The neuroscientific model of addiction is at odds with our freedom to experience the sensual life.
Years ago, during my psychiatry clerkship in medical school, I learned to classify people with personality disorders as either “onions” or “garlics,” depending on their degree of self-knowledge.
The “onions” were offensive to other people and knew they were offensive. The “garlics” were offensive to other people but didn’t know they were offensive. A person with a dependent personality was an “onion.” A narcissist was a “garlic.” Yet all of us are “onions” or “garlics” to one degree or another. People who purposely belch after big meals are “onions.” Leaf blowers who start work at the crack of dawn and dog-owners who run their big dogs off leash are “garlics.” Yet we don’t say these people have personality disorders, let alone herd them into therapy. The reason seems obvious, and yet that reason is hard to explain.
Similar confusion surrounds the issue of addiction. Addiction is defined as using a substance or engaging in behaviors in a compulsive manner despite harmful consequences. Opioid and alcohol addiction are classic examples. Over the years, the definition of addiction has expanded to include activities such as shopping and golf. But when one thinks about it, we all have compulsive behaviors that border on the harmful. Such behaviors are even central to our identities. We know people by what they love and what they hate, typically expressed in a sentence that begins with the word “I,” as in “I love this and I don’t love that.” This “I” of ours—including its peculiar property of loving one thing and not another with varying degrees of intensity, be it ice cream, work, or sexual partners—is how we distinguish one person from another in our minds.
Ronald W. Dworkin – Quillette – 2022-07-25
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