How to make the future better than the present

Hello! I recently heard a talk about something called intertemporal choice, which is a fancy label for delay discounting, which is a fancy label for people’s tendency to value immediate rewards over long-term gains, even though the latter are objectively more valuable. Here’s a simple description from the first few lines of a scientific article:

Humans and animals prefer immediate over delayed rewards (delay discounting). This preference for smaller-but-sooner [SS] over larger-but-later [LL] rewards shows substantial interindividual variability in healthy subjects. Moreover, a strong bias towards immediate reinforcement characterizes many psychiatric conditions such as addiction and attention-deficit hyperactivity disorder.

—Peters and Buchel, Trends in Cognitive Sciences, May 2011, Vol. 15, No. 5

So addicts go after smaller-but-sooner (SS) rewards more than larger-but-later (LL) rewards…more than “normal” people do. You probably knew that, especially if you are or were one. And I’ve posted about it and talked about it ad nauseum.

One interesting question: were we already like that and that’s why we became addicts? This SS/DD overdrive is related to other personality traits, like, oh, impulsivity. Or does being an addict gradually wear away our cognitive controls, reflective skills, etc? Until there’s nothing holding us back from I want it now! I think both are true, in different proportions for different people. I’ve seen some pretty well controlled people fall into addiction, and they weren’t so well controlled after a year or two.

DDHulkSpockIn this talk, a colleague named Bernd Figner (I know, it sounds like Burnt Finger — how else do you think I remember it?) talked about an experiment using transcranial magnetic stimulation (TMS).  Basically, you put an electromagnet right on the person’s scalp, over the part of the brain you’re interested in, and turn it on. And the effect is that that part of the brain becomes discombobulated. The magnetic field causes it to become disorganized. Temporarily.  So he put his TMS device over the top-side (dorsolateral) part of the prefrontal cortex. And when he did that, people’s tendency to go TMSfor the SS reward increased significantly. Especially when he did it on the left side of the head: the left hemisphere does a lot of our thinking for us. Cool. Cognitive control helps us keep those SS rewards at bay while we work toward the LL rewards, like having a life, a wife, a bank account, etc. And the finding might pull for explanation #2: that addiction itself (which depletes cognitive-control on the spot) increases delay discounting. A vicious circle if ever there was one.


Another interesting thing: look at the graph: the effect disappears 30 minutes after the TMS application. In other words, your brain can go back to normal within 30 minutes of whatever it was that interrupted self-control. Which might include drug cues, thinking about drugs or booze, craving, driving toward the liquor store or your dealer’s house… Turn around and drive home, and you should have your brain back within half an hour.

Then Dr. Figner reported on experiments in which they adjust two parameters: The first is the value of the SS and LL rewards. They often use money with adult subjects, so all they have to do is increase the amount you receive after waiting, or reduce the amount you receive in the short term. The second is the time interval. If you can increase the waiting time for either the SS or LL rewards, people’s choices will change also. So some researchers look for the break-point for their subjects. Let’s say you offer me 10 euros today vs. 20 next week. I’ll take the 10 today, thank you. But you increase it to 45 euros next week, and I’m willing to wait. Or if the immediate reward gets less immediate, and I have to wait for the SS payoff for a few hours, then I’m more likely to wait for the bigger payoff next week. But a month? Maybe not.

So by adjusting the value and the timing, you can find the point at which any person will switch from choosing the sooner payoff to choosing the later payoff. Now if you’re an addict, or you’re working with addicts, think about whether this might help. Make the long-term benefits more valuable. Not only will your wife give you back a key to the house, but she will make you your favourite dinner on Tuesday evening, if you don’t get loaded tonight. Or make it sooner. She’ll do that for you tomorrow. Or delay the “immediate” reward. You can do this with self-programming (see recent posts). Get rid of all the booze in the house, so you have to walk four blocks to get some.

See my point? An important strategy for overcoming addiction might be to fiddle with these parameters: how much, how high, when’s it coming? Versus how good will it be, how long do I have to wait? Fiddle with them until the value of the future matches and exceeds the value of getting high today. It’s like saying: Everyone has their price. But instead you’re saying: Everyone has a point at which sanity returns.

41 thoughts on “How to make the future better than the present

  1. Matt May 26, 2014 at 5:36 am #

    Sounds a lot like Carl Hart’s work. Identify the parameters, which are the most significant and to what degree in a given individual, then manipulate them appropriately with the right timing and intensity. The problem is figuring out how to identify, evaluate and train them accordingly.

    • Marc May 26, 2014 at 7:44 am #

      Yes, I thought of Hart’s studies too. For those not familiar, Hart brings crack and meth addicts into a residential research center, and offers them, several times throughout the day, either a hit of crack (or meth) or else a voucher for money — from $5 up — to be cashed in later. To most people’s surprise, these guys very often take the money rather than the hit, even though the payoff isn’t until days or even weeks later. Some will forgo the hit for as little as $5. Hart discusses his findings in terms of the lack of opportunities — choices — available to inner-city minority young men. If there’s little chance of finding an attractive job, relationship, housing, or credibility, then there’s little else going for them than to get high. So the immediate payoff is chosen above a future payoff that is, arguably, not even on the radar.

      Carl Hart, Associate Professor, Columbia University
      — a very cool looking professor who’s made a big splash in addiction research.

      • Cheryl May 26, 2014 at 12:28 pm #

        Yep I think there is a definite correlation to past or current environment condition and the workings of impulsivity verses waiting.

        • Matt May 28, 2014 at 10:19 am #

          Definitely. Before a discussion in groups, I often have people reflect on what has been working for them in the past week, or if they have more time in recovery, reflect on where they are now compared to 6 months ago. It seems to have a priming effect for people to notice the positive strategies used and barriers surmounted, and better focus the discussion on recovery. Every little success gives some positive reinforcement that becomes a larger reward with time.

    • Gary May 26, 2014 at 7:57 am #

      Very interesting stuff in brain thought and thinking about reward and/or gratification. For me, I was anywhere but “present” and gratification was always a future event. “In the present” , whenever I was there, was always much more manageable whereas the past or future held no meaning except for pain and/or despair or possibly the unreachable sense of happiness.

      It was only when I came to terms with the vital importance of embracing the present, as a “gift”, could I even envision a future but then realized that the “future” was NOW!~ I’m a bit curious as to rather or not I would want the future to be better than the present because it would appear, to me, that I would always be chasing something I couldn’t grasp similiar to drug use.

      I believe it is the perception of the present more than the reality that causes grief. Sometimes “belief can be a thief” making a “whole” out of the sum of a small part. The formulation of the world is seen through the filter of my mind thus I see the world the way I am and not the way the world is. So my interpertation of the world changes as i change. In fact, my world has change significantly over the past 26 years, its like I have lived two separate lives.

      At the same time, hopefully science and brain technologies will help compliment the process of change for those who continually struggle.

      “Now” is the time to live where there is very little “attention” to the past or future. Freedom exists only in the moment where I awaken and inhale a life with no labels or judgements just being. There is no-time to “know time” unless it is a future event, change can only happen now.

      Its great to be able to share thoughts with respect to physiological aspects of brain chemistryand biology around limitations as well as exceptions of change behaviour. Very Interesting!!!

      • Marc May 28, 2014 at 4:41 am #

        Hi Gary. There is so much in your comment. Let me just reply to one issue you raise. When I say “the present” in this context, I really mean the immediate future. The SS rewards are not in the actual present, not at all. And as you say, the real present is this incredibly rich and plastic space, perhaps the only space where we have anything resembling full awareness. No, the SS rewards are just around the corner, in the anticipated present, the very near future.

        Because of the influence of dopamine and the way the NAcc operates with high dopamine input, people with addictions are in a state of high-anxious-excited anticipation about the upcoming event — getting high, or whatever. One of the terrible ironies about addiction is that being there is such a let-down. Because it’s never as good as you thought it would be, and it’s so hemmed in by expectations, regrets, and qualifications (e.g., when/where will I get some more) that it’s not much fun after all!

        And the LL future — well, I think there’s a state in which we have a sense of ourselves in time, moving forward from the moment into the future. Sometimes this feels like hope, and sometimes it’s pure anxiety…and perhaps other stuff. But there can be a rich awareness to that connection: an ongoing center, a sense of self.

  2. Stephen Creagh Uys May 26, 2014 at 6:04 am #

    I always enjoy your blog and have seen this particular ‘theory’ at work in my own recovery. I chose methadone and remained a patient for years. Due to the long-lasting effects, it initially curbed my impulsive reward seeking. After a few years, I found that the impulse control (or lack thereof) had greatly changed. I tapered from MMT with a renewed sense of delayed gratification, which remains with me today. I also think the 30 minute normalization is a very encouraging, practical tool which I will certainly add to my toolbox. Thirty minutes is not too much to ask of someone about to make a decision which could possibly have long-lasting consequences. Thank you.

    • Marc May 26, 2014 at 7:49 am #

      Good to hear. I think you hit the nail on the head, calling it a renewed sense of delayed gratification. It IS a sense. It can start to feel familiar and heartening after you practice it for awhile. It can acquire an emotional warmth or sense of security, which I picture as a father with his arm on his kid’s shoulder, saying: We’ll wait it out, and things are going to get a lot better before too long.

      • William Abbott May 26, 2014 at 8:10 am #

        This has been an area of great interest to me for a long time and I use a variant of this approach in trying to enhance motivation in those in early days of recovery at Smart meetings.

        It also brings to mind Richie Davidson’s early work on hemispheriic lateralization ( using EEG ) of positive reinforcement on the left and negative on the right — with Fingers TMS studies

        I wonder if there has been any followup of the marshmallow study kids ( shown again at the Dalai Lama’s meeting) to see if the early data had any predictive value in olders folks developing an addiction .

        • Marc May 28, 2014 at 4:47 am #

          Sure, it connects to Davidson’s emphasis on the left PFC as the “regulator” of the right, and so forth.

          In fact there has been A LOT of follow-up from the marshmallow test. I’m pasting a few sentences from Wikipedia:

          In follow-up studies, Mischel found unexpected correlations between the results of the marshmallow test and the success of the children many years later.[5] The first follow-up study, in 1988, showed that “preschool children who delayed gratification longer in the self-imposed delay paradigm, were described more than 10 years later by their parents as adolescents who were significantly more competent”.

          A second follow-up study, in 1990, showed that the ability to delay gratification also correlated with higher SAT scores.[5]

          So, individual differences in impulse control predict a lot: and there’s no doubt that addiction is a greater risk for those who just don’t have the best machinery for this particular skill.

          • William Abbott May 28, 2014 at 8:55 am #

            I do know of these but was particularly interested if there was a difference in developing a SUD ??

            • Marc May 28, 2014 at 9:46 am #

              Oh, sorry. I’m not sure, actually. I doubt if there’s anything specific to Michel’s cohorts, but there must be something out there. I should ask Gabor Mate. He would know.

    • NN May 28, 2014 at 11:33 am #

      Hi Stephen,
      What is 30 min. normalization? I got one hit on Google to a thesis about heart disease. I can guess it means ‘wait 30 mins before doing something that’s possibly very foolish and harmful; and consider what you really want.’ But I’d like hear from you, as it is for you.

      Can you give some leads and/or links?


      • Stephen Creagh Uys May 28, 2014 at 1:35 pm #

        I was referring to the article. It said that an excited, craving brain will return to its normal state roughly 30 minutes after the triggering event or craving arisen from an unidentifiable source. I do not know how this may work in other fields, but it seems to parallel the experience of a workout. Thirty minutes after vigorous activity, my body seems to return to a state of comfortable equilibrium.

  3. Robin Roger May 26, 2014 at 10:38 am #

    I’ve been mulling over the same general strategy concerning eating in a healthy and moderate fashion, with regards to the process of food acquisition. Though it is far less efficient to walk to the store to buy small amounts of food, it has occurred to me that having to make an effort to acquire food might be more beneficial than having a fridge and larder stocked with ample supplies that I can grab at whim. This doesn’t just apply to less advisable foods such as sugary sweets, but all foods that can be mindlessly consumed. While food is in a slightly different category than other substances because we can’t go very long without eating, and we increase our chance of over eating if we leave it to long, I am going to experiment with having a minimally stocked kitchen for a while to see what happens.

    • Liz May 26, 2014 at 11:59 am #

      Hi Robin!

      I also struggled with similar issues (and sometimes still do), and found that having a minimally-stocked kitchen was helpful. The more barriers to entry, the more the immediate reward of compulsive food intake becomes more distal. It’s like adding a delay! With both options being delayed rewards (binge eating/not binge eating and thus not suffering the consequences), it’s easier to discount the former!

      • NN May 27, 2014 at 6:14 am #

        Yes, Liz and Robin,
        There are certain foods that should not be in the house. It’s one thing
        to go buy an ice cream cone for a ridiculous $4, another to have
        a gallon, bought for $15 in the freezer–beckoning.

        With the surgery and painkillers, I’ve lost 25 lbs and plan to keep
        it that way. Eat half or one third the amt as before, for a start.

        The demand of such an issue make ‘abstinence’ a far too limited
        concept; one might apply it to chocolate cake, but that doesn’t get you very far.

        • Marc May 28, 2014 at 5:15 am #

          Well you three are certainly onto something….something which seems to have eluded roughly 100 million Americans — that wave of obesity is so strongly coupled with fast, available snack foods.

          I also lost 20 pounds through the surgery and post-op period, NN. Isabel says I look too skinny, but I think I look great. I’m ready to go back to my modeling career. However, I have stocked the house with chocolate cookies which I eat regularly to make her happy.

          Same principle?

  4. Richard Henry May 26, 2014 at 11:22 am #

    Great post Marc
    I use this type of Reward strategy all the time. Finding the most powerful tool of Reward at the moment for the future in helping deal with the present situation. For instance: Not to long ago I was having cravings and in a way to fight back those cravings, those thoughts, I went to the mirror, looked myself in the eyes and said…”Leave me alone, and I will give you some ice-cream later”… You know, I laughed at the time, it changed my train of thought and I did reward myself with ice-cream later. If you don’t choose to control and overcome your thoughts by what ever means it is, and quit avoiding your inactivity for change, then you will never conqueror anything in life. One of my favorite sayings is “If you always do, what you have always done, you will always get, what you always got…
    Time for change..
    Regards Richard Henry.

    • Marc May 28, 2014 at 4:50 am #

      Nice example, Richard! Yes, you’ve talked about your ice-cream reward before. This is indeed a great example of giving yourself something special and making it feel good: not only the stuff itself, but the way you imbue it with warmth, humor, and a sense of self-regard. A great way to avert sudden attacks of less healthy gratifications. Quite brilliant!

  5. Liz May 26, 2014 at 12:11 pm #

    I also agree that fiddling with the parameters of the SS and LL rewards could be beneficial for a recovering addict. However, this also sounds like quite a bit of work; something that may be more readily achieved by a person who is NOT inherently impulsive. I’m just wondering what to do with this type of research. We have evidence that individuals struggling with addiction are likely to score higher on trait levels of impulsivity. We have evidence that delay-discounting parameters, which purportedly measure some impulsivity construct, can be manipulated. Do we have evidence that individuals with high trait levels of impulsivity are more resistant to manipulations of delay discounting? Could this have implications for the types of behavioral interventions that we could employ successfully?

    Interesting post!


    • Marc May 28, 2014 at 4:54 am #

      Hi Liz. That’s a very good point. But see Richard Henry’s comment above. What a simple and straightforward way to implement the manipulation of rewards. But I agree that it’s not obvious how to highlight the future before we get there, especially when the immediate is tugging at us relentlessly, and, yes, especially if we have impulsive personalities. Stay tuned, I have more to say about that next post, and I’m also inviting the “clinicians” out there to give us some ideas.

  6. Peter Sheath May 26, 2014 at 12:45 pm #

    Hiya Marc
    Again a really great and timely post. In the UK we have lots of people who are being described as stuck in treatment. Some have stabilised on Opiate Substitute Therapy, manage their lives well, do not use on top, don’t commit crime and are responsible citizens. A bigger majority use OST as an adjunct, continue to use, continue to commit crime, drink hazardously and are far from responsible for just about anything.
    I’m trying to develop a package that will address both of these, especially the latter where I think your blog will help. I also think this kind of fits with a little theory of my own around people holding on to an intoxicant attachment to substances as opposed to the medicinal attachment they need for OST to work effectively. It’s very difficult to move from long term instant grat oblivion seeking to delayed grat controlled use.

    • Marc May 28, 2014 at 5:01 am #

      Hi Peter. Very difficult indeed. Instant-gratification seeking becomes more and more entrenched, I think, the longer we continue our addictions. More of a habit in itself. And that’s serious. There is good strong evidence of a decline in grey matter density in regions responsible for cognitive control, and the decline keeps going, linearly, with years of addiction — at least to some substances. GM density really means the density of synapses you have available in a certain area. So what happens when the factory starts closing down, and you literally lose some of the brain matter required to stave off those impulses? The second of your two groups seems to be well along the road to a shut-down.

      But there is hope. I posted that graph, recently, showing that these areas regenerate with months of abstinence. They can even exceed initial levels. But how the hell do you stay abstinent without the machinery?!

  7. Doug May 27, 2014 at 12:33 am #

    Way cool how a big electric magnet temporarily induces the permanent disease of addiction. Case closed.

  8. Doug Anderson May 27, 2014 at 12:35 am #

    Way cool how a big electric magnet can temporarily induce the permanent disease of addiction. Case closed

  9. Dustin John May 27, 2014 at 2:40 am #

    Hello Marc,
    Thank you for the latest post. It is very interesting. As a heroin addict myself I believe that yearning for the short term reward has always been there for me. At least from the time I had my own cognitive abilities. Great info and great reading. Thank you!

    On a slightly different subject, I sent a request to guest post and didn’t hear back. It looks like nothing new has posted for a while now. Is that still functioning? I would love to write an article about some of my own experiences with addiction. Good luck with all your journeys and I hope you are healing up promptly.


    Dustin John

    • Marc May 27, 2014 at 3:34 am #

      Hi Dustin. Thanks. I’m glad you found it useful, and I take it you’re voting for heightened delay discounting as a personality factor preceding addiction. Well, maybe. But don’t forget, all little kids dive for immediate rewards. It’s not a personality factor until it stands out against the norm. And for little kids, it’s the norm. You know about the marshmallow test? Check out this cute video. Anyway, kids almost all “fail” this task (go for the immediate reward and lose out on the second marshmallow) until about age 4. After that, we normally develop some mechanism for controlling that “lunge” factor. But some develop it less, or less reliably, than others. And maybe you (and I) would be on that list. Maybe.

      As for a guest post. Sure. Do you mean a “Guest Memoir” — one of the menu items above? That’s easy. I’ll publish (almost) anything you send me, maybe with some suggested revision or light editing. A guest post means you do the post of the week, in which case I act as editor and I get to veto it if I think it won’t be of general interest. So tell me which of these you have in mind and we’ll go from there. Sorry to have missed your previous email!

      • Dustin John May 27, 2014 at 7:07 am #

        Hey Marc,

        I should have been more clear in my first post. I did see a few different studies on the marshmallow test. Correct me if I am wrong but I believe I am agreeing with your conclusions. Maybe not, lets see.

        An infant has no capacity for LL until the proper brain development occurs. Once a child is old enough to control the lunge mechanism, it may vary from one person to the next; some showing more control than others. It is my belief that what happens to the infant between day one of birth, until the “lunge control” development begins– is the cause of the different outcomes in subjects. Physical/mental/sexual abuse, misguided parenting, lack of a loving hand, and not receiving any kind of rewarding tasks as an infant causes the brain to have abnormal levels of serotonin, dopamine, endorphins etc. If this is true, then there would be a predisposition for an abused child to react negatively to LL? Maybe I am way off base with this.

        I have never had much control of my trigger happy impulses when I was a youngster. It has gotten better over the years but I had to really work at it. I thought it was caused from some kind of abuse as an infant.

        Originally I meant memoir but I would love to do either one. Having an opportunity to do the post of the week with your insight, expertise, and knowledge would be amazing- even if you do give it the boot!

        • Marc May 28, 2014 at 5:10 am #

          Hi Dustin. I fully agree that abuse, neglect, and other disasters of early development can erode the capacity for self-control. In fact there’s been a lot of work in that area. See talks, papers, books, by Daniel Siegel, and Gabor Mate’s work. Mate talks about the loss of self-regulatory capacity in relation to addiction in his book, “In the realm of hungry ghosts”. But there are also built-in differences. Just like differences in shyness and other personality characteristics come partly from heredity. So I wouldn’t just assume abuse if there’s no evidence for it.

          It sounds like what you have in mind, describing your own experience, would work better as a memoir than a post. That’s what I’d suggest. Take a look at the others, and try to make it good reading. Not too long, and try to come to a point. No telling how many people it will reach, but it will certainly reach some. At least 2,000 people visit this site regularly.

          • Dustin John May 29, 2014 at 11:37 am #

            Hi Marc,

            I will definately look into his work, thank you. I’ve been brainstorming and focusing more into my early years since I got sober (0-6 yrs old). It has always been area easy for me to breeze over because I knew I had never been beaten, raped or had any other obvious trama. At least not that I knew of.

            Anyway, thanks for the opportunity to do a memoir. I will send that over the weekend. Have a great week Marc and thanks for all the valuable information.

  10. shaun shelly May 27, 2014 at 4:02 pm #

    Hey Marc

    In Community Reinforcement and Family Therapy (CRAFT) family members are encouraged to use the exact technique you talk about – increase the reward, such as cooking a favorite meal if they come straight home instead of first stopping at the bar.

    This also explains why contingency management works so well – see Scott Kellogg’s work.

    In early recovery I had a friend who I once called because I wanted to score, instead of saying no, he invited me round, saying we could go score as soon as…. he delayed the process and after a cup of coffee and some cake, the desire had gone! Things were back in perspective.

    There is much to support this line of thinking, and we have discussed how delay discounting can even sabotage getting that perfect high by not being able to delay doses.

    Certainly I am finding that my tendency towards SS is being replaced by LL in all areas of my life!

    • Marc June 3, 2014 at 2:50 am #

      Hi Shaun,
      It’s funny to communicate on the blog after so many skype tete-a-tetes. But this is really good information. I had no idea this was a formal principle in addiction treatment, but I’m certainly not surprised. We keep reinventing the wheel, don’t we? It makes so much sense. And I love your anecdote.

      The way addicts foreclose on big rewards by grabbing for the present too soon…. I find that fascinating, and so true… It’s sort of a paradigm case of this whole DD business. I’ve already written it into that chapter, y’know. From here on in I’m just going to call it the lunge instinct.

      Oh and see my next post for another take on this. And please don’t ignore the invitation to contribute a guest post. What you say about CRAFT would be just perfect. Plus your anecdote. It doesn’t have to be very long. (500 words is enough)

      Take care!

  11. Rachel May 28, 2014 at 12:22 am #

    I’ve combined the ideas of Hart’s studies – the lack of a viable future reward – and Gary’s thoughts about living in the present to add another question to the mix –

    What if, in an addict’s brain/psyche, there is a future-reward sabotage mechanism. Considering how we can only truly perceive ‘now’ as a reality – the future is always just an idea. Some people, especially very logical people who really concretely feel that patterns from the past will definately continue in the future and the world is a stable, rational place may be able to place their trust in future rewards. But others may only be able to trust in the now. For example, what if everything goes wrong between here and future reward? – when you’ve experienced everything you trust and expect suddenly being tipped on it’s head, you may lose the certainty that ‘if I wait half and hour I will get a better reward then’. You may think, ‘I can’t be certain that the world will even exist in half an hour, so I just need whatever reward I can get now.’ So this whole concept of delayed rewards is very enmeshed with the ability to trust in something which is not certain at a given moment.

    This may also link in with relationship self-sabotage, for example, I may know that my addiction is ruining my relationships, so the idea would be, if I delay the immediate reward of my hit, I will be rewarded with improvements in my relationships, quality time with those I love sober. But this , although it is the reward I want, may also be exactly what I am terrified of because of the vulnerability, potential for failure. I may subconsciously feel that I will probably ruin those relationships anyway or that those I love may be disappointed in who I really am, so realistically I can’t actually expect the reward of those future relationships, they will probably fail, so I may as well just get high now anyway.

    Also – This may be a bit controversial but it’s something I’ve always wondered – This whole ‘delayed reward’ system is applicable to every person who has long-term goals, like health, wealth, fitness, whatever.

    In terms of neuroscience, is there any difference between someone who fails consistently at this but in a socially acceptable manner – like someone who can’t give up cake and so can’t lose those last 5 kg – and an ‘addict’ – presumably where the addiction starts to control many big aspects of their life. To rephrase, my question is, is addiction measured by the actual process that goes on in a person, or by the ‘thing’ that the person is addicted to?? Do only certain, ‘harmful’ things count as addiction? Clearly not because you can be addicted to many many things – even things that are ‘normal’ in moderate use – but it’s this “catch and chase” kind of brain cycle that you can’t get out of that seems to constitute addiction. But my question is, do healthy people’s brains work the same way, but they’re just “addicted” to ‘healthy’ or acceptable things?? Ok I know this is a broad scattered question but it’s always plagued me.
    Great post as always

    • Shaun Shelly May 28, 2014 at 7:42 am #

      I think your point is essential. Addiction is very much part of the human condition – some of us just sit on the extremes of the bell-curve. I often use this example:
      If you suffer from migraines and you discover a tablet that takes the pain away, you will continue to take the tablet. If someone now tells you that you MAY develop some rare cancer in 20 years time because of that tablet, it is very few people who will not take the tablet in the throes of a particularly bad migraine!

      Obviously this is a simplistic metaphor, but is good to illustrate the point. Bruce Alexander argues that over 80% of addictive behaviours do not involve drugs. He talks about 4 types of addiction in his book “the Globalization of Addiction”.

      I would argue that all people have the potential for addiction to some extent, and some are full blown addicts but with more acceptable manifestations – Chris Arnade has written in the Guardian about the similarities between Wall Street Traders and street addicts in Hunts Point. Argueably, the trader has the more dangerous addiction!

      • Matt May 28, 2014 at 10:31 am #

        I agree with Shaun. I think you raise an important point— that there may be some dysfunctional primary reward that the addiction helps maintain(?)— like the self-sabotage, fear of success/failure. Sometimes in meetings, I hear people have a self-realization that they were addicted to the chaos, anger, or control. The addiction helps maintain some other problematic developmental, coping mechanism. It may have seemed like a reward at a time past, but now is just keeping one stuck and not working on the primary issue. I think it’s important to eventuall disentangle the primary problem that is driving the addiction. The notion of “dry drunk” may be a manifestation of this.

        I also agree that there is a sense in which anyone can be addicted to anything. It’s just a matter of degree, duration, and frequency. How much for how long with what frequency. Then how it interacts with, and affects other behaviors, important in a person’s life. Social acceptability would play a big role. Isolation, an earmark of serious progressive addiction isn’t considered socially acceptable.

        I think the internal “process” that goes on and the “thing” in Rachel’s comment interact in complicated ways. People that quit excessive drinking, also report that they quit lying as well; that’s a socially unacceptable behavior directly caused by a person’s primal drive to get what they want, even though they are ashamed of doing it.

    • Marc June 3, 2014 at 3:11 am #

      Rachel, I love your comment and Shaun’s and Matt’s replies. Next time you have so much to say will you PLEASE send it to me for a guest post.

      I don’t have much to add. I strongly agree that some of us cannot visualize the future as a reality, or can’t trust in it, whether that includes a wounded relationship or not. I think the prime toxin here is simply disappointment and repeated failure. That’s certainly enough to make a shiny future dubious. I go in that direction myself when Isabel and I are going through a rough spot. The future begins to fade in and out like an out-of-range radio station.

      Magnitude of reward, sure, that counts, and perhaps even more, magnitude of the dire consequences you’re likely to face — and their imminence — in that imagined future. Shaun’s imaginary migraine cure is far more likely to be flushed down the toilet if the cancer is a very painful variety and likely to show up in a month.

      As far as brain differences, the main one I can think of is that slightly fuzzy concept, impulsive personality style. This is probably related to dopamine balance across receptor types in the cortex and striatum, and it can be a stable personality trait, present from childhood.

  12. JLK May 30, 2014 at 1:15 am #

    Hi Marc

    That is a terrific article. When I have quit smoking (once for 15 years until alcoholism got me) I have always noticed that the cravings would stop after 10 or 20 minutes and just knowing that helped keep me going.

    Unfortunately my illness results in major depression episodes and when that heppens I just don’t care anymore and that is always when I lose all my will power or whatever you call it. I have tried to quit 4 or 5 timed in the last 10 years but fail after 1-3 months when hit with the depression.At that point I don’t care if I live or die si why not smoke.


    • Marc June 3, 2014 at 3:36 am #

      Hi JLK. Knowing the craving is time limited is one of the key roads to quitting. They emphasize that in Mindfulness-Based Relapse Prevention. But I know what you mean about depression. It is the worm that infects the most hopeful plans. Depression doesn’t know anything about imagined wellbeing in the near future.

  13. JLK May 30, 2014 at 1:22 am #

    JLK Part2

    I must say that method is very effective for “normal” people.

    The other day a close friend bet me $5000 that I couldn’t stop within one year so I am going to have to figure out a way of getting it done or I will down 5 grand.Maybe the combination will do the job.
    Sorry about the typos

    • Marc June 3, 2014 at 3:38 am #

      I guess the trick would be to get it in installments, each one providing a sense of more immediate reward. I wonder if you can hold onto such a long-range expectation. You’d be carrying the weight of delay discounting on your shoulders. But sure, try it! You got there with alcohol.

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