Speaking of addiction
A striking characteristic of addictive behavior is the pursuit of immediate reward at the expense of longer term deleterious outcomes. Moreover, addiction is typically accompanied by the expression of a strong desire to cease from or at least control consumption that has such consequences, followed by lapse, further resolution, relapse, and so on (Ainslie, 1992). Understood in this way, addiction is said to include not only substance abuse but also behavioral compulsions like excessive gambling or even uncontrollable shopping, which bring immediate short-lived rewards followed by the possibility of longer term aversive consequences (Müller and Mitchell, 2011; Ross et al., 2008, 2010). While profound preference reversal may not amount to a definition of addiction, its prevalence among addicts has led to the understanding that their behavior is explicable in terms of competing brain regions which in turn engender heightened saliency of immediate rewards and awareness of the longer term consequences of indulgence. From another perspective, addiction has been described as a “disorder of choice,” as “voluntary behavior” (Heyman, 2009), albeit in Skinner’s (1953) sense of such behavior as that determined by its consequences in the process of operant learning rather than elicited by preceding stimuli as in classical or Pavlovian conditioning. Given Skinner’s argument that operant behavior is no less environmentally determined than that produced in classical or Pavlovian conditioning, Heymann’s use of the word “choice” is interesting. From the point of view of radical behaviorism, there is no suggestion that the behavior of the addict is chosen in the sense that it reflects free moral agency. Rather, the implication is that such behavior is the result not of a medical condition or underlying physiological susceptibility to the effects of ingested substances but of the contingencies of reinforcement and punishment within
which it is embedded. Hence, if the response costs of obtaining and ingesting such substances increases sufficiently, the behavior will occur less frequently or even cease. Its consequences are its causes. More accurately, its rate of repetition is a function of the consequences which similar behavior has generated in similar circumstances in the past. This is the essence of operant explanation. Intriguing as the debate about free will and determinism in the context of addiction may be, it raises but leaves unresolved the proper role of mental language in the description and understanding of addiction. Cognitive psychology is generally conceived of as a deterministic science but its practitioners have trafficked nonetheless in such intensional concepts as desires and beliefs, information processing and decision-making, which to the layperson imply at least a phenomenological level of understanding and often a sense of personal agency. This book speaks of addiction as an extreme mode of consumer choice, different in degree though not in kind from more routine modes of consumption; that is, consisting in the use of products and services that serve as reinforcers, engendering similar neurophysiological responses and emotional rewards, but in the case of drug and process addictions generating also craving and compulsion that go well beyond the usual desire for more economic goods until the addict’s life is seriously disrupted (Box 1.1).