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The Import of
Integral Pluralism in
Striving Towards an
Integral Metatheory
of Addiction
Guy du Plessis
Adam Gorman
Integral Theory Conference 2013

Abstract?
 This presentation briefly explores the value
of including Integral Pluralism and Integral
Enactment Theory in the quest for a robust
integral metatheory of addiction.
 Integral Enactment Theory highlights the
phenomenon of addiction as a multiple
and dynamic object arising in a
continuum of ontological complexity.

What is addiction?
 Addictions have beleaguered society since human beings first
discovered they could alter their consciousness by ingesting certain
substances.
 How a society views and understands addiction has great significance
for addicted individuals seeking treatment. In pre-modern times
addiction was understood as possession by demons and a moral
aberration, and its consequent treatment was similarly archaic.
 It is only in the last 100 years that scientific theories and explanations for
addiction have come into existence, and as a result, treatment has
become more effective (DiClemente, 2003).

MODEL
Moral
Temperance
Spiritual
Biological
Educational
Psychological
Social learning
Cognitive
General systems
Socio cultural
CAUSAL FACTORS
(Ontology)
Personal choice
The substances
Spiritual deficit
Neuro pharmacology
Lack of knowledge
Psychodynamic
Modeling
Expectations and
beliefs
Family dysfunction
Environment and
culture
INTERVENTION
Criminal justice
Supply control
Spiritual growth
Abstention
Education
Psychotherapy
Skills training
Cognitive therapy
Family therapy
Social policy

The Need for an Integral Metatheory of Addiction
 In contemporary addictionology there is an on-going debate concerning the
nature of addiction, and there is no agreement on a single etiopathogenic
model – a fact which clearly reflects the complexity of this phenomenon
(DiClemente 2003; West, 2005).
 Although there is a move towards more comprehensive models, current
“holistic” models have not yet achieved its goal of providing a truly inclusive
and integrative framework to account for addiction.
 What is missing in these integrative models is a metatheory that adequately
explains the co-arising, multi-causality and integration of the many factors
influencing etiopathogenesis.

Beyond the Biopschycosocial Model
 A dissatisfaction with the fractional explanations proposed by the
previously described single-factor models have prompted some theorists
to propose an integration of these explanations (Donovan &
Marlatt, 1988). By calling their model the biopsychosocial model, they
indicate the integration of biological, psychological and sociological
explanations that are crucial in understanding addiction.
 DiClemente (2003) believes that proponents of the biopsychosocial
approach have not explained how the integration of their tripartite
collection of influences occurs. Without an orienting framework that can
explain how these various areas co-enact and interlink, the
biopsychosocial approach often represents merely a semantic linking in
terms and exhibits limited integration.

Transtheoretical Model
 In an attempt to find commonality amongst the diverse models of addiction
and seek integrative elements, DiClemente and Prochaska (1998) propose
their Transtheoretical Model (TTM) of intentional behavior change.
 Although this model indicates an integrative principle that is common to all
the previous models, and although it highlights the dynamic and
developmental aspects of addiction, I do not believe it provides a meta-
theoretical framework that truly accommodates all the previous perspectives
into an integrative framework. The TTM predominantly focuses on one
dynamic integrating principle found in all the prominent addiction
models, but does not provide the meta-paradigmatic framework needed for
a meta-theory of addiction. (Miller & Rollnick, 2002).

The Import of Integral pluralism in striving towards an integral metatheory of addiction

Integral Enactment Theory
 When striving for a comprehensive Integral metatheory of
addiction, Integral Enactment Theory could provide vital insights, and
can help us unlock some of the mysteries of this exceedingly complex
phenomenon. I adapt valuable insights Sean Esbjörn-Hargens and
Michael Zimmerman (2009) derived from their study of climate
change, in the milieu of etiological models of addiction.
 Esbjörn-Hargens (2010) says that at the core of Integral Enactment
Theory is the triadic notion of Integral Pluralism:
 Integral Pluralism is composed of Integral Epistemological Pluralism
(IEP), Integral Methodological Pluralism (IMP), and Integral Ontological
Pluralism (IOP).

Enactment
 The idea of enactment is vital in understanding why all the previously
discussed theories of addiction do not have to be contradictory, as they are
often interpreted, but can rather be understood as “true but partial”.
Enactment can be understood as the bringing forth of certain aspects of
reality (ontology) when using a certain lens (methodology) to view it.
 In short, reality is not to be discovered as “pre-given” truth, but rather we co-
create or “co-enact” reality as we use various paradigms to explore it.
 For example, when attempting to understand addiction using empirical
research methods we will enact a different ontological reality than when
using a phenomenological approach. By avoiding what Wilber refers to as the
“myth of the given” we understand addiction as a multiple object with no
existing “pre-given” reality to be discovered (Wilber, 2003a, 2003b, 2006).

Enactment
 Different research methods in addictionology enact addiction in unique ways, and
consequently bring forth different etiological models. Virtually all etiological models
(typically based on a positivist foundation, including intrapsychic models founded on
psychoanalytic metapsychology) treat addiction as a single object “out there” to be
discovered or uncovered, and therefore, eventually run into trouble attempting to
explain a feature of addiction outside of its enacted reality.
 For example, physiological models and their accompanying research (naturalistic
scientific) methodologies, enact the biological reality of addiction, and are inherently
incapable of showing any truth of addiction outside the realm of biology, i.e.
societal, existential, and so forth.
 When acknowledging the multiplicity of addiction’s ontological existence, the
“incompatibility” of the various etiological models disappears, because each enacts
a different reality of addiction – each bringing forth valuable insights in its specific
ontological domain.

Integral Methodological Pluralism
 IMP has two essential features: paradigmatic and meta-paradigmatic.
 The paradigmatic aspect refers to the recognition, compilation and implementation
of all the existing methodologies in a comprehensive and inclusive manner.
 The meta-paradigmatic aspect refers to its capacity to weave together and relate
paradigms to each other from a meta-perspective.
 IMP can therefore be understood as the 8PP and its correlated methodologies with
a meta-framework which provides meta-linking between these disparate
perspectives and paradigms.
IMP

A composite model
Zone 1
Phenomenology
Conditioning/Reinforceme
nt Behavioral models
Compulsion and Excessive
Behavior models
Spiritual/Altered State of
Consciousness models
Personality/Intrapsychic
models
Coping/Social learning
models
Biopsychosocial model
Zone 2
Structuralism
Transtheoretical Model
Zone 3
Hermeneutics
Coping/Social
Learning models
Zone 4
Ethnomethodology
Social/Environment
models
Coping/Social Learning
models
Spiritual/Altered State
of Consciousness
models
Zone 5
Autopoiesis theory
Coping/Social Learning
models
Zone 6
Empiricism
Genetic/Physiological
Models
Compulsion and Excessive
Behavior models
Zone 7
Social autopoiesis
theory
Social/Environment
models
Zone 8
Systems theory
Social/Environment
Models
Integral Taxonomy of etiological models

 Each of the aforementioned models brings valuable insight from a specific
paradigmatic point of view, and enacts certain features of addiction by virtue
of applying a certain methodology.
 From an IMP perspective, none of these models or perspectives have
epistemological priority, because they co-arise and “tetra-mesh”
simultaneously. Therefore, these models are all valid from the perspectives they
attempt to understand addiction from, but also always partial in their approach
to the whole.
 By viewing addiction through the quadrants and the eight zones of IMP, we can
see that all these perspectives with their respective methodological families
need to be acknowledged, and as many should be included as possible in
order to gain a truly comprehensive view.
IMP

Integral Epistemological Pluralism
 Previously I highlighted, albeit implicitly, epistemological pluralism when
discussing IMP and etiological models. Often the Indian myth of six blind
men is used which captures the essence of epistemological pluralism.
 Although this story highlights aspects of Integral Pluralism, it is insufficient
in underlining the whole of Integral Pluralism (Esbjörn-Hargens, 2010). This
story represents the elephant as a single “pre-given” object. In
short, when not placing epistemological and methodological pluralism
within the larger framework of Integral Pluralism and Integral
Enactment, it tends to reinforce the “myth of the given” by implying a
single “pre-given” independent object.
IEP

Integral Ontological Pluralism
 Ontological pluralism underscores that addiction is not
a single “pre-given” entity, but rather a multiplicity of
third-person realities. Moreover, as we shall see, the
miscellany of the ontological realities of addiction has
a special enactive relationship with etiological theories
and their respective methodologies.
 Esbjörn-Hargens (2010) describes these relationships as
Integral enactment. Integral Enactment Theory
adeptly points out how etiological models “co-
arise”, in relation to methodology (methodological
pluralism) and enacts a particular reality of addiction
(ontological pluralism), while being mediated by the
world view of the subject (epistemological pluralism)
applying the method.
IOP

Integral Enactment
 I believe the scheme of Integral enactment is valuable in gaining insight into the
nature and genesis of etiological models of addiction, as well as developmental
models of recovery.
Subject < - Method -> Objects
(Who) (How) (What)
[_______Theory_________]
(Why)
 Etiological theories (Why) are part of an Integral enactment of Epistemology (Who),
Methodology (How) and Ontology (What). Each etiological model partakes in this
“algorithm”.
 This “algorithm of Integral enactment” may prove a useful scheme when designing
an Integral metatheory of addiction.
Subject < - Method - > Objects
(Who/IEP)(How/IMP) (What/IOP)
[_______Metatheory_________]
(Why)
Integral metatheory enactment

Addiction as a third order complexity
 Esbjörn-Hargens (2010) describes three orders of complexity as follows; “the first order is
characterized by phenomena that we can more or less “see” with our own senses. The
second order is the result of using various extensions of our senses (instruments, computer
programs, charts) to see the phenomena…The third order cannot be seen with our senses
nor indirectly by our instruments, but only by “indications” (p. 159).
 Addiction can thus be understood as existing as a probability continuum of ontological
complexity, co-arising and enacted through different methodologies and worldviews.
 At the highest level of abstraction lies the notion of the aetiology of an individual’s
addiction, which is a staggeringly complex phenomenon beyond our senses or instruments.
 So addiction “is two steps removed from our direct experience (the first order) and our
perception of it relies on many abstract indicators (the second order), which are
epistemologically distant and ontologically complex“ (Esbojn-Hargens, 2010, p. 159).

 When understanding addiction as a third order ontology, we begin to understand
why certain models of addictions, especially the single factor models, give rise to
such partial and reductionist explanations. They are good at explaining certain
“proto-features” of addiction in the realm of its enacted first or second order
ontology, but methodologically and epistemologically, they are incapable of
enacting addiction on a third order ontology, which is actually the level of
ontological complexity where the notion of addiction exists (first or second order
ontologies cannot articulate a complex phenomenon like addiction, and can only
enact “proto-addiction” probabilities).
 Most of the models discussed have at their foundation a natural scientific worldview
and positivistic methodology that are typically adequate for exploring phenomena
existing on the first and second order of ontological complexity. However, such
models are hopelessly inadequate in explaining complex phenomena like addiction
(or any human behaviour) which “exist” on the third order of ontological complexity.

 Medard Boss (1983) points out that the natural scientific method has its limitations in
explaining the human realm, as it originated from and is only sovereign in the
nonhuman realm (natural sciences). Boss says the dangers of explaining higher
order complex phenomenon (which includes any aspect of human-being-in-the-
world) by using methodology (i.e. empirical observation) and epistemology (i.e.
positivistic) dominant in lower orders of complexity.
 In summary: The notion of addiction is a third order of ontology, which can only be
co-enacted (“bring-forth-in-the-world”) when juxtaposed with associated
“methodological variety” and “epistemological depth” (Esbojn-Hargens, 2010).
 Addiction is caused by, affects and manifests in all areas of our “being-in-the-
world”, and only paradigms (or rather meta-paradigms) that function on this level of
ontological complexity may suffice - if we are ever to understand, and successfully
treat this colossal nemesis.

Developmental
Perspective of Addiction & Recovery

In summary:
 Integral Enactment Theory points out that to
develop an Integral metatheory of addiction
we need to understand addiction as a third
order ontology, existing along a
developmental and dynamic probability
continuum of ontological complexity that co-
arises and co-enacts depending on
epistemological distance and
methodological variety.

 Arriving at an adequate understanding of addiction
has more than just epistemological and scientific
value – for the way we understand addiction
influences the way we treat it. Therefore, the more
comprehensive our understanding, the more
effective and sustainable treatment becomes.
 Addiction is one of the greatest societal problems
facing the world today, and I believe only a truly
integral approach can adequately address this
massive and mind-boggling, complex problem. As
Jan Smuts said in 1927, presaging the Integral age: “If
the soul of our civilization is to be saved we shall have
to find new and fuller expression for the great saving
unities…”.

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The Import of Integral pluralism in striving towards an integral metatheory of addiction

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The Import of Integral pluralism in striving towards an integral metatheory of addiction