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Addiction (1993) 88, 745-756

SCIENTIFIC HORIZONS2

The role of psychobiological states in chemical


dependency: who becomes addicted?
ROB NEISS
Center for Performance Enhancement, Santa Rosa, California, USA

Abstract
This paper argues that recent developments in the understanding of psychobiological states may help to explain
individual differences in susceptibility to addiction. It points out that the construct of arousal is deficient for
this purpose and that a more fruitful approach views humans as bundles of state-dependent selves, strongly
affected by self-efficacy and response expectancies. Coping skills, enhancement behaviors, and other state-regulating techniques are seen as crucial to liability to chemical dependency and the social learning underlying
their genesis is explored. Under this view drug experiences are held to be analogous to hypnotic inductions and
psychological approaches to therapy could usefully focus on helping addicts develop a metaperspective on the
succession of psychobiological states.

Introduction
The drive to alter psychobiological states has
been increasingly viewed as innate, even in nonhuman species.' Indeed, one is hard-pressed to
find adult humans who eschew all psychoactive
substances. The question, "Why do some people
become dependent on them?" has received considerable research attention, perhaps at the
expense of the question, "Why do the majority of
people who are exposed to psychoactive drugs
fail to become dependent on them?" Despite the
attempts of addicts to portray the experiences of
using heroin, cocaine, and so forth as totally
compelling, most people who try these drugs do
not become dependent. Similarly, only a small
percentage of those who try alcohol make its use
the centre of their lives. These individual differ-

Requests for reprints should be addressed to: Rob Neiss,


Ph.D. 726 College Avenue, Santa Rosa, CA 95404, USA.

ences, and the processes that underlie them, are


the focus of this paper.
Addiction researchers in the past have argued
that a need to regulate arousal may play a role
in drug dependency. However it is a premise
of this paper that the concept of arousal has
outlived its usefulness as an explanatory construct in psychology generally and probably also
in the study of addiction. Conceptually a
product of the extreme reductionism of an earlier
era, arousal is a physiological construct divorced
from any psychological context. As such, it is
incapable of distinguishing elation from fear,
grief, or any of the other psychobiological states
which exhibit heightened phy-siological activity.
Arousal, a vestige of past attempts in psychology
to ignore affect by separating body and mind, is
unlikely to be of use in explaining individual
differences in susceptibility to addiction. More
promise is shown by psychobiological states,
which include affect and cognition, as well as
physiology.

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Rob Neiss

Self constructs are viewed here as state-dependent; the succession of states that characterizes
human experience means that normal individuals, despite their illusion of unity, are more
accurately modeled as bundles of selves. I will
argue that the emergence of dreaded, personally
repugnant selves may be central to the problem
of liability to chemical dependency. Under this
view, the use of a psychoactive substance becomes elevated in an individual's motivational
hierarchy to the extent that it replaces dysphoric
states and the attendant negative selves with
positive ones. I explore evidence relating to individul differences in expectancies, coping skills,
and enhancement behaviors as these bear on
susceptibility to addiction. Particular attention is
paid to the role of early social learning in the
genesis of psychobiological states. Sub-clinical
dissociation and state masking are highlighted as
mechanisms enabling individuals to lose awareness, at least in part, of e states most troubling
to them. Data on placebos and on non-chemical
addictions suggest that dmg experiences are
analogous to hypnotic inductions. Further support for this view comes from the contrasting
withdrawal experiences of medical patients and
street addicts which clearly derive fi-om the substantial phenomenologieal difference in the
opiate experiences of these two groups. Willpower, inimical to the formation of addictions, is
reconceptualized as an aspect of the ability to
take a metaperspective in regard to psychobiological states. I sketch some of the clinical and
social policy implications of this position, emphasizing the importance of altemative avenues
of reinforcement.

Arousal versus psychobiological states as


explanatory constructs
The construct of arousal fit the Zeitgeist of midtwentieth century psychology. It appeared
unidimensional, readily quantifiable, and supported by physiological findings. Its proponents
argued that all behavior could be explained by
two dimensionsintensity (arousal) and direction; splitting body and mind in this fashion
represented an attempt to ignore affect. This
oversimplification has been repeatedly challenged by findings from disparate fields which
support the commonsense notion that human

beings do not simply become intense or aroused,


rather they become angry, afraid, sexually
excited, grief stricken, and so on. These I refer
to as psychobiological states, a term that
acknowledges the interactive, interdependent relationship among the cognitive, affective and
physiological components.
Psychobiological states include both emotions
and moods, the latter being "shifting yet pervasive emotional feeling states of varying
durationusually not as intense or as clearly
related to a specific provoking object or situation
as is the case with a fully developed emotion" (2,
p 74). Unlike 'sham rage' and other laboratoryinduced examples of pure affect, naturally
occurring states always have a cognitive component. Indeed, the schemas are the most
conspicuous feature of certain psychobiological
states, leading some investigators to label these
as 'ego states'^'" or as 'states of mind'.' Yet the
affect is an important aspect of these states, even
if its expression is muted. For example,
Berne's " Transactional Analysis model featured
a 'Parent' state: An individual in this state would
respond to a reasonable adult request as though
addressing an unruly child. Although the only
emotion expressed might be mild annoyance, the
affect of shame could be central to the genesis
and maintenance of the state. The affective component of psychobiological states is frequently
suppressed, repressed, or masked by other
emotions.
Conversely, some individuals react to relatively innocuous situations with states displaying
affect so intense that archaic origins must be
inferred. This has led to the reification of particular states'wounded inner child'*to the
extent that some recovering addicts (not suffering from Multiple Personality Disorder) have
taken to naming their various 'inner children'.
Regardless of whether affect or cognition predominates, regardless of whether states are
primarily psychogenic or driven by identifiable
physiological conditions, psychobiological states
exhibit unity.
That arousal is an oversimplification is
refiected by natural language, which uses neutral
terms only for the lower end of the activation
continuum: asleep, sleepy, awake. Beyond simple wakefulness, people usually make reference
to particular goals, feeling states, or drugs that
have energizing properties (working feverishly,
angry at injustice, wired on cocaine, and so on).

Psychobiological states in chemical dependency

The phenomenological experience of these different states varies so enormously that they are
never lumped together under a single rubric. It
may be noted that in normal conversation the
word 'arousal' is rarely used without a qualifier
(e.g. sexual arousal).
This commonly held distinction is supported
by numerous studies I have cited elsewhere'"^
which show that the various states humans
experience differ physiologically as well as phenomenologically. In other words, the repeated
failure of the supposed referents of arousal to
intercorrelate reflects the reality that many quite
dissimilar states show some sort of elevated
physiological activity. The construct of arousal
divorces the elevated physiology from the psychological contexts of these states, attempting to
find commonality in the disparate physiological
activity of, for example, fear, sexuality, and grief.
This is a construct validation problem of the first
magnitude.
Although it is true that insomniacs use sedatives to sleep, and narcoleptics and long-distance
drivers use stimulant drugs to stay awake, most
psychoactive drug use cannot be explained in
terms of arousal. A simple arousal model applied
to recreation drug use poses some puzzles: Why
would people simultaneously ingest heroin and
cocaine (a 'speedball'), as do an estimated half
million Americans?' From an arousal perspective, such behaviour would seem an expensive
way of staying the same. Clearly, something is
occurring which is beyond the capacity of the
arousal model to explain. It is apparent that
individuals generally alter their states with drugs
because they expect to feel better, not to become
more or less aroused. An earlier focus on the
arousal differences between opiate and psychomotor stimulant drugs has been replaced by a
recognition of their shared action on a brain
reward system, relegating the arousal differences
to the status of 'side effects'.'" In fact, according
to Wise (1988), "Classification of drugs as stimulants or depressants can be arbitrary, because a
drug that is a stimulant at one level of analysis
can be a depressant at another"."

Psychobiological states and multiple selves


When Pierre Janet's'^ pioneering psychological
investigations were translated into English, his
key term was rendered 'dissociation' rather than
the cognate, disaggregation. This was unfortu-

747

nate, in my view, as the former term is modeled


on the physical chemistry process that, for example, dissociates water into hydrogen and oxygen.
Disaggregation, by contrast, implies that a bundle of discrete entities has been loosened.
Although habits of thought and language insist
that the self is unitary (except in Multiple Personality Disorder and other dramatic
psychopathologies), human beings might better
be modeled as bundles of state-dependent selves.
On one level, these selves can be thought of as
identity stories. We have various stories about
who we are; while the bare facts may be immutable, the interpretation of themaddressing
the question of what sort of person one iscan
vary markedly.
State-dependent memory being long established, it is not a great departure to see
selvesthose constructs of memory and imaginationas state-dependent. Humans do not
access their memory stores as computers do, but
selectively. Part of what makes positive states
positive is our view of ourselves as being the sort
of people we admire, respect and like, as this is
supported by our memories. In a negative state,
however, we might find that memories surface
and a concomitant 'self which is quite differentfar more like the person we always feared
we might be.
Of course, people differ in the degree of lability they experience, and in the amount of
volitional control they exhibit over the behavioral
manifestations of their various states. Although
undermodulated states may more often bring
individuals to the attention of mental health
professionals, overmodulated states can also
create difficulties. According to Horowitz,
"Overmodulated states are those that seem to
have rigid control features, sometimes leading to
a sense of contrivance or pretense as well as
restraint over expressions and experiences".'
Individuals' unique social learning histories
largely determine which psychological situations
will tend to 'hook' troublesome states for them.
Situations that would be innocuous for others
might nonetheless 'push my buttons'. These triggering situations function analogously to
hypnotic inductions; states may be induced
which feature dreaded selves. For example, encounters with a certain type of authority figure
might lead an individual to experience a weak,
helpless self, leading to compensatory aggression
or other acting out. Great variation exists in the

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Rob Neiss

nature of situations that are problematic for individuals. Yet most of us, even the highly
competent, have incompetent selves that can be
evoked under certain circumstances"I can't do
anything right". For those fortunate individuals
who characteristically experience a sense of selfefficacy, temporary lapses in confidence might be
cured by nothing more than a hot meal. Others
experience enormous difficulty in emerging from
unpleasant states, or in entering pleasant ones.
This can readily become a vicious cycle, due to
the nature of the expectancies that are developed. When (non-chemical) expectancies are
negative in all three areasoutcome, selfefficacy, and, especially, response expectancies
the desire for positive state change can easily take
on a compulsive quality, as is seen in addiction.
Outcome, self-efficacy, and response expectancies
In social learning, theory the occurrence of a
response is hypothesized to be a function of the
expectancy that the behavior will be reinforced
and of the value of the expected reinforcement."
This has come to be called an outcome expectancy, to distinguish it from two other types of
expectancies which were implicit in the original
formulation. Self-efficacy is the belief that one is
able to execute the behavior on which reinforcement is contingent;" response expectancies are
expectancies for the occurrence of nonvolitional
responses, that is, responses that are experienced
as occurring automaticallyemotions, conversion symptoms, sexual arousal, pain, and so
forth.'' As an example, an individual might
believe that writing a book would lead to getting
tenure (outcome expectancy), but would be
unlikely to act without the efficacy expectancy
("I can write a book") and the response expectancy ("Getting tenure will make me happy").
Data from three areas of investigation, placebo
effects, fear reduction, and hypnosis, indicate
that response expectancies generate corresponding subjective experiences. Frequently, the
auth-enticity of these self-reported effects is corroborated by corresponding changes in behavior
and physiological activity. For example, expectancies have been reported to produce dermatitis
and bum blisters, and to have cured warts and
ichthyosiform erythrodermia.'^ It is now widely
believed that reponse expectancies can mimic,
offset, and even reverse the effects of powerful

Elsewhere, I have delineated the crucial role


expectancies play in the genesis and maintenance
of psychobiological states."* Due to the obvious
reinforcement value of such nonvolitional
experiences as elation, sexual arousal, pain, and
fear, response expectancies must be a major
determinant of behavior. Alcohol consumption,
for example, can be influenced by expectancies
for increased confidence, reduced tension, and
enhanced social and physical pleasure."
Coping skills and enhancement behaviors
Many researchers have commented on the
deficient coping skills of the drug dependent.^"
Coping, as defined by most investigators, refers
to the individual's ability to deal with stress or
threat. While this skill is undoubtedly important,
concern with coping has overshadowed a vital
facet of adjustmentenhancement behaviors.
These are the strategies people use to maintain
or enhance their positive psychobiological states
when they are not under stress. As Rotter framed
the problem:
It seems reasonable, both intuitively and clinically, that there are people who are happy,
content, and in a good mood much of the
time, and that the objective circumstances of
such people may not differ markedly from
those of others who are mildly unhappy, discontent, or worried about bad things that
might happen (p. 339).^'
Insufficient research attention has been paid to
enhancement behaviors and to the people who
use them. Some cognitive strategies have been
suggested as helpful: over-attending to positive
aspects of situations, under-attending to negative
ones, finding long-term positive effects in seemingly negative conditions, seeing challenges
instead of threats, and imaginatively rehearsing
positive outcomes. Attributes of happier people,
or people in positive mood states, have been
noted: higher expectancy for positive reinforcement, more altruism, less worry, higher activity
level, better organization, more socializing,
greater liking for strangers, and more generous
A striking feature of alcohol-dependent individuals apparently concerns their setting of
minimal goal level, the lowest goal along a continuum of reinforcements for some life situation
which would be perceived by the individual as

Psychobiological states in chemical dependency

satisfying. People who are characteristically content tend to set minimal goal levels well below
the level to which they aspire (hope for an 'A',
settle for a 'C'), whereas alcoholics have been
shown to have minimal goal levels close to their
level of aspiration, and higher than they ought
reasonably to expect to achieve.^'' Although setting high minimal goals may function as a
short-term means of bolstering shaky selfesteem, it can be disastrous as a long-term strategy. Repeated failures to meet these goals
engender frustration and disappointment which
may then be dealt with by alcohol consumption.
Psychobiological states are a product of
myriad biological, psychological and social processes. Behaviours as prosaic as eating healthy
foods and getting sufficient rest contribute to the
maintenance of positive states in some individuals. Similarly, various lifestyle choices have
implications for the states people experience.
Engaging in certain behaviors tends to produce
states people value and sometimes describe as
'highs'. These would include vigorous exercise,
intimate conversation, yoga, meditation, massage, reading, aesthetic experiences, soaking in
hot tubs, satisfying sex, meaningful work, and
play of all sorts.
What these behaviors perhaps have in common is their affordance of an opportunity for
self-forgetfulness. As described by Csikszentimihalyi:
Self-forgetfulness does not mean losing touch
with intemal or external processes, however.
On the contrary, these may be registered more
intensely and vividly than at other times. What
is lost is not the awareness of one's body or of
one's functions, but only the self construct
(p. 43)."
States of this sort have been referred to as "being
in the flow" and as peak experiences; they are
believed to result at times in peak performance.^^
It seems intuitively plausible that for individuals who regularly experience such states,
drug-induced states might lack allure. The costbenefit analysis for a given drug experience
would be radically different for such individuals,
compared with those for whom the drug seems
the only avenue to produce positive states, or to
avoid negative ones. It is perhaps for this reason
that alcoholics are said to have particularly detailed recollections of their first drink.^' The

749

degree of perceived reinforcement of a first drug


experience has been shown to relate to the magnitude of the subsequent drug habit.^' For an
individual lacking adequate means of transcending negative states such as boredom and anxiety,
the transformation effected by alcohol or other
drugs might register as an epiphany.
It is only for such individuals that the standard
animal models are even somewhat applicable.
Laboratory animals, denied the richness of a
natural environment and the full range of states
it would engender, are not difficult to addict to
various drugs. Interestingly, those housed individually self-administer more heroin in the first
few weeks of testing than do socially housed
animals. Bozarth'" sees this as an instance of a
social manipulation infiuencing the pharmacological reward produced by the drug. Perhaps it
infiuences by contextualizing the reward, altering
the cost-benefit analysis that even a rodent might
conduct.

Drive reduction and incentive motivation as


complementary processes
Addiction can be viewed as a fundamental reorientation of an individual's motivational
hierarchy. Individuals differ in their vulnerability
to such reorientation. It has long been recognized that individual differences mediate
exposure to mood-altering substances; sensationseeking, non-conformity, sociopathy and similar
constructs have all been implicated. Due to the
failure of earlier attempts to isolate an addictive
personality, more recent explanations for the
continued use that leads to addiction have
tended to be couched more in terms of genetic
predisposition than of psychological variables,
although a recent review of genetics and alcoholism has concluded that environmental factors
may be substantially more important than genetic ones in determining abuse.^'
Past attempts to explain motivation have employed two contrasting (and potentially
complementary) positions. Drive reduction theory holds that organisms are motivated by drives
'pushing' toward the goal object, whereas incentive motivational theory asserts that organisms
are motivated by incentives 'pulling' toward the
goal object. Incentive motivation was added to
learning theory as an explanatory construct when
it became clear that a combination of habit
strength and drive was inadequate to account for

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Rob Neiss

forcement to shape behavior, such a strategy can


have positive effects, producing individuals who
reinforce themselves for behaviors that lead to
their own and others' ultimate benefit and experience negative states only in those rare instances
when they behave in a fashion likely to be detrimental to themselves or others.
The foregoing was a best-case scenario of the
effects of parenting on state formation. Unfortunately, many individuals are raised in a manner
that affects them quite differently. Negative
states could become contingent on activities idiosyncratically offensive to the parents (e.g.
self-assertion) or even become non-contingent
on behavior altogether, resulting in global selfloathing and dysphoria. Similarly, parenting has
a major impact on the development of selfefficacy and response expectancies in the area of
emotion-focused coping. For those fortunate
enough to receive consistent, supportive parenting in a relatively trauma-fi-ee environment, the
expectancies about negative states that tend to
develop are: "I can handle this" and "It will
pass". These underlie the capacity for self-soothing. Because its development is a complex
interplay of genetics and social learning, individuals may be expected to differ markedly in this
capacity, as they do in their skill in enhancement
The role of social learning in the genesis of behaviorsthe ability to experience and mainstates
tain positive states.
Even when behaviors are motivated by states one
Thus far, the examples of parenting offered
imagines will occur far in the future, the imaging have dealt with extremes. Most individuals, of
creates and partly comprises a current state.
course, experience intermediate circumstances:
That state can have a powerful affective compoparents who mean well and function effectively
nent. Many individuals are sustained and buoyed
for the most part, but nonetheless regularly act in
through potential hardships by images of a future
ways which undermine various aspects of their
reward and the real-time positive feelings these
engender. On the other hand, intrinsically plea- children's development. Needless to say,
surable activities in the present can give rise to parental influence is only partial; manifold forces
hedonically negative states, depending on the of all sorts impinge upon and shape the growing
individual's expectancies and values. Think of a individual. The net effect of all this is that most
man attending a football game instead of work- people are vulnerable to troublesome psychobioing, dwelling on the repercussions of failing to logical states. These states are often troublesome
in two waysthey have a negative hedonic tone
act responsibly, such that the pleasure is lost.
and they result in performance difficulties, that
The guilt, anxiety, and other negative emois, behavior which tends to reduce reinforcetions this hypothetical situation could induce are
ment. Note that this does not refer to poor pernot there by accident. No doubt the man in our
formance based on underdeveloped skills or to
example had parents who laboured long and
hard to bring about such reactions in him. An the lack of certain behaviors in one's repertoire.
important part of the socialization process is the The hallmark of state-mediated performance
inculcation of negative states contingent on un- difficulties is the inability to access behaviors
desirable behaviors. With parents attuned to within one's repertoire due to psychological ascultural values and using primarily positive rein- pects of the situation. One manifestation of this

organisms' responses to contrasting rewards.^"


Often, incentive motivational theory is regarded
as the more cognitive of the two theories, because the primary motivation is viewed as the
expectancy of reward. Nonetheless, drive-reduction theory can easily be recast as a cognitive
formulation, emphasizing the complex interplay
between outcome, self-efficacy, and response expectancies necessary to 'push' the organism.
Some theorists favor drive-reduction theory to
explain conditions of aversive motivation
escaping or avoiding an aversive stimulusand
prefer to explain appetitive motivation with incentive motivation theory.'" Yet in appetitive
situations as well, one could view the prior state
as relatively aversive. It could be argued that
both drive-reduction theory and incentive motivation theory share these features: the organism
assesses its current psychobiological state (e.g.,
hunger), imagines a more desirable future state
(satiety), and behaves in a fashion designed to
bring about the latter. Human beings, however,
can also be motivated by the contrast between
two imagined future states, for example, picturing oneself attempting to give a lecture when one
is ill-, as opposed to well-prepared.

Psychobiological states in chemical dependency

is known in athletics as 'choking under presSub-clinical disaggregations and state


masking
The inability to access certain behaviors is part
of a larger configuration of impeded awareness. These are sub-clinical dissociations
(or disaggregations, to cleave more closely to
the original term). They are sub-clinical
only in that they do not qualify one for diagnosis
under the heading of Dissociative Disorders in
DSM III-R3' or ICD-10". Nonetheless, problems of this sort often bring people to
psychotherapy.
What are referred to are not the often useful
dissociations of everyday life, for example, the
automatic driving along a familiar route that
fi-ees one for other thoughts. Rather, these disaggregations are motivated by the avoidance of
particular states. Generally, these states feature
ego-dystonic affects and cognitions or perceptions of significant others that are not consonant
with emotionally important views of them. How
poignant to see a child become 'confused' rather
than notice that Mom has broken another
promise.
In adults, it is often far from obvious what
state is being avoided. Gender plays a considerable role. Many men effect the change from hurt
to anger so quickly that neither they nor onlookers have any awareness of the former state.
By contrast, women often successfully hide furious feelings from themselves and others behind a
mask of tears. Many of the defense mechanisms
of psychoanalysis involve the substitution of one
state for another, for example, reaction
formation.
The modal personality style of substance abusing adolescentsimpulsive, antisocial, and
deviance pronecould in large measure reflect
attempts to cover up painful states of self-awareness, especially regarding rejection and a
perceived inability to measure up or fit in. Impulsivity can seem an attractive option as a
lifestyle if one holds the expectancy that
reflecting on options will prove anguished and
futile. This masking of states perhaps explains
discrepant findings in the area of alcohol
consumption.
Hull'' argued that alcohol use is motivated by
the avoidance of painful states of self-awareness
and suggested that the highly self-aware who

751

receive failure feedback from their environment


would tend to use alcohol to decrease their
awareness of such negative self-relevant information. Support for this position initially came
from laboratory research, but more recently was
provided by a field study of adolescents completing an inpatient detoxification treatment.
Among those high in private self-awareness, relapse was significantly related to the occurtence
of negative self-relevant life events; this relationship did not hold among those low in
self-awareness.'''
A recent field study of unselected high school
students, however, produced an opposite pattern
of results: Negative life events were significant
predictors of alcohol consumption for low selfawareness subjects but not high self-awareness
subjects.'' In a second data set of this study, the
interaction between self-awareness and negative
life events did not predict drinking behavior, also
failing to support Hull's model.
This apparent discrepancy can be explained as
follows. The preponderance of evidence supporting Hull's theory comes from laboratory studies
that use induced failure feedback and typically
constrain the availability of coping and enhancement strategies. In the naturalistic study cited
above in support of the model, the subjects were
alcoholics completing a detoxification program.
Perhaps these alcoholic subjects were quite limited in their repertoires of enhancement and
coping behaviors, explaining the tendency of
those high in self-awareness to deal with the
occurrence of negative self-relevant life events by
drinking. In contrast, the subjects in the disconfirmatory study were drawn from the general
population of high school students and presumably had a broader range of enhancement
and coping strategies. In fact, those higher in
self-awareness might have the fullest array of
such strategies and hence be less likely to use
alcohol to deal with negative self-relevant information (as the first data set from the
disconfirmatory study suggested).
Furthermore, treatment for adolescent substance abuse, which the former set of subjects
had undergone, is largely an attempt to strip
away the defenses these young people employ to
mask painful underlying states. Perhaps treatment tended to enhance the self-awareness of
sensitivity to personal failure of these subjects,
bringing them more into accord with Hull's
hypothesis. This underscores the desirability of

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Rob Neiss

drug, and pays more attention to the set and


setting. The individual's introduction to a drug
bears a striking resemblance to a hypnotic induction. Friends, family members, and the culture at
large have already disseminated sufficient
Drug experiences as hypnotic inductions
In the earlier days of addiction research, it was (mis) information about the experience to have
assumed that the central topic of investigation engendered a set of clear expectations.'^ A ritual
was a pharmaeo-physiological event. Two rela- is typically employed to ingest the substance.
tively recent advances have substantially altered Generally, experienced users are on hand to
that view. With the advent of the balanced- convince the novice that the expected state
placebo design, it has become possible to change is occurring. The nature of the activities
unconfound the ingestion of a substance with the engaged in can be crucial to the experience, for
belief of having ingested a substance. This proce- example, in the case of alcohol determining
dure has enabled researchers to deconstruct the whether anxiety is decreased or increased.'^ Bedrug experience, producing the counter-intuitive cause camaraderie has the power to convert
finding that expectancies regarding the drug are otherwise negative experiences to positive ones,
often as strong a determinant of experience as it can make a drug experience joyful, particularly
are the pharmacological properties of the drug for someone who has had prior problems with
itself Balanced placebo research with alcohol social inclusion and status. Additionally, introshows that response expectancies can effect duction to a drug can serve as a rite of passage.
sexual arousal, social anxiety, alcohol craving Such rites, prominent features of nearly all huand aggressiveness; moderate doses of alcohol, man cultures except our own, must serve an
taken without knowledge of consumption, do important function. Perhaps humans have an
not affect these responses, suggesting that many innate desire for initiation into mysteries and for
of alcohol's putative effects are, in fact, placebo a demarcation of childhood's end. Worldwide,
altered states are central to rites of passage.
effects."

treatment programs helping addicts to develop


enhancement and coping behaviors to replace
the defenses that are being dismantled.

Many individuals have pleasant, or even ecstatic initiatory experiences with a particular
drug and nonetheless fail to make that drug the
centerpiece of their lives. Typically, these people
have many other avenues of reinforcement'^ and
are making satisfactory progress toward achieving the positive incentives in their lives and in
removing the negative ones.'' They generally
have positive non-chemical response expectancies, a functioning set of enhancement behaviors,
and well-developed emotion-focused coping
skills.''" Of course, some individuals are protected from excessive involvement with a
particular drug by genetic disaffinity. For example, more than half of Orientals have an
unpleasant flushing reaction in response to alcohol."" Yet the vast array of psychotropic drugs
available insures that a drug of potential abuse
exists for everyone.
There is no reason to assume that those who
will proceed to develop full-blown substance
abuse careers have initiatory experiences any
more pleasurable than those who will become
casual or non-users. What is salient is the conThe perspective on drug ingestion that trast between prior and drugged states. Some
emerges from these new developments de-em- individuals are plagued by dysphoric debilitating
phasizes the pharmacological properties of the states that feature concomitant negative selves;

During the same period, there has been a


burgeoning awareness that various non-drug experiences give rise in certain individuals to a
pattem of compulsive behavior that mirtors drug
addiction. Although some of these experiences
involve ingesting substances (e.g. compulsive
overeating) and in some cases endogenous drug
release has been implicated (e.g. endorphins in
bulimia), these features do not seem necessary to
produce compulsive behavior. Gambling, working, shopping, and certain stereotypic sexual
behaviours are activities to which substantial
members of people reportedly have become addicted. Accounts of individuals suffering these
syndromes reveal the cardinal feature of addictionpersistance in the behavior despite what
would seem high personal cost. The similarities
of behavioral pattems across various drug and
non-drug experiences should serve to focus research on two questions: What is missing from
the lives of these individuals that leaves them so
vulnerable to gross reorientations of their motivational hierarchies? What are these people
avoiding by becoming addicts?

Psychobiological states in chemical dependency

either their expectancy for altering them nonchemically is low or they are predisposed to seek
solutions that involve little effort. Perhaps they
lack meaningful goals, or, having them, feel unable to progress toward them. Suddenly, the
ingestion of a substance effects a magical transformation.
Drugs have the power to alter reactions to
incentives: Maladaptive shifts have been demonstrated even in rats."^ In humans, these
chemically-induced motivational adjustments
"Who cares?"serve as one mechanism of deepening an individual's involvement in drugs. As
striving toward non-drug incentives is gradually
abandoned, the individual's range of potential
reinforcers narrows accordingly. The abused
substance and other substance abusers become
the paramount reinforcers.
What may make substance use rise most
rapidly in a motivational hierarchy, however, is
the effect on sense of self If an individual suffers
protracted, recurrent states featuring personally
repugnant selves, vulnerability to substance
abuse exists. Were these negative states to be
transformed by drug ingestion, such that a positive self were experienced, the individual would
be at risk. Using this substance on a regular
basis, particularly if this use interfered with other
means of inducing positive states, would be expected to exacerbate that risk. To the extent that
other ways of generating self-worth were undermined, the drug experience would become more
captivating. Each instance of use would further
weaken nascent addicts' beliefs in their ability to
feel better without drugs; attempting to do without the substance and relapsing would reduce
self-efficacy and non-chemical response expectancies still fiirther.
Tolerance, withdrawal, and relapse
Bodies homeostatically attempt to regulate functioning in the face of these repeated drug
onslaughts. Nerve cells gradually compensate for
the presence of drugs, enabling brains to continue ftjnctioning at the increasingly higher dose
levels that individuals require to achieve the
same effect (tolerance). To the degree that the
body uses mechanisms that oppose the effects of
the drug, in addition to those that simply decrease its effect, physiological dependence is
created."" Abstinence would then result in a
withdrawal syndrome.
This is taken by some to be the hallmark of

753

addiction, but data suggest otherwise. Many individuals have become physiologically dependent
on morphine, and even heroin, as part of their
medical treatment. When the medical necessity
ends, these people typically terminate consumption, experiencing influenza-like symptoms but
not craving for the drug.
These medical patients have a different experience of withdrawal than do street users because
their reasons for using the drug, and indeed their
experience of it, are quite different. Street users
relieve dysphoric psychobiological states with
opiate drugs; they are typically inducted into a
state featuring euphoria and indifference to anxiety-provoking situations. Medical patients, by
contrast, generally report a sense of tranquility
with pain relief, with some complaining of dysphoria and the inability to think clearly."^ When
the pain for which they were prescribed the
opiate subsides, their physician terminates the
drug while assuring them that the discomfort of
withdrawal will soon passand it does. For the
street addict, abstinence engenders a state which
may be a more intense version of the aversive
state that initially prompted regular use. While
the intensity level might be new, the negative
self-relevant cognitions and bad feelings may be
all too familiar, underscoring the belief that this
state will not pass without more drugs.
Relapse is often precipitated by negative affective experiences,""'" possibly by increasing the
incentive value of the substance. In their responses to stress, relapsed alcoholics were
discriminated from recovered alcoholics and
matched controls by their use of avoidance coping strategies."" A prospective study of alcoholics
attempting to change found that developing an
altemative satisfying behavior was the main predictor of success."*^ Thus, it seems that relapse
may be associated with deficient emotionfocused coping and an inability to induce positive states non-chemically.
Decision rules, willpower, and the development of a metaperspective
Because the various behaviors that create and
maintain an addiction represent a series of
choices, decision theory may be fruitftjUy applied
to this area."" Perhaps susceptibility to addiction
is in part associated with decision rules which
give present characteristics much greater weight
than future possibilities. The ability to delay
ratification has been shown to predict to all kinds

754

Rob Neiss

of success,'" and, along with the ability to persevere with intentions under adverse conditions, is
said to be a component of 'willpower'. This
attribute is widely believed to be inimical to the
formation of addictions, but as yet has attracted
little empirical research.
Willpower could be reformulated as an aspect
of the ability to take a metaperspective in regard
to psychobiological states. Many people function
with relatively little metaperspective; their experience of themselves as a unified self is largely a
fiction. The T that resolutely proclaims a diet in
the moming is not the same T that raids the
refrigerator at night. One state succeeds another;
each features its own self claiming to speak for
the whole person. According to Rossi, "The
apparent continuity of consciousness that exists
in everyday normal awareness is in fact a precarious illusion that is only made possible by the
associative connections that exist between related bits of conversation, task orientation, etc"
(p. 41).^'
The capacity to witness the succession of
states is crucial to the development of a metaperspective. As self-observation is cultivated, the
automaticity with which certain states are evoked
by situations is decreased in favor of the experience of choice. This could take the form of metacognition"Are these fearful thoughts rational?"or proceed in other modes"How do I
feel about becoming angry?" This process would
not lead to a dull uniformity characterized by the
absence of states, but rather a sense of being
more keenly alive as disaggregations are lessened
and situations are met with more complete
awareness. Elsewhere, I have discussed techniques useful in developing a metaperspective."
The development of a metaperspective is the
work of a lifetime and early social leaming is of
critical concem. The ability to delay gratification, for example, is not learned in a vacuum; it
is taught, it is modeled, and, above all, it is
provided a context in terms of situations wherein
reinforcement is ultimately forthcoming. Many
children experience an environment in which it
would make no sense to save for the ftiture due
to the likelihood of being "ripped off". Similarly,
endeavors are not likely to be undertaken in
hopes of future reward unless social conditions
give the appearance of fostering such an eventuality. As loss of love and opiate withdrawal bear
a striking neurological similarity," the experience of being lovedand of lovingmight offer

a measure of prophylaxis for addiction and be


conducive to developing a metaperspective.
Conclusions and implications
Even from a strictly hedonistic perspective, addiction must be viewed as a bad bargain. It is
analogous to borrowing from a loan shark at
exorbitant interest rates: the initial problem, although temporarily alleviated, is exacerbated in
the long run. The psychobiological states that
addicts attempt to avoid retum in an intensified
form during periods of abstinence, while the
highs they so avidly pursue become muted fi-om
their repeated administrations of the drug. Individuals are differentially susceptible to the ftjndamental reorganization of motivational hierarchies
known as addiction. Some of the salient individual differences may be in the areas of coping
skills, enhancement behaviors, and expectancies,
particularly self-efficacy and response expectancies. People who frequently experience psychobiological states featuring personally repugnant
selves may be at risk for addiction when they
encounter a psychotropic substance and concomitant induction procedure which transform
these negative states to positive ones. This risk
would be expected to be exacerbated to the
extent that altemative reinforcers are no longer
pursued.
Susceptibility to addiction might also be conferred by decision rules which disproportionately
weight present sensations over future consequences. This strategy may reflect the lack of a
metaperspective on psychobiological states. Individuals with such a lack, though believing they
have a unified self, might be more accurately
modeled as a succession of state-dependent
selves. The creation of a metaperspective, which
implies a greater trans-temporal aspect of selfhood, should perhaps be viewed as a
psychological accomplishment, rather than as a
given. This accomplishment can be facilitated by
techniques I have described elsewhere."
In a research context, the assessment of psychobiological states may be augmented by
methods I have previously outlined.' To mention
one, facial electromyography has shown promise
in detecting the valence and intensity of even
subtle and fleeting emotional reactions." Yet
these evanescent reactions can also be detected
by human senses, unimpeded by normal social
constraints; therapists able to track these changes
may be in a better position to help clients to do

Psychobiological states in chemical dependency

so. Increasing clients' awareness of state alterations would seem to be a necessary step in
helping them to decrease automaticity and increase choice.
Psychotherapy may be effective in helping
some individuals to develop a metaperspective
on their states. However, many people face obstacles that are not altogether of their own
making. Movement toward meaningfiil goals,
crucial in maintaining positive states, might be
difficult to achieve because of external circumstances, particularly in the lower socioeconomic
strata. Having a stake in conventional life has
apparently saved many middle- and workingclass heavy cocaine users from addiction.'''
It therefore makes sense to implement social
policies that maximize the opportunity afforded
young people to make something of their lives.

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