The images theory of addiction

Abstract

In everyday language, addiction usually refers to a strong desire that drives people to continue habitual behaviour despite acknowledged harm and their own will to quit. Many theorists and practitioners have long rejected the concept because of its tendency to individualize problem behavior, to focus on treatment rather than prevention, and to limit harmful consequences unduly to a selected group of users. There is no commonly accepted etiology of, or evidence-based treatment for, the condition, and diagnostic definitions are based on syndromes only. This article argues that the objections are not valid if we understand addiction as a generic concept, defined in terms of characteristics shared by several specific types, of which some are called prototypes. Addictions involve neurological adaptations but are not caused by them. They always emerge from culturally regulated behaviours, they are processes rather than on-off conditions, and involve types and pathways that depend on the social conditions in which they evolve. Addicted and normal uses are closely related and governed by images that define the functions, norms, meanings and use-values of the behavior. These will be transformed as addictions develop. The Images Theory of Addiction opens the way to understanding cultural variations in the addictive process, as well as to identify particularly risky images of potentially addictive behaviors. The theory is illustrated with examples from recent comparative studies.

Perspectives of alcohol treatment providers and users on alcohol addiction and its facilitating factors in Uganda and Belgium

“…According to Rantala and Sulkunen (2012), addictive behaviours develop from culturally defined and regulated pleasures. Cultural norms and functions determine acceptability of alcohol and range from total abstinence over ritual consumption to use for personal pleasure and conviviality (Sulkunen, 2015). According to Rukundo, Kibanja, & Steffens (2017) alcohol industry creates a 'non-addictive and relatively harmless alcohol impression'.…”

“…Perspectives on addiction are culturally dependent and vary by time and space (Egerer, 2013). Hence, an unequivocal definition of addiction is missing (Sulkunen, 2015). Although the use of the term addiction is criticised for individualising problem behaviour and putting treatment before prevention (Sulkunen & Warsell, 2012), its importance in explaining motivation, relapse cues, and behavioural and psychological aspects of dependence cannot be ignored (Sulkunen, 2015).…”

Addiction: A highly successful, essentially contested concept

“…As Sulkunen (2015) points out, research, but also practice, needs the concept of addiction in order to structure knowledge and compare between different instances of addictive behavior. The patients need the concept when they want to understand why they act in a certain way.…”

Comment on Rehm and Room

“…To advance in this direction, however, reducing culture to norms -what is acceptable and what is not -is inadequate. Functions, usevalues and meanings are partly independent dimensions of the behavioural patterns and their consequences, not only theoretical traditions of interpreting them (Sulkunen, 2015).…”