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William James (1842-1910) was a physician/philosopher/psychologist whose book, Varieties of Religious Experience (1902) had a profound impact on the founding of Alcoholics Anonymous. In 1934, Bill Wilson was at the Charles B. Towns hospital trying to dry out yet again. He said of himself that he was hopeless and in utter despair. He cried out, “If there is a God, let Him show Himself! I am ready to do anything, anything!” Suddenly the room was filled with a white light and he felt a wind of spirit blowing. At that point he realized he was a free man.
Very soon after this experience, Bill W. thought perhaps he was losing his mind. A friend, however, thought differently and gave Wilson a copy of Varieties as a way to understand this remarkable conversion experience. James was most concerned in Varieties with people for whom religion or spirituality exists “not as a dull habit but as an acute fever.” Bill W seemed to have caught that fever.
In Varieties of Religious Experience, Bill Wilson found a treasure trove of first person narratives that resonated with his own experiences as a hopeless and incurable alcoholic. Several of the conversion experiences that James highlights and returns to throughout Varieties involve reformed drunkards. These experiences were all respectfully and compassionately treated by James, which is not surprising for several reasons. Perhaps most relevant was that James had intimate knowledge of the ravages of drunkenness or inebriety, to use the language of the time. His own brother, Robertson (Bob) was a drunkard who had several stints in asylums for the inebriate and spent his last days living with his William and William’s wife Alice.
First person narratives are the primary source of evidence for spiritual matters and conversions that James marshals. James lets them speak for themselves and by so doing, accords these people and their stories a great deal of epistemic (knowledge-based) authority. In other words, there is no third party playing the role of expert on these individuals’ experiences and the understanding and meaning they were able to make of them. The inebriates--people who are often judged to be among the most unreliable or morally suspect--are taken by James to be reliable witnesses to and interpreters of their own experiences. These experiences are side by side with experiences of saints, literary giants and intellectuals such as Tolstoy.
William James later revealed he included his own experience of a deep pathological melancholy in Varieties. Thus, it is important to see this approach of James as democratizing epistemic authority. Or to use an expression from James in “The Will to Believe,” when we respect each other’s mental freedoms, which includes the ability to tell one’s own story, we can create an “Intellectual republic.” This is what James creates in Varieties and it is something that all people involved with addiction treatment and research should strive to create.
It is fair to say that as a medical doctor, James would have respected the potential contributions that sciences can make to the treatment of addiction. It is just as accurate to say that James had an equal or greater concern about the expansion of science into all realms of human living. More specifically, James worried that materialist (biological and chemical) explanations along with their reductionist tendencies tend to bring along a brand of determinism that would call free will into doubt and fly in the face of human freedom. These warnings seem appropriate to revisit now when we start to read more about some people being hardwired or predisposed to addiction.
Addiction studies is presently undergoing a seismic shift, with neuroscience beginning to overtake the field and trump other forms of knowledge. The view is that our brains—our pleasure circuitry—is the organ working in overdrive. Sometimes it is claimed that our brains have been hijacked. The language of addiction diagnosis and treatment is changing to reflect the advancement of the view that addiction is a “brain disease.”
What neuroscience is exploring and in many cases, showing, is all incredibly important. No doubt. The brain’s role in addiction is critical, and there may be well pharmaceutical treatment interventions that will be vital in the literal sense. Neuroscientists ought to have a good deal of epistemic authority. But not all.
Psychiatrists, psychologists, and chemical dependency counselors are starting to be squeezed out of explanations and treatments for addiction. Perhaps even more marginalized are the voices of addicts telling our stories. This is worrisome.
Will addicts begin to once again occupy a disadvantaged position whereby we will be accorded little to no epistemic authority on our own experiences because we will be seen as constitutionally unreliable?
Alcoholics Anonymous and other self- and other-help groups have been successful in ways that puzzle both neuroscientists and social scientists. Fifty years ago, sociologist Howard Becker studied long term marijuana use and argued that using is a whole set of social activities.[1] Becoming a frequent or serious user of drugs is a social process and not just an individual condition. Becker offered that new users have to pass through three steps in order to become seasoned users: learn the technique, learn to perceive the effects, and learn to enjoy the effects. One needs to come to experience the taste as pleasant and to reframe what may seem to be unpleasant effects into highly pleasant and desirable effects. The upshot is that even those who might have a genetic predisposition to addiction may never develop it if they avoid the social processes of alcohol and drug enculturation.
This brings me back to William James. When addicts tell our stories, we are telling how we became addicted and what it was like. Were our brains having dopamine or some other neurotransmitter bonanzas? In many cases, yes. But these “bonanzas” are experienced and understood in different ways. Knowing dopamine has been released may not get at the experience of suddenly feeling like everything is okay in the world or the relief that comes when pain slips away. We not only have knowledge of our experiences; we are experts on them.
The most complete understandings and therefore best treatments of addiction will only happen in the sort of intellectual republic described by James. This means including and respecting the voices and perspectives of those who are addicted along with those who have worked effectively, compassionately, and collaboratively with us for decades.
[1] Howard Becker, Outsiders: Studies in the Sociology of Deviance (New York: Basic Books, 1963).
