Addiction

Over the last couple of posts I’ve been sketching an account of autonomy that locates the ‘self’ of self-governance in a range of elements or processes, rather than trying to pinpoint a single authoritative center. Going forward, I’ll try to motivate this approach by seeing how it fares when brought to bear on a series of different applications. Today I’ll focus on addiction; in my next post I’ll talk about oppressive socialization; and I’ll wrap things up with a discussion of paternalism and consent.

Harry Frankfurt famously drew a distinction between what he called the willing and the unwilling addict: while the willing addict wants her desire for the drug to lead her to take the drug, the unwilling addict doesn’t want her desire for the drug to lead her to take the drug. Because the unwilling addict does not have the will she wants, Frankfurt claims, she is unfree.

Frankfurt’s early work fits with the general approach I talked about earlier – it picks out an element or process that is supposed to speak for the agent, and hence ground her autonomy. In Frankfurt’s case, that element is a second-order volition; for Bratman it is a self-governing policy. In either case, what we are doing is checking to see whether the element or process that speaks for the agent authorizes the motivating desire.

While this approach allows us to acknowledge the different degrees of autonomy exhibited by different addicts, I don’t think it goes far enough. Because it only recognizes one source of authority in the agent, it fails to take note of the  range of different ways in which an addict can be unwilling, as well as the possibility that these different kinds of unwillingness might compound.  

Consider the following first-personal description of addiction, from Crispin Sartwell:

I hate alcohol, marijuana, cocaine, tobacco, methamphetamine, heroin. […] They are mindless, worthless, without value. They are empty... [Addiction is] common as excrement and as profound: reeking, valueless, purposeless, pointless, meaningless.[1]

If anyone is an unwilling addict, Sartwell is. But in what way is he unwilling? One way to understand his situation would be to use a broadly Frankfurtian model – since Sartwell would prefer his addiction didn’t move him to action, he’s thereby unfree (or non-autonomous). But this overlooks another possibility: Sartwell (or someone much like him) may well want his addiction to move him to action; or in Bratmanian terms, he may well have a self-governing policy of treating his desire for drugs as a reason. Why might someone have a self-governing policy of treating as a reason something that they think is ‘reeking, valueless, purposeless’? One explanation I’ve sketched elsewhere is what I call ‘authentic alienation’ – the agent might identify with the desire that clashes with her value systems, and because she takes it to be an authentic expression of who she is, take it to be a reason for action. Another explanation is what I call ‘masochistic alienation’ – rather than identifying with a desire that clashes with her value system, an agent might have a policy of treating such a desire as a reason for action in order to punish herself. The only way to capture what’s autonomy-undermining about such cases, without giving up on the idea that acting contrary to one’s second-order volitions or self-governing policies is also autonomy-undermining, is to recognize the agent’s value system as also having authority.

Here’s another problem –  what should we say about the autonomy of someone like Sartwell, if they successfully resist the urge to take the drug? On a Frankfurtian model, it looks like they’re unproblematically free/autonomous – the desire that moves them to (in)action is the desire they want to move them to (in)action. But suppose Sartwell is nonetheless wracked with desire; on my account, we have the resources to say that his value system places demands not just on his practical deliberation, but also on his affective states. The mere fact of desiring something that you take to be worthless can be a failure of autonomy, once we grant values authority alongside policies and volitions.

Recognizing these multiple sites of autonomy doesn’t just illuminate the various ways in which an addict might be unwilling; it also allows us to see how the damage to autonomy is compounded when these factors combine. Not everyone who fails Frankfurt’s condition for freedom shares the kind of value system Sartwell has – we can want a desire not to move us to action even if the experience of the desire doesn’t in and of itself clash with our values. But when the desire does clash with our values, and we don’t want it to move us to action, then we are double unwilling; and, I would add, significantly less autonomous.

[1] Cited in Jeanette Kennett and Doug McConnell, 'Explaining Addiction: How Far Does the Reward Account of Motivation Take Us?', Inquiry, 56 (2013), 476.

Comments

[Ben M-Y]

Hi Suzy,

I find your project of providing a more nuanced account of autonomy that allows us to distinguish between different ways in which one can fail to be autonomous quite interesting. If I understand you correctly, your view is that various types of psychological functioning may be authoritative for the agent. And a fully autonomous agent is one in whom all of the relevant psychological states cohere. Is this right? (Please correct me if not.)

My question has to do with how you think an agent ought to resolve conflicts between different types of authoritative states. Take your most recent case, involving a conflict between values and volitions. How ought Sartwell to become more autonomous: revise his values or revise his volitions?

I am inclined to think that this kind of case suggests that we have good reason to stick to the traditional approach to theorizing about autonomy--the one according to which we identify a single type of psychological functioning that speaks for the agent. Say we take values to speak for the agent. This implies that the agent stands with his values when other putatively authoritative elements of the his psychological stew conflict with them. In cases like the one you describe in this post, the agent ought to revise his volitions so as to align with his values. We get a clean answer to the practical question of what the agent ought to do in order to render himself more autonomous.

Now, one might think that we need not take the practical question to have such a clean answer. Perhaps there is something like incommensurability of authority here--the agent can side with his values or with his volitions, and neither outcome is antecedently more called for than the other. But I still think there may be theoretical pressure in such cases to favor the traditional approach.

You have mentioned that you want to understand the concept of autonomy in terms of self-governance and to take the idea of governance seriously. I agree. And I am inclined to think that governance should be efficacious. In cases of conflict like the one you've described in your post, the agent's efficacy is likely to be undermined or mitigated--he will have trouble making up his mind what to do and enacting his decision. His efficacy will be increased to the extent that there is a clear resolution to the question how he ought to resolve the conflict between his values and volitions. Again, the traditional approach seems to have a consideration in its favor here.

We might put the point this way: though there are various types of authoritative pscyhological states in an autonomous agent's psychological economy, there is also a specifiable hierarchy of authority. Certain types of psychological state trump others, when push comes to shove. Ultimately, the buck stops at a particular type of psychological functioning, and this is why it is apt to say that this type speaks for the agent.

I've gone on long enough. But I would be really interested to learn what you think about this.

[Suzy Killmister]

Hi Ben,
Thanks for a fascinating set of questions. I won't be able to fully do justice to them here, but I'll at least take a crack at it.

With respect to how Sartwell should resolve the conflict between his volitions and his values: I'd want to be really careful about assuming the primary goal here should be increasing his autonomy. While I think that autonomy is a good, and that ceteris paribus we should try to protect and/or promote it, it's by no means the only value. Sometimes I think people are better off being less autonomous, particularly if the ends they are pursuing are bad for them. So in the Sartwell case, while it seems clear that he'd be better off getting his volitions to align with his values, I'm not sure that's because doing so would necessarily make him more autonomous than getting his values to align with his volitions; there are a plethora of other reasons for hoping his values win out here.

That said, you bring up the point of efficacy. I do think efficacy speaks in favor of bringing the other types of psychological functioning into alignment with the agent's values, rather than vice versa, just because values can be much harder to budge than, say, patterns of decision-making, so it's likely to be a more successful strategy.

But while I think efficacy may favor giving values priority in certain cases, I'd still be hesitant to attribute this to the trumping power of values. Consider an agent who has doubts about her value system - she finds herself questioning it, sees reasons to try to reshape it, and occasionally even decides to try to mold it into something better. I think this pattern of reasoning and decision-making also speaks for the agent; and it would be a mistake to assume that the only way for her to increase her autonomy is to silence these doubts because they conflict with her values.