A recent New York Times article presents an excellent summary of recent trends in addiction research. (Disclosure: my research is partially funded through the National Institutes on Drug Abuse). The article traces how addiction has gone from being perceived as a failure of willpower to an organic disease. According to the article, the turning point came when brain scans showed real physical brain changes associated with addiction.
It's fascinating to me how powerful brain scans are in helping people see that the mind is the brain, and in validating psychological observations. Even though my own research involves collecting brain scans, it's surprising how amazed people can be when brain scans confirm something that we already knew. There's just something about the beauty of brain images that makes us credulous - and something about the ephemeral tools of psychology-without-brains that makes us skeptical.
I had a colleague who was approached by a well-known large candy company. The company offered him a large amount of research funding to see how peoples' brains would respond to various chocolates. They hoped that by using brain scans they could figure out which chocolates people really liked, and then speed up their research and development process.
My colleague said no - he was too busy. But more importantly, he told them of a much more powerful technique for determining which chocolates their customers might like: a standard 7-point scale. The candy company had assumed that brain data had to be more accurate than plain old pencil and paper preference ratings.
Sometimes brain scans can tell us things that people are hiding from us, and sometimes they can tell us things that they don't even know themselves. (For example, how their visual system processes complex visual patterns). But when you ask someone to tell you how much they like a chocolate bar, it turns out they give you a pretty solid answer.
We all have a tendency to succumb to the fallacy that philosophers call Neurorealism - the belief that because something is in the brain it's more real - and its inverse, doubt that something is real because you can't see it. There's even reseach showing that we more readily accept psychological claims if they are accompanied by brain scans - even if those brain scans are irrelevant.
This fallacy is something that philosophers worry about but it's actually harmful. Addiction is an organic disease. Willpower can help, but in many cases, it's not enough. Even worse, by ignoring the biological side of addiction, and blaming willpower, addicts and their friends and family can blame themselves. Then when they relapse, they fall into despair, and make the problem worse.
Addiction is a brain-mind disease. It's just as wrong to think of it as a purely organic disorder and ignore the mind. Willpower is actually just as real as dopamine, and willpower can help with addiction. But the truth is, addiction damages mind and brain, and the best treatments respect for both sides of the problem.