- Neuroessentialism and the Rhetoric of Neuroscience
At the very beginning of Lavallee’s article on addictive craving, they note that they will avoid using the term addict in an attempt to avoid essentializing the identities of people who experience addiction. Neuroscientific approaches to the study of mental disorders could benefit from a similar level of caution with regard to discouraging essentialism. Zachar (2014) characterized psychological essentialism as the “cognitive predisposition to view entities as possessing underlying natures that make them be the kind of things that they are” (p. 58). The view that the brain is the underlying “essence” of the person has been dubbed neuroessentialism. Neuroessentialism entails that mental disorders have an inherent, underlying, and determinantal biological basis in the brain (Haslam, 2011). Neuroessentialist views of addiction can have several detrimental effects that can be seen to be countered in Lavallee’s phenomenological approach. The negative impacts of neuroessentialism are entwined and revolve around the tendency to marginalize the significance of psychosocial explanations while treating the experiences of a person with an addiction as a mere epiphenomenon of brain activity. To be sure, understanding addiction with a neuroscientific approach is not tantamount to essentialism, but it seems that too often the rhetoric of neuroscience feeds into essentialist biases.
The declaration that “Addiction is a brain disease, and it matters” was the title of an influential 1997 article in Science magazine written by Alan Leshner (Leshner, 1997). The discovery of neurological changes in the brain associated with addiction has certainly furthered our understanding of addiction. The concern is that conveying these neuroscientific discoveries in the rhetorically loaded terms of “brain disease” will lead to an essentialist uptake of the science such that the brain is seen as the ultimate explanation and site of therapeutic intervention with regard to addiction thereby rendering sociocultural research and intervention superfluous. Leshner seems to do all he can to foster such essentialist uptake when he states in that article that “Understanding that addiction is, at its core, a consequence of fundamental changes in brain function means that a major goal of treatment must be either to reverse or to compensate for those brain changes” (p. 46). In my opinion, the remarkable act of “undoing” (to borrow a psychoanalytic term) contained in the very next section of Leshner’s article when he states plainly that “Addiction is not just a brain disease” (p. 46) does little to reverse the damage done by his earlier trade in essentialist tropes. It is possible to interpret the rhetorical flourish of “brain disease” cynically as a means to exploit essentialist biases in order to advance a particular research paradigm [End Page 239] in competition for scarce research resources. But to stoke essentialist beliefs that leave discriminatory social norms completely unquestioned and belie the significance of psychosocial research into addiction seems particularly perverse given the historical role that race, ethnicity, and class has played in drug use and the development of drug policy regarding medicalization and criminalization (Campbell, 2007). Lavallee’s work stands out in stark contrast to this rhetoric of “brain disease.” Lavallee cautions that the reduction of addictive craving to appetitive urges within the neuroscientific paradigm could falsely imply that addressing physiologic changes in the brain is all that is needed to help people resist addictive cravings. Instead, Lavallee’s careful phenomenological explication of addictive craving pointed to the important roles that trauma, socioeconomic disenfranchisement, and social disconnection can play in addiction, thereby revealing the significance of psychosocial research and intervention.
One danger in regarding personal experience as a mere epiphenomenon of neural activity is that people, not brains, suffer distress. A belief system that holds that the brain is what “really matters” would naturally take us in a direction away from the belief that it is people and the distress they are suffering that “really matters.” Haslam has noted that essentialist views regarding psychopathology are associated with an increase in stigmatizing attitudes toward the mentally ill (classifying psychopathology). In particular, such beliefs were associated with increased desire for social isolation from people with mental disorders and increased pessimism regarding the potential for recovery from mental disorders. It seems easy enough to understand that the...