Love addiction: reply to Jenkins and Levy

Please note: These are the uncorrected proofs of the article. Do not quote from this version. For the formal, published version, please visit the journal website: http:// muse.jhu.edu/journal/164 Love Addiction Reply to Jenkins and Levy Keywords: Love, addiction, dopamine, behavior W e thank Carrie Jenkins and Neil Levy for their thoughtful comments on our article about love and addiction. Although we do not have room for a comprehensive reply, we will touch on a few main issues. Jenkins points out, correctly in our view, that the word ‘addiction’ can trigger “connotations of reduced autonomy.” It may therefore be used, she argues, to (illegitimately) “excuse” violent or otherwise harmful behaviors—disproportionately carried out by men—within the context of romantic relationships. Debates about love addiction, therefore, “are best addressed with an eye to the more general issue of how we as a society apportion responsibility for things like date rape and intimate partner violence” (Jenkins, 2017, p. XX<EQ>). Jenkins is right to call attention to this fraught backdrop (for further discussion, see Earp, Sandberg, & Savulescu, 2015; Earp & Savulescu, in press); and we agree that the word ‘addiction’ must be applied carefully. The last thing we would want to do is to create an ‘excuse’ for violent behavior, if that meant taking such behavior less seriously, whether from a socioethical or legal perspective. Therefore, we should be extremely skeptical about easy appeals to addiction, especially by way of © 2017 by Johns Hopkins University Press Brian D. Earp, Bennett Foddy, Olga A. Wudarczyk, & Julian Savulescu self-diagnosis, insofar as the goal is to downplay one’s culpability for causing harm. This argument just goes to show how important it will be to solve the underlying ‘mystery’ of autonomy and responsibility as it relates to genuine love addiction (as we highlighted in our paper). In solving this mystery, we must of course be on the lookout for mere excuse making (see Bargh & Earp, 2009; Earp, 2011). However, based on the evidence we reviewed, we should also be open to the possibility that some forms of romantic attachment really could entail a loss of control in certain circumstances. This loss of control, especially if it became associated with violent behavior, might reasonably influence our judgments about ultimate moral responsibility (depending on a range of factors), but it would by no means necessarily justify a more ‘lenient’ response. In fact, if it could be shown that a person ‘really could not help’ his or her out-of-control, harmful behavior on account of a bona fide romantic addiction, then forcible intervention of some kind could possibly be justified, up to and including involuntary confinement. At the end of the day, understanding the true etiology of harmful behavior, including cases in which diminished autonomy is indeed a contributing factor, will be necessary for designing more effective strategies for preventing it (see Earp, 2010). Jenkins also worries about our use of the word ‘love.’ She cites the work of another author, bell Please note: These are the uncorrected proofs of the article. Do not quote from this version. For the formal, published version, please visit the journal website: http:// muse.jhu.edu/journal/164 102 ■ PPP / Vol. 24, No. 1 / March 2017 hooks [sic], who argues that ‘genuine’ love is incompatible with the sorts of toxic relationship characteristics that we used to illustrate romantic addiction. On a practical level, she writes that “using the word ‘love’—with all its attendant positive connotations and associations—to describe [harmful] relationships can be a dangerously rhetorically effective way of concealing how bad they really are” (Jenkins, 2017, p. XX<EQ>). We agree that such rhetoric can be problematic. Indeed, given this type of concern, we are sympathetic to the normative argument that the word ‘love’ should only be used to describe relationships, feelings, attitudes, forms of romantic attachment—and so on—that are conducive to the flourishing of everyone involved. In other words (according to this argument), if it is not positive, happy, or healthy, it isn’t ‘really’ love. We have no particular disagreement with those who use ‘love’ in this restricted way, nor would we want to go out of our way to defend an alternative definition. We would simply note that, throughout history and in much of Western literature, romantic love has been variously described as a sickness, a form of insanity, and even a threat to the social order—calling attention to the power of amorous passion to interfere with our higher-level desires, goals, commitments, and obligations (see Earp, Wudarczyk, Sandberg, & Savulescu, 2013). This use of the term, which has clearly negative connotations, remains common enough that we felt it was appropriate given the aims of our essay. Turning now to Levy. His commentary focuses on the term ‘addiction,’ which he suggests we have ‘hijacked’ from the literature on drug addiction—much as so-called drugs of abuse are said to ‘hijack’ the mesolimbic dopamine system—and misapplied it to the case of love. Now, Levy seems to acknowledge the psychiatric consensus (given in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders [American Psychiatric Association, 2013]) that gambling can lead to a genuine state of addiction. Yet gambling clearly does not dysregulate the mesolimbic dopamine system in the way that some addictive drugs do, by direct manipulation of the dopamine receptors or stores. The fact that gambling is so clearly addictive poses a problem, we suggest, for ‘hijacking’ accounts of addiction. Levy sketches a solution to this problem in his reply: gambling maintains an ability to provoke the dopaminergic learning signal by providing unexpected rewards, so that every gambling win must be processed as a signal “that the world is better than expected” (2017, p. XX<EQ>). Because the gambler can never reliably predict that her gambling behavior will result in a reward, her brain will never downregulate the dopamine signal when she wins. As a result, every win will continue to reinforce the gambling behavior—unlike, we might imagine, the food reward that the monkeys in Schultz’s experiment received (Schultz, Dayan, & Montague, 1997). On its face this seems like a neat solution to the problem that gambling addictions pose for the hijacking view, but it does not quite work. First, it is not clear that the mechanism of problem gambling depends on the intermittent reward schedule, even though randomness is an archetypal property of games used for gambling. Many of the forms of gambling that frequently lead to addiction (e.g., lotteries) pay out so seldom that it cannot possibly be the intermittent monetary payout that provides the neural reward. Even for gambling with a classically intermittent payout schedule (e.g., gambling machines), neuroimaging studies suggest that addicted gamblers stop responding to wins as reward states, and begin to show a reward signal upon seeing the simulated spinning of the machine’s wheels—a reward that is utterly reliable (Shao, Wakeley, Behrens, & Rogers, 2013). But second, even if Levy’s explanation of gambling addiction were correct, it does not seem as though this would weigh against the proposed conception of love as an addiction. If gambling ‘hijacks’ the reward system by providing unpredictable rewards, that would mean that any unpredictable reward would have the power to ‘hijack’ the reward learning systems. This, in turn, would suggest that the category of ‘hijacking rewards’ is much larger than only drugs and gambling, because behaviors with unpredictable rewards are extremely common. Indeed, the rewards associated with romantic love and sex are particularly unreliable, given that they depend so greatly on the responses of another human being; in fact, some of the most harmful outcomes associated Please note: These are the uncorrected proofs of the article. Do not quote from this version. For the formal, published version, please visit the journal website: http:// muse.jhu.edu/journal/164 Earp et al / Love Addiction ■ with romantic love are known to be reinforced by intermittent or unreliable expressions of affection (Meloy, 1996; Miller, Lund & Weatherly, 2012). In short, if any unpredictably rewarding behavior can ‘hijack’ the reward learning system, including behaviors that have existed throughout most of our evolutionary history, then even Levy’s preferred account of addiction—the ‘hijacking’ account—cannot rule out the love-related phenomena we discuss in our paper. References American Psychiatric Association (APA). (2013). Diagnostic and Statistical Manual of Mental Disorders. Arlington, VA: Author. Bargh, J. A., & Earp, B. D. (2009). The will is caused, not ‘free.’ Dialogue: Newsletter of the Society for Personality and Social Psychology, 24, 13–15. Earp, B. D. (2010). Automaticity in the classroom: Unconscious mental processes and the racial achievement gap. Journal of Multiculturalism in Education, 6, 1–22. Earp, B. D. (2011). Do I have more free will than you do? An unexpected asymmetry in intuitions about personal freedom. New School Psychology Bulletin, 9, 34–40. Earp, B. D., Sandberg, A., & Savulescu, J. (2015). 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