Intention and Addiction

The concept of intention may seem an unpromising place to start if our goal is to find a solution to the problem of addiction.  After all, we’ve known for decades that addiction is a brain disorder.  Addicts are victims of defective brains, in which reward pathways tend to overwhelm the inhibitory ability of the prefrontal cortex.  Intention has nothing to do with it, because brains don’t form intentions—they merely respond deterministically to stimulus.  So, for example, the cover article of the September 2017 issue of National Geographic, “The Addicted Brain”, assures us that the only solution is medical interventions, with suggestions ranging from drugs to powerful magnetic fields to sophisticated brain surgery meant to stimulate prefrontal neurons.  Although addiction, we are told, is “a pathological form of learning,” the solution cannot be new learning, because the pathology is not in warped experiences but in a defective brain, which can only, it seems, learn in this pathological way.  

Consider how the matter is put in this article: “addiction remolds neural circuits to assign supreme value to cocaine or heroin or gin, at the expense of other interests such as health, work, family, or life itself.”  As an imbecile, what must I think of this?  This description can make no sense to me. We are not addicted because we have developed habits, or had experiences, or thought about things in a certain way.  No, this personified entity “addiction” has somehow gotten access to our brains and rewired them.  We are addicted because “addiction” has chosen us to work its magic on.  To the imbecile, this is absolutely incomprehensible, but to the hosts of pseudoscientists in the various neuro-prefixed fields, this makes perfect sense.  

For most experts in the field of addiction, intention plays a very small, exclusively diagnostic, role in addiction.  And the term itself seems quite self-evident, never in need of examination.  At least this is what they claim.  

But let’s consider a book published by Oxford University Press the same year as that National Geographic article. The book is called Addiction & Choice, and in their preface the editors are quite frank about just how controversial their approach is:  “to the majority of individuals working with addictions…the notion that addicts can be seen as choosing their addictive behavior, however exactly that notion is understood, would be difficult at first to accept, not to say highly controversial”(viii).  But how controversial is it, really?  One of the editors, Nick Heather, offers this simple definition of addiction: “a repeated and continuing failure to refrain from or radically reduce a specified behavior despite prior resolutions to do so”(11).  The reason this definition of addiction seems so obvious to most of us is that it simply assumes the existence of an individual with free will and the ability to form intentions.  And it does capture the core of the DSM-V definition of “alcohol use disorder,” which centrally focuses on intentions.  

Let’s take just a moment to consider those diagnostic criteria. There are eleven, but only two of the ten need apply to the alcoholic.  Although it is suggested that only two of the criteria are required to make the diagnosis, clearly the list is presented in the form of a narrative of progression.  Here’s the diagnostic test offered on the NIH website.  It asks if you have:  

  • Had times when you ended up drinking more, or longer than you intended?
  • More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
  • Spent a lot of time drinking? Or being sick or getting over the aftereffects?
  • Experienced craving — a strong need, or urge, to drink?
  • Found that drinking — or being sick from drinking — often interfered with taking care of your home or family? Or caused job troubles? Or school problems?
  • Continued to drink even though it was causing trouble with your family or friends?
  • Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
  • More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
  • Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?
  • Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?
  • Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things that were not there?

We can see that intention is the first criteria: you must be doing something you do not intend to do.  Apparently, you must do this because of a “craving” (the actual DSM-V uses the word “desire”), which has the power to overcome intention.  Further down the list, in point ten, we find that what addict “wants” is an effect he cannot achieve.  How are we to understand the relationship between intending, desiring, and wanting?  Furthermore, how can we imagine that we might meet only two of these criteria?  That is, if you don’t meet the first, does it even make any sense to go on with the diagnosis? If you get drunk everyday, but that is exactly what you “intend” to do, how could we possibly apply the rest of the question?  And in what sense could you say you have a strong urge to drink if you in fact don’t do so?  Is an urge that we don’t act on really what we would call as “strong need”?

Intention is at the center of all the questions we ask about addiction, but we never stop to consider what we mean by intending.  We tell addicts not to worry about staying sober forever, but to focus on one day at a time, reducing future intentions to a shorter period. What does this advice assume about how intentions—as well as cravings, desires, urges, needs, etc.—actually work?  If we had a clear idea of what in intention is, would this be good advice?

Let’s begin by approaching this problem as imbeciles.  

Remember that we can think of the imbecile in terms of the children’s story of the emperor’s new clothes.  The moron is the one who simply assumes there must be a suit of clothes if everyone else claims to see it; in fact, he is so sure of this that he eventually may come to believe he actually sees these magnificent clothes.  The idiot, on the other hand, is the one shouting “but he’s naked!”  The absence of clothes is obvious to him, and he cannot grasp what is being asserted by others.  The imbecile is somewhere in between.  Her question is “what does everyone really mean when they say they see clothes on the emperor?  What is the function of this pretense?”  

I’m going to begin by questioning the word “intention” in this way. We all pretend to know what it means, but we really have no idea.  Nevertheless, it isn’t useful to say it means nothing at all.  Instead, we should consider what is at stake in the discussion of intention, in carrying on using this term with no concept behind it.  

My claim is that we will never find a solution to the problem of addiction—much less even be able to establish a working definition of that term—until we have first made explicit the function of the concept of intention.  There will be much more work to be done, of course; but until we know what we mean when we say “intend” we cannot make any real progress.  We will stay right were we are, hopelessly unable to address the problem of addiction, offering only expensive treatments with success rates of zero—in fact, less than zero if we believe the outcome research showing that addiction treatment increases the likelihood of death within a year!  

Part of the problem we face is that intention is such a simple, everyday word.

The word intention is so common that it may seem absurd to spend much time trying to sort out what we might mean by it.  However, it is exactly these ordinary words that do the most work to elide assumptions and commitments, covering over confusion with what we take to be a concrete label.  Think of terms like consciousness, self, or emotion, which we use every day but remain unable to clearly define.  Such terms are often handy if our goal is sophistry, if we want to equivocate in making a case for some project we actually have no really good reasons to support.  

As with terms like consciousness, the philosophical literature on the concept of intention is enormous, with nothing like a consensus on what we mean by the word.  The imbecile’s question, then, is: what does the endless discussion of intention help us to avoid addressing?

In a very lucid and useful survey of the enormous literature on intention in analytic philosophy, Kieran Setiya explains that in the discourse of intention, it is usually assumed that the goal is to somehow reconcile the three distinct common uses of the term.  These are

  1. Intention for the future: as when I intend to write a book about intention and addiction over the course of this year.
  2. Intention with which I do something: as when we suggest that someone’s intention was other than the obvious one, implying ulterior motives, or when we suggest someone did not intend the effect he caused (he didn’t intend to insult you, etc.)
  3. Intentions in the sense of consciously directed action: as when moving my leg was a reflex action, and not done intentionally.  

The goal of the philosophy of intention is to somehow reconcile these three ordinary meanings of the term under one guiding concept.  We might wonder why we would want to do this.  Do we necessarily need to agree with the famous claim made by Elizabeth Anscombe that this is clearly not a matter of there just being three different senses of the word (as with words like “box,” for which it would be idiotic to try to reconcile the meanings of cardboard container and punching one another in the head)?  However, I want to set aside consideration of that problem for now, and simply consider what is at stake in the attempt to reconcile these three loosely related concepts.

Kieran Setiya suggests two axes on which we can asses theories of intention.  Briefly put, we can assess them according to how they manage to unify the three ordinary meanings of the term; or, we can assess them according to how they relate intention to judgements and beliefs.  The point, for the imbecile, is that these two axis of concern both work to limit our focus in conceptualizing intention.  That last sentence may be a bit obscure, so I will attempt to spell out what I mean by it.

I will do this spelling out by considering the nature of the usual examples of intentional activity used to expound philosophical theories.  What kinds of things do they suggest we might intend?  The examples are usually of the same general kind, limited to things such as crossing a street, painting a door, or dieting.  That is, they are the kinds of things an ordinary individual might need to accomplish in an ordinary day’s activity.  Donald Davidson’s examples of what he calls “pure intending” are the intention to build a squirrel house or to eat a hearty breakfast tomorrow.  What kinds of things are we leaving out when we limit our concept of intention to such practical activity? 

Well, let’s look at how Davidson defines the term “pure intention”: 

Wants, desires, principles, prejudices, felt duties, and obligations provide reasons for actions and intentions, and are expressed by prima facie judgements; intentions and the judgements that go with intentional actions are distinguished by their all-out unconditional form.  Pure intendings constitute a subclass of the all-out judgements, those directed to future actions of the agent, and made in the light of beliefs. (137)

Davidson’s point here is that an intention is an overall judgement that it would be good to do something, that some action is in general a good thing given the right circumstances.  So, it is overall a good thing to eat a hearty breakfast, even if on any given day I might not be hungry enough, or might not have enough time.  A “pure intention” is not a specific plan of action, but our set of judgements about what are good things to do, unless particular circumstances happen to prevent them.

Okay.  We can perhaps grant that this may be one way to resolve the three meanings of intention (although it seems most professional philosophers do not think it is).  We might say that forming “pure intentions” about what are in general good things to do covers the future, while the other two sense of the term handle how I go about applying this pure intention in a given situations.  

Once again, as an imbecile, I need to ask: what is being elided here?  Are things like getting a haircut or painting a door really the most significant kinds of actions I take? Are the beliefs they depend on really ultimately beliefs like “good grooming is important” or “painted doors withstand the elements better”?  What about the bigger background level of assumptions about how we act that never make it into the discussion of intention?  Beliefs like the idea that living in a house is good, or that organizing our relations with others by means of money is the most efficient way to get things done, or that electing a leader from two candidates chosen for us by the very rich is the ideal form of government.  Aren’t these more fundamental to even our everyday intentions?  Aren’t there assumptions about what to eat and how to produce and distribute it that are much more fundamental than my individual belief that eating a hearty breakfast is a good thing?  

Examples of intention in philosophy, to put it bluntly, are meant to exclude from the realm of intentionality anything at all about the broader features of the social formation in which we live.  That is, they assume the existence of a certain form of life—generally, this is a middle-class, modern, Western existence—and then debate how it is we can come to “intend” to act correctly in the social formation we find ourselves in.  Decisions about the really important things, like how we will produce our food, how we will arrange our reproduction and child-rearing, what kind of economy we will use to distribute necessities, do not come under the category of intention.  

My point is that this is an endlessly baffling concept exactly because this is left out of it.  We exclude sociality from intention, and then cannot figure out exactly what it is or how it might work.  When I set out to build a squirrel house, to use Davidson’s example, I am not simply making a future plan, for a clear purpose, and directing my body to carry out the steps.  I am also reproducing a host of assumptions about the world, most of which I never consciously examined when arriving at my belief that a squirrel house would be a good thing.  What might these be? 

  • Assumptions about private property: I am thinking of building this in my “own” yard, a piece of the earth I can do what I want on with no need to consult others.
  • Assumptions about nature: I can assume that the lives of animals should be subject to my decisions about which are desirable and should be encouraged to live nearby, and which should be destroyed.
  • Assumptions about food production: I am assuming I don’t need to produce my own food, otherwise I wouldn’t want squirrels around to destroy my crops.

These are just a few assumptions…we could extend this list indefinitely.  But we can see the point, right?  Any intention we form, any judgement that a thing is good, is dependent on an enormous realm of assumptions about how we must organize our lives. These assumptions never become our intentions, because they must remain beyond the level of our judgements. They must be taken as given, and assumed not to be up to us.  

Nevertheless, they are very much part of intentional human action. We have private property and commercial agriculture only because we alway act in ways that produce these things.  But we never seem to “form intentions” about them.  Most intentions, up to and including most of our supposedly natural bodily movements, are not intentions we have in our discrete individual minds at all. They are are intentions that are implicit in our social formation, and which we tend to stop short of thinking about.  

I would suggest that all the philosophical puzzles over intention would dissolve, seem like no longer to be comprehensible as problems, if we included our unexamined implicit assumptions and commitments in our discussion of what we intend.

Davidson seems to see this to some degree.  In discussion the forming of pure intentions, he does claim that  need a “broader and more neutral concept of coming to an have an intention—a change that may take place so slowly or unnoticed that the agent cannot say when it happens” (127).  I would agree.  But when and how does this intention formation occur?

I think the best answer to this question is offered by John McDowell.  Now, this project is not primarily devoted to those familiar with philosophy; and frankly, every philosophy student, or teacher, I’ve ever discussed him with says that McDowell’s writing is so unbearably inscrutable that they’d rather read Plato in Greek than try to parse one of his cryptic sentences.  I don’t know that he’s all that difficult, though.  I’d suggest that his writing is sometimes less than rhetorically effective, but that the real difficulty is that he is arguing for something that is just plain forbidden, ruled out, in the discourse of philosophy. He is arguing for the sociality of our “consciousness.”

In the essay “Meaning and Intentionality in Wittgenstein’s Later Philosophy,” he concludes that the only way to make sense of these two related and puzzling concepts is to admit that they do not arise in individual “minds,” but are socially produced.  He begins with the famous rule-following problem from Wittgenstein’s Philosophical Investigations.  Suppose you are told to continue a number sequence that begins: 2, 4, 6, 8…996, 998, 1000.  What comes next?  You’d assume 1002. But how do you know?  How do you know the rule to follow isn’t something like “if the number is less than 1000, add 2; if it is 100o or more, add 4”?  The problem of intention, Wittgenstein is suggesting, hangs on the error made here.  We assume the individual must come up with the rule by reasoning to a correct interpretation of the situation; then we wind up with all kinds of problems in explaining how anything can have meaning to multiple individuals, much less how anyone can arrive at an intention.  If you intend to play chess, Wittgenstein says, you must have the rules of chess in mind.  If you cannot arrive at the correct rules, then you cannot have an intention at all.  How do you know what you will do, if the underlying rules are never clear?  How can I know I will succeed in the simplest thing, like going to the store and buying a quart of milk, if the underlying rules of this activity, the social rules, are in doubt?  But we cannot ever arrive at the rules with certainty.  To be slightly absurd, the rule might have been that you can go into the grocery store and buy milk with money before April 13, 2000, but after that date taking milk out of the refrigerator case becomes a capital offense.  Yes, I know this is an absurd example, but consider the point.  We cannot by reason alone ever know for a certainty that this absurd rule isn’t the actual rule.  

How do we know this is not the rule?  Wittgenstein, and McDowell, suggest that it is by training.  That is, we learn rules not by reasoning from observation, but by custom.  McDowell’s argument, in this essay and elsewhere, is that “human beings…are transformed into thinkers and intentional agents in the course of coming into maturity…In being initiated into a language, a human being is introduced into something that already embodies putatively rational linkages between concepts, putatively constitutive of the layout of the space of reasons, before she comes on the scene” (Mind and World, 125).  What I take him to be saying here is that we can have intentions because we rely on a network of assumptions about how the world just is, and these assumptions exist in the very language we learn.  They also exist in extra-linguistic actions we take as natural (such as how we sit or stand, our sense of personal space, etc.).  The reason we cannot, as Donaldson realizes, often say when exactly our pure intentions were formed, is because they inhere in the language and culture we were initiated into from birth.  We never formed them at all, and may go through life remaining unaware of many of our intentions.  The part of intention philosophy wrestles with is just a tiny part, inexplicable on its own.  

But the very goal of philosophy, and of the psychology of addiction, is to keep us unaware of most of our implicit intentions.  The function of these discourses is to block us from making these explicit.  

However, once we see that “intention” must be a larger, inherently social, set of assumptions about how the human world should be organized, we can easily see our way to reconciling the three meanings of the term with which we began.  They don’t each need to be reconciled with one another; rather, each needs to be seen as it relates to this larger overall intention.  In that case, my intentions for the future need to be reconciled to the larger intention for the future organization of all human activity in my society; my intention in the sense of what I really mean to accomplish needs to be reconciled with the kinds of tasks that I am permitted and required to perform in my society; the intention of my bodily action must be seen as a measure of whether or not this action is somehow guided by those intentions informing the “space of reasons” in which I am a participant.  That is, we don’t need to reconcile the three uses of the term with one another, but with a broader overall concept of what intention really means: the general construal of the world, embodied in our language and culture, which I have been socialized to participate in.

So why is this arcane discussion of intention at all relevant to solving the problem of addiction?  

My argument is going to be that much of what we call addictive behavior results from two problems: irresolvable conflicts in our intentions, and intentions (of which we may be unaware) which are in conflict with our fundamental nature as humans.  When most of our “intentions” are out of our awareness, created through the long and chaotic process of the development of the social formation in which we must currently live, then we may often be put in impossible positions.  

Let’s take a simple example.  Consider Davidson’s example of something as apparently innocuous as building a squirrel house.  We may think there isn’t much to this at all.  But if we examine all the implications of doing such a thing, we find it is riddled with demands which conflict with our basic human nature, as well as troubled by contradictory intentions that cannot be resolved.  

I’m going to overstate the case more than a little here, for the purposes of illustration, but the problem might look something like this.

What kind of intentions must I have, overall, if I think it is a good thing to build a house for squirrels?  I must think both that squirrels are a good kind of animal (not vermin or dangerous) and should be encouraged; however, I must also believe that it is preferable for humans to so transform the landscape that even such “good” animals cannot possibly survive in it without our help.  I must believe, as I said before, in private property and in a lifestyle where the production of food is separated from the place where most people live out their daily lives.  I must simultaneously be the kind of person who thinks sitting idly on my back deck contemplating my artificially constructed image of “nature” is a worthwhile endeavor, and be the the kind of person who wants to take an active part in shaping the world around me through my constructive activities.  In a larger sense, I must be successful enough in the world to own property on which I can watch squirrels and have enough money to own tools and buy materials for such a useless thing as a squirrel house, yet also be the kind of person who thinks that leisurely contemplation is more valuable than the kind of long hours of work I need to do to get this level of success.  

This example is of course a bit absurd.  But my point is that we are all really caught in exactly such webs of contradictory intentions, dependent on beliefs and desires we did not ourselves form but which we take as natural.  Or, more likely, beliefs and desires we carry out in our actions but have never even given a moment’s thought to.  When I spread chemicals on my lawn four times a year to keep the grass green and thick, is it really my conscious belief that nice grass is so important it is worth the toxins I am pouring into the groundwater, causing future diseases for all the children in my town?  I doubt anyone thought that far.  We just take it as a given that to be a good neighbor my grass has to look like the fairway on a golf course.

We’re a long way from solving the problem of addiction here.  But I would say we cannot get anywhere near such a solution until we begin to think of intentions in this broader sense.  We will eventually need to see that we are enacting intentions every day that we are appalled by…and that we are forbidden by the social intentions into which we are incorporated from fulfilling our basic natures.

The commonplace in addiction treatment is to claim that “thinking leads to drinking.”  Not just in 12-step meetings, but in rehabs and therapists offices across the country addicts are being told that their problem is being too “intellectual” and that they have to stop thinking to get sober.  Then they are told to forget about larger concerns, and reduce their focus to “one day at a time.”  Nowadays, the “wise” drug counselor will often claim that she takes it “one minute at at time,” and get knowing nods of approval from everyone in the group.  

And what is the result?  Addiction treatment has a success rate of exactly zero.  And if we combine the deaths cause by alcohol and drugs every year, it is the single leading cause of death in America.  But every professional in the industry is sure that the solution is to keep doing what has failed so thoroughly for decades now.  

My suggestion in the upcoming series of posts will be that we can only find a solution by leaving aside all the “wisdom” of the addiction industry, and thinking rigorously.  This includes thinking hard about our intentions. And not just our intentions for today, but for the entirety of our lives—even of our whole society.  

Works Cited

Davidson, Donald.  “Intending.”  In The Essential Donaldson, Oxford University Press, 2006.

Heather, Nick & Gabriel Senegal, Eds.  Addiction and Choice: Rethinking the Relationship, Oxford University Press, 2017.

McDowell, John.  “Meaning and Intention in Wittgenstein’s Later Philosophy.”  In Mind, Value, Reality, Harvard University Press, 1998.

———.  Mind and World. Harvard University Press, 1996.

Setiya, Kieran.  “Intention.”  Stanford Encyclopedia of Philosophy, 2018.

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8 Comments

  1. As someone with a long history of whatever it is they call “addiction,” someone who has gone through all of the programs, I must say that I’ve never been quite able to grasp the dominant theories of addiction. When I was being told over and over again that my problem was that my brain lacked the ability to freely resist the “urges” to use, I simply couldn’t understand what I was being told. To me, it never never felt like I used because of some inexplicable craving that was out of my control, and in fact if it weren’t for the lovely field of psychology I would never have dreamed of describing my experience in this way. I could never actually understand the real causes of addiction, but I knew that that wasn’t it.

    In trying to make sense of your argument, a few questions arise. Your point about contradictory intentions does seem to touch on something crucial. But I’m having some trouble trying to think through this, so maybe you can help.

    On the one hand, you seem to me to be arguing that addiction has something to do with intentions (in the broad sense) being repressed, or implicit. You say:

    “How can I know I will succeed in the simplest thing, like going to the store and buying a quart of milk, if the underlying rules of this activity, the social rules, are in doubt?”

    This seems to me to be related to many problems that one might naively label “mental illness.” It seems that mentally ill people generally have trouble reconciling the intentions that are implicit in what is considered to be “healthy” behavior with the fact that those intentions are in some way incompatible with human nature (as you use the term). That is, the reason why addicts and depressed people have trouble functioning is precisely because the “social rules,” or rather the intentions which are assumed to be natural, are not fully understood or accepted as such. The individual has a need to participate in the process of choosing and producing their intentions, but the social formation does not allow this kind of participation for them.

    On the other hand, I take there to be another sense in which we could say that one’s intentions are contradictory. One may be interpellated into multiple ideologies, two or more of which may produce intentions that are incompatible. In this second sense it is something about the failure to reconcile these intentions which leads to symptoms. I personally find myself to be most at risk of relapse, when the contradiction between my intention to increase my understanding of the world, and the need to participate in practices that prevent this, become too overwhelming. Choosing to go on a bender is in some way a decision to stop really participating in either ideology.

    My question is, then, how do bad subjects arise exactly, and what is it about different individuals that makes one more likely to be a good or bad subject? And would you say that a psychoanalytic approach to addiction would attempt to make the intentions implicit in one’s ideologies explicit? It seems like the function of addiction treatment, as you say, is to naturalize or repress the larger intentions at work in the dominant ideology. This is why it never works; it literally reproduces precisely the reason why someone would become addicted in the first place!

    I’m not sure if all or any of this made much sense. I’m just now trying to articulate this problem for the first time, really.

  2. One more thing: If the dominant MoP does not provide everyone with the indispensable goods they need to survive, and this leads to things like addiction, what is it about using alcohol or drugs that seems to, at least superficially, ameliorate this lack? That is, what do drugs provide, what is their function precisely?

    I’m aware that really addiction does not ameliorate anything at all. I’ve always been baffled by the idea that people use drugs to “cope” with reality, to make them feel better. This is obviously not the case, otherwise addiction wouldn’t be an absolutely miserable experience. So the question is, what is actually the function served by ingesting drugs?

  3. Good questions—and if I ever decide to resume this project this is what I want to explore further. I’ll try to give just a partial reply here.

    First, it is important to recall the psychoanalytic “rule” that we should not normalize a problem. That is, we should avoid saying “oh, that’s a very common problem, may people feel exactly that way, and we have here a manual telling us exactly how to cure you.” The goal in psychoanalysis is to focus on specificity. Not “you have addiction, all addicts are like this,” but “what exactly does this addictive behavior mean, uniquely, to you.” So, my goal in discussing things like intentions and contradictions is to give a kind of general background to the problem—not an account of each individual.

    I would say, then, that addiction can be understood by exploring the contradictory intentions we undertake, and by exploring the struggle between our unexamined intentions and the demands of our human nature. For any individual, though, what exactly those intentions are and which kind of contradiction is most significant would be different. We need to focus on those differences, to deal with our individual problems—not try to focus on how all addictions look alike in some superficial way, but on how even two alcoholics can be different in the most essential ways, in the underlying causes of their drinking.

    So the answer to the question “what is it about drug or alcohol use that ameliorates the lack” is the most important concern—and is unique, in some ways, to each individual. The general point is that the addiction, what I mean by addiction anyway, is the kind of behavior that does provide a (not great) solution to the contradiction, to the bind we find ourselves in. But how it does this must not be too quickly generalized. So one person may drink because it allows him to be part of the masculine subculture required by his job, another may drink because it reduces intellectual ability enough to eliminate the demand of her human nature to increase her understanding of the world around her. They may both do things like deny their problem and hide bottles and drink in the morning to quell the shakes etc., but we should focus less on the similarities and more on the unique function of the drinking.

    To use my own experience: there are several contradictions that were at work in my alcoholism. One was the demand that I not make use of my intellectual ability in my everyday life. This was challenging for me—and I found the kinds of things I was required to do to survive economically painfully difficult, and manageable only when I drank enough to remain in a kind of dim stupor most of the time. Alcohol made me miserable, but not quite as miserable as I was when I was sober and forced to do endless repetitive mindless work to earn a bit of money to survive. There were, of course, other contradictions as well—many involving my personal life history. I was often caught in the contradiction of academic culture, for instance, in which we are supposedly interested in pursuing truth but in fact devoted to avoiding it. And personally I had internalized a narrative of being inconvenient in my very existence, which led to a conflict between the demand that I pursue some kind of career and the simultaneous demand that I just go away and stop trying to get the jobs others wanted. This is all muddled, of course, and a bit vague—so it may sound somewhat too “universal” in this brief account.

    In short, my solution to the addiction problem came in making these contradictions explicit—especially the contradiction between what I was aware of, or thought I was, believing and pursuing and what I was actually pursuing in my daily actions—between my declared intentions, and the intentions I was participating in without ever making them explicit. Once these things became explicit for me, I was able to use my natural abilities to work at changing the background socially produced intentions—those assumptions about the world that inform things like going to buy a quart of milk or lawn care or building a squirrel house.

    I don’t know if this clarifies anything. I may try to pursue this project further at a later date, but as I’ve said I suspect there would be a very small audience for it. Just last night I was at a meeting where I heard, repeatedly, the claim that the key to sobriety is to stop thinking. This is so powerfully the mantra of the addiction industry, that I cannot imagine anyone would get past such assumptions, or worse I suspect that many people use such slogans to avoid the often unpleasant work of thinking hard about things—even to the extent that this avoidance kills them.

  4. Craig

     /  May 31, 2020

    I’m curious about intentions. We have intentions of what we say we are doing and then what we really are doing? I’m addicted to sugar, no doubt. I’m a bad, bad capitalist subject and I can relate to everything y’all are saying. AND I’m a former addiction counselor. Since learning of this idea of the ‘bad capitalist subject’ I assumed we used to just blunt the misery of living in a world that is a nightmare of contradictions, meaningless tasks, moving things and making sound for another’s profit. As Tom has said, we are not able to engage in our world fully. We don’t really get to choose our intentions.

    I eat sugar mindlessly. There are specific times of the day that I feel like I will not survive if I don’t have it. This idea was what we taught patients at one place I worked. FWIW, an inpatient facility that catered to doctors and lawyers with a few movie stars thrown in! According to the theory our fight or flight response has been hijacked somehow. Of course eating that shit makes me sick etc. So how can I make my intentions more explicit?

    Incidentally, I’ve never been treated worse in my life than by one psychiatrist at this particular facility. Waking up and going into a job like that everyday is grounds for a rational suicide.

  5. Nicola

     /  June 1, 2020

    A tweet made me think of ideology:

    I started as an outsider.

    I ended up working for the establishment.

    I thought I could change it from within.

    I was dead wrong.

    You can’t change the establishment. It will change you.

    So I’m back where I started: opposing the system.

    Honored to fight alongside you.

    @peterdaou

  6. Craig: You know from experience how useless the traditional approaches to addiction treatment are. At many of those high-end rehabs, repeat customers are a major part of their revenue. My own approach—and by this I mean what worked for me—was to try to make explicit what was going on for me when I had that feeling you describe, the “I just won’t survive without it” feeling. What gives rise to that feeling? Then, I had to figure ways to rearrange my life so that this wouldn’t happen. For me, it meant devoting myself to activities that are just mindless alienated work for another’s profit. Specifically, to educational projects devoted to encouraging people to become active thinkers—to understand how their world works. But there are many ways one can do this, depending on one’s individual situation and abilities. The only suggestion I can offer is to consider what leads up to those “specific times of the day”, and what is going on at that moment that leads to the addictive behavior. In my experience, an analyst helped—but of course most therapists are completely ignorant of psychoanalysis, and analysts are increasingly hard to find (maybe impossible to find in Georgia?). So I think most people will have to do this outside the addiction industry, where therapist just get angry and abusive and try to belittle and insult you if you question the party line.

    Nicola: I’d agree. If you want to work in the establishment, you have to become one of them. That’s just how it works. There’s a wonderful short story by the Argentine writer Valenzuela called “The Censors” that describes this perfectly.

  7. Craig

     /  June 2, 2020

    Tom, thanks for the clarification. Considering what’s going on right at that moment of ‘using’ seems like a useful approach. Usually it’s just a quick listing of one’s triggers and ‘dealing with it’. If I understand correctly, you basically diverted focus from the mindless work to the work you are doin here and other places, right? This might be what you would call a practice I think. You’ve definitely got me thinking.

    I hope to one day go through analysis. There are some here in Atlanta as there is an institute at Emory University. They usually require at least 3 days a week, which is a bit difficult now. Luckily I have done much work in psychoanalytic therapy setting. Not classic analysis though. I imagine the catharsis of going 3-5 days a week would be very interesting.

    And yes, the frequent flyers were a big part of the treatment places I worked. What a weird and disheartening situation.

  8. Craig,
    I’m not sure a true analysis is really necessary for addiction. I believe that a psychodynamically oriented therapist can be of great help without necessarily doing an analysis. The whole three days a week for a year may be great, but probably isn’t crucial to resolving the addiction.

    Listing “triggers” is a bunch of crap, as is the CBD nonsense claiming to examine your thought process and point out it’s illogic. None of that works at all, as decades of studies have repeatedly shown.

    But we develop addictions as a sort of solution to a problem—just likes most psychological symptoms. The problem, for me, was not just figuring out what “problem” I was solving so poorly, but what would be a better alternative. So yes, I decided to devote my energies to studying and writing about things that matter to me—like the book Indispensable Goods. This is what I do to “solve” my problem, instead of drinking myself unconscious every evening. I clearly cannot remove the contradictions of our social formation, so the best I can do is respond to them in a way that I find much more satisfying than addiction—if, perhaps, a bit futile when looked at from the outside.

    Have you ever looked at Lance Dodes’s book “Breaking Addiction”? I don’t like his sometimes condescending or patronizing language, and the talk about “helplessness.” But the strategy of examining the situation leading up to “using”, whether the addiction is gambling, drugs, or food, is very helpful. I just substitute “contradictions of the capitalist social formation” for “helplessness.” And I also think it is not just a matter of finding why we are addicted, but figuring out a new response.

    The idea, so popular today, of avoiding “triggers” just won’t work, when you see, as Dodes does, that the “triggers” or situations leading us to use are not things like “being bored” or seeing someone drinking in a movie, but instead the entire situation of our lives. And it won’t work to just see the “craving” as mere thought you don’t have to act on, or any of that rot. It is important to figure out why the craving arose, and how to respond to this situation. of course, addiction counselors and addicts new to recovery will all tell you that this is a huge mistake—but then statistically 99% of them will relapse within six months, and the rest within two years…so I don’t listen to them. I’ve heard from far too many addiction counselors who were using while working at rehabs like the one you describe, and far too many “graduates” of such places who are still active addicts. Despite the dismal success rate, they want to stick to the strategy they know, and simply deny that it doesn’t work, all the while calling it “evidence based practice.”

    If you’re fed up with it, just ignore them and try something different. Don’t wait for analysis—it’s very expensive and better for other kinds of problems. If you can’t find a psychodynamic therapist willing to work through Dodes’s book with you, just read it yourself, or with a friend (or two or three) for support.

    The best thing about the approach I used is that it is much less expensive than rehab, doesn’t require any medications, and can’t do any harm. The worst that can happen is that it works no better than 28 days inpatient, a year on meds with awful side effects, and six months of overpriced therapy with and annoying mindfulness practice.

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