Urges, Triggers, and Relapses

If you are trying to end a negative habit, especially a habit classified as an addiction, you know that it is very very hard to do. What exactly makes it so hard? Until we know all the details of the underlying neuroscience of addiction and habit formation, we can’t be accurate about explanations, but calling it an addiction or a habit doesn’t really explain why it’s got such a hold over us. Moreover, the answer might be different depending on what specific negative habit we are talking about (emotional eating, smoking, drug use, compulsive sexual activities, alcohol abuse, gambling excesses). But research is telling us more every day. This piece looks at one part of the struggle: relapse.

Relapse means, of course, a return to a negative habit that you had previously stopped and considered out of your life. And “return” means:

1. You are engaging in the negative habit again, and therefore getting some of the thrill or positive stuff that you previously got from the habit;

2. You are responding to triggers that generate urges for the habit again;

3. You are rather alarmingly ramping up to the same levels of the negative habit that you previously engaged in (frequency, dosage, etc.);

4. You are using self-deceptive thinking again, justifying your relapse and most likely giving yourself reasons for continuing with the reinstated habit.

Now we know a lot about brain changes and neurochemicals like dopamine and other substances that are involved in addictions. But today, we want to cover other aspects of what is so tough about ending a habit. Let’s go all the way back to Pavlov, who over 100 years ago tried to figure out the psychology and physiology of learning. Pavlov showed us that if we ring a bell at the same time that we put food in a dog’s mouth that within a few pairings, the dog salivates when the bell is rung, even without food. That’s called “classical conditioning” because we think that salivating (and also gastric events like stomach acid secretion, which also happens) is not voluntary. If you vary the experiment a bit, you can also see in hungry dogs who have been fed every time a bell rings, that the dog will get very active, wag its tail, run to the food bowl, and in a variety of ways demonstrate that it “knows” what that bell means. Food! And so does the dog’s body: it’s salivating and its entire digestive tract is getting ready for food.

OK, now let’s ring the bell and not give the dog food. At first, the bell works just like it used to. In fact, we might even get an exaggerated response for a few bell rings when food isn’t forthcoming. But if we do that a bunch of times, say 20 times in the course of the next hour or so, the dog stops responding. It isn’t salivating anymore to the sound of the bell, it’s not jumping around like the dog in the commercials around its food bowl. It’s done. Fool me once, fool me twice, eh? That process is called extinction, and for a long time, people thought that meant that we had broken that association between bell and food. The dog either forgot the meaning of the bell or learned that the rules have changed. Bell no longer means food.

So let’s take that same dog and ring the bell for him two hours later, or two days later. Or let’s bring him back to the lab where we trained him two months earlier. What happens? He looks for food, he starts salivating. He’s not as enthusiastic as he was when he first learned, but he’s telling us that he believes food is coming because he heard that dinner bell. See, he didn’t forget. This return of the extinguished behavior is called spontaneous recovery. Not only that, researchers now know there are several variations of extinction (reinstatement; renewal) that you can get by suddenly introducing food, by stress, and several other parameters, all demonstrating that the dog’s stopping doesn’t mean he’s forgotten or that the association of bell-food has been broken.

It is possible to get him to stop looking for food altogether when he hears the bell, however. We can do that by ringing the bell day after day, but never giving him food when we ring the bell. But... if we ring the bell and do give him food again, say a month or two later, or even a year later, he’ll very rapidly start to expect food again when he hears the bell, and he’ll be much faster than when he was first taught, and it will be way harder to extinguish him again. So even dogs who look as if they are permanently extinguished never forget. He just thinks the food bell is broken. Or something.

So now let’s change vocabulary. What if we say that when the trained dog hears a bell it is a trigger generating an urge to eat? It wasn’t a trigger before he was trained, but it is now, and it works even after long periods of not being exposed to the bell.

Is this ringing any bells for you?

There is no negative habit, no addiction, that isn’t somehow influenced by the kind of conditioning and extinction that we are talking about. It isn’t the entire story, but it is certainly part of the story. And this is why we emphasize that when you are breaking a habit, you have to start a new habit at precisely the point you used to be triggered in the old habit. Your brain won’t ever forget the old habit, but it can build a new one, eventually a very strong one, in place of the old one, and the old habit can become weaker.

Let’s go back to our dog. When the doorbell rings, the dog rushes to the door and barks like crazy. Why? Think of what you just heard about Pavlov. The dog has learned that “doorbell” means "person at the door”, and "person at the door" means all kinds of things: protect my territory from intruder, get ready to sniff new person, have a new adventure, get petted and shown attention. All kinds of stuff like that, some learned, some based on unlearned natural responses. Want to break the dog of that habit? If you kept ringing the bell but never opened the door, or if you remotely rang the bell, opened the door and the dog kept seeing that nobody was there, he’d eventually extinguish. But there’d be spontaneous recovery in a few hours or the next day. Not only that, people do come to the door all the time, so he’d soon learn to bark all the more because sometimes it pays off.

So what does the dog psychologist say? The same thing the negative habit/addiction psychologist says: Teach the dog a new, super fun, fulfilling reaction to the doorbell. Don’t just try to extinguish. Teach a new pattern. Doorbell rings, dog learns to run to the kitchen, away from the front door, to get a super-desired treat if he runs fast enough (away from the door).
At first, it is really really tough to train the dog that way, since running to the door has been well learned and is really fun, and in many breeds, is essentially hardwired (territory defense). But with perseverance, the right treat, and the right behavior, that’s basically how it’s done. A new habit can be learned.

Back to people and their negative habits. What’s your doorbell? What’s your new behavior going to be? Too bad it isn’t as easy as it is for Pavlov’s dog. Instead of a simple trigger like a doorbell ringing, for most people, triggers that generate urges are complex mixes of moods, events, behavior, and thoughts. Those triggers are not so easy to spot not only because of their number and complexity but also because they work -- that is, they rapidly have an influence over you including some messed up thought processes. So you don’t have full awareness of what happened, and you don’t care. You just want that urge taken care of.

Each of our Willpwr⁺ apps is designed to help you spot your triggers, and each of our apps is constructed to help you work out which new patterns of response to use instead of acting on your old habit. You can get this information as well from support groups by listening to others who have been there, or from professional counselors. So with knowledge, motivation, lots of repetition, and strategies to tolerate discomfort while setting up the new habit, it can be done. It is done, every day. Won’t it be great to really look forward to running to the kitchen and having a terrific reward instead of causing all that turmoil and noise at the front door?