Dopamine highlights the promise of pleasure while blotting out the truth: that the drinking leaves us sick, the gambling hollow, the bingeing full of regret.
“I can resist anything except temptation.”
– Oscar Wilde
In this piece you can read or listen to my answer to a recent live Q&A question. (We hold monthly Q&As on Zoom with our online course delegates and UPTV members.)
But first let me set the scene a little.
There are two characteristics of compulsive and addictive behaviour that any practitioner would do well to fully understand and know how to deal with. Actually there are more, but here I want to highlight these two central and sometimes overlooked features of the ‘addictive trance state’, as they are so central to treating addiction.
The first characteristic of addictive patterns is what I call the rubber band effect.
The rising tension of resisting temptation
If you stretch a rubber band too far in one direction, tension builds up. The rubber band begins to strain back towards whatever you are pulling it away from. If the force away becomes too great, the rubber has an irresistible pull to snap back to its original position.
People work a lot like that, too.
- Tell a small child not to peek inside the box, and they can think of nothing else! The temptation only grows.
- Swear off coffee for a week, and watch how every café you pass seems to call your name louder than ever… until you finally cave and order a double espresso!
- Trying not to binge-watch another episode, not to fire off that late-night message, not to plough through the cookie jar, or not to check what your ex might be up to on Facebook are all good intentions, of course. The catch is that willpower has its limits because of the tension it creates.
Don’t get me wrong, some people will be able to exert so much willpower when fighting their addiction that they eventually find their way free of it and learn to resist its allure in future.
But researchers have found that exercising self-control in one area, like forcing a polite smile through a long, boring meeting, can leave you willpower-depleted later.1 This means you might give in to something else, such as grabbing that extra slice of pizza or the beer you said you wouldn’t have when you get home. The effort of exerting willpower in one place means you feel weaker in another!
We need, and obviously I’m talking metaphorically here, to take the elasticity out of the rubber band so there is no tension created by not engaging in a formerly addictive behaviour.
So the rubber band effect is one problem for many people hoping to escape the gravitational pull of an addiction.
But there’s a second problem: a kind of amnesia that descends upon us when we fall into the addictive pullback.
Addictive amnesia and why it matters
Researchers once asked a group of homeless alcoholics why they drank methylated spirits.2 Each said it was to feel better. But afterward, every one of them admitted they felt much worse after drinking it. Why hadn’t they anticipated that before drinking it? It’s not as if they hadn’t done it many times!
The drinker may have had tremendous illness and terrible hangovers, but the allure of the drink ensures all that is forgotten. The heroin user may have lost their family and self-respect, yet they only seem to recall the wonderful feelings of escapism. The gambler may be ashamed and broke, yet in the heat of the moment, they can think of nothing but the thrill. Why?
Dopamine.
That’s the trap of addiction: in the moment, desire drowns out memory. The amnesic effects of addiction are so often overlooked by therapists.
Dopamine, the brain’s ‘motivator’, fuels expectation and excitement, making us believe the next drink, bet, or binge will deliver what we crave.
But dopamine does more than that.
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Forget it!
Dopamine also distorts recall. It highlights the promise of pleasure while blotting out the truth: that the drinking leaves us sick, the gambling hollow, the bingeing full of regret.
When you are about to give into an addiction because you are only getting dopamine-laced memories of the great feelings you’ve had before when engaging in the addiction, then in the moment you become totally out of touch with the negative realities.
Normally, dopamine works with the brain’s reward systems to guide us towards healthy satisfaction (think learning new things) and survival (think drinking water when we’re parched or resting when tired). Under addiction, though, dopamine hijacks memory and motivation alike, pushing us toward choices that don’t fulfil us at all, and making usfocus only on the perceived positives of the addictive behaviour.
That’s important. In the grip of addiction, dopamine fuels the thrill of expectation while blurring out the reality of consequences.
Instead of guiding us towards healthy rewards (as dopamine is meant to do), in addiction it hijacks memory and motivation, making us forget the sickness, emptiness, or regret that inevitably follows as we keep chasing something that will never truly fulfil us.
So as practitioners we need to recognize but also deal with these central aspects of addiction:
- The rubber band effect, and
- The amnesic effects of dopamine.
So what would happen if the client were able to remain fully in touch, not just cognitively but viscerally, with the downsides of their behaviour when the addiction tries to suck them back in?
In my answer to a question submitted on a Q&A call I hope I offered at least some ideas as to how we might start to do this for our clients.
Listen here to my answer to the following question (and/or read the transcript below, but bear in mind it’s quite a rough, edited transcript, so I’d recommend listening!).
Listen to Mark’s answer or read below
Hear the answer by clicking the play button below:
Or click here to download the clip to play later (you may need to right-click and select ‘Save As…’)
Uncommon Practitioners Q&A transcript
Question
My client operates in an extreme, all-or-nothing mode. He imposes a strict regime of diet, exercise, and restraint from alcohol and unhealthy food, and eventually gets tipped into a crash where he is out-of-control bingeing and gambling. He knows this is unsustainable but struggles to operate any other way. He probably has ADHD but hasn’t been diagnosed. He also shows signs of depression, lacking interest and motivation. We have worked on interventions such as relaxation, having a worry log and dedicated worry time, and some guided visualizations. What else can you suggest?
Mark’s answer
Hi Ian.
It sounds like you’re doing some great stuff with your client, and certainly regular relaxation will help his extremist thinking as well as manage any other ADHD symptoms he may have.
It’s perhaps no wonder that he’s showing signs of depression or lacking motivation if he is prone to all-or-nothing thinking, because that’s a lot of pressure – it’s very hard to live up to your own ideals if you have a perfectionistic standard for yourself. The divide between “what I should be” and “what I am” is so big that you can start to feel depressed.
It might be good to talk to him about how all-or-nothing thinking manifests and trips us up, as it can be a revelation for some clients to understand that. It’s often a sign of progress I think when clients start to spot themselves using it, which shows they’re starting to get some distance on it. They start to become more reasonable.
The more emotional we get, the more all-or-nothing we become – which is why someone who wants you to think in extremist ways will seek to whip up your emotions. That’s the ‘magic button’ to extremism.
Anyway, so your client has this strict, puritanical regime which he adheres to for a while then flips and crashes back into bingeing and gambling. Being puritanical about things can be another reflection of all-or-nothing, extremist thinking.
When helping someone overcome a destructive behaviour, it’s important to separate the behaviour from their identity. Instead of calling it an addiction, we can describe it as something outside of them – a parasite, a bully, a trickster – something trying to con them into harming themselves. This is not to get them to abdicate responsibility but rather to begin to detach from it so the problem is no longer seen as who they are, but as something they can resist and move beyond.
Ultimately we want to separate him from a sense of the behaviour. So we can ask him questions like “How does it trick you to go back to it (‘it’ being the compulsion)? What does it promise to give you?” We want to enhance the rebelliousness of the person against the addiction.
We also prepare clients for the ‘rubber band effect’ – the natural pull back towards old behaviours. When we’re trying too hard not to do something we are still compelled to do, then tension builds until, in a moment of weakness, we ping back all the other way. Therapy needs to help take the elasticity out of the rubber band, so there is no tension or compulsion. The person is no longer interested in going back to that toxic behaviour.
One way to take the elasticity out of a compulsion is, for example, with someone who wants to eat healthily, we ask them to do that 80% of the time. When things aren’t completely forbidden the tension starts to go out of the rubber. (And I realize the word ‘rubber’ has a different connotation in America!)
Another way to help our clients take the elasticity and tension out of the pull away from a behaviour is to help make the behaviour much less compelling. When this happens the client doesn’t want to do the behaviour, so the tension of not doing it fades away: the rubber band is broken.
Addiction has to do with the motivational pathways in the brain, which have to do with dopamine. As I’ve said before, dopamine is the motivational chemical, which drives us towards a behaviour but also, once we’ve descended into an addictive trance state, causes amnesia for the downsides of that behaviour.
So when someone descends into the addictive trance state, the dopamine only presents them with memories of what is exciting or enjoyable about the behaviour. They are denied access to a visceral sense of the, say, shame, or regret associated with gambling or the severe stomach cramps associated with having food binged.
So dopamine-laced memories are selected in the moment of compulsion, and they are positively skewed memories. You might also explain this to your client.
The chronic drinker or drug taker or porn consumer will, while under the sway of the dopamine pathway, only have dopamine-laced memories of feeling good doing these activities. So they are only fed the positive propaganda, so to speak, because of the amnesia produced by the dopamine mechanism in their brain.
So using techniques to start to automatically lift people from the addictive trance and widen their visceral awareness and cognitive perception can be really useful in bringing them out of addictive trance when it matters.
You could seek to scramble the pattern so the dopamine-laced, amnesic addictive trance state becomes broken. The technique of scrambling can be really useful.
Have the client access the dopamine-drenched feeling of being just about to start bingeing or gambling – the excitement and trance-like focus – while their eyes are closed. Then ask them to open their eyes, then close them again and access the feeling of having already gambled a lot of money. So we can start to attach those two feelings so that one immediately feeds into the other; so we are undermining the amnesic effect of the dopamine-laced memories.
Techniques like this, and also the Tipping Point technique – in which the client is asked to get a sense of the point of no return in their addictive pattern, when they have perhaps fought with the urge but reached the point where they are definitely going to do it; then immediately switch states to a situation in which they are least likely to engage in that activity – can also be a highly powerful way of training the brain to flip out of the addictive trance much more easily and automatically when it descends upon the person.
So to summarize: Externalize the pattern, present the idea of the rubber band analogy, describe the amnesic effects of dopamine-laced memories as how addiction sucks people in.
Finally, avoid the pressure of never. The thought “I can never do that again” makes the urge stronger. Instead, frame change as a journey: Even if someone stumbles, they are still moving forward. A nonsmoker who has one cigarette isn’t suddenly a smoker again – they’re simply a nonsmoker who had a cigarette. This takes away the tension and makes relapse less likely.
I don’t get up every morning thinking, “I must never mug an old lady!” It’s just not on my radar, it’s not who I am. I don’t have to think in terms of never. Lasting change comes not from fighting the rubber band effect forever, but from putting it down altogether – shifting focus away from the behaviour and back onto living freely in the present.
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About Mark Tyrrell
Psychology is my passion. I've been a psychotherapist trainer since 1998, specializing in brief, solution focused approaches. I now teach practitioners all over the world via our online courses.
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Notes:
- One study has found that exercising self-control is such hard work, it measurably depletes our glucose levels. See: Gailliot, M. T., Baumeister, R. F., DeWall, C. N., Maner, J. K., Plant, E. A., Tice, D. M., Brewer, L. E., & Schmeichel, B. J. (2007). Self-control relies on glucose as a limited energy source: Willpower is more than a metaphor. Journal of Personality and Social Psychology, 92(2):325–336.
- See: Griffin, J., & Tyrrell, I. (2004). Freedom from addiction: The secret of successful addiction busting (p. 70). HG Publishing.
