What We’re Not Talking about When We Talk about Addiction

Hanna Pickard

The Hastings Center

Originally posted 28 Aug 20

Abstract

The landscape of addiction is dominated by two rival models: a moral model and a model that characterizes addiction as a neurobiological disease of compulsion. Against both, I offer a scientifically and clinically informed alternative. Addiction is a highly heterogeneous condition that is ill-characterized as involving compulsive use. On the whole, drug consumption in addiction remains goal directed: people take drugs because drugs have tremendous value. This view has potential implications for the claim that addiction is, in all cases, a brain disease. But more importantly, it has implications for clinical and policy interventions. To help someone overcome addiction, you need to understand and address why they persist in using drugs despite negative consequences. If they are not compelled, then the explanation must advert to the value of drugs for them as an individual. What blocks us from acknowledging this reality is not science but fear: that it will ignite moralism about drugs and condemnation of drug users. The solution is not to cleave to the concept of compulsion but to fight moralism directly.

The article is here.

A Waste of 1,000 Research Papers

Ed Yong
The Atlantic
Originally posted May 17, 2019

In 1996, a group of European researchers found that a certain gene, called SLC6A4, might influence a person’s risk of depression.

It was a blockbuster discovery at the time. The team found that a less active version of the gene was more common among 454 people who had mood disorders than in 570 who did not. In theory, anyone who had this particular gene variant could be at higher risk for depression, and that finding, they said, might help in diagnosing such disorders, assessing suicidal behavior, or even predicting a person’s response to antidepressants.

Back then, tools for sequencing DNA weren’t as cheap or powerful as they are today. When researchers wanted to work out which genes might affect a disease or trait, they made educated guesses, and picked likely “candidate genes.” For depression, SLC6A4 seemed like a great candidate: It’s responsible for getting a chemical called serotonin into brain cells, and serotonin had already been linked to mood and depression. Over two decades, this one gene inspired at least 450 research papers.

But a new study—the biggest and most comprehensive of its kind yet—shows that this seemingly sturdy mountain of research is actually a house of cards, built on nonexistent foundations.

Richard Border of the University of Colorado at Boulder and his colleagues picked the 18 candidate genes that have been most commonly linked to depression—SLC6A4 chief among them. Using data from large groups of volunteers, ranging from 62,000 to 443,000 people, the team checked whether any versions of these genes were more common among people with depression. “We didn’t find a smidge of evidence,” says Matthew Keller, who led the project.

The info is here.

‘Science and the Good’ Review: The Anatomy of Morality

Julian Baggini
The Wall Street Journal
Originally published Jan. 15, 2019

Here is the conclusion of this book review:

But the authors’ core idea here—that if morality lacks some ultimate, non-natural basis, then it isn’t really morality—is a hangover from a Christian-Platonic way of thinking. For evidence that there is another way, look to China. There the ethics of an entire civilization has for millennia been based on a Confucian philosophy that concerns itself with how we live good lives and create an orderly society in the here and now—without pointing to a metaphysical realm for justification. Messrs. Hunter and Nedelisky rule out the possibility that what we understand as morality in the West might be revisable without our losing what is most essential about it.

They are right, however, to warn that such a deflated morality—concerned primarily with the pragmatics of social harmony—risks becoming a “sophisticated intellectualization for our pervasive regime of instrumental rationality.” Their important and timely book reminds us that ethics at its best challenges rather than justifies the status quo, which is why a purely descriptive science of ethics is never enough.

The info is here.

Time to abandon grand ethical theories?

Julian Baggini
TheTLS.co
Originally posted May 22, 2018

Here are two excerpts:

Social psychologists, sociologists and anthropologists would not be baffled by this apparent contradiction. Many have long believed that morality is essentially a system of social regulation. As such it is in no more need of a divine foundation or a philosophical justification than folk dancing or tribal loyalty. Indeed, if ethics is just the management of the social sphere, it should not be surprising that as we live in a more globalized world, ethics becomes enlarged to encompass not only how we treat kith and kin but our distant neighbours too.

Philosophers have more to worry about. They are not generally satisfied to see morality as a purely pragmatic means of keeping the peace. To see the world muddling through morality is deeply troubling. Where’s the consistency? Where’s the theoretical framework? Where’s the argument?

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There is then a curious combination of incoherence and vagueness about just what it is to be ethical, and a bogus precision in the ways in which organizations prove themselves to be good. All this confusion helps fuel philosophical ethics, which has become a vibrant, thriving discipline, providing academic presses with a steady stream of books. Looking over a sample of their recent output, it is evident that moral philosophers are keen to show that they are not just playing intellectual games and that they have something to offer the world.

The info is here.

What is the ethics of ageing?

Christopher Simon Wareham
Journal of Medical Ethics 2018;44:128-132.

Abstract

Applied ethics is home to numerous productive subfields such as procreative ethics, intergenerational ethics and environmental ethics. By contrast, there is far less ethical work on ageing, and there is no boundary work that attempts to set the scope for ‘ageing ethics’ or the ‘ethics of ageing’. Yet ageing is a fundamental aspect of life; arguably even more fundamental and ubiquitous than procreation. To remedy this situation, I examine conceptions of what the ethics of ageing might mean and argue that these conceptions fail to capture the requirements of the desired subfield. The key reasons for this are, first, that they view ageing as something that happens only when one is old, thereby ignoring the fact that ageing is a process to which we are all subject, and second that the ageing person is treated as an object in ethical discourse rather than as its subject. In response to these shortcomings I put forward a better conception, one which places the ageing person at the centre of ethical analysis, has relevance not just for the elderly and provides a rich yet workable scope. While clarifying and justifying the conceptual boundaries of the subfield, the proposed scope pleasingly broadens the ethics of ageing beyond common negative associations with ageing.

The article is here.

Freud in the scanner

M. M. Owen
aeon.co
Originally published December 7, 2017

Here is an excerpt:

This is why Freud is less important to the field than what Freud represents. Researching this piece, I kept wondering: why hang on to Freud? He is an intensely polarising figure, so polarising that through the 1980s and ’90s there raged the so-called Freud Wars, fighting on one side of which were a whole team of authors driven (as the historian of science John Forrester put it in 1997) by the ‘heartfelt wish that Freud might never have been born or, failing to achieve that end, that all his works and influence be made as nothing’. Indeed, a basic inability to track down anyone with a dispassionate take on psychoanalysis was a frustration of researching this essay. The certitude that whatever I write here will enrage some readers hovers at the back of my mind as I think ahead to skimming the comments section. Preserve subjectivity, I thought, fine, I’m onboard. But why not eschew the heavily contested Freudianism for the psychotherapy of Irvin D Yalom, which takes an existentialist view of the basic challenges of life? Why not embrace Viktor Frankl’s logotherapy, which prioritises our fundamental desire to give life meaning, or the philosophical tradition of phenomenology, whose first principle is that subjectivity precedes all else?

Within neuropsychoanalysis, though, Freud symbolises the fact that, to quote the neuroscientist Ramachandran’s Phantoms in the Brain (1998), you can ‘look for laws of mental life in much the same way that a cardiologist might study the heart or an astronomer study planetary motion’. And on the clinical side, it is simply a fact that before Freud there was really no such thing as therapy, as we understand that word today. In Yalom’s novel When Nietzsche Wept (1992), Josef Breuer, Freud’s mentor, is at a loss for how to counsel the titular German philosopher out of his despair: ‘There is no medicine for despair, no doctor for the soul,’ he says. All Breuer can recommend are therapeutic spas, ‘or perhaps a talk with a priest’.

The article is here.

Is Addiction a Brain Disease?

Kent C. Berridge
Neuroethics (2016). pp 1-5.
doi:10.1007/s12152-016-9286-3

Abstract

Where does normal brain or psychological function end, and pathology begin? The line can be hard to discern, making disease sometimes a tricky word. In addiction, normal ‘wanting’ processes become distorted and excessive, according to the incentive-sensitization theory. Excessive ‘wanting’ results from drug-induced neural sensitization changes in underlying brain mesolimbic systems of incentive. ‘Brain disease’ was never used by the theory, but neural sensitization changes are arguably extreme enough and problematic enough to be called pathological. This implies that ‘brain disease’ can be a legitimate description of addiction, though caveats are needed to acknowledge roles for choice and active agency by the addict. Finally, arguments over ‘brain disease’ should be put behind us. Our real challenge is to understand addiction and devise better ways to help. Arguments over descriptive words only distract from that challenge.

The article is here.

Cadaver study casts doubts on how zapping brain may boost mood, relieve pain

By Emily Underwood
Science
Originally posted April 20, 2016

Here is an excerpt:

Buzsáki expects a living person’s skin would shunt even more current away from the brain because it is better hydrated than a cadaver’s scalp. He agrees, however, that low levels of stimulation may have subtle effects on the brain that fall short of triggering neurons to fire. Electrical stimulation might also affect glia, brain cells that provide neurons with nutrients, oxygen, and protection from pathogens, and also can influence the brain’s electrical activity. “Further questions should be asked” about whether 1- to 2-milliamp currents affect those cells, he says.

Buzsáki, who still hopes to use such techniques to enhance memory, is more restrained than some critics. The tDCS field is “a sea of bullshit and bad science—and I say that as someone who has contributed some of the papers that have put gas in the tDCS tank,” says neuroscientist Vincent Walsh of University College London. “It really needs to be put under scrutiny like this.”

The article is here.

Editor's note:

This article represents the importance of science in the treatment of human suffering. No one wants sham interventions.

However, the stimulation interventions may work, and work effectively, in light of other models of how the brain functions. The brain creates an electromagnetic field that moves beyond the skull.  If the cadaver's brain is shut off, this finding may be irrelevant as the stimulation affects the field that moves beyond the skull.  In other words, how these stimulation procedures influence the electromagnetic field of the brain may be a better model to explain improvement.

Therefore, using dead people to nullify what happens in living people may not be the best standard to evaluate a procedure when researching brain activity.  It is a step to consider and may help develop a better working model of what actually happens with TMS.

By the way, scientists are not exactly certain how lithium or antidepressants work, either.

Philosophy of biology

Peter Godfrey-Smith interviewed by Richard Marshall
3AM Magazine
Originally published April 11, 2014

Peter Godfrey-Smith is the go-to guy in the philosophy of biology. He is forever evolving his thoughts on externalism, complexity and why we shouldn’t expect a settled outcome, the contribution of pragmatists to philosophy of biology, why Fodor gets it wrong, on how best to understand what science is, on Darwinian theory, Darwinian populations, on why Richard Dawkins and David Hull are wrong and on the contribution of philosophy to biology. Like Cool Hand Luke, this one bites like a ‘gator!

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PGS: It’s fine with me if the biologists (and other scientists) get on with their scientific work without input from philosophers. Philosophy does often contribute ideas and theory-sketches to science, which then acquire a life of their own in the new setting, but this “incubator” role is a secondary role for philosophy. The same applies to the “clarification” of scientific concepts by philosophers. It happens, and sometimes it’s helpful for scientists, and that’s a good thing, but it’s not central to philosophy. I don’t think of philosophy as essentially a field that contributes to other fields. Philosophy is, roughly speaking, its own field, though it has a special status because it’s so integrative – because the aim of philosophy is to get a coherent and defensible picture of everything going on. I very much like the one-line description of philosophy given by Sellars: philosophy is about “how things in the broadest possible sense of the term hang together in the broadest possible sense of the term.” If we take this view on board, it implies that philosophy will always be interacting with the sciences and drawing on them, but it won’t be swallowed up by them.

So I have no problem with scientists who do their scientific work while ignoring philosophy. It’s a different matter when scientists start trying to answer philosophical questions, or trying to distill philosophical messages from their work. Sometimes they do this well, sometimes badly. Either way, then they are part of the philosophical conversation.

The entire article is here.

Feminist Political Philosophy

First published Sun Mar 1, 2009; substantive revision Tue Apr 1, 2014
Stanford Encyclopedia of Philosophy

Feminist political philosophy is an area of philosophy that is in part focused on understanding and critiquing the way political philosophy is usually construed—often without any attention to feminist concerns—and on articulating how political theory might be reconstructed in a way that advances feminist concerns. Feminist political philosophy is a branch of both feminist philosophy and political philosophy. As a branch of feminist philosophy, it serves as a form of critique or a hermeneutics of suspicion (Ricœur 1970). That is, it serves as a way of opening up or looking at the political world as it is usually understood and uncovering ways in which women and their current and historical concerns are poorly depicted, represented, and addressed. As a branch of political philosophy, feminist political philosophy serves as a field for developing new ideals, practices, and justifications for how political institutions and practices should be organized and reconstructed.

The entire article is here.

Editorial note: Feminist Political Philosophy is relevant to the practice of psychology: think therapeutic relationship, certain clinical interventions, Guidelines for Psychological Practice with Girls and Women, and advocacy work.

The strange phenomenon of the cult of facts: three case studies

By Masimo Pigliucci
Scientia Salon
Originally published March 30, 2014

Here is an excerpt:

Moreover, as a fellow Bayesian, Silver ought to know that his own analogy is ironically flawed: in Bayesian analysis you always begin with priors, and the whole point is to revise those priors as new data comes in. That is, embedded in the very fabric of the Bayesian approach [4] is that you start with beliefs, you add data (collected on the basis of your beliefs!), and end up with (likely modified) beliefs. You just can’t take the belief components out of the analysis, it’s integral to it, and it’s both affected by the data one gathers and determines which bits of information “out there” actually get to count as data.

As Wieseltier astutely observes, “Silver wishes to impugn not only the quality of opinion journalism, he wishes to impugn also its legitimacy. The new technology, which produces numbers the way plants produce oxygen, has inspired a new positivism, and he is one of its princes. He dignifies only facts … He does not recognize the calling of, or grasp the need for, public reason.”

The entire story is here.

Book Review: Does rationality + consciousness = free will?

Review of Rationality + Consciousness = Free Will
by David Hodgson. New York: Oxford University Press

Review by Brian Earp

Do we have free will or don’t we? Or do we have it in degrees? Is free will compatible with determinism or is it not? What about indeterminism? David Hodgson is not the first to explore this thicket. Following the advice of Hobbes, the first step in any effort to answer such questions should be to pose another set of questions: What do you mean by “free”? By “we”? By “have”and “will”? What is your notion of “compatible” and “incompatible”? How do you define“determinism”? And so on through the list of very pregnant turns-of-phrase.

In his latest book, Hodgson does somewhat less to “examine the Definitions of former Authors”than to “make them himself.” Though he does give some broad gestures at foundational texts in the opening chapters of his work, and while he sprinkles some references to his contemporaries throughout, Hodgson spends the bulk of his time developing his own distinctive account. Let us try to make some sense, then, of what that account is saying.

The author's personal copy of the book review is here.