This article contributes to cultural theorizations of the regulation of deviant forms of thought and behaviour through an analysis of scientific accounts of, and approaches to, managing ‘behavioural addictions’. Much cultural analysis assumes that biomedical formulations of addiction simply provide a scientific façade for forms of social control, and hence, that such formulations are unworthy of serious consideration. I argue that critical inquiries into processes of social change and social regulation could be strengthened by carefully considering, and engaging with, contemporary addiction medicine; and provide an example of such an approach by examining some of the new descriptions of people, emotions and behaviours – as well as new means of acting on individuals, feelings and conduct – that have begun to emerge within theories, therapies and popular science representations that frame behavioural addictions as brain diseases. Although recognizing the validity of some biomedical claims – for example, that there are physiological components to behavioural compulsions, and that effective addiction therapies may act on the bodies of patients – I argue against conceptualizing behavioural compulsions as diseases, and against conceptualizing therapeutic interventions for such compulsions as ‘treatments’. Instead, I make the case that, according to biomedical discourses themselves, it is more accurate to describe addiction interventions – which are used to produce better citizens, rather than to cure biological diseases – as ‘civilizing technologies’.
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I focus on one particular analysis, rather than an overview of cultural and constructionist work on addiction, in order to avoid presenting a strawperson argument; I focus on Sedgwick (1) because she is one of the world's most renowned cultural theorists, (2) because her cultural analysis of behavioural addictions appears to be almost universally acclaimed within the social sciences and humanities, and to have inspired a number of other social analyses, and (3) because her account was written exactly when biological accounts of behavioural addictions were emerging, and yet it insists on an exclusively socio-cultural analysis.
This shift has been brought about in relation to developments alluded to above, when researchers began to identify the brain's reward system as the common denominator for different drug addictions (suggesting the underlying cause of addiction was not to be found in the chemical properties of drugs themselves, but in the anatomical properties of the brain), and when, in the early 1990s the reward hypothesis of addiction began to guide the field of scientific addiction research.
Ruden and Byalick's approach is notable in its departure from the dominant approach in self-help literature on behavioural addictions, which, as Keane notes, generally emphasizes ‘the unique forms of suffering which are caused by a specific addiction, and guidelines for recovery tailored to the particular disorder produce “sex addict” and “food addict” as very specific identities’ (Keane, 2004, p. 191). While these analyses do link different addictions by analogy, they tend to leave it at that. (Ruden and Byalick, 1997), on the other hand, treat different drug and behavioural addictions as essentially the same problem.
Elias examines these processes through an investigation of changing ‘manners’ in medieval and post-medieval European societies – considering, for example, the emergence of norms against publicly burping or passing gas, and the introduction of cutlery into eating practices.
As a treatment, naltrexone may appear somewhat different from Elias's objects – things like handkerchiefs, private bathtubs, nightclothes and cutlery – which have become part and parcel of everyday life. But, of course, Elias's point is that such objects were not always everyday matters: they began to be used by only a few individuals, their use was often surrounded by controversy, and they only gradually entered everyday culture.
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This article has benefitted from feedback that the author received when presenting early versions of this article at the University of Pennsylvania, Monash University (Prato campus), and especially the ‘Addiction, the Brain, and Society Conference’ conference at Emory University. Linsey McGoey and anonymous referees also provided helpful, and much appreciated, comments and insights.
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Vrecko, S. ‘Civilizing technologies’ and the control of deviance. BioSocieties 5, 36–51 (2010). https://doi.org/10.1057/biosoc.2009.8
- civilizing process
- human kinds