The Enactive Approach to Habits: New Concepts for the Cognitive Science of Bad Habits and Addiction

Following on from our opinion piece with Christian Schütz, here is the next installment in our development of a better understanding of addiction.

The Enactive Approach to Habits: New Concepts for the Cognitive Science of Bad Habits and Addiction

Susana Ramírez-Vizcaya and Tom Froese

Habits are the topic of a venerable history of research that extends back to antiquity, yet they were originally disregarded by the cognitive sciences. They started to become the focus of interdisciplinary research in the 1990s, but since then there has been a stalemate between those who approach habits as a kind of bodily automatism or as a kind of mindful action. This implicit mind-body dualism is ready to be overcome with the rise of interest in embodied, embedded, extended, and enactive (4E) cognition. We review the enactive approach and highlight how it moves beyond the traditional stalemate by integrating both autonomy and sense-making into its theory of agency. It defines a habit as an adaptive, precarious, and self-sustaining network of neural, bodily, and interactive processes that generate dynamical sensorimotor patterns. Habits constitute a central source of normativity for the agent. We identify a potential shortcoming of this enactive account with respect to bad habits, since self-maintenance of a habit would always be intrinsically good. Nevertheless, this is only a problem if, following the mainstream perspective on habits, we treat habits as isolated modules. The enactive approach replaces this atomism with a view of habits as constituting an interdependent whole on whose overall viability the individual habits depend. Accordingly, we propose to define a bad habit as one whose expression, while positive for itself, significantly impairs a person’s well-being by overruling the expression of other situationally relevant habits. We conclude by considering implications of this concept of bad habit for psychological and psychiatric research, particularly with respect to addiction research.

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Perspective piece on the concept of opioid addiction

This perspective piece on opioid addiction resulted from a workshop on enactive approaches to psychopathology our group organized last year. The science of addiction is in desperate need of a better theoretical framework, and we hope to be able to contribute to its development in the coming years.

The Clinical Concept of Opioid Addiction Since 1877: Still Wanting After All These Years

Christian G. Schütz, Susana Ramírez-Vizcaya, and Tom Froese

In 1877, the psychiatrist Edward Levinstein authored the first monograph on opioid addiction. The prevalence of opioid addiction prior to his publication had risen in several countries including England, France and Germany. He was the first to call it an illness, but doubted that it was a mental illness because the impairment of volition appeared to be restricted to opioid use: it was not pervasive, since it did not extend to other aspects of the individuals’ life. While there has been huge progress in understanding the underlying neurobiological mechanisms, there has been little progress in the clinical psychopathology of addiction and in understanding how it relates to these neurobiological mechanisms. A focus on cravings has limited the exploration of other important aspects such as anosognosia and addiction-related behaviors like smuggling opioids into treatment and supporting the continued provision of co-patients. These behaviors are usually considered secondary reactions, but in clinical practice they appear to be central to addiction, indicating that an improved understanding of the complexity of the disorder is needed. We propose to consider an approach that takes into account the embodied, situated, dynamic, and phenomenological aspects of mental processes. Addiction in this context can be conceptualized as a habit, understood as a distributed network of mental, behavioral, and social processes, which not only shapes the addict’s perceptions and actions, but also has a tendency to self-maintain. Such an approach may help to develop and integrate psychopathological and neurobiological research and practice of addictions.