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Drug Addiction

William Dubin, Ph.D.
Helping people cope with Addictions and Impulse Control Disorders

The Karma of Behaving Badly

William Dubin, Ph.D. Updated: Sep 22nd 2010

People generally seek my services soon after a relapse. To help them I need to understand how the relapse happens and so after the initial introductions I ask the new client to describe the steps that led from their good intentions to their first lapse. I used to be surprised by the lack of detail I would get. Often they would express total ignorance and answer with, "I don't know."

man with question mark over his headIt is frustrating to me that many individuals cannot tell me much about what happened during the moments preceding the critical first violation of their commitment. The observation is especially perplexing considering the extensive detail the same client is capable of providing when describing some trivial conflict at work. Can this counter-intuitive observation provide a clue to understanding failures of will?

To change your behavior intentionally you must be awake at the critical moment of decision so you can intentionally choose the path that leads to the intended outcome, instead of mindlessly following the path of least resistance.

When clever attorney, H, cannot tell me what happened along the path that led to his relapse, it suggests that he was asleep at the wheel. His conscious mind was not fully engaged; he was on autopilot. He relapsed because he failed to intentionally guide his behavior during the critical high-risk moments.

Perhaps "asleep at the wheel" is too strong. At some level he was conscious of what he was doing. H reports that he observed himself following a path he had previously recognized as harmful and vowed to never follow again. He reports that he remembered his vow of abstinence, yet he simply did not exert the effort required to perform as intended and mindlessly followed the familiar sequence to the first lapse . . . demoralization and eventual relapse.

Autonomous Behavior

Performance becomes easier with practice. In fact, with enough practice, performance can become autonomous - that is, it requires no conscious attention at all. Consider activities such as driving or using a computer keyboard. When first attempted, performance is slow, hesitant, and filled with error, but with practice speed increases, variability decreases, and execution becomes increasingly effortless. What once demanded considerable attention can now be performed rapidly and accurately with little or no awareness of the component actions.

Conscious attention is not required to initiate an autonomous sequence. Mere exposure to the triggering stimulus is sufficient, and, once initiated, the action has a ballistic quality, tending to run on to completion all by itself. For example, when driving, a red light is sufficient to elicit a complex sequence of events that does not require my attention for successful performance. Conscious awareness is not required for my foot to move from the accelerator to the brake pedal or to guide the pressure on the brake to bring the vehicle safely and smoothly to a stop. Rapid, accurate, effortless performance that makes no demands on valuable conscious resources has obvious advantages. The down side of overtraining a behavioral sequence becomes apparent when you want to change it. For example, an experienced driver would take longer to learn to reliably stop at a green light than it originally took to learn to stop at a red light. Until the driver has acquired the new habit, [s]he must pay attention in order to override the well-practiced behavior of driving through a green light.

Stephen Tiffany (A critique of contemporary urge and craving research: Methodological psychometric and theoretical issues. Adv, Beh res Rher, 14, 123-139. 1992), whose views have been paraphrased in the preceding paragraphs, suggests that after considerable practice, addictive behavior becomes autonomous. While autonomous behavior can be overridden, it requires conscious attention to do so. The karma of repeatedly using an incentive is that the path that leads to it becomes progressively easier to follow. As a result, whenever your conscious resources are occupied by a demanding social situation or powerful emotional state, or are diminished by fatigue or intoxication, you will tend to follow this default path.

A mindless relapse occurs when mindful processing, which is necessary to interrupt the autonomous sequence, is not deployed when needed. This may occur when the individual was simply not conscious of the original commitment until the relapse sequence was already well under way. Less dramatic, but probably more common: The individual is more or less aware of the unfolding sequence of events leading to the lapse, and is also fully aware of the intention to abstain, yet simply fails to put forth the effort of will required to interrupt the autonomous chain of events.

The decision to restrict access to a rewarding incentive sets up a conflict. On one side there is the well exercised behavioral sequence that leads to incentive use. Against this is pitted a poorly exercised behavioral sequence that would motivate the individual to respond to a crisis as intended. This is a lopsided conflict; the path of least resistance has the advantage. The ability to keep your head in the face of provocative stimuli is essential.

Understand this: You will not have the resources to respond mindfully during the crisis. You must strengthen your intended overt and covert responses through rehearsal and exercise, to the point where they will be of use to you when you need them.

As a professional boxer can hire sparring partners to help him hone his skills, you can improve your skills by focusing on good performance during the high-risk situations you encounter in real-time. Unlike the boxer, you will not have to pay for your sparring partners-they will come up without you having to do anything special. As you continue to respond mindfully to the challenges as they arise, you will be developing and strengthening your coping skills. The Karma of performing as intended during high risk situations is that doing so becomes easier over time. With sufficient practice, performing the intended behavior becomes effortless-autonomous. The real objective of these articles is to help you transform your default path so that it takes you where you want to go.

Use It or Lose It

Habit strength, like muscle strength, increases with exercise. Each lapse strengthens the sequence of behaviors that lead to the lapse and each successful coping reaction strengthens the intended behavior sequence.

Every high-risk situation is a contest with a finite duration-generally seconds or minutes, rarely hours. You will either win by performing as intended or lose by lapsing. Each win enhances self-efficacy and exercises the responses that produced it, but each loss is demoralizing and strengthens the responses that will lead to future failures.

To change your default path you will have to dedicate the resources required to respond as intended during high-risk situations. Each time you do, the intended coping reaction is strengthened. It will take a finite number of exposures for the new reaction to become stronger than the old one. How many exposures? It takes 42 consecutive willed reactions to establish a new default reaction. Of course, I could be wrong. It might take 112 or 23, but it will not take a million. You will get better at this with practice and after perhaps 42 high-risk situations in which you acted as intended, you will find that your default path has become your path of greatest advantage.

You can succeed at this task, but you must stay mindful during this initial phase and manage each and every high-risk situation you encounter. While you are going through it, it may seem as though it will never end, but if you follow your intended path, you will look back on this stage and see that this part of the passage did not last very long, and the struggle against the pull of the incentive was not without its own rewards.


William Dubin, Ph.D.William Dubin, Ph. D. is licensed by the state of Texas as a Psychologist, and is specialized in the treatment of addictions, having received the Certificate of Proficiency in the Treatment of Alcohol and Other Psychoactive Substance Use Disorders from the American Psychological Association. Readers in the Austin, Texas area dealing with psychological issues (such as depression, anxiety or anger) or "incentive use" issues (otherwise known as addictions) may contact Dr. Dubin for face-to-face consultation and treatment through his practice, Psychological Assessment Referral and Treatment Services, online at Dr. Dubin's PsychARTs office may be reached via telephone at 512-343-8307

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