Self-Control Outside the Genes: ADHD and the Case for Situational Pleas for Mitigating Moral Responsibility (Polaris Koi for A&R October)

[Yet another installment of Agency and Responsibility October, by Polaris Koi (University of Turku). Take it away, Polaris!]

Strawson (1962) divides pleas for mitigated responsibility in two groups. The first group consists in agential pleas, in which the agent is excused or blame is mitigated because the agent is “warped or deranged, neurotic or just a child” (ibid.) – the agent is seen as not being a full-fledged moral agent. The second group, which in Strawson’s view is the less important one, are situational pleas where external circumstances bar the agent from acting according to their true intentions. Situational pleas include cases where the agent is the victim of brainwash, under considerable stress, or tied to a chair.

Self-control is defined, broadly, as the capacity to direct behavior in accordance with one’s intentions in the face of competing motives or impulses. Many neurodevelopmental or mental disorders result in a diminished capacity for self-control. Perhaps the most archetypal such disorder is Attention deficit/hyperactivity disorder, characterized by a family of symptoms relating to the dimensions of inattention and hyperactivity. When persons with ADHD fail in self-control, the disorder often figures among the causes of that self-control failure. ADHD is highly familial and its heritability has been estimated at roughly 80%; risks genes for ADHD were first identified in a genome-wide association study published earlier this year (Faraone & Larsson 2019). As a result, a genetic essentialist rhetoric is common in discussing the agency of persons with ADHD. In this rhetoric, persons with ADHD fail in self-control due to their genetic make-up. When these failures call for responsibility mitigation, the pleas are agential pleas: if persons with ADHD are less responsible, it is due to their innate traits rather than due to situational constraints.

I want to contest this claim. What we know about the behavioral genetics of ADHD does not support the view of self-control impairments in people with ADHD as immutable. The genetic causation of complex traits such as self-control is a multifactorial causal process where environmental causes enter into the equation at numerous junctures along the causal chain. Furthermore, while the agent-environment relationship in the causation of behavioral traits is often seen in passive terms, that relationship also takes active forms, referred to as active gene-environment interactions. In these interactions, individuals actively seek out or manipulate their environments to better fit their genotype, which has an effect on their phenotype. In other words, just because ADHD is heritable does not mean its impact on behavior would be immutable or that individuals and their environments would not have a significant impact on the behavioral phenotype.

Self-control is not a natural kind: rather, it is a group of behaviors and mechanisms, all of which contribute to matching behavior to intentions rather than competing motives or impulses. Some of these behaviors are intrapsychic, such as when an agent rehearses their reasons for that intention (e.g., when a student, intending to write an essay but tempted to chat online with friends reminds themselves of how much they value academic success) or construes of the competing course of action in unfavourable terms. Many such behaviors are environmental, however. Environmental practices include Ulysses arrangements where the competing behavior is made physically impossible (such as by installing an application that prevents the use of certain applications and websites for a given period of time), arrangements where the environment is structured to support the intended task (such as going to the library to write the essay, an environment that this student associates with productivity), setting up external cues and reminders, et cetera. The environment also has an impact on intrapsychic practices: for example, environmental distractions may make them more difficult, especially for persons with ADHD. While self-control is multiply realizable, plausibly not all ways to realize self-control are equally well suited for people with neurodevelopmental disorders such as ADHD. Environmental practices especially present themselves as ways to realize self-control that are equally suited for people with and without ADHD.

While the empirical literature on various operationalizations of self-control is copious, this is not typically reflected in the way we instruct each other to enact self-control. This presents everyone, but especially persons with ADHD with significant epistemic barriers to self-control. For example, guidebooks for students struggling to write their theses often include the sage advice of gluing one’s behind to a chair, a remark that is unhelpful for many persons with ADHD. As a result, self-control practices suited for a person with ADHD may be available, but that person may not be aware of them. Additionally, there may be restrictions on the availability of environmental and other suitable practices of self-control: for example, many impulses are successfully diffused by physically removing oneself from the situation, but this is often not made available in contexts such as schools and workplaces.

I propose that whether a person can be held responsible depends, in part, on whether they had access to self-control behaviors. Which self-control behaviors an individual can access is modulated by their genetic makeup and (neuro)biology but also by their immediate and past environment. For access to be present, there need to be self-control practices that are available for the individual in their immediate circumstances, and the individual needs to be aware of their availability.

ADHD does not necessarily result in impaired self-control; rather, ADHD together with the environment modulates which self-control practices are accessible. An environment that sufficiently enables self-control for most people may fail to do so for persons with ADHD. By analogy, people with mobility disabilities are not inherently less able to get around – rather, an environment that sufficiently enables others to get to a meeting on the 3rd floor may fail to do so for a wheelchair user.

Self-control is fundamentally a set of practices. Innate traits, as well as environmental supports and constraints, modulate access to these practices. When assessing whether responsibility ought to be mitigated, we ought to look into whether the individual had access to self-control practices. The case of ADHD teaches us that pleas to mitigate responsibility due to self-control failures should be situational pleas.

 

Key sources

 

Duckworth, A., Gendler, T. S., & Gross, J. J. (2016). Situational strategies for self-control. Perspectives on Psychological Science 11 (1). 35–55.

 

Faraone, S.V. & Larsson, H. (2019). Genetics of attention deficit hyperactivity disorder. Molecular Psychiatry 34 (4): 562–575.

 

Herdova, M. (2017). Self-control and mechanisms of behavior: Why self-control is not a natural mental kind. Philosophical Psychology 30 (6): 731–762.

 

Strawson, P. (1962). Freedom and resentment. In G. Watson (ed.), Proceedings of the British Academy, Volume 48: 1962. Oxford: Oxford University Press.

 

Tabb, K., Lebowitz, M. S. & Appelbaum, P. S. (2019). Behavioral genetics and attributions of moral responsibility. Behavior Genetics 49: 128–135.

6 Replies to “Self-Control Outside the Genes: ADHD and the Case for Situational Pleas for Mitigating Moral Responsibility (Polaris Koi for A&R October)

  1. Interesting post! I worry a bit about this when it is applied across the board: “I propose that whether a person can be held responsible depends, in part, on whether they had access to self-control behaviors. Which self-control behaviors an individual can access is modulated by their genetic makeup and (neuro)biology but also by their immediate and past environment. For access to be present, there need to be self-control practices that are available for the individual in their immediate circumstances, and the individual needs to be aware of their availability.”

    Take Aaron the alcoholic. He intends to stop drinking because he is an angry, abusive drunk. He is trying AA but it is not a reliable route to self-control for him. If he tried some CBT and psychotherapy to work through his issues from his childhood with his abusive alcoholic dad, this would help with his self control, but he lacks epistemic access to the fact that this is the way to go. He incontinently falls off the wagon, gets drunk, and abuses his family. Tragedy results. Afterward he is wracked with guilt at what he has done and he endeavors to repair his family relations, hoping they will accept him.

    Is it your view that he should not hold himself responsible and that he should not seek to more fully take responsibility for what he has done?

  2. Hi Brad! That’s a great case, and I realize the claim is a big one and would need to be fleshed out more fully. But let’s look at Aaron’s case, specifically. It is complex because we are worried about two things:
    – Does Aaron have access to self-control practices that are suitable for getting sober?
    – Does Aaron have access to self-control practices that help him not abuse his family?
    Aaron could prevent himself from drunkenly abusing his family if he would succeed in preventing himself from drinking (in which case he would never get the violent impulse) or, failing that, preventing himself from abusing while drunk.

    While some self-control practices may be helpful in any context, I think the alcohol case is illustrative because in it, due to the alcohol, Aaron’s brain works differently than it does when he is sober. Strategies that work for him while sober may no longer have the effect he expects, which he might find surprising. He is likely well aware that he acts differently when drunk, but may have put off developing strategies for handling that.

    As you point out, Aaron’s drunken and abusive incident is not an out-of-the-blue event. He has a background of similar behaviour. He has been abusive in the past and tried out AA presumably in part for this very reason.

    Trying to get sober by joining AA has been, for Aaron, one way to prevent future abuse. But we can ask if he has had access to _further_ self-control behaviours that he ought to have enacted. Perhaps, if his abusiveness has been especially towards his family in the past, he could have asked his drinking buddies to make sure he sleeps on their couch on drinking nights instead of going home drunk, or come up with other ways to limit physical contact. Have such strategies been feasible? Has he been aware that he could do that?

    In Aaron’s case, unless it turns out that Aaron has not been aware of a pattern of domestic abuse and the event has come to him as a sincere surprise, my inclination is to hold him fairly responsible for the abuse, because there likely have been things he could have done to prevent the abuse, specifically, despite being an alcoholic. My inclination is also to not hold him responsible for the alcoholism itself, as you describe him as not aware of the ways he could get sober. For Aaron to take fuller responsibility for the abuse would include him acknowledging the ways he could have prevented himself, or at least decreased the odds of him acting abusively.

  3. Hi Polaris,

    I’d like to encourage you to support your position with arguments about the social constitution of disability culled from critical work in philosophy of disability and disability theory rather than or in addition to the sort of work you use at present. In particular, I recommend the first chapter of my book Foucault and Feminist Philosophy of Disability (Ann Arbor: University of Michigan Press, 2017). My book indicates ways to denaturalize disability that would bolster your arguments here.

  4. Hi Shelley!

    Many thanks for the comment. The claim is indeed inspired by reading philosophy of disability, and that part of the argument would benefit from some fleshing out.

  5. Thanks for the response, Polaris! That really helps me see how your view would apply in various contexts. I like the examples you gave of possible ways for the alcoholic to avoid abusing others that fall short of “getting cured”. This is nice because it also points to the fact that people with ADHD might have similar available work-arounds in some contexts.

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