Addiction

A Behavioral Economic Perspective

Shahram Heshmat

• Publisher: Routledge
• Year: 2015
• ISBN:
  9781317684732
• Edition: 1
• Topic: Psychology
• Subtopic: Addiction in Psychology
• Index: Psychology

Addiction: A Behavioral Economic Perspective focuses on the behavioral economics of addiction to explain why someone decides and act against her own well-being. It answers the questions of what accounts for self-defeating behavior patterns and how do we best motivate individuals to act according with their long-term goals. A better understanding of decision processes will lead to an improved knowledge of why people engage in self-destructive behaviors and better policy interventions in areas of addiction and obesity. The approach also promises to be valuable as a framework for understanding decisions for an addict's professional and business life. This book will be of particular use to clinicians, students, and researchers in the fields of addiction, public health, and behavior therapy.

1 Introduction Using Behavioral Economics to Understand Addictive Behavior

DOI: 10.4324/9781315774541-1

Introduction

Why do people often behave in ways that are known to have dire consequences for their long-term health and well-being? The purpose of this book is to provide an understanding of this question using the framework of behavioral economics. Behavioral economics presents a valuable organizing principle to understand when and how people make decision errors, and how people’s decision making can be improved. This chapter provides an overview of the subject.

I have three central objectives in writing this book: first, to inform readers of the behavioral economic aspects of addiction. Second, I want to enhance students’ understanding of the decision-making processes behind addictive behavior. Third, I want to explore the practical implications of behavioral economics combined with a public health perspective to overcome addiction. A better understanding of decision processes should lead to an improved knowledge of why people engage in self-destructive behaviors and to better policy interventions in areas of addiction and obesity.

The main focus in this book is on what motivates people to use drugs. Many of the reasons that young people start using drugs have little or nothing to do with being informed about the dangers of using them. For instance, a discussion of the dangers of drug use will have little impact on the chance that a person who is experiencing anxiety, depression, and low self-esteem will self-medicate with drugs and alcohol. Similarly, there are many situations, such as craving or strong feelings, in which people experience a disconnection between what they desire at the moment and what is best for their long-term self-interest. Moreover, it would not be helpful to go into a lower-class neighborhood and point out that their unhealthy behaviors are killing them. While information might help people to increase their awareness of such situations, once one is in the situation, the most accurate information is unlikely to have much if any impact on behavior. For example, if I accurately predict that I will get arrested if I use illegal drugs, that knowledge does me no good unless I can act on it and control my impulses to use the drugs.

This text is part of a broad study concerning the role of emotion in decision making, and to understand how, why, and under what circumstances emotions shape decisions. My goal is to develop a foundation from which to better understand the relative contributions of cognition and emotion to individual behavior in order to explain how individuals make decisions, and how we can influence those decision processes to improve their decision making and enhance their well-being. There is a general tendency in psychology and behavioral economics to focus on cognitive aspects of decision making. This book shows that focusing on emotion is crucial for a deeper understanding of individual motivations for impulsive desires and addictive behavior. This approach complements the cognitive approach and provides implications for interventions.

The book focuses on behavioral applications, such as addiction, overeating, procrastination, and other areas of life. There is a strong similarity between addiction and obesity suggesting that addiction theory provides a useful framework for understanding and treating compulsive eating. That is, the study of addiction helps to understand why people tend to do too much of anything that they like, not just drugs. This book views addiction as a unitary condition and the focus is on similarities, rather than differences, among substances. The psychoactive drugs are not similar, for example, heroine produces a calming effect, while cocaine produces excitation, and alcohol reduces stress activation.

Self-defeating behaviors (McWilliam, 2012), ¹ such as addiction or obesity, pose fascinating questions from the perspective of maximizing pleasure and minimizing pain. Why would someone decide to act against his own well-being? What accounts for self-defeating behavior patterns? How do we best motivate individuals to act according with their long-term goals? To promote desirable behavior requires an understanding of human behavior. What motivates people when they initiate a new behavior as opposed to procrastinating, failing to act on their intentions, or getting distracted? In short, the text intends to raise awareness of the general principles underlying human behavior and the nature of decisions that people so often make that bears a mixed relationship to their own happiness. Furthermore, if we can understand how addictive habits are made and changed, we can also better understand how to change other habitual behavior like anxiety and depression.

Self-control plays an important role in addicts’ decisions. Addicts show diminished capacity for response inhibition and ability to maintain a goal in the face of distraction. However, this does not mean that they are never in control. The behavioral economic framework guides people in identifying strategies to make healthier choices. To overcome self-control problems such as addiction and obesity, individuals use commitment devices to attempt to protect their long-term goals from short-term consumption decisions.

The behavioral economic approach promises to be a valuable framework for understanding decisions for public health professionals. The possible contributions of behavioral economics have mostly been ignored by the public health field. ² Behavioral economics could therefore become an essential complement to the traditional public health tools. This approach provides an integrated view of individuals confronted with an array of short-term temptations and long-term prospects, and addresses self-defeating choices in the context of addiction.

The behavioral economic perspective also promises to be valuable as a framework for understanding decisions for our professional life, business life, and the way we look at the world. In the following chapters, you will find in-depth discussions of the role of emotions in decision making that may illuminate something about your personal life, such as how emotions shape our choices and alter your capacity to regulate our behavior. Improving decision making is a starting point for improving your life.

What Is Behavioral Economics?

This book presents a behavioral economic perspective for understanding addiction. Behavioral economics provides a framework to understand when and how people make errors. The field of behavioral economics blends insights of psychology and economics to increase the explanatory and predictive power of economic decision making. Behavioral economics is a subdiscipline of economics (Angner and Loewnstein, 2012). Behavioral economics emerged against the backdrop of the traditional economic approach known as rational choice model. Economics provides conceptual models (e.g., rationality) of how we make decisions, and psychology illuminates the processes of those decisions (e.g., decision biases and emotional influences).

Economics provides a conceptual framework to understand how people decide to allocate their limited resources (e.g., money and time) among available alternatives to maximize total happiness. A key assumption in economics is the notion that individuals are mostly rational and seek to maximize total utility (happiness). Utility is understood as the strength of a decision maker’s preference for a particular option, meaning that we assign values to certain things. For example, suppose you are considering buying a new car. You weigh (assign utility) the following features: brand new vs used, comfort, good gas mileage, price, and reliability. Your final choice will require trade-offs within the limits of your budget. In general, the rational person is assumed to correctly weigh costs and benefits and calculate the best choices for herself.

The rational person is expected to know his tastes (both present and future) and to never flip-flop between two contradictory desires. He is supposed to make good decisions that maximize his utility (whatever that is). That is, he will choose the option that will satisfy his long-term preferences. He has perfect self-control and can restrain impulses that may prevent him from achieving his long-term desires. Traditional economics use these assumptions to predict real human behavior. The standard policy advice that stems from this way of thinking is to give people as many choices as possible, and let them choose the one they like best (with minimum government action). Individuals are in the best position to know what is best for them because they know their preferences better than government officials do.

In contrast, behavioral economics attempts to describe actual behavior and shows that actual human beings do not act according to the rational model. People have a great deal of trouble exercising self-control. Human beings have limited cognitive abilities and limited willpower. They are profoundly influenced by context, and often have little idea of what they will like next year or even tomorrow. People tend to discount the future; that is, they let present satisfaction spoil future prosperity. As Daniel Kahneman (2011, p. 5) put this, “it seems that traditional economics and behavioral economics are describing two different species.” Behavioral economics shows that we are exceptionally inconsistent and fallible human beings. We choose a goal and then frequently act against it, because a self-control problem causes us to fail to implement our goals. ³ As discussed in the following chapters, behavioral economics traces these errors to the design of the human mind.

Furthermore, the rational model views the mind as more or less unitary. Neuroscientists argue that the mind consists of many different parts (mental processes), each operating by its own logic (Kurzban, 2011). Because these parts are designed to do different things, they don’t always work in perfect harmony. ⁴ A key insight is that the brain is a democracy (Tononi, 2012). That is, there is no dominant decision maker. Although the behavioral goal of an individual can be stated as maximizing utility, reaching that goal requires contributions from several brain regions. Decisions are made in cooperation of many specialists, each providing its unique contribution. This important insight about the human mind explains why we are conflicted and inconsistent. The inconsistencies in the mind give rise to self-control problems.

The field of behavioral economics recognizes that we are driven by forces beyond our conscious control, hence our capacity for irrationality. That is, many decisions are made on the basis of emotional and unconscious processes (Bargh, 2002). ⁵ For instance, most diets fail because the conscious forces of reason and will are simply not powerful enough to consistently subdue unconscious urges. Yet people might be unaware that their environment is influencing their behavior; they may be unaware of the stimuli that can activate goals and cravings. Because of this, individuals frequently make decisions that depart systematically from the predictions of economists’ standard models.

Behavioral economics attempts to understand these departures and, more generally, integrate psychologists’ understanding of human behavior into economic analysis. In this respect, behavioral economics parallels cognitive psychology, which studies the interactions of emotion and cognition and nudges individuals toward adaptive decision making. Much like a cognitive therapist, behavioral economists attempt to guide individuals toward more healthy behaviors by correcting cognitive and emotional barriers to the pursuit of genuine self-interest (Loewenstein and Haisley, 2008).

Behavioral economics also provides insight into the working of the mind, the irrationality of human nature, and the nature of the decisions that people so often make that bear a mixed relationship to their own happiness. For example, anxiety and depression may induce negative emotions, often leading to addiction. People with these types of problems having successfully quit their “bad habits” (alcohol abuse and overeating), often find a different “habit” to replace the old one. The behavioral economic approach allows us to focus inward and try to understand how irrational behavior is reflected in the context of addictive behavior. This book makes an attempt to enter the private mind to understand its nature and emotion and to convey that understanding to the reader. Problems are best solved when they are pulled out of darkness. In the words of Nobel laureate Eric Kandel (2012), to discover the truth about behavior, we must look below the surface appearance of things. Most of our mental life (cognitive processes) and behavior are shaped by unconscious forces at any given moment.

An important implication of unconscious motivation is the recognition that we are all at some level strangers to ourselves. Indeed, when we introspect, we routinely deceive ourselves, because we only tap into a small fraction of what is going on in our heads. That is, you know far less about yourself than you feel you do. Social psychologists argue that people are in general quite ignorant of their motivations and that awareness of what motivates them to act is a construction (Kiverstein, 2012). For example, the desire for altruism and volunteerism may mask a desire to be recognized as special, and the altruistic act may be partially an expression of a self-righteous desire to be morally superior to others. In resolving a problem, the cognitive system often fills in information in a rather blind manner without insight or self-awareness. In contrast, the unconscious (intuitive) system has the ability to see the whole picture or see the problem in a new light (Schore, 2012). I will say more on this in later chapters.

This lack of awareness compromises psychological freedom and perpetuates self-defeating behavior. ⁶ These private thoughts that are mostly inaccessible to experience are called “intuition,” “gut feelings,” and so on. These private thoughts are also sources of misunderstanding among people. (That is what a lot of marriage counseling is about.) We try to silence our painful emotions, but if we succeed in feeling nothing, we lose the only means we have of knowing what we suffer from, and why (Grosz, 2013). To uncover the essence of a particular behavior (such as addiction and overeating), we need to dig deeper, like archeologists in their excavations, to illuminate the mental processes between a stimulus and the individual response to it. As Panksepp and Biven (2012) note, the deeper we go into our emotional brain, the more we understand our mental origin and the origins of mental illnesses such as addiction. By becoming more aware of our unconscious wishes, we experience ourselves as free rather than as victims.

In sum, behavioral economics presents a valuable organizing principle to conceptualize addiction and other self-control problems. The approach helps us to understand when and how people make errors. Systematic errors or biases recur predictably in particular circumstances. The focus on errors improves the ability to identify and understand decision disorders and suggest interventions to limit the damage from poor decisions. Finally, behavioral economics suggests ways that policy makers might restructure environments to facilitate better choices. The understanding of where people go wrong can help people go right.

Delay Discounting

A key concept in behavioral economics is that of how delayed rewards are discounted by individua...

Table of contents

• Cover Page
• Half Title Page
• Title Page
• Copyright Page
• Table of Contents
• Preface
• Acknowledgements
• 1 Introduction: Using Behavioral Economics to Understand Addictive Behavior
• 2 Decision Biases: A Primer on Behavioral Economics
• 3 Definition and the Nature of Addiction
• 4 Definition and Functions of Emotions
• 5 The Role of Emotion in Decision Making
• 6 Anxiety and Decision Making
• 7 Choice Over Time
• 8 Addiction and Choice
• 9 Sources of Self-Control Failure in Relation to Sustained Dieting Behavior
• 10 Self-Control: The Ability to Achieve Long-Term Goals
• 11 Using Self-Control Strategies to Motivate Behavior Change
• 12 Conclusion
• References
• Index