On the plausible assumption that the mind is instantiated in the physical structures and processes of the brain, mental changes can be realized only through physical alterations of the brain. Even if one takes into account embodied cognition and the extended mind hypothesis (Clark Reference Clark1997), the brain remains the core substrate of the mental; and any ability to control or modify the mental must rely on the capacity to physically alter the brain. This is no less true from the first-person, internal perspective than from the external, third-person point of view. However, the nature of the causal interface can vary enormously. An equivalent change in mind or behavior might be produced by a conscious act of will, an environment of conditioning reinforcers, or a therapeutic drug. Despite the similarity of result, the practical means by which the change is produced and the nature of the causal affordance on which that change relies may differ greatly. It is therefore important to get clear about the range of possible processes, as well as the ways in which multiple mechanisms might interact.
In that regard, the theory of Müller & Schumann (M&S) can be quite helpful. M&S propose that we view at least some non-addictive drug use from an instrumental perspective – that is, that we view drugs as instruments that enable the user to produce adaptive changes in mind and behavior by altering relevant underlying brain states. This perspective seems apt not only for many cases of drug use, but also for a far wider range of processes by which we control our minds and behaviors, including many cases that involve mental constructs. Ideas and patterns of thought, like drugs, can be usefully viewed as instruments by which we exercise adaptive control over our minds and behaviors. Moreover, there are probably many instances in which various instruments, including drugs and ideas, synergistically combine in mutually supporting ways.
Consider a representative example. M&S note that alcohol use can facilitate social interaction and reduce social anxiety, which can have obvious utility and perhaps even enhance sexual and reproductive success. Alcohol has the relevant effects in part through its direct and indirect actions on GABAA and dopamine receptor systems. Hence, nonabusing alcohol users may well learn to use alcohol as an instrument in social interactions; and in doing so, they are also learning to use alcohol to modulate the relevant receptor systems, even though they typically have no conscious knowledge of those systems.
One might also decrease social anxiety through mental constructs or environmental manipulations. For example, one might use relaxation techniques or positive mental imagery to reduce social anxiety. Alternatively, one could try to reshape one's responses to social settings by exposing oneself to a carefully selected sequence of social environments whose initial members were nonthreatening and provided a lot of positive reinforcement. In each case, the relevant means serves in an instrumental way as a lever by which the person can change the underlying physical bases of her emotional and behavioral responses to social interactions. As with the use of drugs, the person need have no knowledge of the underlying physical bases in the brain through which the relevant instruments produce their effects.
Moreover, one could combine the instrumental use of drugs such as alcohol with the use of other instruments of change. The overall effect might be interactive rather than merely additive. For example, one could use alcohol to help produce positively reinforcing outcomes in selected social environments and then subsequently use conditioned associations with specific features related to alcohol consumption in those contexts to enhance the future anxiety reducing effect of alcohol. The successful outcomes produced by alcohol might also provide experiences that could be used as positive imagery or even to rationally persuade oneself to be less fearful of social situations. The non-addictive consumption of alcohol might thus be used in a dynamic mutual interplay with mental and environmental instruments where each enhances the overall adaptive value of the other.
The instrumental use of psychoactive lifestyle drugs M&S describe is similar in these respects to the use of psychotherapeutic drugs, especially with regard to the possibilities for positive interactions with other means of instrumental control. Consider, for example, the utility of combining drug therapy typically involving SSRIs with cognitive behavioral therapy in the treatment of obsessive compulsive disorder (OCD). Each mode of therapy can be viewed instrumentally in M&S's sense and provides a means by which the OCD patient can gain some control over the physical brain systems that underlie her anxiety, compulsive behaviors, and lack of control over repetitive and intrusive thoughts. The two therapies involve different modes of intervention, and the causal interface that each provides is quite unlike the other. Nonetheless, the net results are similar not only at the behavioral level, but also in terms of the brain changes that underlie successful treatment (Baxter et al. Reference Baxter, Schwartz, Bergman, Szuba, Guze, Mazziotta, Alazraki, Selin, Ferng, Munford and Phelps1992). The drug-based direct modulation of serotonin activity, the conditioning effect of exposure and response prevention therapy, and the frontally mediated first-person cognitive reinterpretation of obsessive thoughts all converge on a similar set of brain changes in successfully treated OCD patients. Moreover, many patients obtain the best results from a combination of therapies, which is likely to involve interaction effects. The SSRIs, like the drugs discussed by M&S, alter the underlying base state in ways that facilitate the use of more cognitive constructs to modulate the relevant brain systems.
Hopefully, M&S's instrumental model will encourage a more positive social attitude toward non-addictive drug use. Drug use is too often stigmatized on the basis of the small percentage of users who develop harmful addictions. Moreover, even non-addictive users are typically viewed as having lost some measure of control through the supposed capture by drugs of biological reward systems. M&S's alternative view of drugs as adaptive instruments has the potential not only to explain non-addictive drug use, but also to legitimize such use as among the tools that may enhance our self-control, rather than diminishing it.
On the plausible assumption that the mind is instantiated in the physical structures and processes of the brain, mental changes can be realized only through physical alterations of the brain. Even if one takes into account embodied cognition and the extended mind hypothesis (Clark Reference Clark1997), the brain remains the core substrate of the mental; and any ability to control or modify the mental must rely on the capacity to physically alter the brain. This is no less true from the first-person, internal perspective than from the external, third-person point of view. However, the nature of the causal interface can vary enormously. An equivalent change in mind or behavior might be produced by a conscious act of will, an environment of conditioning reinforcers, or a therapeutic drug. Despite the similarity of result, the practical means by which the change is produced and the nature of the causal affordance on which that change relies may differ greatly. It is therefore important to get clear about the range of possible processes, as well as the ways in which multiple mechanisms might interact.
In that regard, the theory of Müller & Schumann (M&S) can be quite helpful. M&S propose that we view at least some non-addictive drug use from an instrumental perspective – that is, that we view drugs as instruments that enable the user to produce adaptive changes in mind and behavior by altering relevant underlying brain states. This perspective seems apt not only for many cases of drug use, but also for a far wider range of processes by which we control our minds and behaviors, including many cases that involve mental constructs. Ideas and patterns of thought, like drugs, can be usefully viewed as instruments by which we exercise adaptive control over our minds and behaviors. Moreover, there are probably many instances in which various instruments, including drugs and ideas, synergistically combine in mutually supporting ways.
Consider a representative example. M&S note that alcohol use can facilitate social interaction and reduce social anxiety, which can have obvious utility and perhaps even enhance sexual and reproductive success. Alcohol has the relevant effects in part through its direct and indirect actions on GABAA and dopamine receptor systems. Hence, nonabusing alcohol users may well learn to use alcohol as an instrument in social interactions; and in doing so, they are also learning to use alcohol to modulate the relevant receptor systems, even though they typically have no conscious knowledge of those systems.
One might also decrease social anxiety through mental constructs or environmental manipulations. For example, one might use relaxation techniques or positive mental imagery to reduce social anxiety. Alternatively, one could try to reshape one's responses to social settings by exposing oneself to a carefully selected sequence of social environments whose initial members were nonthreatening and provided a lot of positive reinforcement. In each case, the relevant means serves in an instrumental way as a lever by which the person can change the underlying physical bases of her emotional and behavioral responses to social interactions. As with the use of drugs, the person need have no knowledge of the underlying physical bases in the brain through which the relevant instruments produce their effects.
Moreover, one could combine the instrumental use of drugs such as alcohol with the use of other instruments of change. The overall effect might be interactive rather than merely additive. For example, one could use alcohol to help produce positively reinforcing outcomes in selected social environments and then subsequently use conditioned associations with specific features related to alcohol consumption in those contexts to enhance the future anxiety reducing effect of alcohol. The successful outcomes produced by alcohol might also provide experiences that could be used as positive imagery or even to rationally persuade oneself to be less fearful of social situations. The non-addictive consumption of alcohol might thus be used in a dynamic mutual interplay with mental and environmental instruments where each enhances the overall adaptive value of the other.
The instrumental use of psychoactive lifestyle drugs M&S describe is similar in these respects to the use of psychotherapeutic drugs, especially with regard to the possibilities for positive interactions with other means of instrumental control. Consider, for example, the utility of combining drug therapy typically involving SSRIs with cognitive behavioral therapy in the treatment of obsessive compulsive disorder (OCD). Each mode of therapy can be viewed instrumentally in M&S's sense and provides a means by which the OCD patient can gain some control over the physical brain systems that underlie her anxiety, compulsive behaviors, and lack of control over repetitive and intrusive thoughts. The two therapies involve different modes of intervention, and the causal interface that each provides is quite unlike the other. Nonetheless, the net results are similar not only at the behavioral level, but also in terms of the brain changes that underlie successful treatment (Baxter et al. Reference Baxter, Schwartz, Bergman, Szuba, Guze, Mazziotta, Alazraki, Selin, Ferng, Munford and Phelps1992). The drug-based direct modulation of serotonin activity, the conditioning effect of exposure and response prevention therapy, and the frontally mediated first-person cognitive reinterpretation of obsessive thoughts all converge on a similar set of brain changes in successfully treated OCD patients. Moreover, many patients obtain the best results from a combination of therapies, which is likely to involve interaction effects. The SSRIs, like the drugs discussed by M&S, alter the underlying base state in ways that facilitate the use of more cognitive constructs to modulate the relevant brain systems.
Hopefully, M&S's instrumental model will encourage a more positive social attitude toward non-addictive drug use. Drug use is too often stigmatized on the basis of the small percentage of users who develop harmful addictions. Moreover, even non-addictive users are typically viewed as having lost some measure of control through the supposed capture by drugs of biological reward systems. M&S's alternative view of drugs as adaptive instruments has the potential not only to explain non-addictive drug use, but also to legitimize such use as among the tools that may enhance our self-control, rather than diminishing it.