This post is a follow up to a previous post about Daniel Kahneman’s book Thinking, Fast and Slow. He makes a point in that book that tells us a lot about relapse in addiction.
Kahneman tells us of other researchers’ work about when we use the parts of our thinking that he calls System One and System Two. As a refresher, System One is intuitive and effortless. When we use System One we don’t even realize we’re thinking. System Two on the other hand requires real work. It takes attention and effort, and there’s not the least bit of doubt in our minds that we are thinking. This work, he says, gives us the Law of Least Effort.
What the Law of Least Effort says is, that, given a choice between effortless System One and effortful System Two, we will always pick the thinking method of least effort to solve the problem before us. This is one reason for the wide prevalence and persistence of cognitive biases that Kahneman is so fascinated with. Here’s an example he gives: “A bat and ball cost $1.10. The bat costs $1 more than the ball. How much is the ball?”
Got your answer?
Most people just subtract $1 from $1.10 and say, “ten cents.” In fact for the bat to be $1 more than the ball, the ball must be $.05 and the bat $1.05.
He also points out that under stress or even non-stressful use of mental resources, we are more likely to default to the simple (and wrong) answer. Rather than engage in effortful use of System Two and go through a calculation, we chose to answer a different question that is easier to answer.
Let’s be clear; by we I mean humans, not people with addiction. All humans will resort to the easiest method, the one we’ve practiced the most, the one that takes the least effort. So what does this have to do with recovery and relapse?
When people are new to recovery, they haven’t practiced the techniques of recovery much at all. They have practiced the techniques of active addiction. The techniques of active addiction, having been learned well and practiced much, reside in System One where they are intuitive and effortless. The new techniques of recovery reside in System Two and take a lot more effort.
So we should expect in early recovery for relapse to old behaviors to be more common until the new recovery techniques have been practiced enough to become second nature. And even then, when under stress or even non-stressful exertion, it will be harder not to default to the older, more deeply learned techniques of active addiction.
So, the important thing for me, and anyone treating addiction, is that our goal is not to teach people to use System Two or to convince them that System One is bad, but rather to help practice the techniques of recovery until they naturally move from System Two to System One. There they can be taken up intuitively and effortlessly. Unless recovery is as easy as using, the human brain will not default to recovery. The goal of treatment is to teach recovery and make it easy enough to keep.
© Howard C Wetsman MD FASAM 2012