Abstract
Recent experiments have shown that when individuals with a substance use disorder are confronted with drug-related cues, they exhibit an automatically activated tendency to approach these cues (i.e., drug approach bias). The strength of the drug approach bias has been associated with clinically relevant measures, such as increased drug craving and relapse, and activations in brain reward areas. Retraining the approach bias by means of cognitive bias modification has been demonstrated to decrease relapse rates in patients with an alcohol use disorder and to reduce alcohol cue-evoked limbic activity. Here, we review empirical and theoretical literature on the drug approach bias and explore two distinct models of how the drug approach bias may be embodied. First, we consider the “biological meaning” hypothesis, which grounds the automatic approach bias in the natural meaning of the body. Second, we consider the “sensorimotor hypothesis,” which appeals to the specific sensorimotor loops involved in the instantiation of addictive behaviors as the basis of the automatic approach bias. In order to differentiate between the adequacies of these competing explanations, we present specific, predictions that each model should make.
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Notes
This is not to claim, of course, that all addicts are unwilling to stop using drugs.
To be clear, we do not hold it to be conceptually necessary that embodied theories of cognition are anti-representationalist or anti-information-processing. In fact, most embodied theorists are firmly rooted in functionalist, representationalist, information-processing paradigms (e.g., Barsalou 1999, 2002, 2008, 2009, 2010; Damasio 1994, 1999).
We are not claiming that all cognitivist theories are computational (just like we are not claiming that all embodied theories are non-representational) but merely appealing to the computational theory of mind to draw a clear conceptual contrast with embodied theories.
To be clear, we do not hold it to be conceptually necessary that embodied theories of cognition are anti-representationalist or anti-information-processing. In fact, most embodied theorists are firmly rooted in functionalist, representationalist, information-processing paradigms (e.g., Barsalou 1999, 2002, 2008, 2009, 2010; Damasio 1994, 1999).
It’s important to note that philosophers often distinguish between the cognitive system and both sensory and motor systems. The former are thought to involve states, which can enter into reasoning (often construed as semantic, conceptual, intelligent, personal-level processes) and the latter, which are construed as subpersonal or bodily, and which require significant argumentation when conceived of as, e.g., responsive to reasons, or composed of conceptual content. Importantly, this is different from the way in which psychologists or cognitive scientists categorize cognitive systems where, e.g., perception is clearly a cognitive process. This is why, in philosophy, the question about the relationship between cognition and perception constitutes a classic issue in both the metaphysics of mind and epistemology. And, relatedly, the question of cognitive penetrability, i.e., “is the qualitative character of visual perception impacted by cognition (i.e., what we know/believe)?” is a question that makes sense to philosophers.
The movements we have in mind are arbitrary but not random or awkward. Obviously, if entirely counterintuitive movements or symbols were used to test the approach/avoidance bias we would see a decrease in accuracy detecting automatic biases simply in virtue of the fact that subjects would have difficulty learning the connection between the arbitrary task and its assigned meaning.
Thanks to an anonymous referee for making this point.
For more on the spatial organization of human cognition, see Tversky (2009). As she explains, “spatial thinking forms the foundation for other thought” (p.202) and spatial thinking is necessarily tied to the boundaries, shape, and size and function of our bodies, the space of possible action, and our access to the distal layout of the environment which surrounds us.
Examples of the way the body informs the meaning of concepts is illustrated in the following way:
“HAPPY IS UP; SAD IS DOWN; HEALTH AND LIFE ARE UP; SICKNESS AND DEATH ARE DOWN (1980a, p.16).
Obviously, this applies less to the organs that are protected by ribs.
As Damasio writes, “emotions allow organisms to cope successfully with objects and situations that are potentially dangerous or advantageous…[they are] the most visible part of a huge edifice of undeliberated biological regulation that includes homeostatic reaction that maintain metabolism, pain signaling, and drives such as hunger and thirst (2001, p. 781).
Noë writes, “Perceptual experience acquires content thanks to our possession of bodily skills. What we perceive is determined by what we do (or what we know how to do); it is determined by what we are ready to do…To be a perceiver is to understand, implicitly, the effects of movement on sensory stimulation…the enactive approach is that our ability to perceive not only depends on, but is constituted by, our possession of this sort of sensorimotor knowledge” (2005, p. 1). Emphasis in original.
As O’Regan and Noë write. “For two systems to have the same knowledge of sensorimotor contingencies all the way down they will have to have bodies that are identical all the way down (at least in relevant respects). For only bodies that are alike in low-level detail can be functionally alike in the relevant ways” (2001, p. 1015).
By proprioceptive experiences, Barsalou (1999) has in mind the internal bodily sensations involved in, e.g., lifting or running. Introspective experiences also include the experience of emotions or moods such as, happiness or hunger.
Thanks to an anonymous referee for pointing out this possibility.
Of course, a cognitivist could appeal to particular representations and memories as the basis for associative links with affective states. Still, we should notice that if a high degree of match between a particular stimulus and the actual perceptual experience of the agent were relevant for explaining AAT and retraining, then this would eliminate at least one form of cognitive explanation from adequately accounting for the above results.
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CEW was funded by the Berlin School of Mind and Brain and Humboldt Graduate School.
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Fridland, E., Wiers, C.E. Addiction and embodiment. Phenom Cogn Sci 17, 15–42 (2018). https://doi.org/10.1007/s11097-017-9508-0
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DOI: https://doi.org/10.1007/s11097-017-9508-0