Chronic Automaticity in Addiction: Why Extreme Addiction is a Disorder

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ORIGINAL PAPER

Chronic Automaticity in Addiction: Why Extreme Addiction is a Disorder Steve Matthews

Received: 30 January 2017 / Accepted: 16 March 2017 # Springer Science+Business Media Dordrecht 2017

Abstract Marc Lewis argues that addiction is not a disease, it is instead a dysfunctional outcome of what plastic brains ordinarily do, given the adaptive processes of learning and development within environments where people are seeking happiness, or relief, or escape. They come to obsessively desire substances or activities that they believe will deliver happiness and so on, but this comes to corrupt the normal process of development when it escalates beyond a point of functionality. Such ‘deep learning’ emerges from consumptive habits, or ‘motivated repetition’, and although addiction is bad, it ferments out of the ordinary stuff underpinning any neural habit. Lewis gives us a convincing story about the process that leads from ordinary controlled consumption through to quite heavy addictive consumption, but I claim that in some extreme cases the eventual state of deep learning tips over into clinically significant impairment and (so) disorder. Addiction is an elastic concept, and although it develops through mild and moderate forms, the impairment we see in severe cases needs to be acknowledged. This impairment, I argue, consists in the chronic automatic consumption present in late stage addiction. In this condition, the desiring self

S. Matthews Australian Catholic University (ACU), Sydney, Australia S. Matthews (*) St Vincent’s Hospital (Plunkett, ACU), 390 Victoria Street, Darlinghurst, NSW 2010, Australia e-mail: [email protected]

largely drops out the picture, as the addicted individual begins to mindlessly consume. This impairment is clinically significant because the machinery of motivated rationality has become corrupted. To bolster this claim I compare what is going on in these extreme cases with what goes on in people who dissociate in cases of depersonalization disorder.

Keywords Addiction . Marc Lewis . Disorder . Automaticity . Dissociation . Depersonalization

Introduction and Main Claim Marc Lewis describes the case of Johnny, a former alcoholic he interviewed for his 2015 book. During a period of personal stress Johnny had progressed from being a regular drinker to being a serious drinker. Initially most evenings he would attend his local hotel, but as his drinking increased, and the drunken incidents mounted, the shame of it all gradually led Johnny to spend more time alone in his apartment where his drinking might continue unscrutinised. Within this environment Johnny’s alcoholism deteriorated rapidly, so much so that his waking hours consisted solely in mindless consumption. As Lewis remarks, ‘I’ve heard many stories from people whose addictions reached the red zone, but I was astonished by the extremes [Johnny] described’ (p118).

Matthews S.

What were these extremes? Johnny spent nearly six months drinking without a break. A typical day consisted of something like the followi