This intriguing news [item](http://www.nytimes.com/2012/05/12/us/dsm-revisions-may-sharply-increase-addiction-diagnoses.html?_r=1) appeared today in the NYTimes.
> In what could prove to be one of their most far-reaching decisions, psychiatrists and other specialists who are rewriting the manual that serves as the nation’s arbiter of mental illness have agreed to revise the definition of addiction, which could result in millions more people being diagnosed as addicts and pose huge consequences for health insurers and taxpayers.
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> The revision to the manual, known as the Diagnostic and Statistical Manual of Mental Disorders, or D.S.M., would expand the list of recognized symptoms for drug and alcohol addiction, while also reducing the number of symptoms required for a diagnosis, according to proposed changes posted on the Web site of the American Psychiatric Association, which produces the book.
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> In addition, the manual for the first time would include gambling as an addiction, and it might introduce a catchall category — “behavioral addiction — not otherwise specified” — that some public health experts warn would be too readily used by doctors, despite a dearth of research, to diagnose addictions to shopping, sex, using the Internet or playing video games.
I have been arguing for a long time that consumption patterns in the US show signs of addiction. So do uses of technology beyond playing games on iPhones and iPads. The mindless use of technological artifacts to solve “problems” may also be a form of addiction. The “problem,” some incomplete concern, remains while the superficial symptoms may be temporarily mitigated or disappeared. Habitual, that is mindless or unreflected, actions, are fundamental to living. We could not get through a day without them. Cognitive research is finding that, in contradistinction to older models that trace action to some rational decision-making process in the body, most of what we do is habitual in nature, triggered by cues arriving through our senses.
Since, as the Times stories continues, the DSM takes on an authoritative role in deciding what ailments can qualify for medical insurance or be considered in adjudicatory proceedings, the line between addiction and habit needs to be very carefully delineated. Addiction can be defined as habitual use of something that may solve one problem temporarily, but also produces a negative or pathological unintended consequence. Addiction to drugs tears down the body eventually and leads to antisocial behavior.
Shopping, the transaction that precedes consumption, is an inherent part of the basic life processes in this modern economy where we do not create everything directly out of natural sources. We have been shopping in one form or another since we left the cave. So shopping is a basic habit for life. The important question for both therapists and people like me who are concerned about sustainability is when and why does shopping turn addictive. It’s addictive when there is no completion involved; when it becomes the end, rather than the means to serve some domain of care. Bush’s admonition after 9/11 to go shopping was an invitation to addiction, shopping without any mindful end in sight.
The harm created by addictive shopping is the failure to address what is missing from the shopper’s life; what unfinished acts of caring linger. I use unfinished in the sense of non-routine gaps between what the actor is doing and the conditions that would constitute completion. We have many areas of care that require continuous attention, but since we cannot do more than a few things at a time, there will always be such incomplete domains. Addictive shopping ignores impacts on the Earth (absence of care for it), and uses resources better spent to address other domains. If you think that this talk about shopping addiction is bunk, go the web and search for it.
The use of social media is another activity that can easily slip from a useful habit to an addiction. It has the positive function of connecting the user to the world of events and people. But when its use turns people into things, when friends become an abstract concept defined merely by someone’s name on the wall, its use takes on an addictive tone. The connections it produces are temporary and fritter away real relationships, as the meaning of friend hardens into a lifeless object.
Making these kinds of uses of technology and and mindless shopping qualify to be called addictions is a timely recognition of a deep cultural problem and one that is fundamental to the unsustainable state of today’s world. Unconstrained and mindless shopping places a load on the world it cannot take any more. The transformation of people to means, a risk that any technology carries, breaks down human relationships central to the health of the whole person.
I wonder, however, how effective it will be for therapists to add shopping or Facebook addiction to their list of services treated. Addiction is not embodied solely in the addict. It always (perhaps with a few exceptions) occurs in some context surrounding the addict. The family or other contextual contents are a part of whatever is supporting the habit. It is possible to gather in all the parties in cases of alcoholism and other drug uses in attempting to change the systemic context. The 12-step method relies on placing the addict in a supportive community.
But where is that community for shoppers? The culture itself is shouting out messages to buy this or that. No therapist will be separate the addict from the ubiquitous barrage of messages to buy something. The same is true for addiction to devices and the “games” they offer. The harms caused by addictive use of drugs and other substance that harm the body are reflected in societal norms, giving care-givers a standard from which to operate.
It is completely different with the “new” addictions that may become recognized in the DSM. There is no associated societal norm that recognizes the harms. It is just the opposite. There is no safe haven for the addict to retreat to. I am reminded of what R. D. Laing called insanity: “Insanity: a perfectly rational adjustment to the insane world.” Simply replace “insanity” with “shopping addiction” and you will immediately see the dilemma we have placed ourselves smack dab in the middle of. We can either ignore the insanity of the world and continue to stigmatize those who are most perceptive about it, or change the world and allow both it and its inhabitants to flourish.