“Despite the scientific implausibility of the same disease—addiction—underlying both damaging heroin use and overenthusiasm for World of Warcraft, the concept has run wild in the popular imagination. Our enthusiasm for labeling new forms of addictions seems to have arisen from a perfect storm of pop medicine, pseudo-neuroscience, and misplaced sympathy for the miserable.” — Vaughan Bell (Slate)
My enthusiasm for labeling new forms of addiction comes from clinical observation. They dynamics of substance addictions and addiction to video games are remarkably similar. I use this as a working definition of addiction: to persist in a behavior despite negative consequences and despite a desire to stop or limit the activity. There is no scientific implausibility involved in thinking the same disease is involved in chronic heroin use and excesive videogame playing –in terms of neuroscience PET scans of the the brains of cocaine-stimulated cocaine addicts and gambling addicts while gambling show similar activity in critical regions of the brain. There is also the phenomenological experience of those who have experienced addictions to stimulants and video games: the withdrawal is experienced as depression, frustration, ennui, etc.
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It may turn out that these pop “addictions” share the same neural and psychological mechanisms as those to addictive drugs. In fact, it seems likely, from my reading of the neuroscience. However, the point of the article is that it is not yet proven. Thus, we need to worry about the trend from the point of view of the overmedicalization of everyday life. Don’t you think?
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I think that the medicalization of deviance (I think of sociologist Peter Conrad here), or overmedicalization of everyday life is not as much of a problem as the undermedicalization. For example, criminal behavior is viewed by many (most?) Americans as a matter of pure choice, perhaps as a result of a cost-benefit analysis, or the act of evil persons, or even just “Evil” acting in the world. I think of it as the primary attribution error. To introduce more people to the idea of determinism, biological or psychological, is progress away from an over-reliance on individual responsibility as the explanation (and solution) for everything. This leads in many ways to a less punitive approach to deviance. So there’s a pragmatic benefit (from my perspective and values). Of course, it’s important not to cook the science, or “fix” the data (another one-liner from 2009).
Where things get really tricky, from a clinical viewpoint, is the realization that the disease model of addiction is very persuasive on the evidence and is also pragmatic in producing less stigmatization, shame and punitive responses. Yet, we believe that individuals who recover from alcoholism or other substance addictions need to take responsibility for their own recovery-oriented actions, and we do want to hold them responsible for dangerous substance abuse-related activities such as drunk driving. Do practical (or political) considerations or our ideologies always have more importance in our deliberations than the science? Is our way of understanding the scientific findings always influenced by the urgent questions concerning implications of the findings? Is objectivity in the behavioral or social sciences even possible?
I think it’s time for a symposium (or at least a brown bag) at a hospital near you.
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Jim, are you suggesting that forced medication to make everyone act according to an official and inevitably political view of how people are “supposed” to behave would be a good thing?
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