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Addiction and subjectivity : concepts of personhood and illness in 12 step fellowships

This thesis is an investigation into ways of seeing 12 Step fellowships. The
latter provide a popular but controversial means of recovery from various
addictive behaviours. The conceptual basis of 12 Step fellowships is the idea
that addictions are an illness or disease, and this idea has become the focus
of the negative critiques of 12 Step fellowships. Concepts of illness and
disease are closely related to concepts of personhood. What 12 Step
discourses construct as 'illness' can also be understood as a condition
characterised by failure of human capacities for agency, choice, and
responsibility. How we understand 12 Step discourses of addiction, illness,
and recovery will depend greatly upon the concepts of personhood, illness,
and knowledge that inform our view.
In order to investigate the concepts that make diverging views of 12 Step
fellowships possible, this study develops post-Enlightenment concepts of
personhood, illness and knowledge. I use these concepts as a lens with which
to examine the negative critiques, and to provide a more positive reading of
12 Step fellowships and illness concepts. In doing so, this thesis aims to
show, first, that a positive view that can articulate the value of 12 Step
fellowships to 12 Step members is possible, and second, that 12 Step
fellowship discourses are philosophically interesting and challenge modern
western notions of the self and its capacities.
The thesis has six chapters. Chapter One presents an overview of the study,
and introduces the basic concepts and practices of 12 Step fellowships.
Chapter Two presents an epistemology called perspectivism which provides
my research methodology as well as a means of analysing the
epistemological assumptions at work in the negative critiques of 12 Step
discourses.
In order to understand how the capacities of the self may fail, and how such
failures might be remedied, Chapter Three presents a post-Enlightenment
theorisation of personhood as constituted, embodied, and socially embedded
subjectivity. This theorisation enables us to examine how embodied selves
may be constituted with diminished capacities for agency, responsibility,
and choice, and permits the construction of an account of addiction that
explains why addictive disorders are a significant social problem in
contemporary western societies. Finally, this theorisation enables us to
investigate the concepts of personhood that inform the negative critiques.
Chapter Four investigates how concepts of illness inform the negative
critiques, and shows that it is possible to understand terms such as 'illness'
and 'disease' in a non-medical sense. Arguably, such understandings are
better able to illuminate the connection between the notion of illness and
recovery practices in 12 Step discourses of addiction.
Chapter Five uses the conceptual framework provided by Chapters Two,
Three, and Four to present a positive view of 12 Step fellowships and
discourses. The three key features of this view are, first, that 12 Step
fellowship discourses describe addictions as an illness of the self; second,
they provide a phenomenology of the sick self; and third, 12 Step recovery
discourses and practices are consistent with the notion that the constituted
self is limited, and can be reconstituted or changed through practice of the
12 Step recovery program. Together, these three key features show us that
12 Step fellowships provide a valuable social resource for people with limited
capacities for self-regulation to help themselves and each other.
Chapter Six considers the implications of this more positive view of 12 Step
fellowships in terms of the primary and secondary aims of this thesis.

Identiferoai:union.ndltd.org:ADTP/218943
Date January 1997
CreatorsFraser, Elizabeth, n/a
PublisherUniversity of Canberra. Education
Source SetsAustraliasian Digital Theses Program
LanguageEnglish
Detected LanguageEnglish
Rights), Copyright Elizabeth Fraser

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