A few months ago I realized that I had something important to say to addicts who wanted to quit but hadn't yet figured out how. I was invited to participate in a TEDx event on the theme of trust. For me that meant trust and addiction. Hmmmm....what could I say about that? That nobody trusts an addict? Not exactly news... That addicts can't trust the treatment industry? Ho hum. Then it hit me: The crucial role of "self-trust" in recovery. That's what worked for me, 32 years ago, when I finally broke my psychological dependence on opiates. Mightn't it work for others?
I had promised myself I was finished with drugs many times before, and I'd fallen off the wagon just as many. As is typical of addicts. Roughly 200 times in four years, and this yo-yo routine was killing me. Then, one time, something changed in the way I said it to myself. Instead of saying "only on weekends" or "just no injecting," I said "never again." And this time I trusted it. Suddenly I felt a new kind of warmth, engaging, kind, and smart. Instead of saying "sure, I've heard that before", a higher self (or at least a sense of self that extended into the future) put its arm around me and said: "we" are going to make it this time. We are that strong.
But why was it so difficult until then? Why is it so hard for addicts to "just say no?" We can answer this question only if we can explain what it is about addiction that works against self-trust.
There are two psychological phenomena that are central. I'll talk about one of them now and save the other for my next post.
Ego depletion refers to our fundamental inability to maintain impulse control for a long period of time.
Areas of prefrontal cortex (dorsolateral PFC and anterior cingulate) that are in charge of self-control run out of fuel. Like muscles, these areas get weakened and strained with continuous use. So, you can maintain self-control for a while -- but not for very long.
In a classic experiment by psychologist Roy Baumeister, subjects come to
the lab hungry. They are told not to eat either from a bowl of chocolate chip cookies (one group) or a bowl of radishes (the other group) sitting right in front of them. After several minutes, they have to complete cognitive tasks requiring self-control. Those who had to suppress their impulse to eat the cookies did less well on those tasks. (Nobody had a strong impulse to eat the radishes.) They had used up some of that precious cognitive resource -- inhibitory control.
Ego depletion is a serious problem for addicts of all stripes: because the thing you're trying to control is there all the time. The bar on the corner, the phone number of your dealer, the bottle in the medicine chest -- cues associated with your addiction are always present.
And addicts have to control their impulses, not just for minutes, but for hours, day after day, week after week. So, they run out of capacity, and they give in.
Recent research shows that people who believe in their capacity for self-control are less affected by ego depletion. Why should this be? How can a subjective state, a feeling, have such influence on a fundamental brain mechanism?
I think it's because, if you don't believe you can do it, the task is actually two tasks. You have to control not only the impulse but also your own doubt. Trying to maintain that double inhibition, to maintain your confidence while controlling your actions....exhausts your resources all the sooner.
That makes it very tough for addicts. Why should they trust their impulse control? They've failed time after time. So, each time, ego depletion is like a poison just waiting to take effect. And each time they fail, their capacity for self-trust is further weakened. All their trust is eventually invested in the drug, drink, or behavior they've come to rely on. And that ends up betraying them as well.
I'm always struck by a certain irony: People think addicts are weak and lazy. In fact it's the opposite. Addicts work harder than anyone else at keeping things together.
The second phenomenon is delay discounting. That's the tendency to devalue long-term rewards in favor of immediate rewards. Which happens to be an unfortunate side effect of dopamine's impact on attention and motivation. Dopamine metabolism is the so-called common pathway to addiction.
More on that next post. For now, let's just say that ego depletion and self-trust are mutually incompatible. Which means that ego depletion loses its insidious power to sabotage you when you finally figure out how to trust yourself. You don't have to grit your teeth and say "no" over and over -- if you actually believe in your own resolve. And that moment, when you switch sides and become your own coach, feels so right...that you already know it's going to work before the first day is over.