Reason Evolves

Reason's cover story for May, '03 was "Pulling Our Own Strings: How Evolution Generates Free Will", an interview with philosopher Daniel Dennett, who's just published his second book on free will, Freedom Evolves (the first was Elbow Room).  Of considerable interest is that Reason, a libertarian publication, chose to present Dennett's case against traditional contra-causal free will (and for a compatibilist understanding of freedom) so forthrightly and so prominently.  After all, in libertarian circles, it's often supposed that the basis for political liberty is some sort of metaphysical, ultimate freedom - the power to choose without oneself being entirely determined to choose.  Being fully caused creatures logically threatens our status as ultimately autonomous, self-made individuals who can lay claim to resources and privileges (e.g., unlimited financial rewards) because we pulled ourselves up by our bootstraps and thus deeply deserve what's coming to us (the same goes for punishment, of course).  That libertarians do in fact often presume they have such freedom (what philosophers have called, not entirely coincidentally, "libertarian" free will) is evidenced by some exchanges posted at Nat.Org, including a recent letter Reason kindly published in response to Thomas Szasz.   For further evidence, see also a commentary on a recent op-ed piece by the fiercely libertarian Sheldon Richman of the Future of Freedom Foundation.   He says, "If we come to believe that metaphysical freedom is impossible, we will hardly be in a position to complain when our political freedom is taken away."

            Reason, by giving Dennett airtime, and by virtue of the fact that interviewer Ronald Bailey offers no rebuttal to Dennett's claims for determinism, materialism, and naturalism, is an encouraging counter-example to the stereotype I exploit above.  Bailey, in fact, seems rather comfortable with determinism, both here and in another excellent piece on The Battle for Your Brain, in which he concedes we don't need to be immaterial essences with contra-causal free will in order to be held responsible (see the section "Authenticity and Responsibility").   Compared to 1998, when it published Brian Doherty's "Blame Society First", Reason has indeed evolved away from the knee-jerk defense of this sort of freedom, for which it is to be congratulated.  This progress seems to be driven by Bailey's (and perhaps editor Jacob Sullum's) respect for science, as opposed to tradition, as the arbiter of what we should believe about human nature.  (I realize to speak of evolution isn't strictly to speak of progress, of course, but it makes for a nice title.)

            Further evolution is in order, however.  Both Reason (Bailey) and Dennett (in both his books) studiously avoid articulating one obvious conclusion that follows from rejecting libertarian free will:  that the justifications for rewards and punishments based on ultimate moral desert, justifications so beloved by the right, go by the boards.  As philosopher Galen Strawson puts it in an interview posted on Nat.Org, "These desires for revenge and retribution are just not going to be the normal human thing if they don’t involve the belief that the hated person has DMR [deep moral responsibility]. They’re going to be unusual."  How does one, after all, justify retribution if you're a naturalist? 

            Since it goes to the very heart of our assumptions about who deserves what and why, it's no surprise that this conclusion goes significantly unmentioned by those who are otherwise naturalists: they may not want to rock the boat quite this much.   After all, it calls into question such things as our extremely punitive criminal justice system and the absurdly high disparities in access to a decent standard of living.   Some incentives and disincentives are necessary, of course, to properly order a liberal society, but the extremes at play in our culture can only be justified on grounds of ultimate desert, something that Dennett and Bailey understand is an illusion.   Furthermore, the conclusion that we are fully determined creatures prompts us to look at the actual causes of crime and success, instead of crediting the individual as the sole source of good and evil.   Ignorance is therefore no longer an excuse for inaction, nor can we any longer blame the victim.   Although it's unlikely that anyone soon will publicly make the case for social policies consistent with inclusive naturalism, (although see Derk Pereboom's work for a heartening exception, thus far still confined to the academy), the conclusion and its implications are there, waiting their time to come. 

TWC, 5/03

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Boston Globe: Neuroscience enters the debate on free will

The October 15th 2002 issue of the Boston Globe science section ran a lead story, "A Question of Will," on recent advances in neuroscience and their implications for our conceptions of self and freedom.  To my knowledge, this is among the first articles to appear on this topic in a mainstream US news outlet.  Although hard line skeptics about free will weren't consulted (e.g., Owen Flanagan, Derk Pereboom, Stephen Morse), the piece nevertheless suggests that traditional contra-causal free will is under considerable pressure.  It ends with  reassurance from neuroscientist Michael Gazzaniga that "brains are automatic and people are free."  But what sort of freedom is this?  Not that of the uncaused soul, clearly.  My letter in response makes the crucial point that, despite determinism, we can and must still hold people accountable - compassionately.

A Question of Will

The issue of free will has perplexed theologians and philosophers for centuries - now neuroscience enters the age-old debate

by Carey Goldberg, Globe Staff, 10/15/2002

Try this: At a moment of your choosing, flick your right wrist. A bit later, whenever you feel like it, flick that wrist again.

Most likely, you'd swear that you, the conscious you, chose to initiate that action, that the flickings of your wrist were manifestations of your will.

But there is powerful evidence from brain research that you would be wrong. That, in fact, the signal that launched your wrist motion went out before you consciously decided to flick.

''But, but, but,'' you'd probably like to argue, ''but it doesn't feel that way!''

With that protest, you would be joining a great debate among neuroscientists, philosophers and psychologists that is a modern-day version of the age-old wrangling over free will.

The traditional conundrum went: ''How can God be all-knowing and all-powerful and yet humans still have free will?'' And later: ''How can everything be governed by the determinist forces of physics and biology and society, and yet humans still have free will?''

Those questions still concern many, but the new neuro-flavored debate over free will goes more like this: Is the feeling of will an illusion, a wily trick of the brain, an after-the-fact construct? Is much of our volition based on automatic, unconscious processes rather than conscious ones?

When Daniel M. Wegner, a Harvard psychology professor and author of a new book, The Illusion of Conscious Will, gives talks about his work, audience members sometimes tell him that if people are not seen as the authors of their actions, it means anarchy, the end of civilization. And worse. Some theologies, they tell him, hold that if there is no free will, believers cannot earn a ticket to heaven for their virtue.

In reality, neuroscience is not generally tackling the sweeping philosophical issue of free will, but something much narrower, said Chris Frith, a neuroscientist at University College London.

''There has been much recent work addressing the question of how it is that we experience having free will, i.e., why and when we feel that we are in control of our actions,'' he wrote in an e-mail.

That is not to say that neuroscience will never enter the philosophical fray.

It could even be that, once the physiological basis of will becomes better understood, ''You'll get a more mature, larger view of what's going on and the question of free will might vanish,'' speculated V. S. Ramachandran, director of the Center for Brain and Cognition at the University of California at San Diego. No one argues about ''vital spirits'' now that we know about DNA, he noted.

Meanwhile, the debate is still on, and near its center is an 86-year-old University of California professor emeritus of physiology, Benjamin Libet.

His seminal experiments on brain timing and will came out back in the mid-1980s, and the results are still reverberating loudly today.

Just this summer, the journal Consciousness and Cognition put out a special issue on ''Timing relations between brain and world'' that prominently featured Libet's work. And, at a conference, titled ''The Self: from Soul to Brain,'' held by the New York Academy of Sciences last month, ''Libet'' rolled off more tongues than Descartes or Kant or Hume or the other philosophers whose names usually come up when the subject is will.

What Libet did was to measure electrical changes in people's brains as they flicked their wrists. And what he found was that a subject's ''readiness potential'' - the brain signal that precedes voluntary actions - showed up about one-third of a second before the subject felt the conscious urge to act.

The result was so surprising that it still had the power to elicit an exclamation point from him in a 1999 paper: ''The initiation of the freely voluntary act appears to begin in the brain unconsciously, well before the person consciously knows he wants to act!''

Libet's experiments continue to be criticized from every which angle. At the New York conference, for example, Tufts philosopher Daniel C. Dennett argued that it could be that the experience of will simply enters our consciousness with a delay, and thus only seems to follow the initiation of the action.

But, though controversial, the Libet experiments still stand and have been replicated. And they have been joined by a growing body of research that indicates, at the very least, that the feeling of will is fallible.

Among that research is the following experiment by Dr. Alvaro Pascual-Leone, director of the Laboratory for Magnetic Brain Stimulation at the Beth Israel Deaconess Medical Center.

A subject, he said, would be repeatedly prompted to choose to move either his right or his left hand. Normally, right-handed people would move their right hands about 60 percent of the time.

Then the experimenters would use magnetic stimulation in certain parts of the brain just at the moment when the subject was prompted to make the choice. They found that the magnets, which influence electrical activity in the brain, had an enormous effect: On average, subjects whose brains were stimulated on their right-hand side started choosing their left hands 80 percent of the time.

And, in the spookiest aspect of the experiment, the subjects still felt as if they were choosing freely.

''What is clear is that our brain has the interpretive capacity to call free will things that weren't,'' he said.

Wegner's book discusses a variety of other mistakes of will. Among them is the ''alien-hand'' syndrome, in which brain damage leaves people with the sense that their hand no longer belongs to them, and that it is acting - say, unbuttoning their shirt - out of their control.

Another recent book, ''The Volitional Brain: Toward a Neuroscience of Free Will,'' includes a psychiatrist's description of a German patient who felt compelled to stand at the window all day, willing the sun across the sky.

Wegner argues that ''the feeling of will is our mind's way of estimating what it thinks it did.'' And that, he said, ''is not necessarily a perfect estimate.'' It is ''a kind of accounting system rather than a direct read-out of how the causal process is working.''

In Libet's interpretation, free will could still exist as a kind of veto power, in the fractions of a second between the time you unconsciously initiate an action and the time you actually carry it out.

For example, he said in a telephone interview, ''The guy who killed the mayor of San Francisco, he was obviously deliberating in advance, but then when he gets to the mayor, there's still the process of, does he now pull the trigger? That's the final act now. That is initiated unconsciously, but he's still aware a couple of hundred milliseconds before he does it and he could control it, but he doesn't.''

''That is where the free will is,'' Libet said.

Such veto power is not enough for many people, however. ''I want more free will than that,'' Dennett complained at the conference.

He may not get it, but he will almost surely get more data about it. Some neuroscientists are using new brain imaging technology to try to pinpoint what happens in the brain when a person wills something. With its help, and further work being done on patients with abnormal volition, more progress appears likely.

''I think,'' Frith wrote, that ''in the next few years we will have quite a good understanding of the brain mechanisms that underlie our feeling of being in control of our actions.'' But that, he hastened to add, ''does not in any way eliminate free will.''

Further comfort comes from Michael S. Gazzaniga, director of the Center for Cognitive Neuroscience at Dartmouth College.

There is no need, he said, ''for depressing nihilistic views that we're all robots walking around on someone else's agenda. It's the agenda we build through experience, and the system is making choices.''

And just because some processes in the brain are automatic does not mean they all are, he said. ''My take,'' Gazzaniga said, ''is that brains are automatic and people are free.''

Carey Goldberg may be reached at Goldberg@globe.com

Click here for TWC letter published in response, "Accountability is still in play."

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Free Will in the News ( 8/02)

Neuroscience and freedom  - The May 25th, 2002 issue of the The Economist ran a story, "Open Your Mind," on the ethics and implications of brain science.  The introduction said: "Genetics may yet threaten privacy, kill autonomy, make society homogeneous and gut the concept of human nature.  But neuroscience could do all of these things first."  This sentiment lines up with Tom Wolfe's 1996 prediction in "Sorry, but your soul just died," that neuroscience, not genetics, will pose the most immediate peril to human freedom and dignity.  After a review of the growing capabilities of brain scans and other sorts of "neurotechnology" to diagnose disease, screen for neural and cognitive defects, and perhaps even enhance brain-based capacities, the article gets to the main issue: the threat of neuroscientific understanding to our concept of free will.  "Although some philosophers see free will as an illusion that helps people to interact with one another [e.g., see "Is Free Will a Necessary Fiction?"], others think that it is genuine - in other words, that an individual faced with a particular set of circumstances really could take any one of a range of actions.  That, however, sits uncomfortably with the idea that mental decisions are purely the consequence of electrochemical interactions in the  brain, since the output of such interactions might be expected to be an inevitable consequence of the input."    

Here, starkly, is the contrast between what philosophers call "libertarian" free will - the capacity to have done otherwise in the exact same situation were it to arise again - and determinism, which denies that such a capacity exists.  Neuroscience reveals that the brain is a more or less deterministic mechanism, and if mental states somehow just are this mechanism, then libertarian free will goes by the boards (for a good deal more about this concern, see Neuroscience and the Human Spirit).   After admitting that neuroscientific understanding of propensities for aggression and violence might indeed have an impact on assessing criminal responsibility, the article concludes, rather lamely, by suggesting there's still hope for the human soul.  After all, science hasn't yet found it!  Indeed, science never will, but that can only give comfort to those who put stock in non-scientific claims to knowledge.   For those of us committed to empirical grounds for knowledge, living without the soul is the only viable option, since not to find it is good evidence it doesn't exist.  

Causality and capital punishment - On June 22, the New York Times ran an op-ed piece, "The Changing Debate Over the Death Penalty," by Stuart Banner, law professor at ULCA and author of The Death Penalty: An American History.  The fifth and sixth paragraphs read (emphasis added):

"But throughout American history, support for the death penalty has risen and fallen with the times. In periods when Americans have tended to think of crime as the product of the criminal's free will, the criminal justice system tilts toward retribution, and capital punishment has grown more popular. In periods when they have paid more attention to causes other than the criminal's free will — the criminal's social context, for example — the system has emphasized rehabilitation, and the popularity of the death penalty has waned.

"The past 30 years were a period of strong support for capital punishment, as part of a trend toward retribution in criminal sentencing. (This trend is also evident in other sentencing measures like "three strikes" laws.) For the past 250 years, however, such periods have always been followed by times of growing opposition to the death penalty."

Banner suggests here that  support for the death penalty and other harsh punishments hinges in part on our perceptions and beliefs about causality and human behavior.  If we come to believe that individuals are not ultimately self-originating - that they don't have libertarian free will - then of course they don't ultimately deserve the death penalty.   We must seek outside the offender for the causes of crime, and rehabilitation, or at least non-punitive detention, seems more justifiable than the retributive "just deserts" of harsh prison conditions or capital punishment. 

Banner stays agnostic on the question of whether free will exists, but there's little doubt that the growing understanding of the causes of human behavior (e.g., see above re neuroscience) must undercut the idea that individuals are ultimately self-caused.  Although it's unlikely that an op-ed writer will any time soon suggest, in an influential public forum such as the Times, that free will doesn't exist, and that therefore we should rethink our beliefs and policies regarding punishment, this conclusion is implicit as science continues to naturalize the self.   Education about causality and crime will eventually help undermine support for capital punishment, but it's a long haul, since the belief in human causal exceptionalism is deeply entrenched, and widely thought necessary to ground responsibility and morality.  To see why it isn't, click here and here.

Legislating Naturalism (3/01)

- An op-ed about why science and naturalism can't be separated, even though intelligent design theorists are trying.  For a very detailed, cogent, and persuasive account of these issues, see Stephen D. Schafersman's essay "Naturalism is an Essential Part of Science and Critical Inquiry" -

At the close of Carl Sagan’s novel, Contact, astronomer protagonist Ellie Arroway discovers within the structure of mathematics a sign that the universe is the intentional creation of superhuman intelligence. Far along into the otherwise random sequence of digits generated by the expansion of pi (the ratio of a circle’s diameter and circumference), a patterned series of ones and zeros appears.

When arranged in a two dimensional grid, this series forms a geometrically perfect circle of ones against a background of zeros. What could this be if not the mark of design? Sagan writes: "In the fabric of space and in the nature of matter, as in a great work of art, there is, written small, the artist’s signature. Standing over humans, gods, and demons…there is an intelligence that antedates the universe."

Earlier this year, the Kansas Board of Education adopted standards for teaching evolution in public schools that give short shrift to such a possibility. The Darwinian story endorsed by these standards says we are the unintentional products of strictly material processes.  But in the ongoing Kansas creationism-evolution debate, one side claims to see evidence of intelligent design, not in the expansion of pi, but in the form and function of our very bodies.

Jody Sjogren, the founder of the Intelligent Design Network (IDN), said that to rule out the possibility of a purposive agent in explaining how we came to be is "legislating naturalism into the public school curriculum," not the unbiased pursuit of science. Science, says the IDN, is perverted by the philosophy of naturalism into assuming that evolution is necessarily Darwinian - mechanical and unpurposive - when in fact the hypothesis of intelligent design is a better reading of the fossil and physiological evidence.

Even though he obviously understood the emotional and spiritual attractions of the design hypothesis, there’s no question that were he alive, Sagan would stand firmly on the other side of this debate, with those who see science as inevitably allied with, not biased by, naturalism. Naturalism - the assumption that the universe is of a piece, with nothing that escapes being constrained by physical laws or being constituted by the basic building blocks of matter and energy – seems essential to the scientific method.

To develop explanations which unify our understanding of the cosmos, which is after all the purpose of science, its practitioners can hardly rest content with postulating an intervening intelligence which in turn is not subject to explanation. To do so splits the universe into two parts, one part natural and potentially explicable, the other supernatural and out of bounds for investigation. But it is precisely the possibility of overcoming such bounds in the quest for understanding that motivates scientists.

This is why, despite their protestations of being true to science, those who champion intelligent design cannot really play the science game, at least not at any deep level. It is also why it is highly unlikely that design "theorists" will ever be published in prestigious peer-reviewed journals such as Science, Nature, or Physical Review Letters. Any so-called explanation of our origins which includes the equivalent of "and then a miracle occurs" won’t cut any ice within the scientific community, nor should it.

It is conceivable that Sagan’s fantasy in Contact might come true, that scientists discover a creator’s "signature" embedded in pi, or in super-string theory, or in some as yet undreamed-of mathematical description of nature that fits the empirical facts. But for any scientist worth her salt the immediate questions raised by such a discovery would concern the characteristics and origins of this creator. In other words, how does this designer fit into the universal scheme of things, considered as a whole?

Unfortunately for intelligent design theorists, this shows that scientists wishing to teach Darwinian evolution have no need to legislate naturalism into public school science standards, since naturalism resides in the very motives and practice of science itself. As even those in Kansas might say, when contemplating the vast, interconnected web of nature as it stretches from molecules to galaxies, "we’re not just in Kansas anymore."

TWC  3/01

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Who Wrote the Book of Life?

(Editor's note:  Just in case you missed Clinton's public piety at the press conference on the human genome, here's an op-ed piece which suggests that crediting evolution, not God, for our "book of life" is a far more interesting context for this scientific milestone.  This appeared in The Humanist, September/October 2000)

Who, or what, wrote the book of life? That was the unasked question that nevertheless got answered at the press conference announcing the near-completion of the sequencing of the human genome. President Clinton preempted any doubts about his religiosity, saying that "Today we are learning the language in which God created life." Not to be outdone, Francis Collins, head of the public Human Genome Project, added that "It is …awe-inspiring to realize that we have caught the first look of our own instruction book, previously known only to God." In refreshing contrast, Craig Venter of the privately held Celera Genomics remarked on the "beauty of science" as a collective human endeavor, and the wonder of discovering that "we are all connected to the commonality of the genetic code and evolution."

It is both dispiriting and disquieting that public officials feel the need to pay lip service to God while celebrating a scientific achievement. Although I’m not suggesting a lawsuit, Clinton’s piety vaults the wall of church-state separation. The policy implications are worrisome as well: if God wrote our instruction book, are we then permitted to rewrite it, or is it an unalterable sacred text? It would seem that learning the "language in which God created life" puts us in a better position to play god, but according to Tony Blair (also at the conference) we have a duty "To ensure that the powerful information at our disposal is…not abused, to make man his own creator…".

But beyond politics and policy, what’s most galling is that giving God credit for authoring our genome is such a cramped, safe, and utterly uninteresting context for this discovery compared to the naturalistic view that Venter hints at. The really marvelous, intriguing thing about the "language" of DNA is that it evolved on its own, without supervision or purpose, and that we are here on this earth as a natural contingency, not an outcome of intentional design. Of course what I and other humanists find enchanting is for many a monstrosity: the possibility that the universe is a vast unsupervised unfolding of material properties without an externally imposed purpose is an affront to their desire that humans play a starring role in a drama with ultimate significance.

Citing God as our creator functions as a buck-stopping explanation, a paternalistic reassurance for those looking for a privileged place in the scheme of things. It’s designed to ward off embarrassing inquiries, very much like a parent who shuts up a doggedly curious child by saying "Because I say so, that’s why!" Those content with such tactics transparently fail to ask the next, obvious question about our purported designer: from whence cometh this creator? Not to ask this question, or to deem it unreasonable, reveals a basic antipathy towards unrestricted inquiry, driven by a rather shallow, adolescent fear of the cosmic dark.

At least that’s what I and other humanists might say, implying that theists should really grow up and bite the bullet of naturalistic contingency. Don’t you see, we’d continue, that life’s far more interesting when shorn of any imposed purpose, however grand or noble? What’s more fascinating, after all, than the questions of existence, sentience, and the parameters and laws of natural phenomena? Add God and all these become his possibly arbitrary creations, subtract him and they become the eternal mysteries themselves, possibly endless in their unraveling, possibly impenetrable. But for Clinton (if we take him at his word, not always recommended) et al. such engagement with the unfathomable goes by the boards, tamed by traditional theism.

What motivates these opposing stances, perhaps, are the sometimes conflicting desires for security and exploration, each of which has a claim on us. Those driven more by security tell the conventional, comforting story: scientific understanding decodes the text of a God who makes everything work out in the end, as we join him after death. Those driven more by the exploratory impulse disdain a designed universe, preferring the uncertain but exhilarating quest for further understanding. Security, exemplified by the church, wants an end to questions, while exploration, exemplified by science, prizes questions that may indeed prove unanswerable.

So who’s right here? Humanists by nature tend towards curiosity and impolitic questioning, so we’ll judge Clinton wrong not just because he implicitly endorsed theism in a public capacity (hence marginalizing non-believers) but also on aesthetic grounds: giving God credit for creation takes some of the fun out of life. And besides, there’s no good evidence God exists, by our lights.

If, in rendering this judgment, we remember that it originates in our preferences for empiricism and exploration, we’ll stay true to these preferences and likely show more compassion toward those (the majority in this country, it seems) with greater needs for psychological security. We can patiently tolerate their belief that the genome is the word of God, since we understand they haven’t yet outgrown the need for a cosmic hand to hold. Eventually, with our gentle, self-critical proddings and suggestions, former theists will discover that they can walk unassisted and with excitement into the unknown.

TWC, July 2000

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Seeing Drugs as a Choice or a Brain Anomaly

(see related articles on the Addictions page)

by Michael Massing

(Editor' note: This appeared in the New York Times on June 24, 2000 in the Arts and Ideas Section.   Massing does a nice job in bringing together various strands of the debate on the disease model of addiction, in which free will is the unstated subtext.   Some responses follow the article, and have a look at the Addictions page as well.)

Dr. Alan I. Leshner, the director of the National Institute on Drug Abuse, a division of the National Institutes of Health, is known for his slide shows. Two or three times a week he gives a speech -- to treatment counselors and prevention specialists, physicians and policymakers -- and almost all feature slides culled from the work of the 1,200 researchers supported by his institute. The slides are of brain scans, and they usually come in pairs. The "before" slides show the activity of a normal brain; the "after" ones depict a brain that has had prolonged exposure to drugs. Lacing his presentation with jokes and Yiddish expressions -- as a youth, Dr. Leshner summered at a Catskills hotel owned by his grandparents, and he has a bit of Alan King in him -- he tries to translate the science into plain English.

What the science shows, he says, is that the brain of an addict is fundamentally different from that of a nonaddict. Initially, when a person uses hard drugs like heroin or cocaine, the chemistry of the brain is not much affected, and the decision to take the drugs remains voluntary. But at a certain point, he says, a "metaphorical switch in the brain" gets thrown, and the individual moves into a state of addiction characterized by compulsive drug use. These brain changes, Dr. Leshner says, persist long after addicts stop using drugs, which is why, he continues, relapse is so common. Addiction, Dr. Leshner declares, should be approached more like other chronic illnesses, like diabetes and hypertension. Going further, he says that drugs so alter the brain that addiction can be compared to mental disorders like Alzheimer's disease and schizophrenia. It is, he says, a "brain disease."

In promoting this concept, Dr. Leshner has stepped forthrightly into a debate that has smoldered for decades: are drug addicts responsible for their behavior? Should they be treated as sick people in need of help, or as bad people in need of punishment? Dr. Leshner has come down squarely on the side of illness. And he is winning many people over. Today the brain-disease model is widely accepted in the addiction field, and Barry R. McCaffrey, the White House drug adviser, routinely invokes it.

Others are not convinced. "I reject the notion that addicts fall under the spell of drugs and become a zombie and so are not responsible for anything they do," says Dr. Sally L. Satel, a senior associate at the Ethics and Public Policy Center in Washington and a practicing psychiatrist at a methadone clinic. To her and other critics, the brain-disease model is a new orthodoxy based less on science than on a desire to soften the stigma attached to addiction.

The idea that addiction is a disease is not new. In the 1960's Alcoholics Anonymous began speaking of alcoholism as a disease. But, initially at least, A.A. used the term figuratively to suggest the tenacious hold drinking has on alcoholics. Over the last decade or so, however, advances in brain-imaging technology have allowed researchers to measure the impact of psychoactive substances on the brain with increasing precision. Investigators have found that drugs like cocaine, heroin and alcohol increase the brain's production of dopamine, the neurotransmitter that regulates pleasure, among other things. This helps account for the euphoric high drug users feel. But these drugs deplete the dopamine pathway, disrupting the individual's ability to function.

At the Brookhaven National Laboratory on Long Island, for instance, Dr. Nora D. Volkow has found that even 100 days after a cocaine addict's last dose, there is significant disruption in the brain's frontal cortical area, which governs such attributes as impulse, motivation and drive. Dr. Volkow says that "the disruption of the dopamine pathways leads to a decrease in the reinforcing value of normal things, and this pushes the individual to take drugs to compensate." Other researchers have found a physiological basis for the craving so many addicts experience, but it is not yet clear how long such physiological changes remain.

Dr. Herbert D. Kleber, the medical director of the National Center on Addiction and Substance Abuse in New York, says that the brain-disease concept fits with his experience with thousands of addicts over the years. "No one wants to be an addict," he says. "All anyone wants to be able to do is knock back a few drinks with the guys on Friday or have a cigarette with coffee or take a toke on a crack pipe. But very few addicts can do this. When someone goes from being able to control their habit to mugging their grandmother to get money for their next fix, that convinces me that something has changed in their brain."

But does causing changes in the brain qualify addiction as a brain disease? Not according to Dr. Gene M. Heyman, a lecturer at the Harvard Medical School and a research psychologist at McLean Hospital in Boston. "Since we can visualize the brain of someone who's craving, people say, 'Ah hah, addiction is a brain disease,' " he remarks. "But when someone sees a McDonald's hamburger, things are going on in the brain, too, but that doesn't tell you whether their behavior is involuntary or not." While acknowledging that addiction does induce compulsive behavior, Dr. Heyman says that addicts still retain a degree of volition, as evidenced by the many who stop using drugs.

"Smoking meets the criteria for addiction, but 50 percent of smokers have quit," he says. This change, he goes on, is "demonstrably related" to the data about the hazards of smoking that have emerged since the surgeon general's report on the subject in 1964. By contrast, Dr. Heyman says, "information about schizophrenia hasn't reduced the frequency of that illness." Dr. Heyman also cites a well-known study of Vietnam veterans who were dependent on heroin while overseas. Within three years of their return to the United States, the study found, nearly 90 percent were no longer using it -- strong evidence, Dr. Heyman says, that the addictive state is not permanent.

Sally Satel first became skeptical about the brain-disease model in 1997, when she attended a conference of the drug-abuse institute on the medical treatment of heroin addiction. "So pervasive was the idea that a dysfunctional brain is the root of addiction that I was able to sit through the entire two-and-a-half-day meeting without once hearing such words as 'responsibility,' 'choice,' 'character' -- the vocabulary of personhood," Dr. Satel wrote in a paper called "Is Drug Addiction a Brain Disease?"

Written with Dr. Frederick K. Goodwin and published as a booklet by the Ethics and Public Policy Center, the paper offers a blistering attack on the drug-abuse institute and its brain-disease terminology. "Dramatic visuals are seductive and lend scientific credibility to NIDA's position," the paper states, but politicians "should resist this medicalized portrait for at least two reasons. First, it appears to reduce a complex human activity to a slice of damaged brain tissue. Second, and most important, it vastly underplays the reality that much of addictive behavior is voluntary."

To support that claim, Dr. Satel cited the results of the Epidemiologic Catchment Area study, paid for by the National Institute of Mental Health, which asked 20,300 adults about their psychological history. Of the 1,300 people who were found to have been dependent on or abusing drugs, 59 percent said they had not been users for at least a year before the interview; the average time of remission was 2.7 years. "The fact that many, perhaps most addicts are in control of their actions and appetites for circumscribed periods of time shows that they are not perpetually helpless victims of a chronic disease," Dr. Satel said.

At the mention of Dr. Satel, Dr. Leshner bristles. "Simplistic and polarizing," he says of her writing. More generally, Dr. Leshner maintains that his views have been distorted and misinterpreted. Still, he says, he has lately modified his message, giving more recognition to the role of volition in addiction. "Today's version," he says, is that addiction is "a brain disease expressed as compulsive behavior; both its development and the recovery from it depend on the individual's behavior."

But where does choice end and compulsion begin? The slide showing that has not yet appeared.

***************

Responses:

Deciphering Addiction (letter to the Times)

by Mary M. Cleveland, research director for the Partnership for Responsible Drug Information

A June 24 Arts and Ideas pages article describes the debate between two camps of anti-drug crusaders: those who say drug addiction is an immoral choice and others who see it as a "brain disease."   But it is also possible to see addiction as an obsessive-compulsive behavioral disorder, akin to compulsive gambling or repetitive hand-washing. Treatment for such disorders emphasizes helping people understand and manage their behavior.  That includes identifying false assumptions ("I just have no self-control") and avoiding circumstances that set off compulsive behavior (hanging out with the guys).

Treating addicts as immoral or diseased makes them view themselves as bad or helpless, and makes it harder for them to gain self-knowledge or self control.

-------------

Editorial Note: This letter pretty much nails it, as long as we understand "self-control" to mean behaving in a responsible, socially sanctioned manner, not some sort of magical control exerted by a self independent in some respect of environment or heredity.  Heyman's work in behavioral choice theory is all about how the voluntary aspects of addictive behavior - what gets talked about as self-control (or its absence) - are determined by the addict's social environment.  For more on this see my reply to Massing below, and also see the Addiction page.

Editor's Reply to Massing:

Dear Mr. Massing,

I read with great interest your June 24 New York Times piece, "Seeing Drugs as a Choice or as a Brain Anomaly." Underlying this debate, but not usually made explicit, are assumptions about volition and free will. Until these assumptions themselves are openly debated I don’t think we’re going to make much headway in resolving the controversy over the disease model of addiction.

For instance, you quote Gene Heyman as saying that "addicts still retain a degree of volition." "Volition" suggests to many people a free choice independent of environment and heredity, but what Heyman actually means by volition is quite different. It’s the voluntary component of addictive behavior, that which is sensitive to consequences, as exemplified by the higher quit rate of smokers exposed to information about the risks of cancer. Heyman believes (as do I) that voluntary behavior is just as caused, or determined, as involuntary behavior, but that its causes lie in transactions between persons and their environments; it’s not driven directly by brain anomalies (personal communication). There is no role for free will here, understood as some sort of self-originated choice that’s independent, in some respect, of a person’s biology or social circumstances.

Like Heyman, Satel certainly understands the power of environmental contingencies in shaping addiction, but she consistently reinterprets this sort of causality as a matter of the addict’s self-control, suggesting to the unwary that there might be a freely willing self that chooses addiction (or not). For instance, you quoted her from her (and Fredrick Goodwin’s) booklet, "Is Drug Addiction a Brain Disease?" saying "The fact that many, perhaps most addicts are in control of their actions and appetites for circumscribed periods of time shows that they are not perpetually helpless victims of a chronic disease." But being "in control" of one’s actions and appetites is nothing over and above having one’s behavior shaped to conform to social norms by one’s social and interpersonal situation, perhaps with the help of pharmaceutical interventions. It’s not a matter of free will.

Satel is aware of this issue, since in the preface to her pamphlet she writes: "Among the questions raised by this essay is whether the traditional concept of free will can be sustained in the face of new knowledge about biological and environmental forces that shape human behavior." Curiously, however, nowhere in this booklet does free will get discussed (I hope it will be in future publications from the Ethics and Public Policy Center, Satel's organization). Instead, Satel gives plenty of examples of how addictive behavior is a function of various factors (e.g., it can be influenced by Contingency Management, is exacerbated by "boredom, depression, stress, anger, and loneliness") but always ends up ultimately blaming the addict, as in the following: "They are instigators of their addiction, just as they are agents of their own recovery…or non-recovery. The potential for self-control should allow society to endorse expectations and demands of addicts that would never be made of someone with a true involuntary illness."

Interestingly, the second sentence of this quote draws on clear the connection between self-control and reinforcement contingencies, since addicts only have *potential* for self-control, which gets *realized* by placing expectations and demands on addicts (or by having them grow up in better social circumstances in which good behavior is the norm, not the exception, thus avoiding addiction in the first place). If such is the case, then how can addicts be the "instigators" of their addiction or recovery?

Satel doesn’t seem to want to face the implications of a scientific understanding of addiction, or behavior generally: there is no originative, freely willing agent to praise or blame for choices. Perhaps this is because she supposes, as do many, that having got rid of free will there are no longer grounds for holding addicts (or the rest of us) accountable. But of course this is wrong. The same grounds exist as before: we want to conform addicts’ behavior to social norms so that they become responsible adults. Therefore we are justified in arranging social contingencies which can shape their behavior, or, to use that highly misleading expression, give them "self-control."

To the extent that punitive attitudes (some of which I detect in Satel) are based in the notion that we are the instigator of our own faults, seeing through the myth of free will constitutes the ultimate distigmatization of addicts. This means that in choosing contingencies to shape behavior, we can no longer justify punitive contingencies on the grounds that people could have done otherwise in the biological, psychological, and social conditions they were faced with growing up, and that therefore they deserve to suffer. (They might have done otherwise if conditions had been different, but they weren’t, which is why we have to change those conditions.) Knowing that choices are not willed independently of circumstances, our attitudes towards addicts might change to become more compassionate; as a result we might pay more attention to preventing the formative conditions of addiction than to after-the-fact sanctions.

However, this is not to say that "tough love" isn’t sometimes necessary. The threat of losing privileges as a result of bad behavior does work to instill "self-control". But the default position differs from Satel’s: it is to minimize the addict’s suffering in the process of recovery, and head off problems before they start with all the resources we can muster directed at the conditions which generate addiction. This is not, as you can imagine, the libertarian laissez-faire prescription I suspect Satel might endorse.

Once those championing the disease model of addiction (such as Alan Leshner) understand that voluntary behavior is just as determined as any disease process, they won’t any longer have to deny the voluntary component of addiction in order to destigmatize addicts. But they will have to face the fact that a certain number (one hopes a bare minimum) of negative contingencies may be necessary as a last resort to restore dignity and responsibility to an addict. So the anti-stigma folks have to concede something here, as well as the libertarians.

I want to thank you again for raising this issue, but I think you’ve only hit the proverbial tip of the iceberg. Whether its depths will be plumbed, given the social reticence about exploring the issue of free will, is an open question.

Regards,

Tom Clark

...and a letter to the Times, unpublished:

To the Editors:

Michael Massing usefully examines the disease model of substance abuse, pointing out that there are voluntary choices involved in drug seeking behavior, even in the late stages of addiction (Arts and Ideas, June 24).  But just as physiological abnormalities in the addict’s brain can be traced to the chemical effects of drugs, so too the voluntary aspects of drug use can be traced to the addict’s social and psychological milieu.

This means that to treat and prevent addiction effectively we must pay as much attention to the environment of potential addicts as to their brains. It also suggests that in destigmatizing addiction, discovering the environmental determinants of choice is just as important as finding the genetic and physiological mechanisms of compulsive craving.

In the light of a scientific understanding of voluntary behavior, social stigma might still play a role in helping to reduce drug abuse, but it should be applied only when other, less punitive means are proved ineffective. Seeing why addicts behave as they do will force us to acknowledge that were we handed the same genetic and environmental lot in life, our choices would have been much the same.

TWC

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Playing God, Carefully

(Editor's note:  This is a response to Cho, et al., "Ethical Considerations in Synthesizing a Minimal Genome."  Their concern - that biotech might devalue life - is a good example of what might be called "fear of mechanism.")

The December 10, 1999 issue of Science reported that microbiologists may eventually pin down a "minimum genome": the bare bones, molecularly speaking, of what it takes to make a living organism. The interplay of DNA, proteins, and other sub-cellular components in supporting the necessary functions of life – in this case a very simple bacterium – would be completely understood. Nothing mysterious or "protoplasmic" would remain: the very mechanism of life would stand revealed in all its complexity.

The same issue also carried a companion piece by a group of bioethicists on "Ethical Considerations in Synthesizing a Minimal Genome," in which they grapple with what they believe are the worrisome implications of such knowledge. "The attempt to model and create a minimal genome," they say, "represents the culmination of a reductionist research agenda about the meaning and origin of life that has spanned the 20^th century." This agenda is far from benign, according to these ethicists, since it challenges the tradition which holds that life is valuable because it is more than "merely physical." Their worry, in essence, is that "The special status of living things and the value we ascribe to life may …be undermined by reductionism."

This is a serious charge, one that might well tend to foster prejudice against science. If a thorough understanding of the mechanics of life necessarily devalues it, then shouldn’t we pull back from the pursuit of biological knowledge? One might expect that the supposed threat of reductionism would be made clear, but in fact the authors don’t sustain their indictment. Rather, their article suggests that reductionism, properly understood, poses little danger. Even with a minimum genome in hand, science simply isn’t in a position to offer definitive pronouncements on the meaning of life.

Their worries rest on a confusion between materialism, the thesis that we essentially are physical creatures, and what might be called strong reductionism, the claim that higher level phenomena, such as human behavior, can be completely explained in terms of its underlying physical mechanisms. Now, some indeed are threatened by materialism, since being "merely" physical undercuts the traditional reassurance that the soul might outlive the body. But it’s not clear that anyone should be worried about strong reductionism, since it’s patently false, and must be distinguished from the bread and butter science of analyzing biological processes, which is what work on the minimal genome consists of.

The ethicists point out that "a reductionist understanding of …human life is not satisfying to those who believe that dimensions of the human experience cannot be explained by an exclusively physiological analysis." True enough, but does anyone really suppose that physiological analysis is even relevant to most human experience? Such strong reductionism is simply a straw man, not an encroaching scientific agenda.

For instance, a thorough understanding of the brain at the neural level, while often necessary for tracing specific mental functions and pathologies, is simply inappropriate for dealing with the everyday psychodrama of our motives, aspirations, disappointments and interpersonal interactions. Even though our having experiences at all may depend on our having properly wired brains, the meaning of experience derives from its social context, not its substrate in physiology. In short, since analytical physical science is irrelevant to domains in which it is useless for explanatory or predictive purposes (which is to say, in much of our lives) its success cannot threaten our dignity.

The ethicists also suggest that extensions of minimal genome research, by specifying the genetic definition of the human organism and its beginnings in utero, will have implications for the abortion debate. Although they don’t tell us precisely what these implications are, they do conclude that "the complex metaphysical issues about the status of human beings cannot be discussed in terms of the presence or absence of a particular set of genes". Quite true, but this is yet another illustration of how physiological analysis is not about to rule our ethical intuitions. Even if we agreed on a definition of human life at the DNA level, all the contentious issues of fetal viability, birth defects, quality of life, and the sometimes conflicting interests of mother and potential newborn, remain to be decided at the social level. Science simply isn’t in competition with social policy debates, although it can help inform them.

But beyond abortion, the most pressing issue, they say, is whether identifying minimal genomes, or perhaps even creating artificial organisms from such blueprints, "constitutes unwarranted intrusion into matters best left to nature; that is, whether work on minimal genomes constitutes ‘playing God’." How much should we intervene in the mechanics of life to suit our desires? An analytical understanding of life’s mechanisms is the key to genetic engineering, both of other creatures and ourselves. If we decide we should play God, then we’ll use the key; if not, we should throw it away.

The authors point out that a spectrum of views exist on playing God. Many of religious persuasions reject it as arrogant hubris; others believe that it should be the no-holds-barred culmination of our capacity for self-design. They themselves recommend a middle path of careful biotechnological stewardship that "would move forward with caution into genomic research and with insights from value traditions as to the proper purposes and uses of new knowledge." They also state that "while there are reasons for caution, there is nothing in the research agenda for creating a minimal genome that is automatically prohibited by legitimate religious considerations."

If, as these ethicists conclude, there is no deep moral objection to our playing God -carefully - then a detailed analysis of life’s mechanisms is simply a means to an end, not an intrinsic threat to the specialness of life or our attachment to human beings and other creatures. And it is these attachments that will shape the ends we seek, and that must channel the use of biotechnology in humane, not monstrous, directions.

Were we to conclude that playing God is wrong, then advanced biology does pose a threat, and we might seek to limit research into what once were the mysteries of life. Indeed, the success of science in showing that simple life forms are mechanisms, albeit astoundingly complex, lends power to what some feel is a deflationary materialism: we no longer need mysterious, non-physical explanations for what life does. The sheer ability to play God, therefore, threatens those who think God is, or should be, a necessary hypothesis at the physical level. They would prefer science to fail, even in its proper arena, and one sure way to ensure failure is to limit biological research.

But in reality, of course, it’s too late not to play God. By knowing that we have the power to know, even a decision to "let nature run its course" is yet another God-like choice, albeit it one that renounces domains of understanding and control. Such a choice would make us a God of the Deists, a passive onlooker of unfolding creation, rather than an active participant in shaping our destiny.

The question, therefore, is not whether we should play God, but what sorts of local gods we will, or should, become. Will materialism (not the straw man of strong reductionism) demoralize us, or will we continue to find meaning in our personal and social lives, even though life itself is understood to be a mechanism? The latter outcome becomes possible if we grasp that our lives’ meaning need not depend on our being ethereal, as opposed to purely physical, creatures. Either way, our response to the success of science will help determine how we play the leading role in which nature has cast us on this planet.

TWC, January 2000

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Scientists Unmask Diet Myth: Willpower

By Jane Fritch

New York Times, Science Times, October 5, 1999

(Editorial note: Below is a telling expose of will in an everyday context.  With one exception, the scientists quoted by Jane Fritch pull no punches in dismissing willpower as a fraud.   They recommend instead the Skinnerian solution to overeating: set up your environment to make it less likely you'll want to, or be able to eat.  If you do a good job at this, one says, it will even seem as if you've got willpower!   The trick is to generalize this message into other realms of behavior, but of course that gets controversial...)

A thin person, the kind who has always been thin, is confronted by a chocolate cake with dark fudge icing and chopped pecans. Unmoved, he goes about his business as if nothing has happened.

A fat person, the kind who has always struggled with weight, is confronted by the same cake. He feels a little surge of adrenaline. He cuts a slice and eats it. Then he eats another, and feels guilty for the rest of the day.

The simplest -- and most judgmental -- explanation for the difference in behavior is willpower. Some people seem to have it but others do not, and the common wisdom is that they ought to get some.

But to weight-loss researchers, willpower is an outdated and largely discredited concept, about as relevant to dieting as cod liver oil. And many question whether there is such a thing as willpower.

"There is no magical stuff inside of you called willpower that should somehow override nature," said Dr. James C. Rosen, a professor of psychology at the University of Vermont. "It's a metaphor that most chronically overweight dieters buy into."

To attribute dieting success or failure to willpower, researchers say, is to ignore the complex interaction of brain chemicals, behavioral conditioning, hormones, heredity and the powerful influence of habits. Telling an overweight person to use willpower is, in many ways, like telling a clinically depressed person to "snap out of it."

It is possible, of course, to recover from depression and to lose weight, but neither is likely to happen simply because a person wills it to be so, researchers say. There must be some intervention, either chemical or psychological.

The study of weight loss began in earnest in the early 1950's, a time when doctors and nutritionists treated overweight people by telling them to eat less and sending them on their way.

"Willpower was a kind of all-embracing theory that was used all the time to make doctors feel good and make patients feel bad," said Dr. Albert Stunkard, a professor of psychiatry at the University of Pennsylvania who has been studying weight loss for five decades.

"Most people think that willpower is just a pejorative way of describing your failures," he said. "Willpower really doesn't have any meaning."

The role of willpower in weight loss was a major issue among scientists about 30 years ago, when the behavior modification movement began, Dr. Stunkard said. Until then, the existence -- and importance -- of willpower had been an article of faith on which most diets were founded, he said.

The behavior modification approach had its roots in a 1967 study called "Behavioral Control of Overeating," which tried to analyze the elements of "self-control" and apply them to weight loss. The study, by Richard B. Stuart of the University of Michigan, showed that eight overweight women treated with behavior modification techniques lost from 26 to 47 pounds over a year. They had frequent sessions with a therapist and recorded their food intake and moods in diaries. And the therapists helped them develop lists of alternatives to eating, like reading a newspaper or calling a friend. One cultivated an interest in caged birds; another grew violets.

"No effort is made to distinguish the historical antecedents of the problem and no assumptions are made about the personality of the overeater," Mr. Stuart wrote in his article, published in the journal Behavioral Research and Therapy.

After that, the focus of weight loss programs shifted toward behavioral steps a dieter takes regarding eating, said Dr. Michael R. Lowe, a professor of clinical psychology at the MCP Hahnemann University in Philadelphia, and away from "something you search for within."

Behavior modification is now the most widely accepted approach to long-term weight loss. Practically, that means changing eating habits -- and making new habits -- by performing new behaviors. Most programs now recommend things like pausing before eating to write down what is about to be eaten, keeping a journal describing a mood just before eating and eating before a trip to the grocery store to head off impulse buying.

There is also mounting evidence that behavior affects the chemical balance in the brain, and vice versa. Drugs like fenfluramine, half of the now-banned fen-phen combination, reduced a dieter's interest in eating, thereby making willpower either irrelevant or seemingly available in pill form. And Dr. Stunkard has just completed a study that showed that people with "night-eating syndrome" -- who overeat in the late evening, have trouble sleeping and get up in the middle of the night to eat -- have lower-than-normal levels of the hormones melatonin, leptin and cortisol in their blood.

Still, to deny the importance of willpower is to attack a fundamental notion about human character.

"The concept of willpower is something that is very widely embedded in our view of ourselves," said Dr. Lowe of MCP Hahnemann University. "It is a major explanatory mechanism that people use to account for behavior."

But Dr. Lowe said he and others viewed willpower as "essentially an explanatory fiction." Saying that someone lacks willpower "leaves people with the sense they understand why the behavior occurred, when in reality all they've done is label the behavior, not explain it," he said.

"Willpower as an independent cause of behavior is a myth," Dr. Lowe said. In his clinical practice, he takes a behavioral approach to weight control. In part, that involves counseling dieters to take a more positive attitude about their ability to lose weight. It also involves some practical steps. "Most importantly," he said, "you need to learn what behavioral steps you can take before you get in the situation where you're in the chair in front of the television with a bowl of potato chips."

And, he said, it is important for dieters to keep in mind that there are formidable forces working against them and their so-called willpower. "We live in about the most toxic environment for weight control that you can imagine," Dr. Lowe said. "There is ready, easy availability of high-fat, high-calorie fast foods that are relatively affordable, combined with the fact that our society has become about as sedentary as a society can be."

Not all experts, however, reject the notion of willpower. Dr. Kelly D. Brownell, director of the Yale Center for Eating and Weight Disorders, said that this was the most difficult time in history for dieters, and that it would be a mistake to dismiss the concept of willpower. "A person's ability to control their eating varies over time, and you cannot attribute that to biology," he said.

"There's a collective public loss of willpower because of this terrible food environment that challenges us beyond what we can tolerate," Dr. Brownell said. "One needs much more willpower now than ever before just to stay even."

All the temptations notwithstanding, thousands of people find a way to lose weight and keep it off, a fact demonstrated by the National Weight Control Registry, a research project that keeps tabs on people who have lost at least 30 pounds and kept the weight off for more than a year.

" A lot of times in weight loss programs patients will say to me that they need to learn to be able to live with an apple pie in the refrigerator and not eat it," said Dr. Rena Wing, a professor of psychiatry at the University of Pittsburgh and the Brown University School of Medicine, who is collaborating on the registry project. Most behaviorists think dieters should instead arrange their lives so that they rarely have to confront such temptations.

"If I were to put an apple pie in front of everybody every minute of the day, I could probably break down everybody's quote-unquote willpower," she said. "We really are trying to get away from this notion of willpower. If you make certain plans, you will be able to engineer your behavior in such a way that you will look as if you have willpower."

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On the Supposed Inscrutability of Evil

by Currents editor, TWC

In the wake of the Columbine High School shootings in Littleton, Colorado, several newspaper articles, including two by Massachusetts sociologists, downplayed the possibility that we can ever truly understand the evil behind such events.  Evil, it seems, is not fully explicable by causal factors, but is instead the product of an intrinsic, self-chosen malevolence within individuals.  Alan Wolfe of Boston University concluded his piece defending suburban culture ("Littleton Takes the Blame," New York Times Op-Ed, 5/2/1999) with a telling tautology: "We ourselves should not try to find an explanation for all of life's mysteries.  Not everything requires a sociological analysis.  The evil that was Columbine was not about franchise outlets, cell phones or cliques.  It was about evil."   The Boston Globe ran a piece by University of Massachusetts sociologist John Hewitt ("Trying to make sense of the senseless," Op-Ed 4/29/99) which went even further in mystifying evil:

"More ominously, this tragedy might have an explanation that we are not prepared to accept.  Science has taught us to look for peculiar social or psychological circumstances that cause people to do what they otherwise would not do. The mind does not rest easy with the idea that seemingly ordinary people who are a bit odd but generally keep to themselves might quietly be forming awful plans. We would rather think of bad acts as the unfortunate consequences of discoverable and remediable social and personal conditions. Yet it is precisely the account we do not wish to believe that might best capture what happened in Littleton.

"The two dead members of the 'Trench Coat Mafia,' together with their fellows, might simply have chosen evil in circumstances where others choose to play football or to crave membership in the National Honor Society."

Last, but not least, the New York Times ran a Sunday Week in Review article ("Science Looks at Littleton and Shrugs," 5/5/99) in which Dr. Jeffery Fagan, director of the Center for Violence Research and Prevention at Columbia University was quoted saying that "a much more hard-heading approach [to explaining Littleton] says 'Sometimes bad things happen and we can't always explain it.'" 

It speaks to the power of the myth of radical autonomy (see next section) that even experts in the art of explanation throw up their hands when confronted with extreme acts of violence, as if these were somehow beyond nature, or culture, and have to be chalked up to an incomprehensible Evil residing within the person.  Such a stance not only misplaces the person outside of nature and culture, it suggests that evil is beyond our reach to contain or control:  it relieves us of responsibility for creating a less punitive culture in which retaliatory episodes such as Littleton (and many, many more unpublicized killings) become less frequent.  Don't blame or try to change suburbia, says Wolfe, evil is simply evil.   Don't look to science to illuminate the killings, says Hewitt, it's just a personal choice, like choosing to play football.  If we are hardheaded realists about such tragedies, says Fagan, we will admit that they are ultimately inexplicable.  This last bit seems simply wrongheaded, not hardheaded.

Such defeatist nonsense is driven by the deep cultural assumption that individuals are in some sense freely willing first causes, insulated from biological, psychological and social factors.  On the contrary, only by naturalizing evil - that is, showing how it arises from such factors - do we stand a chance of conquering it.  Clinging to the myth of autonomy, far from giving us power, guarantees that the recent history of Littleton will repeat itself, perhaps in a community near you.  For a response to Wolfe published in the Times see the Letters section, "The End of the Suburban Dream?".

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Radical Autonomy in the New York Times

DNA and Destiny

An excerpt from a 11/16/98 New York Times op-ed piece by David P. Barash, a professor of psychology at the University of Washington at Seattle:

The existentialists had it right. From a religious thinker like Kierkegaard to an atheist like Nietzsche, the existentialists recognized that all human beings define themselves as unique, responsible individuals. As Simone de Beauvoir put it, a human being is a being whose essence is having no essence. Or, in Jean Paul Sartre’s famous phrase, "existence precedes essence."

In other words, our essence is ours to choose, depending on how we direct ourselves with all our baggage, DNA included.

This is not to minimize our gene-based, Darwinian heritage. It is, rather, a reminder that within the vast remaining range of human possibility left us by our genes and our evolutionary past, each of us is remarkably, terrifyingly free.

Editorial comment: Yeah, right. Like so many responding to the threat of genetic determinism, Barash ignores the other, complimentary set of determining factors which shape the self - the environment. Beyond genes and environment, there are no other factors involved in the development of individuals, certainly not a self free from such influences. And on what basis would a radically free self choose to shape itself in one direction over another? On the assumption of radical autonomy - the existentialist assumption Barash champions - no explanation could ever be forthcoming. This sort of ill-considered flight to freedom is typical of those who see determinism as a threat to human dignity.

Smoking is a Choice

In a 11/21/98 letter to the New York Times, Marc Beauchamp of Falls Church, VA writes:

Your Nov. 19 front-page article about Jan Binder, a smoker who has been unable to quit, is emblematic of today’s culture of victimization. Ms. Binder is an addict and outcast not by chance but because of choices she’s made.

I was a pack-a-day smoker from my late teens until my late 30’s. I took my last puff eight years ago. What I learned from my struggle to kick the habit was that you can’t quit for the wrong reasons: because it costs too much, because your family thinks it’s a vile habit, because a friend or relative smoked themselves to death. You can only quit when you decide that’s what you want to do. Period.

It’s a smoker’s choice to be a smoke victim.

Editorial comment: Note the startling lack of explanation for why a smoker would choose to quit: "You can only quit when you decide that’s what you want to do. Period."  The smoker’s decision is imagined to be in isolation from any and all influences, making it inexplicable except as an act of sheer will, which itself comes out of the blue. This sets up the agent to take all the blame, and suggests that outside factors are insignificant in helping smokers to quit. This is the core of the defense that tobacco companies mount in lawsuits to avoid accountability. Unfortunately, most juries buy it, wedded as they are to the fiction of free will.

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Dr. William Provine: Free Will a Cultural Myth

American Atheist Conference, 6/12/98

Dr. William Provine, Cornell University Professor, addressed the convention on the theological concept of "free will." He began with a detailed discussion on recent developments in evolutionary biology as formulated by Charles Darwin. He noted that the idea of a universe created by a deity - "intelligent design" - was refuted by the findings of science, specifically the doctrine of natural selection.

Provine asserted that "when you're dead, you're dead," and that in looking at life from an evolutionary perspective, one sees that there is no ultimate, absolute reference in formulating an ethical system. "No, human beings on this planet are alone, and we exist in a world which was made by processes that don't care one whit about us... we live in a universe that will probably continue to expand for some time, then contract."

"The meaning we seek in our lives cannot be ultimate meaning, but a meaning which we create."

Dr. Provine then continued that "free will is a terrible cultural myth." He added that "Giving up the idea of God is great for a rational mind."

Provine also made a strong plea for competing viewpoints to be aired throughout the academy, and society; he called upon Atheists to actively debate creationists. "Some of my best friends are creationists, and they like me, because they know I want to see their ideas presented and contested in class."

Source: American Atheist Magazine

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Underreporting Antidepressant Use Tied to Stigma of Mental Illness

(excerpt chosen and emphasis added by Currents editor)

...Rost and associates reported a study of coding practices among primary care physicians treating depression that may help explain our findings. These researchers used a structured survey of primary care physicians. They found that 50.3% of respondents who had seen a patient meeting the DSM-III-R criteria for major depression in the previous 2 weeks admitted that they deliberately miscoded the diagnosis. The most common diagnoses substituted for depression included fatigue/malaise, insomnia, headache, anxiety, adjustment/grief reaction, and anorexia, as well as somatic syndromes such as fibromyalgia and irritable bowel syndrome. These results correlate closely with the pattern of diagnoses seen in our primary care record sample.

The reasons physicians cited for using alternative diagnostic codes are intriguing and have interesting clinical, societal, and ethical implications. "Uncertainty about the diagnosis" was reported by 46.0% of respondents. This highlights the need for both objective screening and diagnostic tools for common mental illnesses in primary care practice as well as improved provider education. A variety of studies have concluded that primary care physicians significantly under-report and undertreat depression. Paradoxically, it appears that in many cases they suspect the correct diagnosis but fail to record it due to uncertainty or other factors described here.

Other reasons reported for miscoding the diagnosis have health system and societal implications. "Problems with reimbursement for services if depression is coded" was reported by 44.4% of respondents; this demonstrates that reimbursement bias also affects the accuracy of the outpatient record. This finding also reflects the incongruities of the health plan design, which reimburses treatment for "physical" illnesses but not brain diseases with demonstrated organic, neurobiologic basis.[40, reference below]

All of these results reflect the stigma of mental illness that continues to be explicitly reinforced, as is evident in the list of other reasons given for not identifying depression as the diagnosis. These reasons include "jeopardize future ability to obtain health insurance" (29.4%), life insurance (12.8%), employment (10.2%), or disability (6.4%). Moreover, 20.9% of physicians reported that the "stigma associated with depression was likely to delay recovery," and 12.3% reported that the stigma would "negatively influence future care from other providers." Finally, 11.8% of physicians reported that patients were "unwilling to accept the diagnosis," and 11.2% of patients specifically requested that depression not be recorded.

reference:

40.   Shannon, BD: The brain gets sick, too—The case for equal insurance coverage for serious mental illness. St Mary's Law J 24:365-398, 1993.

Source:   "Research Using Physician-Reported Anti-depressant Claims," Medline, 6/22/98, http://www.medscape.com/SCP/DBT/1998/v10.n05/d3249.brow/d3249.brow-06.html

Editorial comment:  The "incongruities of the health plan design" mentioned above is a good example of how the mental/physical conceptual split controls both how coverage for illness is allocated and attitudes about depression.  As long as depression is thought of as "mental," it can be safely excluded from standard medical coverage of physical illnesses, and it can be chalked up to personal shortcomings.  As we move towards understanding ourselves as strictly physical creatures, whose "mental" problems are entirely rooted in the brain as it responds to physiological and environmental influences, the stigma of depression should lessen and medical coverage should become more equitable.  TWC

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