BACKGROUND: Ontological addiction theory (OAT) is a novel metaphysical model of psychopathology and posits that human beings are prone to forming implausible beliefs concerning the way they think they exist, and that these beliefs can become addictive leading to functional impairments and mental illness. The theoretical underpinnings of OAT derive from the Buddhist philosophical perspective that all phenomena, including the self, do not manifest inherently or independently. AIMS AND METHODS: This paper outlines the theoretical foundations of OAT along with indicative supportive empirical evidence from studies evaluating meditation awareness training as well as studies investigating non-attachment, emptiness, compassion, and loving-kindness. RESULTS: OAT provides a novel perspective on addiction, the factors that underlie mental illness, and how beliefs concerning selfhood are shaped and reified. CONCLUSION: In addition to continuing to test the underlying assumptions of OAT, future empirical research needs to determine how ontological addiction fits with extant theories of self, reality, and suffering, as well with more established models of addiction.
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