Subjectivity and Addiction: Moving Beyond Just the Disease Model

By Daniel Lende

This week when students in my Alcohol and Drugs class spoke of their obessions, of MySpace and gambling and television and text messaging, they easily acknowledged their own subjectivity. Winning big, losing big; getting away from reality; having fun; becoming wrapped up in whatever particular compulsion is their own – they spoke of what it meant to them, why they did it, what sorts of feelings and experiences characterized that activity.

On Thursday I started class by asking them to write down their own definition of addiction. Unlike the descriptions of their own activities, there was a marked move towards a more causal and biological framework: “dependence” was the first word that came out of one small group discussion. Uncontrollable, using to fulfill a need, both physical and psychological, a disease – these were all other ways to characterize addiction.

Obsession did appear as well, the only clear link to a subsequent discussion on the popular sense of addiction, of what people mean whey they say they are addicted to Facebook, to a favorite food, to a friend or lover. “Need” came up too, but more as an afterthought, a recognition that sometimes their popular obsessions get too strong a hold on their everyday lives.

After discussing these two senses of addiction, as a problem and a type of involvement, we turned to looking at how the Diagnostic and Statistical Manual IV (DSM-IV) defines substance abuse and substance dependence. These are the guidelines that health professionals use to diagnose mental health problems.

For abuse, oddly defined as being the lesser problem, some of the main criteria include: “Recurrent substance use resulting in a failure to fulfill major role obligations,” “Recurrent substance-related legal problems,” and “Continued substance use despite having persistent or recurrent social or interpersonal problems.”

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