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Body & Society
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On the Embodiment of Addiction

DARIN WEINBERG
Body Society 2002; 8; 1
DOI: 10.1177/1357034X02008004001
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01 Weinberg (jr/d) 11/13/02 11:48 AM Page 1
On the Embodiment of Addiction
DARIN WEINBERG
Addiction provides a remarkably fruitful empirical site for studying the relation-
ship between body and society. However, students of the body/society nexus
have yet to fully appreciate the wealth of insights that addiction research might
provide. While there have been occasional nods toward addiction in the literature
on the body (McCarron, 1999), focused and sustained theoretical attention is not
yet evident. The distinctive potential of addiction research for contributing to our
theoretical grasp of the body/society nexus lies in the following fact. While the
ostensible symptoms of addiction overwhelmingly consist in social or cultural
transgressions, its underlying nature is generally located in one or another sort of
bodily pathology, deficit or vulnerability. In view of this fact, addiction research
can provide opportunities to explore empirically how our bodies are variously
configured as causal forces under different social conditions. This kind of research
could do much to counter the oft heard criticism that social research on the body
has attended too exclusively to representations of the body and too little to the
body as a materially incarnate social force (cf. Turner, 2000). Addiction research
is not entirely unique on this score. There are, after all, other disorders about
which the same point might be made. Nonetheless, because it is apparently so
pervasive and so closely linked to a variety of core sociological topics (e.g. age,
class, consumption, crime, race), addiction should hold a particularly serious
interest for scholars concerned to explore the historically and culturally specific
social realities of the body.
This article seeks to promote a more rigorous sociological regard for the
embodiment of addiction by providing a critical survey of extant theorizing, and
proposing a more sociologically incisive theoretical alternative to existing
research paradigms. After a very brief summary of the history of addiction
Body & Society 2002 SAGE Publications (London, Thousand Oaks and New Delhi),
Vol. 8(4): 119
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2 Body and Society Vol. 8 No. 4
theorizing, I critically compare three major contemporary approaches to the

study of addiction: neurology, learning theory and symbolic interaction. I show
that neurological theories and learning theories have failed to account for the role
of culturally transmitted meanings in the addiction process. While symbolic
interactionist theories have been centrally concerned with the meaning of
addiction, they have failed to theorize how issues of meaning might figure in the
addicts inevitable subjective estrangement from his or her drug-related activities.
This stems from their failure to appreciate the reality of non-symbolic meaning,
or meaningful experience that manifests pre-reflectively, at the level of our
immediate bodily encounter with reality. The article concludes by suggesting that
sociological students of addiction adopt a more thoroughly praxiological orien-
tation to meaningful experience, so as to overcome the analytic limitations
inherent in the antinomy between biological reductionism and disembodied
cognitivism.
A Brief History of Addiction Theorizing

In its earliest usage the concept addiction was held to refer indiscriminately to a
persons enslavement by someone or something. Well into the 19th century, the
idea of addictive enslavement was used widely to describe many different sorts of
human fixation (cf. Rothman, 1990). But as Temperance movements grew, the
concept addiction was refined and its scope of reference delimited. Many of the
early theorists sought to locate the source of addiction in the object of addiction
itself (Levine, 1978). By these lights, certain substances, like alcohol or morphine,
were inherently capable of enslaving us. Hence the root nature of addiction was
to be found through inspection of their distinctive properties. As time passed,
cases of people who used alcohol and drugs without becoming enslaved accumu-
lated. This, combined with a variety of complex changes within the fields of
alcohol and illicit drug control (Weinberg, 1998), eventually moved addiction
theorizing away from addictive substances themselves and toward the person of
the addict. Most authorities eventually ceased to believe the nature of the problem
was to be found in the bottle, as it were, and came to believe it was to be found
in the man.
Early 20th-century theories of addiction focused predominantly on intrinsic
personal deficits like psychopathology, an addictive personality of some sort, or
other sorts of deficits that might induce addictive self-medication. Like those that
focus exclusively on the fixed properties of putatively addictive substances,
theories that focus exclusively on the fixed properties of addictive people have
also been subject to a litany of rather damning critiques. Perhaps the least

On the Embodiment of Addiction 3
damaging critique is that intrinsic-personal-deficit theories are post hoc. They do

not predict who will and will not come to exhibit addictive behaviors but simply
classify addicts after the fact. More significantly, because the posited personal
deficits are not unique to addicts, intrinsic-personal-deficit theories cant tell us
when or why their possessor will lapse into addictive behavior and when or why
s/he will not. Nor are intrinsic-personal-deficit theories particularly good at
explaining why so many people who eventually come to exhibit the symptoms of
addiction manifest no signs of pathology before their addictions actually ensue.
A smaller number of addiction theorists have sought to address the problem
more processually (cf. Jellinek, 1960; Lindesmith, 1938; Vaillant, 1983). Alfred
Lindesmith (1938), the pioneer of this approach, argued that addiction cannot be
explained atemporally, as the product of timeless chemical, anatomical, physio-
logical, or psychic variables, but must be seen as an intrinsically social process that
certain otherwise normal people undergo. Lindesmith did acknowledge that some
substances possess a characteristic chemical disposition to generate physiological
withdrawal symptoms after repeated administration. However, though he felt this
disposition was a necessary ingredient for addiction, he did not feel it was
sufficient. To lend empirical support to his case, Lindesmith pointed to instances
of heavy morphine use among hospital patients after surgery. These patients are
often administered sufficient doses of morphine to produce physiological with-
drawal symptoms but they do not generally become addicted to morphine after
they leave the hospital. Lindesmith explained this apparent anomaly by pointing
to patients ignorance of the source of their withdrawal distress. By and large
hospital patients dont know their nausea, muscle aches, runny noses and other
symptoms stem from morphine withdrawal and hence do not infer a need for
opiates from these experiences. The symptoms eventually pass with no yearning
for further drug use having been produced. Street addicts, on the other hand, use
opiates consciously. They generally do possess knowledge of the fact that these
drugs can produce physiological withdrawal symptoms and that further use will
alleviate those symptoms. Lindesmith argued that, by learning to use drugs
specifically to alleviate withdrawal, mere drug users are transformed into genuine
drug addicts.
Lindesmiths work reflected the wisdom of an era wherein it seemed sensible
to speak of distinctions between hard drugs (defined by the fact that they produce
physiological withdrawal symptoms) and soft drugs (defined by the fact that they
do not do so). But the era has now passed when people could speak confidently
of a distinction between drugs that produce genuine, or physical, addictions and
drugs that might produce only a more nebulous psychological addiction. The
single most important catalyst to this eras passing was the advent of crack. Crack

cocaine is widely recognized as extremely addictive by clinical professionals and

non-professionals alike but, oddly enough, it produces no gross physiological
withdrawal symptoms (Gawin, 1991). The same can also be said of nicotine, and
all of the so-called behavioral addictions, sex, gambling, eating, etc.
Furthermore, reliance on the distinction between physical and psychological
addiction always suffered another serious analytic problem: relapse. Many
consider relapse, or the resumption of a dis-preferred pattern of behavior despite
ones desire not to, as the defining mark of addiction. Theories that trade on the
distinction between genuine physical addiction and a less severe psychological
addiction cannot remain consistent in their explanations of relapse. A return to
Lindesmiths classic theory will illustrate the problem. Lindesmith explained the
resumption of drug use after withdrawal symptoms have ceased primarily in
terms of the former addicts subconscious generalization of his or her response to
withdrawal distress to other forms of stress (cf. Lindesmith, 1968: 154). This
theory is plainly residual in the sense that it pastes a new subconscious mechan-
ism on to the original physiological withdrawal-plus-knowledge-of-withdrawal
theorem. Furthermore, it is not consistently supported by empirical data on
opiate addiction, and affords no explanation of relapse into the use of substances
like nicotine or crack, which do not produce gross physiological withdrawal
symptoms in the first place. Given the analogous tendency of former crack and
nicotine addicts to relapse, we are well advised to look beyond the generalization
of withdrawal distress to adequately understand this process.
Three major theoretical approaches have emerged which seek to explain the
addicts propensity to suffer relapse. These include theories which attend to
neurological changes that make the one-time addict vulnerable to relapse (cf.
Gawin, 1991; WHO, 1981), various learning theories based in the tradition of
behavioral psychology (cf. Akers et al., 1968; Childress et al., 1992; Siegal et al.,
1988; Wikler, 1973) and sociological theories based primarily in the school of
symbolic interaction (cf. Denzin, 1993; Lindesmith, 1968; Ray, 1961; Stephens,
1991). Each of these approaches usefully captures important features of the
addiction process. However, each approach also suffers from important limi-
tations. In what follows I briefly describe these three approaches, discuss their
respective limitations and conclude by suggesting a theoretical alternative by
which these limitations may be overcome.
The Neurological Understanding of Addiction

Neurological theories of addiction are based, in large part, on empirical evidence
gathered through laboratory experiments using non-human animals. These

investigations have indicated many common features between the effects of

various drugs on people and on non-human animals and hypothesize that the
long-term neurological effects of sustained drug use observed in animals are
largely analogous to what occurs in human beings. These long-term neurological
effects, or neuroadaptations (WHO, 1981), are believed to explain the propen-
sity of former heavy substance users to relapse. Before speaking to the limitations
of this approach it will behove us to briefly consider the argument and to note
some of its strengths.
According to neurologists working in this area, psychoactive chemicals
produce euphoria in those who use them largely by affecting neural processes in
the pleasure/reward circuitry of the brain. By either promoting the release of
neurotransmitters, preventing their re-uptake, or mimicking their effects,
psychoactive drugs like heroin, cocaine, alcohol and nicotine change the routine
functioning of the brain in ways that tend to be profoundly reinforcing to those
so affected. That is, once exposed to their pharmacological effects, people and
animals endowed with properly functioning reward circuitry will be strongly
inclined to use drugs again. Experiments done with laboratory animals have
produced compelling evidence that, indeed, once exposed to the biochemical
effects of certain drugs, animals will seek them out and self-administer them,
sometimes until they die of overdose or of sheer exhaustion.
As is evident in the level of self-administration observable among some people,
it would seem that the ingestion of some chemicals can also have profoundly
reinforcing effects in human beings as well. However, it is one thing to suggest
that the effects of some drugs are profoundly reinforcing to most people and are
thus sought out, all other things being equal. It is quite another matter to suggest
that even after users become painfully aware of the serious negative consequences
that using drugs has for them, drug use, nonetheless, continues to produce the
same reinforcement. Studies of heavy users of various drugs have repeatedly
noted that, after prolonged use, the positive effects of drug use are often eclipsed
by the negative (cf. Koob et al., 1989). Some heavy users even report that drug
use ceases to give them any rewarding experiences whatsoever and that they
simply continue to relapse because they feel they cannot refrain from doing so
(cf. Lindesmith, 1968). How do neurologists account for these seemingly anomal-
ous findings?
They do so by suggesting that prolonged drug use may induce a compensatory
neurological adaptation which, in effect, amounts to the production of a tolerance
to the drug in the nervous systems of heavy drug users. While the development
of this type of tolerance may or may not induce gross physiological withdrawal
symptoms upon removal of the drug, it does produce what neurologists call

anhedonia, or a marked decrease in the capacity of one so afflicted to experience

pleasure after drug use has been discontinued. Studies of abstinent former cocaine
users suggest that in the absence of neuro-adaptation, anhedonic symptoms will
lift in between two and twelve weeks (Gawin, 1991). However, in the presence of
neuro-adaptation the duration of anhedonia is uncertain. During this period the
former substance user remains in a comparatively depressed state and thus signifi-
cantly more vulnerable than s/he might otherwise be to stimuli that cue him or
her to consider the analgesic effects of drug use.
This approach is instructive in a number of important ways. First and
foremost, it has important practical payoffs in that it informs our efforts to
generate pharmacological therapeutic interventions. Drugs like Naloxone have
proven to be life-saving for people in acute stages of opiate overdose and others
like Methadone and various anti-depressant medications have improved the
quality of life for former heavy drug users who might otherwise have remained
without help. In addition, this approach provides theoretical resources for under-
standing intrinsically maladaptive human behavior and thus encourages us to
recognize the possibility that some behaviors simply cannot be plausibly
described as adaptive responses to environmental conditions. Social scientists, in
particular, sometimes forget that the human organism itself can and indeed often
does interfere with our performing as competent social actors (Leder, 1990;
Turner, 2000). A sensitivity to neurological processes can provide an important
check on our social scientific propensity to regard all human conduct through a
rationalizing gaze.
However, this said, the neurological model does suffer from significant theor-
etical limitations. Most fundamentally, as I have said, most of the findings that
support the model are taken from experiments using non-human animals. These
animals are not administered drugs in the same way, at the same rates, or under
the same environmental circumstances that characterize human drug use, and thus
their behaviors must be interpreted with the utmost caution as analogs to human
drug-using practices. Moreover, we must not be lured into believing that the
meanings drug effects have for human beings are analogous to the meanings those
effects have for non-human animals. There is a great deal of evidence to suggest
the meanings drug effects have for people strongly influence whether those effects
are experienced as pleasurable or unpleasurable (cf. Becker, 1953, 1967; Mac-
Andrew and Edgerton, 1969). These meanings cannot be explained exclusively
with respect to biochemical effects in the brains pleasure/reward circuitry
(Weinberg, 1997). Because they seek to predicate their theories of compulsive
drug use on a presumption that certain chemicals invariably produce pleasurable
experiences (cf. Gardner, 1992), neurologists systematically occlude the culturally

transmitted meanings of drugs and drug use from their analyses. If our effort is
to understand the dynamics of compulsive drug using practices in people then
blindness to the meanings of drug experiences is a very serious theoretical
handicap.
Lastly, we must realize that conceptual resources drawn from neurology are
not particularly well-suited to research that seeks to elucidate the subjective
experiences and/or the social contexts that foster compulsive drug use or those
that foster its amelioration. Theoretical approaches to these kinds of analyses,
though they must certainly be open to the possibility of neurological influences
on human behavior, must not cast human behavior and experience as merely
epiphenomenal to neurological processes.
Approaches to Addiction from Learning Theory

Learning theories of addiction begin from the premise that there are two basic
types of learning that occur in drug using situations. One, operant conditioning
or instrumental learning, occurs when behavior is followed by rewards or
punishments. Under circumstances that reward a given behavior, that behavior
has been found likely to increase, and under circumstances that punish the
behavior the behavior decreases. The second type of learning, classical condition-
ing, involves the conditioned association of reinforcing events with events that
routinely occur concomitant to those events. Research concerning operant and
classical conditioning has a long and diverse history but was originally inspired
by Ivan Pavlovs famous experiments in conditioned reflexes (Pavlov, 1927).
Pavlov noted that repeated pairing of one stimulus which precipitates a known
response (what he called the unconditioned stimulus or UCS) with another novel
stimulus (the conditioned stimulus or CS) can train a subject to associate the CS
with the UCS and indeed respond to the CS in a manner akin to the response
known to follow the UCS. Pavlovs most famous experiment was one involving
dogs, wherein by ringing a bell (the CS) in conjunction with feeding (the UCS)
he was eventually able to evoke salivation, the known response to food, simply
by ringing the bell alone. This experiment has been replicated many times and
clearly demonstrates that animals and humans alike can be trained to respond to
novel stimuli by associating those stimuli with stimuli already known to provoke
a given response.
This insight has been shown to hold in the case of prior heavy drug users
insofar as responses akin to those elicited by drug use (or by drug deprivation)
can be provoked by exposing former drug users to other kinds of events that
routinely accompanied their drug use (or deprivation) (cf. Childress et al., 1992).

These findings are consistent across drug types, including opiates, cocaine,
alcohol and nicotine. Events former drug users associate with drug use can include
external or environmental events like the recognition of a former drug using
accomplice, former copping areas, the sight, smell, feel, sound or taste of the drugs
themselves, or virtually anything at all the drug user could possibly regard as
having an affinity with drug use. They can also include various internal states like
fatigue, hunger or moods.
This theoretical approach has contributed a great deal to our understanding of
addiction insofar as it accounts for how, in the absence of physiological with-
drawal symptoms, certain external and internal cues can provoke craving for a
drug and thus induce relapse for a long period of time following cessation of
physiological withdrawal symptoms. This approach is also consistent with the
reports of drug users who tell us that, though they feel capable of resisting drugs
under certain circumstances, and indeed give little thought to them under those
circumstances, they feel they become powerless to resist their cravings under the
kinds of circumstances that had routinely accompanied their former drug using
activities (Robins, 1993).
Therapeutic interventions based on this theoretical approach work in two
distinct sorts of ways. Either (1) they endeavor to train subjects to associate
negative responses like nausea with drug use and/or drug using situations, or (2)
they endeavor to extinguish positive associations with drugs through repeated
exposure to drug cues in the absence of chemical reinforcements. These inter-
ventions have been widely used but where they have been tested they have shown
only modest successes (Childress et al., 1992). One important reason for this lack
of success is the failure of research subjects to generalize the training they receive
in test settings to their lives beyond the test settings. While repeated exposure to
drug scenes and drug-related practices in the absence of the drug itself may desen-
sitize a subject to drug cues in a controlled test setting, it does not seem to have
the same effect once subjects return to the world outside. As for pharmacologi-
cal behavior modification techniques like Antibuse, which do continue to exert
effects outside the clinical setting, clients generally exhibit little inclination to
stick with the regimens.
This disparity between results in clinical or test settings and the real-world
lives of heavy substance users portends some of the serious theoretical weaknesses
of the social learning approach. For example, though unconditioned and
conditioned stimuli may be relatively easy to separate into discrete variables in
test settings, it is far more difficult to do so in real-world settings. A drug user
may very well find drug use pleasurable only because the situations in which the
drug has routinely been used were also found pleasurable. Parties, music and

friends, to name only a few common cues, can be powerfully reinforcing factors
for drug use as well as cues that trigger the desire for a drugs putatively intrin-
sic pharmacological effects. If we accept this then it may be advisable, in some
cases, to regard the drug taking as the conditioned stimulus and the contextual
features of that drug taking as the unconditioned stimuli. Again we are forced to
reckon not only with the putatively basic psychoactive effects held to derive
from the chemical composition of a drug but also the culturally transmitted
meanings those drugs come to have for individual drug takers.
Another difficulty attendant on this theoretical approach is its rather rigid
distinction between operant and classical conditioning. Symbolic interactionists,
as well as phenomenologists of various other schools, have shown us that stimuli
often, and perhaps always, acquire their distinctive character as behavioral cues
due to the trajectory of practical action under which they are encountered. For
example, a cigarette in the hand of a friend may cue a response very different from
that cued by a cigarette in the hand of a chef who is making ones meal. In the
first case ones practical trajectory may entail fostering solidarity with a friend.
The character of the cigarette as a cue will then be shaped by that practical trajec-
tory. In the second case, ones practical trajectory might entail seeing to it that
s/he is served an untainted meal and the character of the cigarette as cue will be
likewise shaped accordingly. The same ostensible object (i.e. the cigarette) may
cue two very different responses. In light of this plasticity of a given stimulis
cueing potential, we may be well advised not to draw so fine a line between
operant and classical conditioning. Courses of human behavior and the cues that
constitute our behavioral environments are far more interdependent than behav-
ioral psychologists have often been prepared to acknowledge.
In fairness, it must be noted that a few versions of learning theory (cf. Akers,
1985; Bandura, 1986) are more sensitive to these difficulties than are most others.
However, though some of the leading learning theorists do seem at least partially
aware of the problems I have raised here, they continue studiously to avoid the
use of naturalistic research methods. They thereby seriously impair their ability
to investigate or appreciate the various mechanisms by which meanings attach to
drugs and drug effects in the natural settings in which drug use actually does
become meaningful to people. For this reason they do little to illuminate the role
played by meaning when addiction processes take place in real-world settings.
Symbolic Interactionist Approaches

Both neurological theories and learning theories have been found to give inade-
quate attention to the culturally transmitted meaning drugs and drug effects have

for drug users. Symbolic interactionist approaches, on the other hand, focus quite
directly on the relevance of meaning. Alfred Lindesmith (1938) was the first to
note the theoretical significance of the meaning drug users find in their drug
experiences. As Ive said, he noted that people who are given enough morphine
in hospital settings to develop a physiological tolerance rarely become addicted.
He attributed this to their ignorance of the source of their withdrawal symptoms
and hypothesized that, in addition to suffering withdrawal symptoms, the onset
of addiction requires that users cognitively appreciate their withdrawal symptoms
for what they are and seek to alleviate them by re-administering the drug
(Lindesmith, 1938: 606). Critical to his theory was the meaning drug effects have
for drug users.
Lindesmith pioneered the investigation of drug use and drug effects by quali-
tative social scientists allied with the symbolic interactionist school. Social scien-
tists since Lindesmith have drawn upon ethnographic methods of investigation
and/or the theoretical resources of symbolic interaction to describe drug cultures
(cf. Finestone, 1957; Johnson, 1980; Preble and Casey, 1969; Rosenbaum, 1981;
Rubington, 1968), the social settings of drug activity (cf. Adler, 1992; Bourgois,
1998; Sutter, 1969; Wiseman, 1970), the ritual practices attendant on drug use in
natural settings (cf. Becker, 1953; Waldorf et al., 1991; Williams, 1992), and the
self-identities of drug users (cf. Denzin, 1993; Lindesmith, 1968; Ray, 1961). These
studies are the tip of an enormous iceberg of naturalistic investigations of drug
use and drug users that have vastly enriched our understanding of the meanings
attendant on drugs and drug experiences for those involved in these worlds. Any
theory of the addiction process must draw upon the insights these studies provide
if it is to fully account for the place drugs take in the lives of those who use them.
However, only a small fraction of these studies actually speak explicitly to the
nature of addiction itself. Furthermore, those studies that actually do broach the
nature of addiction tend to render the addiction process somewhat counter-
intuitively, and/or in ways that do not jibe well with much of the available empiri-
cal evidence (Weinberg, 1997). A closer look at some exemplary studies will
demonstrate the point.
Lindesmith himself spoke predominantly to the attitudes and behaviors of
physiologically tolerant drug users and spent considerably less time addressing
the propensity of former heavy heroin users to relapse back into heroin use after
the cessation of withdrawal symptoms. However, he once listed the following set
of influences to explain the propensity of the former heavy heroin user to relapse:
. . . the changed perceptions of the addict which lead him to respond to virtually all distress as
though it were withdrawal distress to be banished by a fix; the neutralization of memories of
the miseries of addiction which are relatively remote consequences of taking a shot compared

to the invariably satisfactory immediate ones; the rationalizations of the abstainer that life
without the drug is dull, that he is better off using the drug than not, and that he might as well
use it because he is stigmatized anyway; the knowledge or beliefs acquired from direct personal
experience of the marvelous potency and versatility of the drug; and finally, the attraction
exercised by associations within the drug using subculture, which, with a few exceptions,
provides the only social setting in which full and free communication on all matters associated
with the habit is possible without risk to the ego. (Lindesmith, 1968: 1545)
This list no doubt reflects many of the issues that bear on the propensity of
many former heroin users to relapse. However, it fails to speak to two essential
questions that arise from listening to addicts speak of their problems and from
observing them in the conduct of their lives. First, it does not adequately explain
how we are to understand relapsers reports that, under certain kinds of circum-
stances, they feel they are truly overwhelmed, rather than just rationally
persuaded, by their craving to use drugs (Weinberg, 1997). And, second, it does
not account for the repeated cycle of abstinence and relapse. Why does the chronic
relapsers propensity to neutraliz[e] memories of the miseries of addiction not
wane to extinction after repeated calamities involving drug use? We should expect
to see all addicts who experience serious drug-related problems mature out
(Winick, 1962), but unfortunately we dont. What is it about some peoples drug
experiences that fosters powerful visceral cravings even after repeated association
of drug use with negative experiences and despite their stated desires to abstain?
Either each and every person who reports such experiences is dissembling or
mistaken, or our theoretical resources for understanding the cycle of abstinence
and relapse must go beyond Lindesmiths pioneering, and indisputably seminal,
theoretical work. Later symbolic interactionists have fared little better than
Lindesmith in answering these questions. Ultimately, however, they are not only
important theoretical questions but also critical policy and treatment questions
because it is precisely those who continue to report powerful craving experiences
despite serious substance-related problems who are most exquisitely in need of
therapeutic assistance.
Marsh Ray (1961) is the symbolic interactionist who has most explicitly
addressed the cycle of abstinence and relapse, and his is probably also the most
widely cited theoretical statement of how relapse can be understood from a
symbolic interactionist vantage point. Richard Stephens (1991: 578) cites Rays
theory as the primary resource in his own symbolic interactionist account of
relapse. Dan Waldorf (1970: 229) cites Rays theory as the only . . . attempt to
learn anything of the processes of relapse after a period of abstention, though he
expresses some reservations as to the theorys explanatory power. According to
Rays theory, the cycle of abstinence and relapse should be understood as a

process during which the former user consciously oscillates between a commit-
ment to his using and non-using self-concepts. Ray concludes his classic essay:
. . . socially disjunctive experiences bring about a questioning of the value of an abstainer
identity and promote reflections in which addict and non-addict identities are compared. The
abstainers realignment of his values with those of the world of addiction results in the redefi-
nition of self as an addict and has as a consequence the actions necessary to relapse. (Ray, 1961:
140)
This theory suggests relapse is a process necessarily involving conscious delib-

eration and comparisons between ones using and non-using identities. As one can
see, Rays is an extremely cognitivist, and indeed, rationalist, construal of the
relapse process. The relapser is an individual who rationally evaluates the pros
and cons of being an addict versus being an abstainer before deciding to relapse.
But does this sound like addiction? If Ray is correct, what sense is there in
thinking that addicts require any kind of therapeutic assistance whatsoever? Aside
from its somewhat ominous policy implications, this theory suffers on purely
scientific grounds. The difficulty is that it provides no place for the visceral
components of relapse the embodied and emotional compulsions a great many
people report experiencing and to which they themselves very often assign
primary responsibility for their relapses.1 Though we must by no means adopt
our informants accounts uncritically (Weinberg, 2000), we must contend better
than does Ray with the activities and accounts of those whose lives and experi-
ences constitute our only sources of data.
Norman Denzin (1993) is the only symbolic interactionist who has sought to
explicitly introduce the body and the emotions of the substance user into his
account of compulsive drug use. He is thus the only symbolic interactionist who
has tried to move beyond the disembodied cognitivism that uniformly marked
earlier symbolic interactionist contributions to our theoretical understanding of
addiction. In his theory of the alcoholic self, Denzin suggests that alcoholics
suffer from an emotionally divided self wherein the self is divided against itself
(Denzin, 1993: 362). While this appreciation of the role of emotion in the
addiction process is indisputably a significant advance over previous efforts, it
does not succeed in fully eliminating the cognitivism and rationalism tradition-
ally implicit in symbolic interactionist approaches. Cognitivism and rationalism
slip back into Denzins theory in his insistence that situations which induce the
alcoholic to drink are consciously evaluated as such on the basis of a fully
grounded interpretive system (Denzin, 1993: 67) or lay theory of alcoholism
(Denzin, 1993: 648).
Denzin accepts the traditional distinction between physiological craving
and what he calls psychological, symbolic, or phenomenological craving,

characterizing the latter as a compelling need or desire to drink or use in the

absence of physiological withdrawal symptoms (Denzin, 1993: 34). This second
variety of craving is understood as a learned emotional response rather than an
innate biological one and it is quite clear throughout his text that it is the psycho-
emotional type of craving which holds primary interest for him. However, there
is a feature of Denzins theorizing on emotion that makes his position somewhat
difficult to apply to the experience of addictive craving as it is commonly reported
by addicts themselves. Following John Deweys view that emotion as such arises
through the inhibition of a tendency to act (Denzin, 1984: 423), Denzin insists
that experiencing emotion necessarily entails that people consciously evaluate
their perceptions or behavior as emotional. He writes:
Pure behavior is not emotion, nor is the simple awareness of that behavior emotion. Behavior
becomes emotional only when it is interpreted by the person and brought into self-interactions.
The body adjusts itself to the emotional interpretations persons place upon it. (Denzin, 1983:
4034)
This nominal view of emotion properly insists that we recognize emotion as

an interpretive category which is, at one level, socially constructed. However, it
introduces a cognitive step that is not consistent with the reports of many people
who have struggled with addictive craving. According to Denzins model, craving,
to the extent it is an instance of emotional experience, must involve 1) a sense of
the feeling in terms of awareness and definition, 2) a sense of the self feeling the
feeling; 3) a revealing of the moral or feeling self through this experience (Denzin,
1983: 4034).
Denzins model proposes that addictive craving necessarily involves, in
addition to ones imperious desire to use, a reflexive interpretation of this desire
as such, a reflexive acknowledgment that one is the particular self who is experi-
encing the craving, and some type of moral evaluation of that particular self. This
model reintroduces the cognitivism that prevented Ray from grasping the spon-
taneous visceral character of craving and forces us to conceive of relapse as always
preceded by a reflexive interpretation of oneself and ones emotions. This inter-
pretive work is construed not just as a possible component, but as an analytically
necessary component of the relapse process. This theory disregards the profound
power of what George Herbert Mead called the affective side of all conscious-
ness (quoted from Denzin, 1984: 423) which, though it occurs beneath the level
of deliberate interpretation, nonetheless steers us in much of our practical life.
And like Rays theory, it ultimately requires that relapse be viewed as a deliber-
ate, quasi-rational, rejection of the recovering alcoholic identity in favor of the
resumption of drug use (Denzin, 1993: 2867). It thereby denies credence to the
reports of many who claim to experience relapse not as a decision to resume drug

use but as a steadfast commitment to a non-addict identity and lifestyle that is

painfully and persistently thwarted by powerful visceral compulsions to use.
A Praxiological Alternative
I have sketched a brief summary of our theoretical options for understanding the
nature of addiction that shows how these options force us to choose between the
Scylla of biological reductionism and the Charybdis of a disembodied cognitivist
rationalism. We have, it seems, been ill-equipped conceptually to transcend this
antinomy, always alternating between two theoretical positions both of which fail
to elucidate the actions exhibited, and experiences reported, by those apparently
struggling with addictions. Must we either ignore the meanings drugs and drug
effects have for people or else consider those meanings at the expense of
completely rationalizing addictive behavior? I dont think so. We may instead
draw upon advances in social phenomenology to suggest that meaning can be, and
indeed usually is, apprehended without any intervening necessity of rational
reflection or conscious interpretation.
Following the work of a growing number of phenomenologically informed
social scientists (cf. Bourdieu, 1990; Coulter, 1994; Coulter and Parsons, 1990;
Ostrow, 1990; Shusterman, 1991; Turner, 2000) we may understand the culturally
transmitted meanings inherent in drug use and craving as pre-reflective, non-
symbolic, and embodied rather than interpretive, symbolic and disembodied.
According to the praxiological view I would advise, we must not regard Meads
affective side of all consciousness as necessarily involving an interpretive step
between brute sensations and meaningful experience. Instead we must under-
stand that social learning occurs not only through symbolically mediated inter-
pretive work, but through embodied forms of collaborative practice as well
(Bourdieu, 1990; Mead, 1934). By learning through practice to participate in social
activities, people come to personally embody culturally transmitted meanings at
a pre-reflective, or habitual, level of being (Camic, 1985). Instead of insisting, as
symbolic interactionists traditionally have, that a process of symbolic interpre-
tation always intervenes between the environmental stimulus and the behavioral
response (Blumer, 1969: 79), we must instead recognize that social life fashions
the relationship between stimulus and response always prior to the conscious
encounter of the actor with his or her world (Dreyfus, 1991). Recognizing this
pre-empts the threat that human beings would be rendered automatons or
cultural dopes and also makes unnecessary the counter-intuitive, untenable and
unverifiable assumption that in all our affairs we unwittingly experience a brute

collection of physiological stimuli just prior to rendering those stimuli meaning-

ful through symbolically mediated interpretation.
Instead of regarding the apprehension of meaning as in every instance a super-
imposition of linguistic or cultural categories on raw feels or brute sensations,
the praxiological view suggests we regard it as a faculty of habit that is developed
through socialization into social worlds involving objects and activities of various
sorts. It is not that social objects like drugs and drug experiences have some sort
of intrinsic biological or pharmacological meaning or practical significance, nor
is it that we must deliberately interpret intrinsically meaningless arrays of sensory
stimuli. Instead, the meaningful world we inhabit is comprised of our actual
practical involvements in that world. Applied to addiction, this approach suggests
that the meaning of drugs and the emotional effects drugs have on us derive to a
significant extent from the ways in which we have come to use those drugs in the
various social contexts that make up our lives. But again, because these meanings
and emotional effects manifest non-symbolically, pre-reflectively, pre-
discursively and unwittingly, it is reasonable to regard their impact on our
behavior as, in a very literal sense, uncalculated and involuntary.
Addictive behavior is exhibited when people, or their significant others, come
to perceive that their tacit practical reliance on a drug for coping in one area of
their lives negatively impacts upon that or other areas. This perception is often
not enough to produce a cessation of drug use, though, because the urge to use
does not manifest in lived experience as a deliberate decision, let alone a holistic
costbenefit analysis, but as a viscerally felt compulsion informed by the
perceived practical demands of the moment. The addictive craving to use drugs is
thus experienced as deriving from beyond the self and decidedly not in any way
an exercise of self-will. However, the difficulties thus experienced may occur with
various degrees of intensity depending upon whether people are competent, or
are confident they can become competent, in exercising coping techniques other
than drug use, or are relatively free to avoid the settings wherein drugs had
become integral to their perceived ability to cope (Marlatt and Gordon, 1985).
Conclusion
So what is the wider relevance of these remarks for empirical social research? I
would like to conclude the article by answering this question with respect to my
own research with homeless addicts. Most social scientists are, for good reason,
critical of research that makes too much of the relationship between homeless-
ness and drug addiction (cf. Snow and Anderson, 1993). It is feared that such
research will encourage victim blaming, and that it distracts us from the much

more important social-structural causes of homelessness. I share these fears. But,

in place of polemics against naturalizing, or pathologizing, homelessness, I am
convinced it is a good deal more useful to de-naturalize addiction that is, to
enlighten people as to the deeply sociological dimensions of addiction and
recovery among homeless people.
As I mentioned earlier, behaviorist talk of secondary reinforcers now domi-
nates scientific theorizing regarding the social environmental sources of addictive
behavior. According to the behaviorists logic, arbitrary elements of the drug
users social environment may come to be cognitively associated with the experi-
ence of intoxication and thus cue cravings for drugs which, by virtue of their
invariably pleasurable biochemical effects in the brain, are understood as primary
reinforcers. This view completely misses the fact that the pleasurability of these
biochemical effects is not a foregone neurological conclusion but is itself socially,
culturally and personally variable in the extreme. This view also encourages
images of the homeless addict as innately impulsive, hedonistic, short-sighted,
undisciplined, self-centered and incapable of deferring gratification. It is natural-
ized neurological and psychological theories like these that genuinely blame
victims.
In my view, if we are to adequately understand and cope with the relationship
between addiction and homelessness, we must strive to free ourselves from these
kinds of images. In opposition to such views, I would insist that people do
literally use drugs in ways that are always personally meaningful to them. And
this meaningful use of drugs is always embedded in, and at least to some extent,
practically responsive to, socially structured contexts of action. This is particu-
larly obvious in the case of homeless drug users. Who can doubt that homeless-
ness provides myriad incentives for drug use? But in opposition to some rational
choice theorists, who would have us believe that the fact of drug use is logically
inseparable from a calculated resolution to use, we must insist that not all
meaningful, or even all sociogenic, behavior is behavior that we deliberately
choose or with which we self-identify. Even when it is recognized as drenched in
social structure, culture and meaning, there remains a depth to the human psyche
of which we as selves, subjects or egos are at best only dimly aware, and at best
only partially able to control (Chodorow, 1999). My research suggests the
extreme material and emotional hardships of homelessness quite seriously inten-
sify the tendencies we all sometimes have to find the other, the not-us and not-
me, in our own personal actions and experiences. Though we might sometimes
wish to relish such mysteries, we might sometimes also find them profoundly
disturbing and yearn for therapeutic assistance to secure for ourselves a more
intelligible and integrated social being. In this sense, the work of fostering

recovery from addiction may be seen as a simultaneously collective and personal

project of self (i.e. social being) actualization one among many types of struggle
for redemption from the jointly psychic and social spaces of otherness with which
we cannot or do not want to identify. We should not, then, simply ignore or attack
the linkage of homelessness with addiction, so much as try to formulate more just,
more therapeutic and more theoretically defensible understandings of that
linkage.
Notes
I would like to thank members of the Body Research Group at the University of Cambridge for their
comments and discussion of an earlier version of this article. Writing of the article was supported by a
grant from the Lindesmith Center of the Open Society Institute.
1. The following fieldnote excerpt from my own research with homeless drug users will serve to
illustrate what is a ubiquitous tendency in the narrative accounts sufferers give of their own drug
problems:
Ive promised myself I wouldnt use a thousand times and really meant it. And then I use. I
mean its like there are two sides of me. The rational reasonable person who knows hes gonna
die if he keeps on living the way he is and the insane one who just doesnt care. My reasonable
side of me can be as sure as it wants to be but when those drugs appear in front of me the insane
one takes over and all those reasons I had not to use are just gone. They just disappear. And I
use. Its like my mind just goes dead and my addiction takes over. I hate myself right after-
wards and Im completely confused by the fact that I just used. I didnt want to but I did. Its
all well and good to say you need to make a commitment but for some of us thats not enough.
We need something more than that and it doesnt help for people to be all smug about how we
need to make a commitment and its all that simple.
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Body & Society

On the Embodiment of Addiction

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On the Embodiment of Addiction

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theorizing, I critically compare three major contemporary approaches to the

A Brief History of Addiction Theorizing

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damaging critique is that intrinsic-personal-deficit theories are post hoc. They do

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cocaine is widely recognized as extremely addictive by clinical professionals and

The Neurological Understanding of Addiction

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investigations have indicated many common features between the effects of

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anhedonia, or a marked decrease in the capacity of one so afflicted to experience

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Approaches to Addiction from Learning Theory

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Symbolic Interactionist Approaches

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This theory suggests relapse is a process necessarily involving conscious delib-

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On the Embodiment of Addiction 13

characterizing the latter as a compelling need or desire to drink or use in the

This nominal view of emotion properly insists that we recognize emotion as

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use but as a steadfast commitment to a non-addict identity and lifestyle that is

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collection of physiological stimuli just prior to rendering those stimuli meaning-

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16 Body and Society Vol. 8 No. 4

more important social-structural causes of homelessness. I share these fears. But,

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On the Embodiment of Addiction 17

recovery from addiction may be seen as a simultaneously collective and personal

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