The Role of Self Concepts in Addiction and Recovery

There is a growing literature on the nature of addiction. One view is that addiction can be characterized using a medical model where addiction results from a brain disease. An implication of the medical model is that an individual with this disease has no choice but to keep using. The shortcoming of this approach is that it fails to explain how many individuals with addiction eventually achieve abstinence. As Pickard (2020) points out, individuals with addiction have great difficulty ceasing to use drugs because they establish a concept of self that is based entirely on their addiction. Thus, the choice to stop using is difficult because it would require abandoning their identity as an addicted person.

In this presentation, we focus on the role of the self in the characterization of addiction. We rely on a view of the self that identifies continuity of the self with the maintenance of a self-concept. We argue that addiction might cause a discontinuity of self because the addicted person attempts and fails to maintain a sense of continuity with a pre-addiction concept of self. We argue that one of the reasons why an addicted person might continue to attempt recovery, even after they have formed an alternative concept of self, is because they are aiming to ameliorate the rupture between the pre-addiction and the addiction-based self. Our account can explain how an individual might form an addiction-based self and explain how the pre-addiction concept of self can motivate recovery.

Ethan Cowan – Emergency Medicine – Icahn School of Medicine at Mount Sinai