ABSTRACT

The very understanding of addiction as a disease is controversial, as is the best way to explain it. Psychiatry is dominated by a version of the medical model that sees psychopathologies as diseases whose observable symptoms are causally explained by abnormalities in underlying neurobiological systems. Although addictions seem similar in terms of symptoms, they can vary widely in their consequences and pathology. Many conceptions of addiction see the symptoms as primarily behavioural or psychological, defining it in terms of phenomena like craving (Elster 1999) or in economic terms (Ross et al. 2008). However, even if these psychological or economic theories of the phenomena are correct, there is still room for exploring the logic of the causal explanations that comport with the medical model. This is because the medical model can be seen as an application to psychiatry of the commitments of cognitive neuroscience (Murphy 2006) and the dominant approach in the cognitive neurosciences is that human behaviour consists of capacities that can be analysed into other personal level capacities (Cummins 2000). In turn, these can then be situated within a hierarchy of biological processes. Personal-level phenomena can be broken down into their component processes and these processes can be understood, typically in representational terms, as the outputs of sub-personal systems that do things like assign a meaning to a phonological representation or compute visual edges.