Denial in Addiction

Abstract

I argue that denial plays a central but insufficiently recognized role in addiction. The puzzle inherent in addiction is why drug use persists despite negative consequences. The orthodox conception of addiction resolves this puzzle by appeal to compulsion; but there is increasing evidence that addicts are not compelled to use but retain choice and control over their consumption in many circumstances. Denial offers an alternative explanation: there is no puzzle as to why drug use persists despite negative consequences if these consequences are not straightforwardly known. I describe the nature of the causal knowledge that one's drug use is causing negative consequences; map the conceptual landscape of denial and explain how it can block such knowledge; and explore some of the processes and mechanisms that have been studied by philosophy and the cognitive sciences and which may underpin denial in addiction, including well‐established information‐processing biases, motivational influences on belief formation and self‐deception, and cognitive deficits with respect to insight and self‐awareness. I conclude by suggesting that addiction is as much a disorder of cognition as a disorder of conation.

Pornography Consumption and Satisfaction: A Meta-Analysis

“…People who consume pornography more frequently and for longer durations are especially likely to perceive such positive impacts (Hald & Malamuth, 2008;Mulya & Hald, 2014). It is common for people to rationalize and justify, and to perceive themselves as personally less susceptible to, any negative impacts of behaviors that provide them with immediate and powerful rewards (Chapin, 2001;Dillard, McCaul, & Klein, 2006;Jamieson, Mushquash, & Mazmanian, 2003;Pickard, 2016). However, the authors of these studies caution that these self-perceived effects may also be due to rationalization, justification, and biased optimism.…”

“…However, the authors of these studies caution that these self-perceived effects may also be due to rationalization, justification, and biased optimism. It is common for people to rationalize and justify, and to perceive themselves as personally less susceptible to, any negative impacts of behaviors that provide them with immediate and powerful rewards (Chapin, 2001;Dillard, McCaul, & Klein, 2006;Jamieson, Mushquash, & Mazmanian, 2003;Pickard, 2016). It is also common for people to believe that they are personally unaffected by any pernicious effects that others may experience from using media with antisocial elements (Perloff, 2009;Sun, Pan, & Shen, 2008).…”

Balancing costs and benefits: a clinical perspective does not support a harm minimisation approach for self-injury outside of community settings

“…Quite generally, alcohol and some drug use in moderation is widely considered compatible with a life of flourishing; relatedly, those people who struggle with drug and alcohol problems do not typically use substances with the deliberate aim of causing self-damage. They may, of course, appreciate the negative consequences of use and consume nonetheless—although given the prominence of denial in many cases of drug and alcohol misuse, even this cannot simply be assumed 12. But the key point for our purposes, which makes drug and alcohol harm minimisation not analogous to self-injury harm minimisation, is that most problematic substance use is not done with the express purpose of causing self-damage, but for other reasons.…”

Addiction as an indicator of vulnerability: The case of indoor tanning

“…The denial of the negative consequences of an addictive behavior is an important characteristic of addiction (O'Guinn & Faber, ). Pickard () viewed denial of harm by addicted individuals as a motivated defense mechanism. As such, Hypothesis 6 predicts that addicted tanners will underestimate the physical risks associated with tanning for everyone and will perceive a lower personal probability of danger for themselves than they do for the general population of tanners.H6 Addicted indoor tanners rate their own personal probability of cancer and other noncancer indoor tanning injury risks lower than do nonaddicted indoor tanners.…”