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24 Jan 08 – Alcoholism – Where’s the Humanity?

24 January 2008

On this day in 1930, Charles R. Schuster was born.  Schuster conducted behavioral pharmacology studies, which changed the view of drug abuse from a disorder of the will to a behavior maintained and altered by basic mechanisms of operant and classical conditioning. 

As a result of the studies conducted by Schuster, it is not uncommon to read statements such as the following (made by Thomas H. Kelly in an article published in Experimental and Clinical Psychopharmacology):        

            “Drugs of abuse are unconditioned reinforces whose functional effects are

            mediated through neuropharmacological mechanisms.”

I’m actually quite amazed that scientists are willing to give such emphatic statements regarding the causes of psychological phenomena, such as drug abuse.  I’m amazed – and am likely to continually be amazed – because the majority of us have Doctorates of Philosophy but do not appear to understand the philosophical implications of such statements.   The foregoing statement is based on the assumption that research data has “proven” that drugs of abuse develop from operant and classical conditioning means and are demonstrated in their effects on the brain.  Unfortunately, the philosophy of science teaches us that we cannot, in principle, prove anything!  In fact, the closest we can come is falsifying something (showing that it is false).  This, even, is incredibly difficult as those with a particular perspective on something very often come up with arguments that allow them to maintain their perspective, even with disconfirming results.  In fact, what is required is a crucial test or, simply, a change in regime – new people entering the field that are willing to see things in different ways than those who came before them.

Still, individuals such as Victor Stenger, a very thoughtful, intelligent physicist who has made many efforts to combat “pseudoscience” and, especially, “post-modernism” concedes this point.  However, he says that we know the truth well enough from scientific research that we would bet our lives on the findings of research.  I certainly am willing to accept that we have the requisite knowledge for someone to conduct a surgery on me and get it right, for example (even though there are plenty of times, even with the requisite knowledge, that they get it wrong).  Or, to use an example that Stenger gives, the law of gravity has been tested by enough experiments to conclude that it is “real” and will help us predict, with confidence, that after jumping off a tall building we will fall to our precipitous death.

Still, even this example is marred with the “reality” of the philosophy of science.  This reality is that what our data tell us is not the truth.  Instead, they tell as an indicator.  As David Hume, the noted British empiricist, admitted, we must rule out all other possible explanations.  The problem is that we rarely do so.  Even Stenger’s wonderful example regarding the proven construct of gravity has counterarguments.  One of the counterarguments comes from physics, itself.  In fact, it comes from Einstein.  Einstein conceived not of gravity but the curvature of space as the reason why we fall to the precipitous grounding.  Gravity is a metaphysical construct (a theory regarding something that we cannot see) that Newton created even in his attempt to describe things in as physical terms as possible.  Einstein felt that this was unnecessary and developed an alternative. 

Whether the curvature of space (or any other alternative to gravity) is correct or not is not my current concern.  Instead, I use this example to indicate that it is not our data that tell us anything.  It is our interpretations, the theories and philosophies that we apply, that we use to explain and give meaning to the data.  Still, as the example of gravity demonstrates, there are many ways to interpret the same phenomenon. 

Like the perspective on gravity, the operant and classical conditioning with physiological mediation of drug abuse is just one possible interpretation.  From my perspective, while the entire behavioral (e.g., conditioning) perspective is designed to be parsimonious (simplify description and removing superfluous constructs), I don’t even think that it is the most simple explanation of drug abuse.  The reason I do not think that it is is that it does not explain all components of drug abuse.  For example, it does not explain spontaneous remission, people with identical environments not succumbing to drug abuse, the variant effects of drug abuse, etc.  In other words, I believe parsimony requires sufficiency of explanation and the conditioning approach does not give us this.

I think the reason that this is so is that it is restricted to one (or two) aspect(s) of the issue of drug abuse.  That is, it is focused on the environmental (and the biological) aspects of drug abuse.  But, it does not take into consideration the personal choice that is involved.  Even if we are pushed/determined by environmental contingencies and biological mechanisms to drink alcohol, for example, there is always the opportunity to choose not to do this (see Libet’s physiological experiments on free will – even if we do not possess a true choice in doing something, it appears that we do have a choice to not do things…I won’t get into the potential problems of Libet’s experiments negating the original choice right now, however).  In other words, what is missing is the exploration of choice.  The reason it is missing is because behaviorists deny that choice exists; it is a human fabrication (or anthropomorphizing…falsely attributing human characteristics to humans!).

Following this lack of belief in choice, “meaning” is not explored in this research.  That is, what it means for people to engage in drug abuse is not explored.  The reason for this is that meaning requires an individual agent acting; there is no meaning to actions if they are determined.  For example, when a rock rolls down a hill, we don’t say, “Why did you do that Mr. Rock?”  There is no significance to the action: it just happens.  Likewise, when we conceive of humans as having no choice, there is also no meaning (no significance) – and no responsibility – in the action.

Still, choice and meaning would explain some of the findings that clearly speak against the conditioning models and disease models, for example, of alcohol.  The most prevalent contemporary theories of alcohol abuse clearly rely on conditioning and disease model formulations.  An outgrowth of such a conceptualization is that people with alcohol problems should abstain completely form alcohol use because any use of alcohol will re-engage the disease process, which lays dormant until the individual starts to drink again.  However, the findings can certainly be interpreted as not conforming to this model.  For example, a number of studies indicate that the drinking of chronic “alcoholics” is not characterized by loss of control.  Instead, it is frequently goal directed – they do it because they want something out of it (e.g., it is a choice).  Furthermore, alcohol-related problems are quite diverse and, themselves, fluctuate over time, even within the same individual.  This means that different contexts have different meanings at different times.  There also appears to be a social element, with a tendency toward binge drinking in conservative Protestant sects (especially those from dry regions – not desert but those places that prohibit alcohol consumption) and in Irish Americans in comparison to those from Mediterranean backgrounds.  This would indicate not only a drinking culture (perhaps in Irish Americans) but also a somewhat retaliatory drinking culture (in responses to proscriptions – the cultural requirement to abstain).  The latter indication is quite remarkable given the mandate for “alcoholics” to abstain.  It is even more remarkable given the finding that those who are in abstinence programs are even more likely than those in “controlled-drinking” programs to “relapse.”  That is, abstinence does not work (especially force abstinence as the prohibition movement in the United States demonstrated).  Finally, socialization toward moderation in alcohol use appears to be more productive as a treatment.  Changing the meaning and the choices that people make regarding use appears to be more helpful in preventing alcohol problems than requiring them to abstain.

A human with choice and meaning and…responsibility?  This must be fantastical!  It certainly is easier to give that all away to environmental and biological determination.  Still, it would lack sufficient explanatory power…and it is utterly ruinous for society (see my blog on emotional disorders and expulsion a couple days ago).

Fuel for thought, I guess… head to my website for more fuel for thought regarding psychology.


January 24, 2008 Posted by | In Psychology | , , , , , , , , | Leave a comment