Narratives of Addiction or Addiction to Narratives?: The Role of Culture-Specific Knowledge in the Recognition and Diagnosis of Addictive Disorders

Vollständiger Abstract

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This paper analyzes narratives of personal experiences of addiction, with a focus on the processes through which addiction is recognized and named in everyday life prior to entering institutional treatment pathways. Drawing on qualitative research based on 20 semi-structured, in-depth interviews with participants undergoing the rehabilitation phase of a treatment program at the Clinic for Addiction Disorders, Institute of Mental Health, the study examines the role of culture-specific knowledge in the development and recognition of addictive disorders. At the center of the analysis is the question of how individuals, before encountering expert or medical discourse, come to identify certain patterns of behavior as "pathological" and certain substances as "addictive." The paper argues that such processes of recognition are not solely dependent on formalized expert knowledge, but are significantly shaped by culture-specific knowledge produced and transmitted through everyday narratives. These narratives form informal epistemic frameworks that circulate within families, peer groups, and broader cultural contexts, enabling individuals to interpret and articulate their own experiences. By focusing on early encounters with addiction and psychoactive substances, as well as on the formation of the category of "the addict," the analysis highlights the importance of embodied experience in the habituation of behavioral patterns that are later labeled as addictive. Particular attention is paid to the ways in which individuals come to perceive their relationship with substances, or forms of impulse dysregulation, as "pathological," thereby shaping their lived experience. Addiction is understood as a socially mediated and embodied phenomenon, based on the concepts of embodiment and enactment. The gendered dimension of addictive experience is further examined from a critical feminist perspective, with attention to the ways in which normative expectations shape both the experience itself and its interpretation. Finally, the socially constructed image of "the addict," subsequently internalized by individuals, is analyzed from below, that is, from the perspective of those with lived experience of addiction. The paper underscores the importance of culture-specific knowledge about psychoactive substances and addiction in shaping the processes of the development, recognition, and treatment of addictive disorders.