Abstracts:
Robert Kurzban: "Why everyone (else) is a hypocrite". In this talk, I will argue that the
key to understanding our behavioral inconsistencies lies in understanding the mind's
design. The human mind consists of many specialized units designed by the process of
evolution by natural selection. While these modules sometimes work together seamlessly,
they don't always, resulting in impossibly contradictory beliefs, vacillations between
patience and impulsiveness, violations of our supposed moral principles, and overinflated
views of ourselves. This modular, evolutionary psychological view of the mind
undermines deeply held intuitions about ourselves, as well as a range of scientific
theories that require a "self" with consistent beliefs and preferences. Modularity suggests
that there is no "I." Instead, each of us is a contentious "we"--a collection of discrete but
interacting systems whose constant conflicts shape our interactions with one another and
our experience of the world.
Edmund Henden: “Addiction, Bias and Autonomy”. What is it about addiction that
impairs addicts’ autonomy and how can such impairment be explained? According to a
standard philosophical account what addictive behavior lacks which, were it present,
would make this behavior autonmous, is a certain form of “self-governance”. In this talk,
I consider three versions of this account (synchronic, historical and diachronic), all of
which I argue fail to explain the autonomy impairment characteristic of addicts. The
reason they fail, however, is not that addicts are in fact fully autonomous (as some have
claimed), but that these accounts rest on an insufficient conception of autonomy. One
issue that has received surprisingly little philosophical consideration concerns the role of
attention in autonomous behavior. This is a relevant issue because there is empirical
evidence suggesting that addicts’ decisional capacity is impaired primarily because it is
affected by drug-related attentional bias. I propose an explanation of why and how such
bias might be thought to undermine addicts’ autonomy that does not rule out that many
addicts can be “self-governing” agents.
Justyna Klingemann: “The Congruence between Lay and professional Concepts of
Alcohol Addiction". The issue of a congruence between lay and professional concepts of
alcohol addiction is explored on the basis of the Polish qualitative data. The presented
study identifies and categorizes concepts of addiction among treated and non-treated
former alcohol dependents, and their function in the process of recovery from addiction
within the post-communist treatment system dominated by the Minnesota model.
Methods: This qualitative study is based on a media recruited sample of 29 former
alcohol dependents (ICD-10) in Warsaw/Poland 2006/2007. They reported a recovery
time of at least 2 years. In-depth interviews were analyzed according to the PCI method
using Atlas.ti software. The applied triangulation procedures ensure reliability and
validity of the data collected and the analysis of the narrative accounts. Results: The
results of the study show that professional concepts of addiction reconstructed on the
basis of narratives from treated respondents resemble the disease model of addiction. A
first category of lay concepts of self-changers adopt a medical–moral model of
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dependence including strong will as a key element of the successful recovery. A second
category describes dependence as a symptom of maladaptive social functioning and
recovery as a process of understanding one’s role in society and fulfilling social
expectations. While self-changers relied on one of these lay concepts, treated respondents
were confronted with a conflict between lay and professional definition of dependence.
Conclusions: It is argued that lack of recognition of lay concepts of addiction by
treatment providers may weaken help-seeking and increase drop-out rates. Moreover, the
disease model implies the stability of the status of the alcoholic – which potentially
affects the individual’s sense of autonomy and – consequently - weakens his/her chances
to reach the stage of stable recovery.
Carl Hart: "Ask the wrong question, get the wrong answer". If you ask the wrong
question, be prepared to get the wrong answer. Whether addiction is a disease or a matter
of choice is not a question that is even important. There are cases in which addiction falls
under both classifications. While the vast majority of users do so without endangering
their safely, many people struggle to control their intake of various substances, which
have disrupted their ability to function.The better question is how do we best treat drug
addiction? In recent years a disturbingly narrow focus on addiction as a biologically
based disease has evolved, even though there are extremely limited data to support this
view. As a result, efforts to develop treatments for drug addiction have overwhelmingly
concentrated on searching for medications that correct some nebulous underlying
biological deficit to the exclusion of addressing other important contributing factors such
as co-morbid psychiatric disorders and the lack of better alternatives to drugs. The more I
studied actual drug use in people, the more I became convinced that it was a behavior that
was amenable to change like any other. So why did it seem so intractable in poor
neighborhoods? A key problem is that poor people actually have few “competing
reinforcers.” Crack or any other drug isn’t really all that overwhelmingly good or
powerfully reinforcing: it gained the popularity that it achieved in the ‘hood (far less than
advertised) because there weren’t that many other affordable sources of pleasure and
purpose and because many of the people at the highest risk had other pre-existing mental
illnesses that affected their choices. While drug use rates are similar across classes,
addiction — like most other illnesses — is not an equal-opportunity disorder. Like cancer
and heart disease, it disproportionately affects the poor, who have far less access to
healthy diets and consistent medical care. In a series of experiments, my colleagues and I
began investigating some of these questions. In one study, we gave methamphetamine
addicts a choice between taking a big hit of methamphetamine (50 mg.) or five dollars in
cash. They took the drug on about half of the opportunities. But when we increased the
amount of money to twenty dollars, they almost never chose the drug. We had gotten
similar results with crack cocaine addicts in an earlier study. This told me that the
addictive potential of methamphetamine or crack was not what had been previously
claimed; their addictiveness wasn’t extraordinary. Our results also demonstrated that
addicts can and do make rational decisions and this information could be used to inform
treatment development efforts.Treatments based on providing alternatives to drugs have
shown repeatedly that they can be effective in changing addictive behavior. This kind of
treatment is called “contingency management.” The idea comes from basic behaviorism:
our actions are governed to a large extent by what we are rewarded for in our
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environment. These cause-and-effect relationships where a reward is dependent
(contingent) upon the person either doing or (in the case of drugs) not doing a particular
behavior can be used to help change all types of habits. Contingency management is
arguably the most successful substance abuse treatment strategy, despite the fact that it
does not purport to correct some neural deficit. The lesson here is that we should be less
preoccupied with characterizing addiction and more focused on what treatments work.
Louis Charland: "Loss of Control and Disease in Addiction: Five Fallacies". The
hypothesis that repeated use of addictive substances may result in ‘loss of control’ and
that it is appropriate to call the ensuing syndrome a ‘disease’ at this stage of scientific
research, is often met with strong – sometimes vehement – disproval and denial. Indeed,
many philosophers, scientists, politicians, and members of the general public, insist that
addicts ultimately always have the ‘free will’ to choose their destiny no matter how dire
the circumstances. I argue that there are five pervasive fallacies that tend to undermine
and stifle productive debate in this area. These are: False Dichotomy, Overgeneralization,
Essentialism, Intellectualization, and Scientific Opportunism. Ironically, philosophers,
who should be leaders in detecting fallacies in reasoning, are often among the culprits in
these disputes.
Jørgen Bramnes: “What is the neurobiological knowledge of addiction, and what has
this knowledge contributed to understanding the phenomenon?” It is popular among
scientists to speak of the neurological correlates of human or psychological phenomena.
Implicit to such understanding is the assumption that neurobiology has made only minor
contributions to understanding the addiction phenomena. Neurobiology is reduced to
reflections on “what we already know”. In this talk, therefore, I will show that the
neurobiological model is neither unidimensional, nor too general, or in contradiction with
other, more dynamic or complex models. There are numerous examples of how
neurobiological knowledge may enhance our understanding of psychological phenomena,
and expand on these. In short, neurobiological research shows that intoxication or
euphoria on the one end, and addiction/prioritizing on the other end are two separate, and
parallel mental processes, mediated by different neurotransmitter-systems. Through
dysregulation of these systems we have observed how people may progress from seeking
euphoria to seeking normality, to avoid anhedonia. Situationally dependent “cue craving”
is important to this process. In this talk I will discuss how this knowledge has prompted
development of new medicines, as well as greater understanding of the relationship
between substance use and mental illness. I will also discuss the current debate in the
wake of these discoveries, and comment on some of the most serious critiques.
Hanna Pickard & Serge Ahmed: "Addiction, Choice, Foresight". The puzzle of
addiction derives from the fact of persistent use in the face of knowledge of negative
consequences. We argue that the orthodox view of addiction as a neurobiological disease
of compulsion solves this puzzle, but is undermined by a range of philosophical concerns
and empirical data that taken together suggest that addicts have choice over their drug
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and alcohol consumption. We propose an alternative solution to the puzzle which draws
on the real-world psycho-socio-economic context in which chronic addicts typically live,
but also raises a new puzzle about the values expressed by addictive choices. We explore
this puzzle by considering the extent to which addicts lack concern for their future,
whether for rational reasons or due to cognitive impairments, but respond positively to
present, and especially social, reward.
Peter Railton: "Two kinds of failure to learn in desire". I have elsewhere presented a
model of desire as a compound state involving affective regulation of motivation via a
positively-valenced representation. This state primes the individual for learning as well
as action. This compound nature suggests two broad ways in which desires can fail to
learn. There can be dysregulation and failure of feedback in affect--for example, in
affective disorders like depression and mania--and there can be regulatory failures when
affective representations cease to exercise effective control of motivation. Addiction and
certain other forms of compulsive motivation appear to be examples of the second type of
failure.
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