Inside the Mind of an Addict
A behavior becomes entrenched through what social psychologist Albert Bandura called ‘self-reinforced.’
Nearly 108,000 Americans died from drug overdoses in 2021. That figure is an extraordinary increase in recent years: In 2016, it stood at just over 60,000. It’s been called an epidemic, but its victims weren’t unwitting. They opted into it. Ignoring this distinction has led to drug-addiction therapies that haven’t capitalized on the psychological factors that underlie drug use.
Addictions begin when people start using drugs for medical or recreational reasons, then take additional doses of substances they knew are dangerous. In his 1947 book, “Opiate Addictions,” University of Indiana sociologist Alfred Lindesmith found that human users become addicts when they realize that their painful withdrawal symptoms are the consequence of not having the drug in their bodies.
Apes experience physical withdrawal symptoms as humans do, but they don’t react with the frantic search for an additional “fix” characteristic of human addicts. Why not? Because apes don’t have minds capable of making the connection between their suffering and the drug’s absence. Although animal brains are very much like human ones, animals aren’t capable of thinking about their pain and its causes. Lindesmith believed addiction required an intellectual understanding of what was causing the pain of withdrawal in order to seek a fix. Consequently, he would likely not apply the term “addiction” to a broader category of compulsive behavior, such as gambling, for the pain of withdrawing is merely psychological.
Years later, in the course of studying how children learn, the distinguished Stanford social psychologist Albert Bandura invented the concept of “self-reinforcement.” Bandura’s research clarified how the mind’s first experience with something creates a desire for a second.
Whatever the first experience may be, the human mind can rehearse it in memory, miss it and thereby make the second experience more attractive. Addicted gamblers experience pain when they’re tempted to gamble—but it’s purely psychological. Their thoughts about the pleasure of gambling are similar to the drug addict’s temptations.
The concept of self-reinforcement shows how the first experience with drugs, sex, cigarettes or alcohol can lead to the second. It takes a memory of the experience as being at least partly pleasurable. Self-reinforcement doesn’t make the second experience inevitable, but it is necessary for addiction to occur. Self-reinforcement also reinforces socially approved habits not generally considered addictions. You may become a chronic novel reader after finding your first reading experience enjoyable.
Personal experiments with socially disapproved behavior don’t always begin in isolation, although all of them have to be thinkable before they are doable. Teenage drinking, smoking or drug use may become thinkable because friends talk about these activities or partake in them before the uninitiated youth. If a boy sees his friends taking drugs, and a glazed but happy look comes into their eyes, he can’t avoid concluding that drug use is sometimes pleasant. If he is offered a beer, which others are already consuming, social influence reinforces his curiosity.
The puzzle isn’t why unsavory behavior begins but why such behavior, after becoming thinkable, doesn’t become more frequently doable. A sociological explanation is that the disapproval engendered by conventional cultural and social norms works successfully against disapproved activities most of the time. Nevertheless, subcultures can still encourage generally proscribed activities. Hence engagement with disapproved behavior can arise not only because of individual actors but because of the influence of subcultural groups.
Drug addiction is different from a disease like Covid. Because human addictive behavior must be self-reinforced to become fully established, it is potentially easier to overcome than biological infections. Ultimately, addictions are temptations that have been gratified and remembered. They will never be completely forgotten. But people, unlike apes, resist temptations that they want to resist.