A Clinical Tale

The worst thing about addictive disorders is the high relapse rate. Substance abusers, dieters, gamblers, etc make the same blunder again and again, despite repeatedly learning the lesson that the first lapse was a mistake. They do not profit from their expensive education, because they are repeatedly taken in by the Soul Illusion [See PIG # 6]. At the crucial moment when decisive action is required to prevent an obvious disaster, they see no danger.

An illustrative example of the Soul Illusion is the case of a financially successful attorney, Hannibal Hasselbring. During our first session, scheduled shortly after his third DUI, he reported that it is now clear to him that intoxication has much greater costs than benefits for him and his family. He stated that our sessions were just a formality because he was already highly motivated to quit drinking.

He has been here before, and came to the same conclusion [drinking alcohol produces bad outcomes for Hasselbring and his family]. Each time he sincerely vowed to change his ways, each time he violated his vow, and, sadly, each violation led to a demoralizing relapse, causing Hasselbring to once again experience the familiar remorse that results from failure to do what he set out to do. Now, in my office, he is about to do it again. He is not stupid, and is aware of his history, yet he is convinced that this time he really means it. Why can't a clever attorney learn this simple lesson of cause and effect? Answer: Experiential phenomena such as perception, learning, motivation, and memory are state dependent.

A Society of Possible Selves

The expansive Hasselbring who was drinking and carrying on with his buddies the night of his most recent DUI was a completely different entity than the remorseful fellow before the judge, or the one who showed up in my office for his first session. Telling this remorseful fellow that he ought to quit dinking is like preaching to the choir – he knows it. In fact, during an early session he laughed at himself while recounting the rationalizations that set the stage for some of his previous relapses. It is almost like two different people: One seriously believing he can control his drinking, and the other finding it humorous that the first one could be taken in by such obvious denial. But these are only two of the possible versions or states of Hasselbring, which also include the tender father version, the angry version, the sexually aroused version, and – when he is cool and calm and willing to dhis attention to the task - the effectivproblem solving version. Alas, certain social situations evoke his self-conscious vnt biases. As soon as his attention shifts to himself and his self-critical thoughts, he is no longer the logical, sophisticatedattorney who thinks three steps ahead. Now Hasslebring is trance formed into a self-conscianxious state, now lacking the impressive cognitive resources that were available to him jua few hours earlier. The addictive trap sucks everything in.

Typically at such times Hasselbring’s conscious awareness begins to narrow on alcohol related issues. While before there were many things he might think about, now he is focused on drinking or not drinking. What started out as social anxiety has become a drinking issue, and once he begins to think of drinking [or not drinking] he becomes trance formed into the “alcohol focused” Hasselbring. And now, at the crucial moment of a high risk situation it is he who is making the decisions. Unlike the Hasselbring in my office, this version expects the outcome of the first drink to be positive, and it is he who lapses.

Soon after the first lapse he recognizes that he has violated his vow, and the remorse trance forms him into the remorseful Hasselbring, who must pay the emotional price of the relapse. Once again he believes that this time he has learned his lesson and so makes another permanent vow that he will never drink again – and this time he really means it. The cycle is likely to repeat until he has lost everything.

To the therapist and most observers it is clear that he is different when in the remorseful state than he is when he is anticipating the first drink. But regardless of his current state, he believes that he perceives the objective truth, and that he will continue to view things this same way in the future.

The soul illusion results from the fact that perceptual bias is always invisible to the perceiver. He thinks, "I can control my drinking,". He's certain that this is true and he will always feel this way.

This is also true when he is in a different state and believes, "I will never drink again and this time I really mean it".

Evidently, both of his beliefs were false, and his perspective was transient. Despite this being so obvious to most observers, few dependent individuals appreciate that their current motivation to use or refrain from using the substance is transient, and depends to a very extent on local circumstances.

The soul illusion: We think we see reality for what it is, but instead our perception is biased by different filters at different times. Because we are blind to these transient, state dependent biases, we over estimate the validity of our current beliefs.

Hasselbring's pain is testimony to the power of the soul illusion. He can look at previous examples of the "vowing-abstinence-and-then-relapsing" sequence and recognize that the beliefs he used to justify the first lapse and demoralizing slide to relapse did not turn out to be objectively valid. Nevertheless, he will again defend such beliefs and voluntarily follow the path that everybody knows will lead him to pain and regret until he destroyed everything . . . unless, he finally gets it.

He has not gotten it yet because reality is state dependent. The remorseful Hasselbring who vows never to drink againaround during the high risk situation. It is an alter ego, the “anticipating-the-first-buzz” Hasselbring who violates the vow, because in his world the first drink does not appear to be an error. Later,the error will once again become apparent to the remorseful Hasselbring.

Hasselbring when he is in my office and I force him to review his history. You may think he is somehow defective since he continually makes tsame error. Rest assured that your follies would be equally obvious to Hasselbring, while to you they remain invisible.