But, unfortunately, the day comes when your luck runs out. You die from cirrhosis or collapse from a heart attack. You look back and ask yourself, "What was I thinking?"
We underestimate the danger of behaviors or conditions that continue on a regular basis. Smokers, drivers not wearing seat-belts, people who don't take their medication, people who are in debt, obese individuals and people who drive unsafely all underestimate their future risk because they assume that nothing bad has happened and therefore the future is safe. This is like playing Russian roulette with successive spins of the barrel--eventually, your number is up. However, as you have been spinning the barrel-and each time it is empty-you have become more complacent, incorrectly believing that your good luck so far is a predictor of better luck in the future.
Ironically, then, exposure to risk over the long-term produces cumulative risk.18 Cumulative risk is risk that increases over the long term. The more you repeat the behavior, the greater the chance that something bad will happen. The longer you drink, the greater the risk of cirrhosis. The longer you are obese, the greater the risk of a heart attack. The longer your exposure to risk, the greater the risk. But risk-takers act as if each time they engage in a "risky" behavior-and nothing bad happens---they feel safer.
Increased exposure to risk paradoxically reduces the perception of risk. Thus, smokers will underestimate risk. They think, "I haven't died yet, so it must be safe".
The Next One Won't Kill Me
Young cigarette smokers say to researchers, "The next cigarette won't kill me".19 When we think about taking another smoke or overeating or drinking another drink or not wearing a seat-belt, we often think, "There's very little chance that the next time will kill me". Of course, this is true. The next cigarette or drink may not kill you. But what if this is your continual belief for the next 350,000 cigarettes during your lifetime? It may not be that the next cigarette will kill you, but it may be true that holding onto this belief will kill you.
All of these risks involve "near-sightedness"-or what we call "myopia". We focus on the next one-not on the long string of behaviors. We tend to think that the "next time I go out driving without my seat-belt, there is a very low probability that I will get killed". This is true---but each time increases the probability. It's like playing Russian roulette. There is a bullet in the barrel, but you don't know how many barrels there are.
You Don't Recognize Addiction
A common problem for these deadly bad habits is that we seldom recognize the addictive quality of our behavior. Although there is clear evidence now that nicotine addiction is a true addiction (just as heroin addiction is real), we tend to discount the addictive nature of overeating, drinking, and over-spending. These are behaviors that bring immediate gratification---we feel good instantaneously---and this immediate gratification strengthens the bad habit. When young smokers were asked if they worried about the addictive nature of smoking, they often said, "I'll stop before it gets too bad."20 Thus, we tend to underestimate how addictive these behaviors are. By the time the addiction is established, it has become extremely difficult to reverse the bad habit. We are hooked.
You Use Anecdotes Rather Than Probabilities
When I asked a 55 year-old smoker if he was concerned about getting lung cancer, he told me about his uncle who smoked until he died at 83. Another man justified his heavy drinking by claiming that his grandfather drank every day---although he failed to point out that his grandfather only had two glasses of wine each day. We tend to rely on concrete examples---or anecdotes-to support our belief that things are safe. Worriers also rely on anecdotes or concrete examples---rather than relying on abstract baseline information. For example, the worrier who has a headache refers to an anecdote or concrete example of someone he heard about who had a headache that was due to a brain tumor. These concrete, emotionally evocative anecdotes are more "convincing" to a worrier that the abstract, baseline information that refers to the percent of people with headaches who do not have brain tumors. And if you are trying to justify your risky behavior you will turn to anecdotes that "show" you how safe it is.
Anecdotes are quite memorable for us---we can get a picture of someone who does not wear a seat belt or who smokes every day. When we form the picture, we then use this as evidence that things are safe. Now trying to think about probabilities is very hard. It's almost impossible. Our primitive brains are not built to think about abstract probabilities. It wasn't useful in the primitive environment of our ancestors to try to calculate the percent of people who ate something who died.
The problem, though, in relying on anecdotes, rather than probabilities, is that you can always come up with an anecdote to justify your behavior. For example, even though we know that smoking causes cancer, that alcohol abuse results in early death for many, or that unsafe sex can lead to contracting herpes or AIDS, we can readily come up with concrete examples of people who smoke who do not have cancer, people who drink excessively who go to work every day, and people who do not use condoms who are healthy. We need to keep in mind that safety is about probabilities-and anecdotes do not tell us anything about probabilities.
You Try To Feel Better Too Quickly
Worriers are often trying to avoid negative emotions---they do not want to allow themselves to feel anxious right now-so they worry to engage in "problem-solving" or "hypervigilant" thinking that actually temporarily reduces their anxiety. This emotional avoidance ironically also underlies the tendency to avoid thinking about actual risky behavior. For example, Frank worried about his girlfriend's opinions of him-whether she saw him as a successful man---but he did not worry about his taxes that had not been filed in two years. Whenever he thought about his taxes he became anxious-and, therefore, he avoided thinking about them. This emotional avoidance-and the attempt to feel better right now---is a key element in both worry and in avoiding thinking about preventable risk.
A key element in your risky behavior is that you are trying to feel better immediately. Research on drug addiction and alcohol abuse shows that people with these addictions seldom get to the "withdrawal" experience---they are continually experiencing the "positive" feelings associated with drugs and alcohol.22 The reason people do these things is that they are immediately reinforcing--they work immediately. The same thing is true for overeating, unsafe sex, and over-spending. The rewards are up-front.
Psychologists have referred to this kind of addictive process as a "contingency-trap".22 This means that you continue to choose a habit-forming behavior because the consequence (contingency) is immediate gratification. This immediate gratification not only strengthens the habit, but blinds you to consider the longer-term consequences of the habit that could be devastating.
Ellen had been upset about a breakup with her boyfriend-so she began to drink more. This made her feel better immediately. It worked. When I asked her what she predicted would happen if she didn't drink for three months she predicted that she would feel worse. Ellen believed that drinking made her feel better immediately and terminating drinking would make her feel worse. My argument is that there is some truth in Ellen's "myopic" or "near-sighted" emphasis on feeling better immediately-but it is only part of the truth.
A Contingency Trap
The question-it seems-is, "When would you feel worse"? People who are alcohol abusers are often depressed. They think that they need to drink in order to deal with their depression. But within two months of abstaining from drinking, 90% are feeling less depressed. This is because alcohol serves as a central nervous system depressant---it will depress you. But it initially reinforces you, because alcohol can calm you down immediately. So when you stop drinking completely you might feel more anxious for the first week-but later, after a week or two, you begin feeling better.
