Normal Person Plus

Why is it that theories and countertheories about the generating mechanisms of addiction, neurodivergence, and Madness get so much discussion?

Apr 23, 2023

“Generating mechanisms” of addiction

A major focus of this blog is addict interiority. What’s it like to be us, and how can we convey those experiences to others? In this post I’m flipping the question. I’m going to use a tool familiar to disability philosophy: trying to think myself into the abled epistemic standpoint. This procedure is a fundamentally projective one. I ask: what is it like to be a nonaddict, observing the addicts around oneself?

Of course, I can’t really know. There was never a time when it made sense to conceive of myself as a nonaddict. When I wasn’t an addict, I was just somebody who had not yet been evaluated by the addict/nonaddict shibboleth. I wasn’t a nonaddict who became an addict: I didn’t get “hooked” by a substance I had a preexistent non-pathologized relationship with. My first real introduction to the concept of addiction—the apparatus by which society partitions people into normalized and pathologized subgroups—occurred when it became obvious that I fell into the pathologized category. Hence much of my investigation of the nonaddict mind is a sort of double mental modeling: imagining them imagining me.

People direct much time and energy to coming up with theories explaining the “generating mechanism” of addiction: what it is about certain people that makes them become (a word I’m generally hesitant to use) addicts. I’ll write elsewhere about the “self-medication hypothesis of substance use disorder,” on which addicts’ atypical relationships to our substances and processes of choice is a result of our desire to change our subjectivity from an undesirable to a desirable one. There’s also the “weakness-of-will” view and the “brain-hijacking” theory. And so on.

Why is it that people want to “explain” addiction in this way? Why is it, more generally, that we want to explain certain identities—disability, queerness, Madness—by appeal to biological or social generating mechanisms unifying the relevant group, when we wouldn’t do the same for identities like “extreme sports person” or “North American”? In this post, I set out to answer that question (and criticize that answer). To outsiders, generating-mechanism theories are intuitively explanatory of a strangeness that is otherwise very hard to explain. So first, I want to characterize what it is about addiction that seems “hard to explain.” I think there is a particular feature that strikes nonaddicts as the fundamental problem of addiction, the thing that makes it cry out for explanation. The generating-mechanism theories apparently satisfy that cry.

My claim is that what rings salient to nonaddicts is that we are at once like them in some ways and unlike them in others. That intuitively contradictory fact is a scratch that needs to be itched. I describe how this gets resolved through the “Normal Person Plus” theory, which is a received conceptual structure relevant to general disability theory. The Normal Person Plus theory extends, I think, in a way that provides understanding of a systemic way in which disabled people are perceived and in which these perceptions function to precipitate theory production—speculation about disabled subjectivity, written by and for nondisabled people.

Weirdness is Weirder in Isolation

Addiction has got to be bizarre to observe from the outside. Watching people compulsively consume a drug makes it very difficult, I take it, for nonaddicts to understand what could possibly be going on in their heads. I’m hedging with language here because of course it seems normal to me. And it always has. Almost as soon as I knew what alcohol was, I knew it must be the case that I perceived it differently than most people did; otherwise their actions made no sense. This isn’t to say that I was “born this way” (I think that’s untrue), just that as far back as I can remember, I had access to these sensibilities. Between my interior experience and my ability to extrapolate, there was never a time when normatively pathological relationships to specific substances struck me as odd. The autistic literature discusses the “double empathy problem” between autistic and allistic people. I think I’m describing something similar here.

The “just say no” information I was given in childhood was mostly about cigarettes. Like everyone else, I was forced to watch long videos about the consequences of smoking. Yet I never crystallized the sensibility that smokers were behaviorally anomalous in the way nonaddicts generally take addicts to be. Smoking is a very idiosyncratic addiction, for a bunch of reasons that I’ll describe elsewhere. The major difference between it and other addictions is this: The public perception of nicotine addiction is more that smokers are gross than that they are weird. Calling smokers gross is, of course, bad and relevant to oppression, but it’s a very different sensibility than the one undergirding public perception of alcohol and drug addicts. The “weird” thing doesn’t come up because there is an unquestioned received view about the generating mechanism of nicotine addiction: chemical dependence. The apparent properties of cigarettes, not those of smokers, explain why smokers behave as they do. We are told that people smoke because nicotine itself is addictive, in a non-person-indexed way.

When it became obvious I was an alcoholic, other people did not view me the way I remember being instructed to view smokers: “Oh, wow, this could happen to anyone, better never accept a cigarette lest I get hooked.” The drinkers around me could not demarcate a point of departure between this world and a counterfactual one in which they blamelessly took a first drink and subsequently, deterministically, ended up like me. From watching them watch me, I got the sense they thought my relationship to alcohol was fundamentally unlike theirs could ever be. It was an uncrossable chasm. I think this generalizes: Addicts’ behavior appears strange to nonaddicts. They have no reference point for making sense of what parses as an obsessive, seemingly self-independent desire to consume a particular substance. (And no, I wouldn’t describe my or others’ experience of being addicts as “obsessive, self-independent desire to consume a particular substance.” But I think it’s unambiguous that that is what nonaddicts think it is.)

But the strangeness of active use isn’t enough—it’s not why nonaddicts find the phenomenon of addiction so interesting. Plenty of people all the time do things that strike us as bizarre, and we don’t think much of it. Sometimes their behavior seems bizarre because it is morally unconscionable. (Mass shooters. The Westboro Baptist Church.) Some are value-positive: we’re awed by them even as we appreciate the unimaginability of behaving as they do. (The Geoguessr guy.) But others are value-neutral and really just strange. (Monks. Doomsday preppers. People who are monomaniacally focused on breaking very specific Guinness world records.) We don’t direct much energy to thinking about why those people behave as they do. We can easily avail of an explanation: in at least one way, they’re just very different from us, internally. They have motivations, beliefs, relationships to the world that we can’t and don’t understand. Sometimes those relationships are bad—they have fundamentally incorrect and morally wrong interpretations of the universe. Sometimes they’re good: they have devoted their time to the cultivation of beautiful, fascinating skills. And sometimes they’re just weird. Regardless of our opinions about the desirability of these interiorities, the point remains: in some relevant respect, they’re nothing like ours.

In the case of addiction, that explanation doesn’t work. Aside from our one super bizarre characteristic, addicts appear to be very much like anyone else. That—not the bizarreness of the aforementioned characteristic—is what makes addiction so dramatic and interesting for nonaddicts to observe. The observed “regularity-cum-irregularity”1 in addiction plays naturally into the idea of struggling against a demon on your shoulder. When the demon’s asleep, you can go to the supermarket just like the neighbor, but when it wakes up, you start behaving strangely.

This is different from the contrast cases above. And it isn’t just that addicts, unlike the people above, behave atypically along one axis but not others. That is compatible with the totally-different idea we have about the aforementioned groups of people. We don’t think of monks or people hyperfixated on breaking a world record as fundamentally unlike us. In fact, they probably are more similar to us than different. But importantly, the limited way in which their interiority diverges from ours satisfies our curiosity about why they behave as they do. They depart from us in just a small way, but it is a very explanatory one: some self-contained set of desires or motivations or beliefs.

A similar account of addiction—addicts diverge from nonaddicts in some subset of their desires or motivational structures—does not work. The problem is that the explanation seems to frustrate its own efficacy. It is either too strong or too weak. Either its stringency overcommits addicts to anomalous behavior unreflective of reality or else its laxity fails to explain why addicts ever behave anomalously. For addicts to have a uniformly different set of desires or motivations about particular substances would predict behavior that is on the whole much more unusual than addicts’ actual behavior. (If alcoholics are like nonalcoholics except for a much greater desire to drink, then why is it that our drinking fluctuates in ways that appear random to the nonaddict observer? Why aren’t we blacking out all the time?) But for us instead to have desires in relation to our substances of choice that are divergent only in moderate respects from nonaddicts’ desires would not predict that addicts sometimes do things like this:

Hal was a nurse who stole painkillers from patients to gratify his addiction. Hiding in hospital bathroom stalls, he would fill two syringes, one with painkillers mixed with toilet water, and the other with an antidote to stop him overdosing on the painkillers. The syringe with the painkiller was taped on and into one arm in such a manner that by flexing his arm the plunger would close to inject more of its contents. Hal created the same kind of arrangement with the antidote syringe taped on and inserted into the other arm. Having twisted his body around to position that forearm near the bathroom floor, if he collapsed due to an overdose, he would fall on that arm, thereby pushing the plunger in to inject the antidote.2

Anaesthetic addicts orchestrating these sorts of setups; opioid addicts injecting with unsanitary needles; alcoholics finishing strangers’ abandoned drinks: these are reports from an alien world. But we are oftentimes faced with reports from alien worlds that do not bother us. Sometimes it’s because they’re too alien—we don’t feel compelled to bother to understand them. (Only Thomas Nagel contemplates the interiority of the spider.) And sometimes it’s because they’re not alien enough—we strike Wittgensteinian bedrock, or observe the Köhler phenomena, or whatever. What makes addicts seem so odd to nonaddicts is that neither of those things works. Extrapolating from the similarities does not cut it. (If we had typical attitudes toward our substances of choice, we would behave like nonaddicts.) But the theory of a totally unfamiliar subjectivity, which would otherwise account for the departures, cannot be true either, for addicts do not behave in idiosyncratic ways all the time. Appealing to a unifying conception of a structural difference between addicts and nonaddicts is not satisfactory. Within similar contexts, addicts sometimes behave in a non-normative way, and sometimes behave like anyone else. To put it most simply: Sometimes we use and sometimes we don’t.

Strangeness as a Variant of the Normal

The problem is that our culture has a tendency to view strange behavior as both most interesting and most strange when performed by people we consider to be otherwise normal. I don’t think this view makes much sense: for example, someone with a long-established habit of performing one non-normative behavior suddenly switching to a very different one reads to me as just as in need of explanation. But nonetheless the sensibility stands. As indicated by news reports, apparently the most interesting thing you can say about markedly atypical people is that they always seemed normal. What fascinates us about serial killers is that they had standard-seeming relationships with some of the people around them and killed others. (Think Exceedingly Wicked, Shockingly Evil and Vile.) That is the kind of auxiliary information that tickles the viewer’s brain. In light of a background of typicality, isolated atypicality demands special explanation. It makes you think, That could have been me—and that is a very uneasy thing to sit with if the behavior in question is immoral or otherwise not conducive to the “good life.”

Addiction is a paradigm case of the intuitive strangeness of something being exponentiated by a background of non-strangeness. Modern social contexts create a sort of convergent evolution between addicts and nonaddicts that relegates the observable differences between the groups to isolated, dramatic instances. This occurs through a cloaking phenomenon: less isolated and less dramatic ways in which addict interiority is different from nonaddict interiority are hidden or downplayed. If you could observe us 24/7, you would conclude that the differences are severe: we are very unlike you.

Now, these differences need not be natural or essential. It may be entirely socially constructed: the presence or absence of various oppressions in one’s life can affect your day-to-day experience and behavior. The important thing is not the origin of the differences but their hiddenness. For various reasons, the casual ways in which addict experience does not resemble nonaddict experience are ignored or lost, and the sensational ways are highlighted. I like to describe it with this picture:

Imagine every person is a malleable foam shape. Nonaddicts are cubes; addicts are shaped like a 3D visualization of a speech bubble. When you force the speech bubble into the cube-shaped hole, it highlights both the fact that it almost fits and also the really dramatic way it doesn’t. The callout bubble sits snugly in the cube-shaped hole: we behave generally like nonaddicts. But putting it there creates the protrusion of the spike: in certain situations we behave very differently than you, and this departure is pushed to even greater salience because we fit so well otherwise. We desire happiness, shrink from pain, seek family and friendship and professional success, try to act morally. Yet we also perform actions that code to you as possessed: put ourselves into dangerous situations willingly, plan for binge consumption of drugs, cast health and sanitation to the wayside and lock ourselves into public bathrooms to ingest those drugs while making complicated contingency plans in case of overdose.

Central to the tension is the apparent coexistence of rationality and irrationality. The man in Brody’s vignette above is employed, successful, and self-aware. His drug use involves careful and strategic planning, but it also relies on injecting unsanitary water into his bloodstream. This last feature in particular boggles the abled mind. The simultaneity of rational thinking and covert, physically dangerous substance use—how is this to be explained? Simple: addicts are normal people plus something else added on: a weird craving for drugs or alcohol or gambling or what have you. Our rational thinking is used in service of this unexplainable and ego-dystonic craving, a craving beyond the contemplation of nonaddicts. In short, addicts behave like everyone else…except when we really, really don’t.

So: Addicts are in some ways very similar to and in other ways very different from nonaddicts. Explanations that account for the differences ignore the similarities, and vice versa. It’s the juxtaposition—very similar but very different—that cries out for explanation. One such explanation is something I call the Normal Person Plus view: “Atypicality equals normality plus pathology.” In keeping with the earlier metaphor, the Normal Person Plus view is that addicts (or anyone else who usually is perceived as behaving “normally” but sometimes as “very strangely”) are like this.

On this view, addicts aren’t a speech bubble. We’re a cube plus a weird antenna-like appendage on top. The incongruity does not go all the way to the bottom. It is superimposed, tacked on. Through a divide-and-conquer approach, the Normal Person Plus view explains both why addicts sometimes do typical things and also why we sometimes fail to, or do different things instead. We are behaviorally standard in some ways because our psychology is essentially identical to that of nonaddicts; we have similar desires, interests, life plans. We diverge dramatically because of this strange compulsion to consume our substances of choice: a compulsion tacked onto our personae bizarrely and senselessly, like the protrusion created by the callout bubble when stuffed into the cube-shaped hole. The compulsion is externally imposed, a craving that exists against the will of the self. It is independent of—and often contradictory to—our desires, beliefs, plans, values. Rather than a necessary feature of our subjectivity or identity (and thus ego-syntonic), it is a melan genie, an evil demon whispering in our ears.

If you are an addict reader and you think this reads as sensationalizing addicts’ behavior: It’s meant to—I’m trying to describe and critique a view that nonaddicts have that is not usually stated outright. Basically, nonaddicts have redescribed our behaviors in ways that make them sound insane. To us, some such behaviors are overblown in their telling, some are brilliant resourcefulness, and the rest are just common sense. (Part of me shouts: If people aren’t finishing their drinks, someone ought to drink them, and it might as well be me! Don’t let it go to waste!) But surely you also understand how strange this all seems to nonaddicts, even if it does not sound strange to you. I don’t think that they’re right and we’re wrong. Rather, I fancy myself to be writing up a variant of that paper Body Ritual among the Nacirema, where an anthropologist describes American culture in the way Western anthropologists describe faraway, “primitive” societies. I’m trying to describe circumstances that seem generally normal to me from the vantage point of someone to whom they seem aberrant. I am defamiliarizing my community, for I have been given to understand that the nonaddict response to these sorts of anecdotes is bafflement. If we are to facilitate greater understanding, we must start by engaging with that bafflement.

I’ve never been a nonaddict, but I don’t need to be to recognize the bafflement. It’s obvious. It comes across in nonaddict discussion about addicts, and such discussion is everywhere. (For starters, almost every piece of media about addicts is written by nonaddicts!) Not so for the addict experience. Our stories, when we are allowed to relay them at all, are reflexively refracted through the nonaddict hermeneutics of addiction. It is taken as granted that we ourselves do not understand why we’re behaving in non-normative ways. We must tell the tale as if we are a nonaddict mind trapped in an addict body, confused at the self-independent actions we find ourselves performing. But while that narrative resonates with some of us, it doesn’t for others. For me, and at least some others I know, the feeling isn’t primarily of misalignment. The careful counting, the planning, the anti-overdose setups that parse to nonaddicts as belabored Rube Goldberg machines, are in fact sensibly fine-tuned to evade hospitalization, incarceration, or death.

Hence I find myself in this uneasy disconnect. Like in one of those traintop fights from an old Western, I imagine myself spread out, half my body on the roof of each of two parallel trains that are about to diverge. I see both the intuitiveness and the alienness of my own life as quantum superpositions. Believe me, I devised alcohol poisoning prevention protocols of tremendous specificity and arcaneness. To me they seemed, and even now seem, like common sense. Yet I can all too easily imagine how the Darwin Awards people would have salivated at the prospect of describing me, had my story turned out differently.

Normal Person Plus: disabled people in abled worlds

What I’m going for here is similar to Rosemarie Garland-Thomson’s theory of misfitting. Disabled people don’t quite fit in environments accessible only to the abled—or, as I’d rather say, those environments don’t fit the project of disabled access. The juxtaposition of a disabled person with the uncritical structures of the abled world creates disabled vulnerability importantly attributable to the juxtaposition itself, not to anything inherent in the disabled person. Through the vehicle of misfitting, Garland-Thomson draws attention to the harm and oppression ableist structures enact. But on the object level, what actually happens when a round peg comes into contact with a square hole? What beliefs about disability are facilitated by the mismatch between disabled body, mind, interiority, etc. and abled world?

One, obviously, is that disabled people are inferior to abled ones. But it’s also really important to address the perception that disabled people are weird. Not just in the sense of atypicality (bodies, minds), but in the sense of socialization (behaviors, mannerisms, modes of engagement). Garland-Thomson’s example of the juxtaposition between a Deaf signer and a hearing boardroom makes this salient, contrasting the “extravagant…gesturing” of the Deaf person with the “contained comportment” of the boardroom (595). Deafness, through the observation of hearing people, becomes a whole slate of ways of moving in a space.

I think this is ultimately a more pernicious sentiment about disabled people—it’s robust against much of the ongoing project to eradicate disability stigma in a way received views about disabled lives’ value (hopefully) aren’t. But it’s not obvious how it arises. Being viewed as meaningfully socially weird is not purely downstream of medicalized stigmatization. It’s mediated by the process of misfitting itself, and crucially, by abled people’s observation of disabled individuals as misfits.

Abled people, by and large, view disabled people as Normal People Plus Pathology. (The “normal” there is meant to be sardonic.) What I mean by this is that certain disanalogies between abled and disabled experience—the constant, humdrum ones, the features of our everyday lives—are cloaked by the operation of the social paradigm. Nonaddicts don’t clock how I stop in my tracks when I hear the unmistakable sound of a can opening in a Miller Lite YouTube advertisement through my headphones. They think nothing of it when I turn down offers to socialize in bars. Those behaviors are either unobservable to them or else reflexively recategorized as normal. What was highly observable and impossible to recategorize was my drinking patterns: constant blackouts, hiding bottles around my room, slipping out of events and getting caught drinking in bathroom stalls. I am atypical in virtue of my alcoholism in all sorts of ways. But received views about which atypicalities are dramatic—which ones dictate others’ attention—metastasize into claims that non-dramatic departures from normalcy are not atypical at all.

This pattern generalizes to all sorts of disabled experience. First, neurodivergence: Autistic people are salient to neurotypicals when they are stimming or experiencing so-called “meltdowns,” conspicuously violating abled norms in ways that are difficult for the neurotypical to imagine doing. In other settings, even though their actions may be importantly different from neurotypical behavior, the differences do not register. Some behaviors are viewed as autistic, and others are viewed as awkward, unkind, cold and diffident—morally charged, but not unimaginably abnormal.

Perceptions of ADHD are like this too. Neurotypical people take certain kinds of information about me as explained by my ADHD—my “distractibility,” my halting speech, my eye contact patterns—but not others. For example, my long-winded, “cartographical” writing style parses as just a thing about me rather than a result of my neuroatypicality. But of course, it’s in virtue of my ADHD that I write this way! My mind is a constellation of mini-thoughts that get developed simultaneously into interrelated subparagraphs as I write. (I’ll write a whole post about that later.)

Madness is parsed in this way too. Mad people are only oriented to the observer as being Mad when certain auxiliary factors come into play. The psych ER clinician only sees the man who hears voices when his behavior has reached some threshold of abled perception as sufficiently dangerous. People diagnosed with personality disorders are considered to be atypical in their relationships to other people when those atypicalities come off as threatening. To have what is viewed as an emotional outburst, or to render an ultimatum and then quickly back down from it, invokes the Cluster B PD canard. To more generally have non-normative ways of conceptualizing one’s relationships to the people one is close to just doesn’t. The phenomenon is so profound, I worry, as to have heavily influenced diagnostic criteria. The clinical definition of bipolar I disorder is drawn in reference to specific, isolated periods of departure from normality. The extent to which bipolar people experience the world differently from non-Mad people is relegated to their being manic or depressed—the spike on the foam cube. If there are elements of bipolar experience that aren’t reducible to these highlighted, dramatic atypicalities, they are ignored.

One might expect me at this point to bring up “hidden” or “invisible” physical disability like epilepsy, MS, or ME/CFS; it’s obvious how those are refracted through the Normal Person Plus conceptualization. But this holds too for “visible” physical disability. I think the general underscoring element to the Normal Person Plus view is that abled people conceive of us as visitors to the abled world. Nondisabled people are not around to observe how people with spinal cord injuries interact with their home environments, how they relate to their families and caretakers, how they water their plants. They see instead what they cast as the archetype of the Quadruplegic: a person who arrives in their presence with an intrinsically othering sort of fanfare and ridiculousness. The wheelchair user can only ever be a visitor to abled spaces, an alien diplomat—escorted in, with much to-do, making conspicuous use of elevators and stair climbers. Her perception as a wheelchair user is inseparable from bureaucratic logistical nightmares, hushed whispers, extensive strategizing. The bus has to park and the ramp be pulled out while the abled world waits and watches. I don’t have an SCI, and in some sense it feels audacious to analogize this imagined person’s experience to mine, for she faces dramatically more systematic and extensive oppression than I do. But I feel this for her when I write: the gut-wrenching fury of knowing you are being perceived as a fussy affair. That experience I share. It is common across disability, I think. Abled people perceive us as disabled only when we are considered to be conspicuously performing disability.

The Zoom paradigm created in the wake of the global pandemic, for all its benefits, has further emphasized the disconnect between disabled people in disabled worlds and disabled people as visitors to abled worlds. Often, disabled people who would be viewed by abled people as disabled in an in-person interaction are not so recognized in virtual interactions. Blind people’s sensory atypicalities are cloaked in phone communication. Little people’s stature is hidden in online meetings. I don’t think this is quite the same as passing—it’s a different but related phenomenon. Often there are plenty of auxiliary indicators of disability status available, but abled people are not primed to notice them. Virtual communication enables abled people’s witness of disabled people’s home lives, but only in ways that reaffirm the idea that disabled people’s divergence from abled people in physicality, interiority, goals, and values is restricted to certain kinds of hot-button circumstances rather than an overarching artifact of disabled life.

Addicts, autistic people, those with high-level spinal cord injuries: what do abled people think we are like in our own homes and communities, outside their gaze? One might be inclined to say the abled think we are much the same beyond the panopticon as in it—spectacles, albeit unwatched ones. But I don’t think that’s true. Rather, I suspect they sort of think we cease to be disabled when we stop performing disability for the abled audience. I’m sure they don’t think that reflectively; clearly it makes no sense. But it is the underlying sensibility. The abled view of disability is fundamentally relational, for the “Plus” in Normal Person Plus is witnessed only when it stands in relief against a status quo. When not within the perceptual field of the abled observer, the person with an SCI is indistinguishable in their view from another abled person. How does she interact with them when they cannot apprehend her directly through abled sensory cues? Maybe she sends emails. Emails don’t disclose her otherness—they’re the same as abled people’s emails. Ask an abled person (probably even most disabled people who aren’t wheelchair users) how someone with a high-level SCI writes emails, and they have no idea; they have to come up with stuff on the spot. It didn’t occur to them to ask. They didn’t think people with SCIs can’t or don’t write emails. They just didn’t realize the ways in which it must involve a different process. I think, probably, that their snap-judgment picture is of the person sitting in a wheelchair, at a computer, typing with her hands. Then their brows wrinkle because that can’t be the case.

Again, I’m not saying that abled people genuinely think that disabled people cease to be disabled when we move outside their spaces. Nor are disabled people believed to vanish like NPCs when traveling beyond abled worlds. Rather, the abled view of disability only takes on meaning in light of the abled observer, like a felled tree that makes a noise only if an auditory listener is around. What I am arguing is that the immediately perceived scope of our disability is determined by the existence of an abled audience. When we are not in front of that audience, they forget about disability. Logistical questions—how do autistic people manage sensory overload at home?—no longer seem salient. This is neither a result of an impoverished notion of disabled people’s capabilities nor an idea that disabled people stop existing outside abled spaces (although both those sentiments may certainly still be held). Partly it is because those logistical questions no longer feel to abled people like their problem. But more generally it is an offshoot of the phenomenon wherein abled people minimize some, and defamiliarize others, of the myriad ways in which disabled lives do not resemble their own. As Peña-Guzmán and Reynolds write in “The Harm of Ableism”:

In the perceptual field of one under the sway of ableism, a person with epilepsy registers simply as an epileptic object, a blind person as a walking cane on the precipice of danger, and a person in a wheelchair as one “confined” and “bound” to ever-limited self- or other-pushing…Disability, which is to say, ableist assumptions about disability, crowds their perceptual field so thoroughly that they are incapable of not looking at it, not talking about it, not being distracted by it. The tricky part, here, of course, is that it is not the disability that is responsible for producing this effect, but the way in which the disability is perceived and interpreted by the abled-bodied individual (222).3

As a final note: “Normal Person Plus” generalizes to contexts outside disability. Heterosexual views of bisexuality strike me as a paradigm case of the NPP view. Rather than being viewed as people attracted to more than one gender, bisexual people are pathologized in virtue of the apparent aspect of that attraction that presents as atypical in light of received views (i.e. bisexual people are framed as “half straight and half gay,” with the “gay side” subject to oppression; the broader ways in which bisexuality is unlike monosexuality are ignored). The same holds for racialization (especially mixed-race status) and transness. I frequently reference Talia Mae Bettcher’s work4 on the deceiver-pretender double bind, and think it is relevant here. Much trans oppression is facilitated by the demarcation of trans people as either pretenders (imagining themselves to be of a different gender, as if playacting) or deceivers (willfully attempting to take advantage of dupes by dissembling with gender presentation). Both the pretender and the deceiver role are fundamentally relational; this helps us to frame the backlash against trans identity in terms of the Normal Person Plus view. To the gender critical observer, transness is fundamentally a spectacle. After all, people can be deceivers or pretenders only when there is someone around to be the victim or audience. Perhaps I’m overshooting with this attempt to project myself into the standpoint of Kathleen Stock or whoever, but I get the sense that such people think that absent an active social setting, trans people just sit around, not being trans.

Normal Person Plus and theories of addiction

Here are some telling excerpts from generating-mechanism hypotheses about addiction.

Addiction, despite social misconceptions, is one's pursuit of the good. The addiction may turn into something horrendous, even life-threatening, but the aim is always towards the perceived betterment of the individual. One does not engage in drunkenness everyday because one believes it is bad for them. Instead, the alcoholic turns to the drink because it is something to ease the pain, cure the boredom, or get the high they need.5

Another one.

As long as drug addiction can be blamed on a mythical disease, the real reasons why people use drugs—those related to socioeconomic, existential, and psychological conditions, including low self-esteem, self-worth, and self-efficacy—can be ignored.6

Both of these excerpts invoke a view that seem facially to disagree with the generating-mechanism theories of addiction: the so-called choice model, on which addicts use because they choose to. But a careful reading shows there’s actually no dispute between the precommitments of the different theories. Most frame addiction as downstream of a desire to change one’s subjectivity, usually in a way that avoids pain. Basically, addicts use their substance of choice for the same reasons that nonaddicts use it. We consume more of it and in a more compulsive fashion not because our motivation is different, but because the scope of the motivation—the extent of our social anxiety, sadness, desire to escape ourselves, whatever—is greater than yours. The reason for use is similar in kind, but different in degree. This makes sense of the alienness of addict behavior without requiring nonaddicts to think we are, in terms of interiority or day-to-day life, substantially different from them. It says our psychology is basically the same as theirs. Where we diverge is in having a deep sadness, an incorrigibly defunct emotionality. What was previously incomprehensible is made comprehensible if described in terms of scale. We are regular sad people—like you when you’re sad—taken to an extreme.

To summarize: the fundamental problem of addiction is the juxtaposition of normality and abnormality. Addicts sometimes behave like anyone else, but sometimes behave very differently. This is a peculiar problem for intersubjectivity. It at once frustrates and affirms the core conception that we are similar to the people around us. It seems unreasonable to conclude that you are totally dissimilar from addicts—if so, why are we responsive to similar mechanisms; why do we adopt a broadly analogous set of ends? But it is no more plausible to think we are much like you. The solution provided by presenting a generating-mechanism theory like the self-medication hypothesis is that we are a version of what you could be if placed in a particularly difficult-to-imagine situation. That scratches the itch.

Some closing notes: a reaffirmation of the commitment to describing addict interiority

My endeavor so far has been more expository than critical. I’m trying to show that the Normal Person Plus notion lurks underneath the received views of addiction. It makes the attempts to isolate generating mechanisms seem sympathetic and the allegations of particular generating mechanisms appear accurate. Something similar holds for abled theorizing about disability more generally, and we should learn to recognize it when it is present.

Now for the criticism: I’m sure it’s obvious that I am not happy with the Normal Person Plus view. The whole structure is built on an uneasy scaffold—its motivation is misinformed. It fastens to the illusory idea that strange behavior is stranger in one cordoned-off set of persons than in others. To find it compelling one must first accept that there is some objective normality, abstract, transhistorical, and separable from social contingency, that constitutes an inductive basis for behavioral analysis. I think that whole idea is unfounded.

Characterizing generating mechanisms of addiction allows the outsider to sympathize with the (apparent) plight of the addict. But do not confuse sympathy for understanding. The reason I define addiction in terms of oppression is that it is good to fear the generating-mechanism definitions: they are, for the most part, clear cases of explanation without understanding. The reason such theories appear sympathetic is precisely that they are insuperably wrong! They try to bypass the fundamental oddness of addiction from the nonaddict standpoint without grappling with that oddness—by explaining it away rather than acknowledging and sitting with it. Hence they describe the phenomenon of addiction in terms understandable to nonaddicts. They take nonaddict experience as the primitive, the essential standpoint from which addiction must be explained.

Of course that makes no sense! Why should a theory of normatively strange behavior appeal to an explanation in terms of normative sensibilities? That flies in the face of the claim that the behavior is strange in the first place. Any attempt to describe addiction in terms consonant with nonaddict hermeneutics will not explain the atypicality. It will outsource it. If addicts aren’t biologically atypical, then the pressures to which we have been subjected are, or our drugs are, or our brains have developed in atypical ways. This is my biggest problem with medical attempts to come up with unifying theories of something considered abnormal. Atypicality does not divide out; it is merely relegated and redescribed. The cognitive model of mental illness is much the same. Such theories constitute attempts to isolate atypicality to a well-defined, quarantined mechanism, and in so doing, to refract disabled experience through abled hermeneutics.

Taken from Popper’s use of the phrase in the context of describing random sequences, Realism and the Aim of Science.

Brody, Alan (2012). “Addicts, mythmakers, and philosophers.” Philosophy Now 90. url: https://philosophynow.org/issues/90/Addicts_Mythmakers_and_Philosophers

Peña-Guzmán, David M. and Joel Michael Reynolds (2019). “The harm of ableism: medical error and epistemic injustice.” Kennedy Institute of Ethics Journal 29 (3): 205-242.

See, i.e., Bettcher, Talia Mae (2007). “Evil deceivers and make-believers: on transphobic violence and the politics of illusion.” Hypatia 22(3): 43-65. url: https://www.jstor.org/stable/4640081.

Stark, Michael (2012). “Review of Addiction and Virtue.” Denver Journal 15. url: https://denverseminary.edu/the-denver-journal-article/addiction-and-virtue-beyond-the-models-of-disease-and-choice/. (Emphases mine.)

Schaler, Jeffrey (1994). “Alcoholism is not a disease.” url: https://www.ojp.gov/ncjrs/virtual-library/abstracts/alcoholism-not-disease-alcoholism-p-34-44-1994-carol-wekesser-ed. From the NCJRS Virtual Library, last accessed 20 April 2023. (Emphases mine.)