Philosophical Problem with the Brain Disease Model of Addiction: Epiphenomenalism

​The essay below so perfectly articulates my view on epiphenomenalism and its importance to psychology that I couldn’t resist sharing it. (Epiphenomenalism is a self-referentially refuting concept.) Please give Steven Slate some traffic if you are interested in either Philosophy of Mind or Addiction:

“Behaviorists believe that materialist determinism is the correct, objective scientific approach to psychology. Actually this doctrine is self-refuting. Numerous philosophers and psychologists have identified the insuperable contradiction of epiphenomenalism and therefore of psychological determinism (e.g., Bandura, this issue; Binswanger, 1991; Boyle, Grisez & Tollefsen, 1972; Locke, 1966). The advocate of epiphenomenalism is asserting that his doctrine is true and at the same time asserting that he is just a robot, conditioned or programmed to emit certain word sounds by heredity and/or environment. Further, the epiphenomenalist is claiming to offer logical arguments in order rationally to persuade his audience of his view, even as he claims that his audience consists of robots who have no choice about their beliefs.” (Locke, 1995)

The brain disease model of addiction is rooted in a problematic philosophical stance on the mind and brain: epiphenomenalism. I know, it’s a big word, but bear with me. Here’s how the Stanford Encyclopedia of Philosophy sums up this view:

Epiphenomenalism is the view that mental events are caused by physical events in the brain, but have no effects upon any physical events. Behavior is caused by muscles that contract upon receiving neural impulses, and neural impulses are generated by input from other neurons or from sense organs. On the epiphenomenalist view, mental events play no causal role in this process. LINK

So, from this point of view, both our thoughts and our behavior are caused by brain activity – but what we think has no effect on our behavior or on the activity of the brain. Essentially, this philosophy completely rejects free-will at both the level of thought and action. From this view, brain activity simply happens as part of a fully physically determined chain of cause and effect – the brain develops in certain ways according to genetics and conditioning, and just reacts chemically, producing thoughts and behaviors over which we have only an illusion of control. Or, as researcher Edwin Locke put it:

A more common “soft” materialist view of thought is that, although thoughts exist, they are epiphenomena of physical events, that is, by-products of the physical having no causal efficacy. The doctrine of epiphenomenalism, of course, is a version of determinism, or more precisely, psychological determinism. This doctrine holds that with respect to his beliefs, thoughts, decisions and actions man has no choice. Given the conditions of his environment and his genes at any given time, only one alternative is possible. In sum, man has no control over his destiny; he is totally controlled by conditioning and physiology. (Locke, 1995)

addiction why can't they just stopThis is the view of behaviorists and of the current crop of psychologists touting brain scans as evidence of the “causes” of various behaviors and psychological states. They have tried to reduce human functioning to the physical actions of the brain – completely ignoring the role of volitional thought, reasoning, beliefs, etc. This is essentially the view of the world’s most popular “addiction expert”, Nora Volkow of the NIDA. She revealed this view in a seemingly innocuous foundational statement for her brief essay on addiction in the companion book to HBO’s popular special documentary titled Addiction: Why Can’t They Just Stop?:

“The human brain is a complex and fine-tuned communications network containing billions of specialized cells (neurons) that give origin to our thoughts, emotions, perceptions, and drives. [emphasis added] (Hoffman & Froemke, 2007)”

Usually, we’d breeze right past such statements, but let’s stop for a second to really think about the implications of what she said there. She says that the brain and its activity “give origin to our thoughts, emotions, perceptions, and drives.” Does it really? If so, then any act where we feel like we are contemplating, judging, thinking something over, trying to reason through something, etc – and choosing, is a meaningless illusion. Any feeling of effort at thinking would just be an illusion from this point of view. It would all simply be the product of physical brain activity in which our conscious thinking self has no control – and in which our thinking self doesn’t even really exist as we know it. Are the physical actions of the brain the most relevant place to look in order to explain mental phenomena?

I think there’s more to our thoughts than just brain activity, and I think most people would agree *if they thought about it*! Personally, for example, I can introspect and see that I have reasons for my emotions. When I am sad, it’s often because I think that I’m missing out on something, or suffering a loss. Recently, my cat has been having some medical issues, and there’s little that can be done about it. I know that he’s very old, and can imagine that I will be without him soon. This results in a feeling of sadness, because I know I will suffer a loss, and I even wonder how quick or drawn out it may end up being. The mere sight or knowledge of any cat’s suffering would be somewhat upsetting to me, but not nearly as upsetting as when I consider what will happen to my cat and how it will affect me. There are evaluations I go through in my mind, and they have to do with the meaning I’ve attached to this particular cat’s life, and what I predict may happen to him, as well as how it will affect me.

There’s a lot of mental stuff involved in that process of creating an emotion – like judgment – I judge that I will lose something and feel pain in the future, and anticipating this makes me sad. Or how about love? I love this cat, and want him to be comfortable – the thought that he may feel pain and suffering himself actually hurts me too. Do neurons “judge”, “love”, or even “think”? Do neurons “hurt”?

It is said that the “addicted brain” “wants” only the “rewards” provided by substances – that the brain “craves” drugs and alcohol, etc. Brains don’t really “want” “crave” or experience “reward.” People – not brains – with their consciousness, lives, ideas, evaluations, etc. – are the type of entity that crave, want, desire, and experience rewards. Brains do no such thing. This is a serious conceptual problem in the field of neuroscience, as some respected thinkers have pointed out:

…do we know what it is for a brain to see or hear, for a brain to have experiences, to know or believe something?  Do we have any conception of what it would be for a brain to make a decision?  Do we grasp what it is for a brain (let alone a neuron) to reason (no matter whether inductively or deductively), to estimate probabilities, to present arguments, to interpret data, and to form hypotheses on the basis of its interpretations?  We can observe whether a person sees something or other – we look at his behaviour and ask him questions.  But what would it be to observe whether a brain sees something – as opposed to observing the brain of a person who sees something.  We recognize when a person asks a question and when another answers it.  But do we have any conception of what it would be for a brain to ask a question or answer one?  These are all attributes of human beings.  Is it a new discovery that brains also engage in such human activities?  Or is it a linguistic innovation, introduced by neuroscientists, psychologists and cognitive scientists, extending the ordinary use of these psychological expressions for good theoretical reasons?  Or, more ominously, is it a conceptual confusion?  Might it be the case that there is no such thing as the brain’s thinking or knowing, seeing or hearing, believing or guessing, possessing and using information, constructing hypotheses, etc., i.e. that these forms of words make no sense?  But if there is no such thing, why have so many distinguished scientists thought that these phrases, thus employed, do make sense? [emphasis added] (Bennett, 2007)

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