconstructed “dynamic and non-dual self”, as (...) cultivated in their treatment. Rather than this reconstructed self simply being socially desirable for functional purposes, I will underscore the meaning-generative case for ontological status, in the absence of which, a pervasive ‘sense of lack’ is evident, with all attendant individual, psychological, social, ecological and ethical implications. This article brings a developmental psychology perspective to bear in appreciating ‘personhood’ as an emergent, progressively realised and is thus similarly aligned with the intent of OAT in overcoming egoic addictive suffering. This mapping of the territory however populates a blind spot in OAT’s diagnosis by affirming unique personhood, a quality of ‘integrative presence’, meaningfully understood as a psycho-spiritual ontological reality. It offers, as with OAT’s stated intent, the merit of avoiding attendant mental health and developmental pitfalls, which can beset what we may discern as an implicit transcendental reductionist assumption operative in OAT, where ‘the many’ are reduced to ‘the One’ and there are, it is assumed, no real many. This framing is resonant with the lived experience of healthy ‘individuation’, a process distinct from the problematic phenomenon of ‘individualism’, evidenced by the empirical data on post-conventional human development, which potentially provides diagnostic markers for any optimal treatment discernment. It is also attuned to what many recognise as a contemporary Fourth Turning in Buddhism, in its conscious evolutionary recognition of the emergence in non-dual states of a ‘unique personal perspective’, and/or a relative individuation within the whole. This differentiation has formerly been interpreted through an ‘impersonal’ lens as an egoic holdover, and potentially inhibits ethical action in the world, as distinct from the ethical import and potential fruits stemming from the ontological affirmation of the person. Keywords: ego; unique personhood; ontology; epistemology; contemplative traditions; Western Enlightenment; developmental psychology; transcendental reductionism; Fourth Turning in Buddhism. (shrink)

According to a number of influential views in penal theory, 1 one of the primary goals of the criminal justice system is to rehabilitate offenders. Rehabilitativemeasures are commonly included as a part of a criminal sentence. For example, in some jurisdictions judges may order violent offenders to attend anger management classes or to undergo cognitive behavioural therapy as a part of their sentences. In a limited number of cases, neurointerventions — interventions that exert a direct biological effect on the brain (...) — have been used as aids to rehabilitation, typically being imposed as part of criminal sentences, separate treatment orders, or conditions of parole. Examples of such interventions include medications intended to attenuate addictive desires in substance-abusing offenders and agents intended to suppress libido in sex offenders.This chapter reviews some of the ethical issues raised by the use of neurointerventions as aids to rehabilitation. (shrink)

Leading versions of hedonism generate implausible results about the welfare value of very intense or unwanted pleasures, while recent versions of desire satisfactionism overvalue the fulfillment of desires associated with compulsions and addictions. Consequently, both these theories fail to satisfy a plausible condition of adequacy for theories of well-being proposed by L.W. Sumner: they do not make one’s well-being depend on one’s own cares or concerns. But Sumner’s own life-satisfaction theory cannot easily be extended to explain welfare over time, (...) and it makes mistaken (autonomous, informed) self-assessment impossible. A new account of well-being based on the stable realization of personal values enjoys the advantages claimed for these subjective theories while avoiding these problems. (shrink)

According to the 2020 docudrama, The Social Dilemma, our very addiction to “social media” has, today, become encapsulated in the tensions between its facilitation as a mode of interpersonal communication and as an insidious conduit for machine learning, surveillance capitalism and manipulation. Amidst a variety of interviewees – many of whom are former employees of social media companies – the documentary finishes on a unanimous conclusion: something must change. By using the docudrama as a pertinent example of our “social media (...) malaise,” and while remaining aware of the problems and unethical practices encompassing international digital/social media companies, this paper will argue that we continually refrain from the very question(ing) that would call these companies to account: what does the algorithm desire? In approaching this question, this article will draw from Lacan’s ‘hysterical’ position in accordance with Robert Pfaller’s notion of interpassivity. Together, these concepts will be used to provide a psychoanalytic account of how our subjectivization in social media renders an unconscious endorsement that both frames our awareness of the dilemmas encompassing social media, while also positing an inherent limitation that may offer a possible path out of its impeding affects. This subjective ambivalence – delegated yet reluctantly disavowed – offers an opportunity to realign discussions on the lost object of desire (objet a) and its reproduction in social media algorithms. In so doing, the case will be made that an account of interpassivity can help lay bare the hysterical significance underscoring our digital subjectivization. (shrink)

We may succed in the fulfilment of our desires but still fail to properly own our practical life, perhaps because we acted as addicts, driven by desires that are alien to our will, or as “wantons,” satisfying the desires that we simply happen to have (Frankfurt, 1988 ). May we equally fail to own the outcomes of our epistemic life? If so, how may we attain epistemic ownership over it? This paper explores the structural parallellism between practical (...) and epistemic rationality, building on Williamson’s ( 2002 ) suggestion that we should commence with successful performances as the foundation for both domains, be it action or knowledge. By highlighting the limitations of higher-order regulative approaches in epistemology, exemplified by Sosa ( 2007, 2011, 2015, 2021 ), the paper introduces a form of teleological epistemic constitutivism inspired by Velleman ( 2000, 2009 ). The proposal is that epistemic ownership is not attained in the mere pursuit of truth or knowledge, but requires furthermore a struggle to understand what we know. (shrink)

This paper will address René Girard’s critique of the “humanization of nothingness” in modern Western philosophy. I will first explain how the “desire for death” is related to a phenomenon that Girard refers to as “obstacle addiction.” Second, I will point out how mankind’s desire for death and illusory will to self-divinization gradually tend to converge within the history of modern Western humanism. In particular, I will show how this convergence between self-destruction and self-divinization gradually takes shape through the evolution (...) of the concept of “the negative” from Hegel to Kojève, Sartre and Camus. Finally, we shall come to see that in Girard’s view “the negative” has tended to become an ever-preoccupying and unacknowledged symptom of mankind’s addiction to “model/obstacles” of desire. (shrink)

Orthodoxy holds that the difference between weakness of will and compulsion is a matter of the resistibility of an agent's effective motivation, which makes control-based views of agency especially well equipped to distinguish blameworthy weak-willed acts from non-blameworthy compulsive acts. I defend an alternative view that the difference between weakness and compulsion instead lies in the fact that agents would upon reflection give some conative weight to acting on their weak-willed desires for some aim other than to extinguish them, (...) but not to their compulsive desires. This view allows identificationist theorists of moral responsibility to explain why weak-willed actions, but not compulsive actions, are attributable to agents such that they can, in theory, be praised or blamed for them. After motivating and presenting the view in detail, I show how it has unique resources for explaining the ethics of managing one's compulsions. (shrink)

This article explores the utility of Nietzsche’s ethical thought for philosophical counselling. Central to the philosophical counseling process is philosophical counsellors applying the work of philosophers to inspire, educate, and guide their counselees in dealing with life problems. For example, Logic-Based Therapy (LBT), a method of philosophical counselling developed by Elliot Cohen, provides a rational framework for confronting problems of living, where the counselor helps the counselee find an uplifting philosophy that promotes a guiding virtue that acts as an antidote (...) to unrealistic and often self-defeating conclusions derived from irrational premises. I present the argument that Nietzsche’s moral philosophy, and more specifically his analysis of suffering, is one such uplifting philosophy which can be of utility to philosophical counselors to help their counselees with confronting problems of living. According to Bernard Reginster, suffering forms the bedrock of Nietzsche's life-affirming concept of the will to power. Nietzsche’s notion of the will to power radically alters our conception and significance of suffering – and that the will to power is best understood as man’s desire for the activity of overcoming resistance. Nietzsche's analysis implies that the fundamental human impulse is not to avoid suffering, but instead to will nothing less than suffering itself. To find meaning in suffering is tantamount to affirming life itself. (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)

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)

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

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)

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)

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

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)

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)

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)

It is often assumed that, except perhaps in a few rare cases, people with addiction can be aptly held responsible for having acquired the condition. In this chapter, I consider the argument that supports this view and draw attention to a number of challenges that can be raised against it. Assuming that early decisions to use drugs were made in possession of normal-range psychological capacities, I consider the key question of whether drug users who later became addicted should have known (...) that addiction was a likely outcome of their decisions to use drugs in a way that makes them blameworthy for their lack of foresight. I focus on three different points of contention surrounding this claim: how likely the outcome to be predicted was, how tolerable risk should be weighed against the expected value of decisions to use, and how reliable the relevant predictive abilities of the average person are. Once we consider in some detail what would have to be true in order for someone to be aptly held responsible for becoming addicted, the prospects for making a convincing case to that effect look, I argue, somewhat more uncertain than they might at first appear. (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)

The global rise of addictions in the modern world is alarming. What the discipline of modern Western psychology fails to recognize is the connection between the loss of a sense of the sacred and the rise in addiction and mental illness. Due to the spiritual desolation prevalent in the present day and its traumatizing effects, the human search for wholeness and healing is all too often diverted into destructive and dysfunctional behaviors. It is only a spiritual approach to the science (...) of the soul that allows psychology to restore the categories of Spirit, soul, and body, along with their corresponding degrees of reality. This paper examines the root causes of addiction in order to better understand the collective search for wholeness and healing. The framework employed for this study is the perennial psychology—an application of the universal wisdom found in humanity’s spiritual patrimony to the proper understanding of this burgeoning crisis. The objective of the study is to propose a more integrative approach to assessment, diagnosis, and treatment of addiction. (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)

Desire theories of well-being claim that how well our life goes for us is solely determined by the fulfilment and frustration of our desires. Several writers have argued that these theories are incorrect because they fail to capture the harms of self-sacrifice and severe depression. In this paper, I argue that desire theories of well-being can account for the harm of both phenomena by rejecting proportionalism about desire and motivation. This is the view that desires always motivate proportionally (...) to their strength. If we reject this view, then we can explain the harm of many cases of self-sacrifice as arising when we act upon our weaker desires and thereby frustrate our stronger desires. Moreover, the harm of many cases of severe depression can be explained by its suppression of the motivational force of desires. This inevitably frustrates desires that we are left unmotivated to fulfil. I argue that this approach captures the experiential quality of self-sacrifice and severe depression better than rival views that seek to problematise these phenomena for desire theories of well-being. Moreover, these theories have sufficient conceptual resources to account for residual cases of self-sacrifice and severe depression that are less well explained by this approach. (shrink)

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

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

According to the thesis of the guise of the normative, all desires are associated with normative appearances or judgments. But guise of the normative theories differ sharply over the content of the normative representation, with the two main versions being the guise of reasons and the guise of the good. Chapter 6 defends the comparative thesis that the guise of reasons thesis is more promising than the guise of the good. The central idea is that observations from the theory (...) of content determination can be used in order to constrain possible theories of the representational contents associated with desire. The authors argue that the initially most promising versions of the guise of the good fail to meet these constraints, and then explain the steep challenge confronting any who wish to craft a new guise of the good theory which meets the constraints while also preserving the initial motivations for adopting any guise of the normative theory at all. But a simple version of the guise of reasons not only avoids the troubles besetting the guise of the good but proceeds immediately from a deep diagnosis of the source of its difficulties. (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)

In this paper, we present two puzzles involving desire reports concerning series of events. What does a person want to happen in the first event – is it the event with the highest expected return, or the event that is the initial part of the best series? We show that existing approaches fail to resolve the puzzles around this question and develop a novel account of our own. Our semantics is built around three ideas. First, we propose that desire ascriptions (...) are evaluated relative to a contextually supplied set of propositions, or alternatives. The semantic value of an ascription ‘S wants p’ is determined by S's preference ordering over these alternatives. Second, we propose that desire reports carry a requirement to the effect that the prejacent of the ascription must be suitably related to the background set of alternatives. Finally, we suggest that desire reports carry a dominance condition concerning the subject's ranking of the alternatives. Overall, we argue that our theory provides us with an elegant resolution of our puzzles, and yields a promising approach to desire. (shrink)

It is often taken for granted that our desires can contribute to what it is rational for us to do. This paper examines an account of desire—the ‘guise of the good’— that promises an explanation of this datum. I argue that extant guise-of-the-good accounts fail to provide an adequate explanation of how a class of desires—basic desires—contributes to practical rationality. I develop an alternative guise-of-the-good account on which basic desires attune us to our reasons for action (...) in virtue of their biological function. This account emphasises the role of desire as part of our competence to recognise and respond to normative reasons. (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.

Providing heroin to heroin addicts taking part in medical trials to assess the effectiveness of the drug as a treatment alternative, breaches ethical research standards, some ethicists maintain. Heroin addicts, they say, are unable to consent voluntarily to take part in these trials. Other ethicists disagree. In our view, both sides of the debate have an inadequate understanding of voluntariness. In this article we therefore offer a fuller conception, one which allows for a more flexible, case-to-case approach in which some (...) heroin addicts are considered capable of consenting voluntarily, others not. An advantage of this approach, it is argued, is that it provides a safety net to minimize the risk of inflicting harm on trial participants. (shrink)

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)

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. -/- .

Desire satisfaction has not received detailed philosophical examination. Yet intuitive judgments about the satisfaction of desires have been used as data points guiding theories of desire, desire content, and the semantics of ‘desire’. This paper examines desire satisfaction and the standard propositional view of desire. Firstly, I argue that there are several distinct concepts of satisfaction. Secondly, I argue that separating them defuses a difficulty for the standard view in accommodating desires that Derek Parfit described as ‘implicitly conditional (...) on their own persistence’, a problem posed by Shieva Kleinschmidt, Kris McDaniel, and Ben Bradley. The solution undercuts a key motivation for rejecting the standard view in favour of more radical accounts proposed in the literature. (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)

This article argues that political injustices can arise from the distribution and character of our sexual desires and that we can be held responsible for correcting these injustices. It draws on a conception of structural injustice to diagnose unjust patterns of sexual attraction, which are taken to arise when socio-structural processes shaping the formation of sexual desire compound systemic domination and capacity-deprivation for the occupants of a social position. Individualistic and structural solutions to the problem of unjust patterns of (...) sexual attraction are assessed in the context of racialised sexual aversion, racial fetishism, and the desexualisation of people with disabilities. While both forms of intervention can help in principle, some of the advantages of structural approaches are laid out. A schema for assigning political responsibilities for addressing this injustice is proposed, with some limits identified to the kinds of state and social responses that are justified. Finally, the status of the merely aesthetically unappealing is considered, with a relational egalitarian approach concluding that they are subject to structurally unjust patterns of sexual desire only when exposed to oppression or second-class citizenship as a result. (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)

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 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)