Institutional Footprints in the Addiction Image:

The concept of addiction is increasingly applied in order to understand various problematic behaviours. However, this inclusion remains disputed. The study examines the conceptualisation of addictions by analyzing stimulated group discussions of general practitioners and social workers in Finland and France on the topics of alcoholism, pathological gambling and eating disorders. The dissertation consists of one methodological workingpaper (I.), three empirical sub-studies (II., III., and IV.) and a summary article. Sub-study III. was written together with Matilda Hellman and Pekka Sulkunen. The study builds on the assumption that social reality is constructed and taken-for-granted. Concepts develop in a certain cultural context. Culture in its different occurrences is the framework for thinking and acting. This study is particularly concerned with institutions as one occurrence of culture. The empirical bases of the enquiry are 27 Reception Analytical Group Interviews, which challenged the participants to question their taken-forgranted understanding of addiction by presenting them with short film clips. Finnish informants focus on the harm done towards the family and society and therefore follow the traditional Finnish non-medical model. French participants by contrast laid emphasis on the suffering of the individual addict and consequently express characteristics of the medical model (II., III., and IV.). Secondly, Finnish social workers understand all three problem behaviours similarly as social problems, whereas their French colleagues understand alcohol and eating problems as individual issues. A common denominator in both countries is a functional explanation of all three problem behaviours as a form of poor coping with life’s hardships (except for gambling in France) (III. and IV.). Finally the study shows that in the context of the modern Finnish welfare state the importance of citizens’ autonomy allows individual excess to some extent, as long as innocent others are not harmed (III.). This study traced the influence of institutions on images of addiction. It suggests considering addiction as culture-level bound. Beside the traditional concept of addiction other institutional settings also have an impact on the images of addiction. Due to the complexity of the contexts involved, this dissertation recommends cautiousness when including behavioural excesses under the umbrella of addiction. Treatment research should take into account institutionally embedded understandings of addictions when implementing new treatment strategies and policy approaches from other cultural contexts. This dissertation asks for a layered concept of culture, which can account for the multifarious influences of the social context on the concept of addiction.