About Rationally Speaking


Rationally Speaking is a blog maintained by Prof. Massimo Pigliucci, a philosopher at the City University of New York. The blog reflects the Enlightenment figure Marquis de Condorcet's idea of what a public intellectual (yes, we know, that's such a bad word) ought to be: someone who devotes himself to "the tracking down of prejudices in the hiding places where priests, the schools, the government, and all long-established institutions had gathered and protected them." You're welcome. Please notice that the contents of this blog can be reprinted under the standard Creative Commons license.

Wednesday, February 26, 2014

(Psychological) Gravity’s a Bitch: On Addiction and Phillip Seymour Hoffman

by Steve Neumann

You are a comet. You were formed by material and processes in the deeps of time, hurled from your home star system out into the wider universe. You’re able to travel for long stretches through vast swathes of space relatively unencumbered; but as you approach certain sufficiently large celestial bodies, you feel the drag of their gravitational pull. Sometimes you get pulled in so close you can never break free from their influence, and are forever caught in their orbit. There’s even a chance you could perish altogether. 

These bodies are your weak spots — maybe even your blind spots — those areas in your life that cause you a good deal of what we normally consider an excessive amount of anxiety, stress and pain. You may see these bodies looming on the distant horizon, or you may never see them coming, realizing you’re under their control only after you’re already firmly in their grip. 

Gravity’s a bitch — psychological gravity, that is. And just like the gravity of physics, this type of gravity is pernicious, in that the closer you get to its field of influence, the harder it is to escape. But people can and do escape. Why is it that some people can, while others can’t? This question is as much philosophical as it is psychological, and deals with the always fun topic of freedom of the will. 

Poor Phillip Seymour Hoffman. It’s tough to see anyone succumb to drug addiction, even anonymous, complete strangers; but I always seem to get an extra pang of loss when that person is some type of exceptional talent, maybe because talent is so rare, and there’s a fear that it might not appear again. But that feeling usually subsides after a few minutes, because I realize again and again that life is a profligate spender. Clearly heroin was Hoffman’s greatest gravitational weakness. The Hoffman-comet got stuck in its orbit and eventually disintegrated, after flaunting its radiance across our skies for years. Almost immediately upon hearing the news that Hoffman died of a drug overdose, people generally fell into two camps on the matter: one, that addiction is a disease and he succumbed to it as if it were cancer; and two, he did it to himself and therefore has only himself to blame.

Is one of these conclusions correct, to the exclusion of the other? Or is there a middle ground that lays blame on both — or neither? I don’t now remember where I first found it, but I came across a blog post from someone named Debbie Bayer who has “worked for 9 years as a psychotherapist in facilities treating addiction, mood disorders and eating disorders,” and who has “over 25 years experience working with 12 step communities.” The title of the post is “Phillip Seymour Hoffman did not have choice or free will and neither do you.” Coming from an expert in addiction, that would seem to settle the issue. Except that it doesn’t. It is, however, a clear cut example of the first opinion I mentioned above, and it may also be the prevalent one. 

In talking about the few sorry souls out of the vast majority of us who haven’t succumbed to addiction, Bayer contends that their brains simply don’t respond in the same way that a hopeless addict’s brain does. This is undoubtedly true — and a tautology. Of course their brains responded differently; otherwise they wouldn’t have yielded to the narcotic temptation in the first place. But the stronger claim about addiction is that an addict is hardwired or genetically predisposed to it, with the implication that they are fated to be addicts, and nothing they do can commute that life sentence. Their comet-trajectory is fixed, and it’s just a matter of time before they fall headlong into a star of destruction, and their feathery ice-flame is forever extinguished.

But is this really true? Is it the case that someone born with a predisposition to addiction will inevitably become an addict, and likely die from it? Yes, gravity’s a bitch, but even comets get knocked out of their orbits every now and then. The universe is in motion — stars explode and die, jettisoning vast amounts of material into their environs; other stars are born and grow, greedily accumulating ambient material; other celestial bodies collide and spread debris in all directions. Space is awash in detritus. 

Likewise, our friends and family die, and we feel the jolting psychic reverberations of these events; other friends and family are born or otherwise enter our lives, providing opportunities to alter our trajectories; and strangers collide, for good or ill, and the results of these collisions can send us careening far and wide. In other words, there are ample opportunities for life to change our direction. 

But it could be argued that, even though we are constantly buffeted by events, by chance and circumstance, we still have to be cognizant enough to exploit them to our advantage. If I’m fated to be an addict, and to die at the hands of the dragon I’ve been chasing, then it doesn’t matter what life throws at me, right? If my best friend tragically dies from a heroin overdose, what is that to me? If my partner gives birth to a beautifully delicate little girl, what do I care whether or not I’m around to see her grow up and have a family of her own? If a shady dealer holds a knife to my throat or a gun to my head and robs me of all my money, what do I care if I have to steal in order to get my next fix? 

I’m sure many people cringe at the thought of these scenarios, but nevertheless they continue to believe that the addict has no choice in the matter. But if we take a look at what Bayer considers to be some of the mechanisms involved in the etiology of an addict’s fix, we might find some room for choice. She says that when withdrawal symptoms (e.g., physical distress, anxiety caused by emotional stress, etc.) reach a certain critical mass in the brain, then “the brain automatically cuts off the access to the frontal lobes (in a manner of speaking) and begins to direct the body to rebalance the stress, to find equilibrium.” But what happens before this point of no return is reached? Aren’t there opportunities for the trajectory of the addict’s comet to be redirected? Just because the addict is experiencing those negative emotions doesn’t mean that he must feel them, or at least that he must continue to feel them — why can’t those feelings change before it’s too late, before the addict texts his dealer? 

There is some research that shows that bad moods and good moods can lead to preferences for different kinds of foods. An example from the research shows that, “if given the choice between grapes or chocolate candies, someone in a good mood may be more inclined to choose the former while someone in a bad mood may be more likely to choose the latter.” Personal experience seems to bear this out. I’m usually stressed out by the end of the week, but instead of making a rejuvenating fruit smoothie packed with vitamins and minerals, I’ll grab my glencairn glass and fill it with a dram of bourbon, preferably Mr. Hayden’s amber restorative. [1] Surely the same forces are in play when it comes to a narcotic like heroin. [2]

So the crux of the research is that “individuals in a positive mood, compared to control group participants in a relatively neutral mood, evaluated healthy foods more favorably than indulgent foods,” and that “individuals in positive moods who make healthier food choices are often thinking more about future health benefits than those in negative moods, who focus more on the immediate taste and sensory experience.” As a result, the researchers recommend what they call “mood repair motivation,” or getting the individual to focus their attention on more harmless ways to alter their mood. They suggest talking to friends or listening to music as mood boosters. 

Engaging with friends, listening to music — these and ten thousand other activities are the forces that present themselves as raw materials for us to exploit to our advantage. But it’s up to each individual to come up with the right recipe that will generate the desired changes to his trajectory. An addict’s choices are just as productive as the unchosen forces that have shaped him hitherto. And even though some of his key choices thus far have been determined by his predisposition to addiction, there still remains available to him the capacity to choose differently the next time. [3]

Ah, but that’s the rub, isn’t it? How does the addict go about making choices that will change the orbit of his suicidal comet? In a word, influence. He has to be able to be influenced by people and events. It’s certainly not easy, even for someone “addicted” to chocolate, much less heroin. But it’s possible. Psychological gravity’s a bitch, and it’s not going away; but, just like with the physical world where we can achieve escape velocity of our planet’s gravitational pull, we can achieve escape velocity from the gravitational fields that populate our psychology. It takes conscious effort on the part of the addict and, yes, some luck; but even the smallest effort may have substantial repercussions, strong enough to jostle him onto a different path. 

In her post about Hoffman, Bayer says that it’s “time for all of us who got through unscathed to stop patting ourselves on the back for our genetic good luck, and it is time to stop judging those who were not born with the same good genes as defective.” I couldn’t agree more. Our American culture needs more of this kind of sensibility, which jibes nicely with the consequences that can be derived from Worldview Naturalism. So I would just add one thing: knowing what we know about the power of genetics and the causal web in which each of us is ensconced, those with better genetic good luck should make an extra effort to share responsibility with those who are struggling with the gravity of their hazardous situations. When we see their comet getting caught in a dangerous gravitational field, we should offer our best help and not fall victim ourselves to the fallacy of fatalism, the idea that no matter what we do the outcome will be the same. 

We can find strength and maybe even solace in the knowledge that, even though the future is fixed, we don’t know what that future will be, and only in the unfolding of our own choices does the future take shape. So it behooves us to make the best choices we can, for ourselves and others.

———

[1] My nod to Christopher Hitchens.

[2] Yes, this “surely” marks a weak spot in my argument — release the Hounds of Dennett!

[3] When I say that the addict can “choose differently,” I don’t mean to say that he can choose to do other than he did in the exact same circumstances. That’s why I added the “next time.”

43 comments:

  1. I have no time for a proper response, but I don't buy that the future is fixed - that is dogma. I don't know that I had that much luck in the gene department - I am autistic with ADHD but I had a lot of luck in the family, friends and society department and I really think that is where the difference is made.

    Margaret Thatcher got it wrong when she said there is no society, only individuals. We are just not that kind of animal. Anyway, when I have time I would like to talk about another addict from a completely different set of circumstances whose story, I think, sheds a lot of light on the problem.

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    1. To the likes of M. Thatcher, we should reply that there are no forests, only trees; that there is no oceans, only water molecules; and that there are no humans, only cells.

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    2. Robin -

      Why do you think the idea that the future is fixed is dogma? To me, dogma is something that is "a principle or set of principles laid down by an authority as incontrovertibly true." Are you saying the philosophical concept of causal determinism is dogma? Or perhaps the cosmological idea of the block universe?

      Agreed about Margaret Thatcher.

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    3. Yes, I am saying the philosophical principle of determism is dogma.

      I am not sure what you mean by a block universe.

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    4. To clarify I would say that the philosophic idea that causal determinism contradicts free will is a dogma. How does determinism contradict my idea that I can determine the future within certain parameters?

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    5. Robin -

      From Brian Greene's "The Fabric of the Cosmos" on the block universe:

      Just as we envision all of space as really being out there, as really existing, we should also envision all of time as really being out there, as really existing, too. Past, present and future certainly appear to be distinct entities. But, as Einstein once said, “For we convinced physicists, the distinction between past, present and future is only an illusion, however persistent.” The only thing that’s real is the whole of spacetime. (p. 139, original emphasis)

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    6. I see what you mean, I just don’t recall that particular phrase being used to describe this concept.. The interesting thing is that the block universe does not contradict free will in any way.

      The mistake people make is thinking of the entirety of space time as itself existing in time - so they think of it as something static. But of course the concept “static” only has meaning in relation to time.

      If the whole of spacetime exists as an entity then I am a part of that entity and a tiny part of the shape of that entity is due to the choices I make.

      To say that the block universe implies the future is fixed is to imply that our minds exist in a different sort of time than the time of the universe or that our minds are not part of the universe.

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  2. Given that many of the readers here are secularists, I am taking this opportunity to remind people there are many "secular" options to AA and NA, free of god, religion "spirituality," or a "higher power" and also not build on the 12-step theory.

    For example, there is Lifering Secular Recovery at http://lifering.org. If you, or someone you know, needs help, I encourage you to visit this or similar "secular sobriety" organizations.

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  3. I don't think it is helpful to frame 'psychological gravity' as a bitch. I do think the relationship between gravity and stress is an interesting one though. The stress of gravity is a physical requirement for us. Without it our bones turn to mush and our muscles quickly atrophy. Our capacity to form a healthy relationship with physical and 'psychological' constraints such as gravity make growth (inflation?) stable and sustainable.

    I agree we all need to help each other as the tendency to cling to closely to one concept or substance which blinds us from it's complement is strong. If we try to distance ourselves to far from the pull gravity we can loose our root. As you mention if we get pulled in to close there is no turning back. The orbit is best place to be I think so long as understand how to sustain the relations.

    I also think you are placing a bit to much emphasis on the genetic component. There are many variations of expression of a given genetic profile, and I think we each have something to do with the environments we create for ourselves and others.

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    1. Seth_blog -

      "The orbit is best place to be I think so long as understand how to sustain the relations."

      Yes, some orbit is better than *no* orbit - humans can't survive that way either. The challenge is finding a "healthy" orbit..

      "I also think you are placing a bit to much emphasis on the genetic component. There are many variations of expression of a given genetic profile, and I think we each have something to do with the environments we create for ourselves and others."

      Interestingly, I'm currently reading Jennifer Ouelette's new book "Me, Myself, and Why" where she is "searching for the science of the self." She talks a lot about nature and nurture, genetics and environment, etc. I didn't get the book in the mail until just after I finished this post, so I might amend the post to say that our genes are our gravity fields, too. Genes certainly aren't destiny, but they are obviously a major player. And if an individual doesn't decide to pursue different life choices and courses of action, they very likely will get stuck in their genes' gravitational pull. So even with genes, people can and do alter their life trajectories.

      In Ouelette's book (so far) she specifically addresses alcoholism; she asks several scientists if alcoholics are born or made, and all of them respond that it's a bit of both. Debbie Maher's post on Hoffman implies that they are born only.

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  4. Interesting post.

    You seem to be straddling two issues: Free Will and efficacy of psychology. I prescribe, no surprise, Dennett for for the first, and Sally Satel for the second. And maybe some Pigliucci inspired Aristotle to wrap the whole thing up.

    I'll skip Dennett for now, because I think we've all read him.

    Sally Satel and Scot Lilienfeld might have some insight into the psychology of addiction. More specifically, the efficacy of the treatment options. For one thing, your expert says she has a lot of experience, but contra Malcolm Gladwell, 10,000 hours of unsound methods only makes you really good at unsound methods. I think it's appropriate on a rationalistic blog to question the gold standard of addiction treatment: 12 Step Programs. It looks like it only retains 5% of participants, and this is the method that is often court mandated? Sally Satel mentioned that there might be, not a death spiral, but an invetitable 8-10 year "career" of addiction. It ends either in death or recovery, and, this is my cynical spin more than hers, all the purported treatment is just cargo cult behavior to pass the time. Psychology is impoverished at this point. I hope we will soon make progress, but, no thanks to Oliver Sack's cherubic platitudes, we know so very little about the mind and have no operating theory of self. Until then, it's just witch doctoring. I don't think Psychologists should be blamed for being in a field that is in its infancy, but they should be held accountable for pretending they know things they don't and have treatments they don't.

    Aristotle makes it clear that we are victims of the fates, but should we be blessed with the proper virtues, we will be able to make the most of our circumstances.

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    1. OneDay, I hope you'll note my comment above, and link, about secular sobriety programs. If not, again, here is one with which I am familiar: http://lifering.org.

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    2. OneDayMore -

      "For one thing, your expert says..."

      Not my expert; I'm actually criticizing her position in this post.

      "no thanks to Oliver Sack's cherubic platitudes, we know so very little about the mind and have no operating theory of self. Until then, it's just witch doctoring. I don't think Psychologists should be blamed for being in a field that is in its infancy, but they should be held accountable for pretending they know things they don't and have treatments they don't."

      Pretty much agreed, even if tangential to the post. I just got a copy of Jennifer Ouelette's "Me, Myself, and Why" where she is "searching for the science of the self." It's clear we've made a lot of progress in neuroscience and psychology, but it's also pretty clear we have a LONG way to go in understanding the self, among other things...

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    3. Steve, that's why I've said before, here and elsewhere, that we're probably in the Early Bronze age on science of the mind.

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    4. Thanks, Steve. I think I did misread you a little. It might be that I had an ax ready to grind regardless.

      Thanks, Gadfly, I will definitely look that up. I don't think, however, that the problem is the spirituality per se, but the fact that it doesn't really do what it claims. I'm guessing the secularist versions don't have a higher success rate.

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  5. It's not just genetics. Trauma affects the child brain in ways that predispose to depression and addiction (or both): http://healthland.time.com/2012/08/01/how-childhood-trauma-may-make-the-brain-vulnerable-to-addiction-depression/

    http://www.nature.com/npp/journal/v37/n12/full/npp2012133a.html

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    1. Exactly. Epigenetics is an issue that's only going to be on the rise for years, I think. And, it's heritable, of course. And, if, on depression (or anxiety, which you didn't mention), or addiction (which likely is a secondary-level issue stemming from the above), it's arguably heritable across multiple generations. If a parent through epigenetic problems with anxiety causes a child to wrongly react to anxiety-provoking issues, then it can pass down another generation.

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    2. LadyAtheist -

      " Trauma affects the child brain in ways that predispose to depression and addiction (or both)"

      Absolutely agreed. I would also add that certain experiences in adulthood may have similar effects.

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  6. Massimo wrote "...even though the future is fixed"

    This implies that my choice for breakfast this morning was somehow encoded in the Big Bang.

    It would also imply that all our language about conscious states was also encoded in the Big Bang.

    There is nothing in physics which would lead us to believe that the future is fixed, quite the opposite.

    But neither is our future random.

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    1. Robin,

      actually, I didn't, Steve did.

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    2. Robin -

      "There is nothing in physics which would lead us to believe that the future is fixed, quite the opposite."

      Nothing? The opposite? Can you elaborate on that?

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    3. Well - do you think that your choice of breakfast this morning was set at the Big Bang? Was it a fact already when our Sun was still a nebula?

      As far as I can see physics says there are no precise states in nature and therefore no precise next states.

      What in physics leads you to believe that there are precise states and exactly one precise next state?

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    4. Do you believe that your choice of breakfast this morning was set at the Big Bang?

      From any physics I have seen there is no such thing as a precise state in nature and therefore no precise next state.

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    5. Robin -

      Well, I suppose I do believe that, in a sense; and here's a link to one physicist who claims that the consensus is that the future is fixed: http://worldsciencefestival.com/videos/based_on_what_we_know_today_is_free_will_real_or_illusory

      I'm no physicist, but from what I've read, even though at the micro level there is only "probability" that a particle will be in one place or another, at the macro level those probabilities average out and give us the deterministic universe we experience at the human level, if that makes sense...

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    6. Hi Steve,

      Actually Greene, in your link, agrees that the future is not fixed. He further goes on to suggest that this means that we don’t have free will but as this is such a short grab I cannot determine his reasoning behind that. Also he doesn’t say it is a consensus, maybe he is implying this by using “we”.

      But that is the trouble, if so many smart people think that we don’t have free will then why can’t somebody just put this into clear, concise reasoning?

      Personally I can’t see any reason, even accepting the truth of Naturalism, why I can’t have just the sort of free will I think I have - I just don’t see the contradiction.

      Actually, listening to Greene, it occurred to me that when we look at the laws of physics we don’t find consciousness either. Does that mean we are not conscious?

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  7. I met “Keith” at a train station in a posh Sydney suburb. He was staggering with his eyelids at half mast and a face that looked like it had been in dozens of fights. Everybody on the platform was avoiding him and hoping he wouldn’t talk to them.

    I was hoping the same thing - but he did come and talk to me.

    All he wanted was to know which was the right train to get him home. It turned out he was more scared than scary. When the train came he still wasn’t sure and I pointed it out to him. As it was my train too I ended up spending a lot of the journey with him.

    He said that he had been slipped something in his coffee earlier and he did not know how he had got to that suburb. He said he was an addict who had been clean for over a year. He suffered from schizophrenia and had been in and out of jail. He had a good friend who looked after him but unfortunately it seemed that this friend encouraged him to get into fights. He appeared to be surrounded by people who took advantage of him although that might have been an impression given to him by his illness.

    The last I saw of him was when I had to get out at my station and I told him, at his request, which stations to look for so that he could know when his own stop was coming up. He seemed to be extremely grateful for my help although it did not amount to very much.

    I don’t know how much of what Keith told me was true - but he seemed to be genuine. He seemed to be someone with everything against him.

    The point is that Keith seems like he is as far behind the 8 ball as is possible in terms of free will - with mental illness, addiction, poverty and a decreased ability to reason. Those seems to be a more severe form of gravity than Philip Seymour Hoffman had to contend with.

    But Keith knew that he had choices and there were things he could do to help himself and his family. That is what free will seems to mean to me, we can have it in spite of all that biological gravity.

    If Keith does not succeed then I don’t think we can simply chalk it up to pitiless biological destiny, if he fails then it will be because we failed him - because we are not the sort of animal that can go it alone.

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  8. Massimo wrote: “Personal experience seems to bear this out. I’m usually stressed out by the end of the week, but instead of making a rejuvenating fruit smoothie packed with vitamins and minerals, I’ll grab my glencairn glass and fill it with a dram of bourbon, preferably Mr. Hayden’s amber restorative.

    But you could still choose the smoothie or whatever over the glencairn even if the glencairn is your preference. Preferences are just one input into the process of making a decision.

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    1. Robin, again, it's not me, it's Steve... ;-)

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    2. Robin -

      "But you could still choose the smoothie or whatever over the glencairn even if the glencairn is your preference. Preferences are just one input into the process of making a decision."

      Correct. But I said it's *difficult* and not *impossible* to make those other choices. Sometimes I don't have a glass of bourbon on a Friday night; I'll have a cup of white tea. Or nothing. But given my temperament, I'm more likely to choose bourbon when I'm stressed ;)

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    3. Sure, but that say anything against the idea of free will, except that it is not easy.

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  9. As for the Hounds of Dennett, is he being deliberately ironic by using a weak argument about how to spot a weak argument?

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  10. Alcohol and tobacco are drugs for many or most that are more powerful than the human mind can control. Millions of American are hurt and killed every single day by these deadly poisons. Ironically, the US Department of Alcohol, Tobacco and Firearms controls the manufacture, distribution and sales of these substances without any liability. The ATF is a subsidiary department of the IRS. Who is to blame? =

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  11. “Gravity’s a bitch — psychological gravity, that is. And just like the gravity of physics, this type of gravity is pernicious, in that the closer you get to its field of influence, the harder it is to escape. But people can and do escape. Why is it that some people can, while others can’t? This question is as much philosophical as it is psychological, and deals with the always fun topic of freedom of the will.”

    “Fun topics” have a gravity all their own. Let’s call it philosophical gravity - an unfortunate tendency to pull discussions in their direction, to subtly warp the manifold of public discourse such that we come to see many unrelated issues through their distorting lens. “Free will”, as this article demonstrates, is one such fatal attractor. Perhaps we would have struck out for the Ithacan isles of neurobiology, social psychology, and public health policy had we not been lured on to rocks by compatibilism’s siren song. Or perhaps this diversion was fated.

    Mixed metaphors aside, the substantive questions Steve raises are quite clearly amenable to scientific investigation. What factors are associated with long-term stable recovery from heroin addiction? Most studies suggest adequate social support, development of constructive coping skills, stress reduction and avoidance of situations associated with previous drug use. The methodology of these studies, by and large, is straightforward: Researchers monitor a cohort of recovering addicts over a period of time and see which environmental and personal factors correlate with various outcomes (e.g relapse, hospitalisation, run-ins with law enforcement). What could be less philosophical?

    To be fair, Steve does cite some research about “mood repair motivation” and stress how important it is that we try to alter the addict’s trajectory using all the tools at our disposal. There seems to be very little awareness, however, of the specificity of the problem, and no attempt to engage with the research which has been carried out in this field.

    Even the question about whether or not a substance abuser’s destructive actions may be considered expressions of their “free will” is a scientific one - once the contentious term has been defined to everyone’s satisfaction. We are not, after all, asking if rational actors in general are capable of freely exercising their wills. Our scope is rather narrower: Have addicts, by virtue of either genetic or environmental factors lost certain cognitive capabilities we (believers in free will) ascribe to most of the rest of the human race? If we happen to be deterministic incompatibilists, the question need not be asked. Addicts are puppets, like everyone else - they just happen to have shorter strings.

    More importantly, I worry that framing discussions about addiction in terms of “free will” (as opposed to going down the more conventional route of describing these addictions as illnesses with which some of us struggle) may have adverse effects, regardless of which answers we eventually come up with. If we insist addicts are “free”, we find them morally blameworthy. If they aren’t “free”, we undermine their self-efficacy and make relapses more likely. Neither outcome is desirable.

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    1. Carolus -

      "“Free will”, as this article demonstrates, is one such fatal attractor. Perhaps we would have struck out for the Ithacan isles of neurobiology, social psychology, and public health policy had we not been lured on to rocks by compatibilism’s siren song."

      Haha, yes; but this is primarily a philosophy blog, and I'm more interested in philosophical issues than those others.

      "There seems to be very little awareness, however, of the specificity of the problem, and no attempt to engage with the research which has been carried out in this field."

      Again, this is a blog post, not a research paper submitted for peer review. I like that blog posts give just enough substance to initiate points of departure, such as the comments here.

      "More importantly, I worry that framing discussions about addiction in terms of “free will” (as opposed to going down the more conventional route of describing these addictions as illnesses with which some of us struggle) may have adverse effects, regardless of which answers we eventually come up with. If we insist addicts are “free”, we find them morally blameworthy. If they aren’t “free”, we undermine their self-efficacy and make relapses more likely. Neither outcome is desirable."

      Well, I didn't *completely* frame the discussion in terms of free will. But yes, I agree that if we just label an addict (or anyone) as "metaphysically un-free" then that might engender the fatalism I mention. And that's why I say that, regardless of the free will issue, these psychological gravitational fields are very real for the person involved, and that therefore we should do everything we can to help them. Merely telling them they're not free to change would certainly decrease their motivation to help themselves.



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  12. Steve, thanks for your post on this important topic. Carolus Darwin, thanks for re-contextualizing to return us to earth, so to speak: "If we insist addicts are 'free', we find them morally blameworthy. If they aren’t 'free', we undermine their self-efficacy and make relapses more likely. Neither outcome is desirable."
    Gadfly, thanks for the information on LifeRing.

    It's no secret that recidivism rates for addicts is discouraging. Many addicts cannot afford private treatment facilities, and so the availability of a 12 Step program is often the most immediate option for an addict who seeks help. Forced attendance in these programs is seldom successful, but has little to do with the common notion that they are about religious conversion. Anyone with first hand experience knows that the "Higher Power" concept can be anything of the addict's choosing. Those in 12 Step programs are free to attend any of the many meetings held in larger metropolitan areas, and addicts are encouraged to "sample" as many as possible before deciding upon a "home group". This decision is usually made on the basis of one's compatibility with the group's members, not their religious convictions.

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    1. Agreed that many of our actions are at least partially psychologically determined, especially with addicts. In many such cases, as epigenetics shows, if not the addiction itself, something like anxiety or depression that is often behind the addiction is also somewhat physiologically determined.

      On the 12-step movement ... well .... yes, but ...

      In the typical AA meeting, see what happens if you really call a doorknob your higher power, per the old joke.

      Then, going to Step 1, see what happens when you try to say that (psychological background aside), you're really not "powerless."

      And, this only scratches the surface of whether telling someone like a survivor of physical or sexual abuse that they need to believe they are "powerless" is going to help that person stay sober.

      And, that, personally, is why I share the inform

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    2. Oh, and per "court-ordered" attendance, more and more legal authorities are accepting email "attendance slips" for going to online meetings. Gives us secular groups a bit more even of a playing field.

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  13. Massimo,
    writing as someone who's struggled with opioid addiction (heroin, oxycontin, and others which are actually waaay better that H-- but I can't go into that right now, except to say that Haven exists-- it's a combination of drugs that makes H and oxcodone seem for amateurs.
    On a more serious note and but back to the relevant point, which is, that we've witnessed the total failure of most governments (incl. the U.S.) to figure out how to deal successfully with the problem of heroin and opioid (the quintessential) addiction in general.

    What's so incredible is that it's only in the past 5-10yrs that some European countries have taken a different route and have began to actually deal with the problem. The answer: Heroin Assisted Treatment, which is to say, giving the addicts what they want (within limits, of course, such as using the drug in specified clinics, that are not dissimilar from Methadone clinics, though unlike with Methadone, you can't take heroin home and you have to go there, I believe, twice a day, to use the narcotic under the supervision of the medial stuff).

    It's not hard to see the immediate benefits from such programs (btw, thy're available only to long-term, over 5 yrs., addicts who've failed other forms of treatment.):
    -- no jail time for users,
    -- no blood-borne diseases
    --no broken families due to the enormous price of the street heroin (probably 20 times(!) higher compared to what it would cost if sold like any other prescription drug),
    -- no overdoses and the unspeakable tragedies of so many families. To give an example: one of my best childhood friend and my first cousin, whom I felt closer than my own brother, both died from OD at the age of 18 and 20, respectively. The suffering that caused was so enormous that I'm not sure I can remain my composure talking relating these events any further, except to say that I'm willing to bet my life both of them would be still be alive and well, and probably married or even having children, if it wasn't for the bottomless stupidity of the government and the criminal "war on drugs", which I have no doubt one day will be looked upon with as much incomprehension and astonishment as we look upon racial segregation in the South nowadays.

    Another short-term benefit, as shown by the experience of countries like Switzerland, is the drastic reduction of the amount of illegal heroin smuggled into those places where addicts are actually "assisted" by the state (for obvious reasons). The result:
    --no gang violence over turf and the vast profits from illegal heroin
    -- no billions of dollars spent by government to fight a losing battle by chasing and imprisoning mere users
    --no ruined lives and lost opportunities for literally millions of otherwise decent people (possibly except drug-dealers), due to felony records that never get expunged
    -- no enormous amounts of money going back to the terrorist organizations in Afghanistan and other countries, which the US spends billions of dollars combating,
    --etc., etc.,

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  14. (...continue)
    What about the long-term benefits: in cities in countries where Heroin Assisted Programs have been opened, it turns out that not only the people who use "medicinal ", as opposed to "street", heroin (believe it or not, apart from addiction, studies show that apparently the only long-term damage to the human organism caused by heroin use --which, in fact, is, less toxic than morphine and almost all of the other painkillers on the market)--is..well, chronic constipation! What's more, most participants not only start living more or less regular lives after years or decades of delinquency, manage to find jobs, get married, and so on (not agonizing over how to obtain the hundreds of dollars needed daily to sustain street heroin habit, tends to change one's priorities), but the MOST important aspect of those programs is as follows:
    --virtually everywhere Heroin Assisted Treatment is adopted, the number of new users, who get hooked up each year, fell sharply! There seem to be a t least 2 reasons for that:
    1) the relative absence of street heroin (see above ) makes it much less likely that a teenager (who could be your son or your daughter) will get his or her hands on the drug at a party or any other event.
    2) given that those who attend Heroin Assisted Programs are given appropriate documents (much like doctors do with, say, diabetics), heroin-users essentially become qualified as sick people, in need of treatment, which takes much of the allure of narcotics-- opiates are no longer considered "cool" and become much less attractive to young people.
    3) The conclusion is that, in effect, once the "old guard" dies off, there chances are that in a generation or two, addiction to heroin(or morphine, oxycontin, percacet, vicodin, etc) will be so marginalized, as to be non-problem.

    If all of the above sound a bit radical, let me remind you that it did so to countries like Switzerland, Denmark, Germany, and a number of others who adopted the programs In their own admission, the results have surpass their most optimistic expectations. After a decade or so, the hard data is in. Hopefully the U.S, and others. will follow suit.

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    1. G -

      "If all of the above sound a bit radical, let me remind you that it did so to countries like Switzerland, Denmark, Germany, and a number of others who adopted the programs In their own admission, the results have surpass their most optimistic expectations. After a decade or so, the hard data is in. Hopefully the U.S, and others. will follow suit."

      Yeah, I've been reading about those programs, and it just drives home how fundamentally flawed the "war on drugs" has been in the U.S. Let's hope things start to change here, too.

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  15. By all means, my great condolence goes to Hoffman.

    "… You may see these bodies looming on the distant horizon, or you may never see them coming, realizing you’re under their control only after you’re already firmly in their grip.”

    Truly wonderful about the above statement. While some people can and do escape from the psychological gravity, there is no place for the freedom of the will to play in the field of influence of the Nature Master who set the rule of His gravity with three steps (ready, get set, go), and no physicist can go beyond His control by dreaming up his adversary (the Multiverse).

    The unlimited expectation for the freedom of human will is another kind of addiction.

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