Nobody wants to develop an addictive disorder. Most people intend to use the incentive judiciously and receive the benefits, but not harm their loved ones, integrity, or health. Nevertheless, despite the best of intentions, the consequence of repeatedly exposing a biological creature to immediate gratification is to create a trap from which escape is deceptively difficult. Most underestimate the task difficulty because good short term outcome is common, and many people achieve incentive free periods after going through a treatment program or simply “deciding to change.” But good long-term outcome is rare, and most people relapse.

Relapses are bad and each one promotes dependence. There are many variations of the path to bad outcome; here is one example:

Louie interprets this as an omen of good fortune and shifts his gaze to the Lottery Ticket display. Will he buy a ticket and break his vow? If he does, what does that mean about the strength of his future commitments? As you may have guessed, Louie did buy a bunch of lottery tickets that night. Evidently, his behavior was dependent upon local conditions rather than on his promise that he would not gamble.

Dependence is a Complex Phenomenon with Many Causes

Loss of Willpower: Whether or not the lottery ticket paid off, Louie lost something when he bought it. He promised he would not gamble anymore. By then breaking his promise, he lost the expectation that he keeps his promises. Making a commitment is like making a bet that you will do what you said you would do. If you honor your word, your willpower is enhanced, but if you lapse, you lose. What is lost is the power of your word to influence your actions, which turns out to be important. Dependence is a consequence of losing the bet too many times.

Karma of Relapse: Each time Louie uses the incentive, he strengthens the sequence of behaviors that leads to it. With sufficient practice this sequence becomes the default path, and once it does, it requires conscious effort to interrupt the sequence. Henceforth, whenever the cognitive resources required to consciously direct behavior are compromised, Louie tends to follow this path of least resistance to incentive use.

Misattributing the Cause of Failure: Dependence is often iatrogenic (pathology caused by ill-advised treatment). After the relapse, Louie was remorseful and tried to figure out why he failed. Like most people in his situation, he attributed the cause of his relapse to internal and stable factors—that is, there is something wrong with me, and it is not going to change. Louie endorsed the popular misconception that once you have made up your mind to change, relapse shows that there is something wrong with you, perhaps a disease or character defect. Repeated failures decimate self-efficacy: “I am powerless (have a disease), so I must turn over responsibility for change to an external agent.” In fact, relapse is usually the result of insufficient respect for the challenge resulting in insufficient preparation. Past failures are more an indication of the difficulty of this task—an external factor that can change if you develop your skills—than to your intrinsic defectiveness.

Treatment Promotes Dependence on External Agency

You can influence the course of your life, but this is an ambitious undertaking and requires a serious investment of energy and attention. Most people fail to achieve good long-term outcome, not because the task is impossible, but because they have insufficient respect for the challenge. Consequently, their plans, if they make them at all, tend to be too shallow to have a chance at success. To add insult to injury, because everyone—the individual as well as friends and family—believes that it should be easy to quit doing something that is obviously causing more bad than good, the relapse is all the more demoralizing. In the United States, the vast majority of treatment programs for addictive disorders are based on the disease model. According to this view, the afflicted individuals have little control over the course of their disease—other than complying with the treatment regimen.

Escape from Freedom

Outcome research has been unkind to conventional treatment approaches for incentive use disorders, including inpatient and intensive outpatient programs. Intrusive treatment methods can and do produce immediate results, but rarely lead to freedom from dependence. As network marketers and Al Qaeda recruiters demonstrate, a clever agent can influence some people to change their ways dramatically. Compliance is the quick and easy path to change, but it is not a path to independence. Good long term outcome is the byproduct of developing the skills to act as intended during high-risk situations.

The Buddha’s Secret

It is obvious to all but the most naïve that there is no secret to escaping addiction—no formula or incantation that will make you impervious to the forces of stress and temptation. Still, it is tempting to seek an external salvation from suffering. The Buddha spent years seeking the secret to understanding the human condition and the sufferings that go with it. His insight was simple, and it can free you of an illusion that promotes dependence. The secret is, “There is no secret.” The idea that Santa Claus knows who has been naughty and who has been nice, and that he dispenses goodies on that basis is discovered to be fiction by most people when they are children. A similar discovery awaits adults who have become dependent: The search for an external salvation from an addictive disorder is a vestige of childhood. Your passage from dependence to self-direction is the one that you must create. Your path of greatest advantage is for your steps alone; no one can take it for you nor spare you the experience.