Thinking Fast and Slow


On Facebook this morning, I ran across a recommendation by ZDoggMD (government name: Dr. Zubun Damania) — a book called “Thinking Fast and Slow” by From Daniel Kahneman. This piqued my interest for a couple of reasons. First, Kahneman, despite being a psychologist, won the Nobel Prize for Economics in 2002. Second, the book’s subject matter is Human Irrationality. In other words, why do we do stupid shit despite the fact that it’s bad for us?

Take, for example, drug abuse. It’s estimated that over a half-million people die every year from various forms of drug abuse. So, with overwhelming evidence saying that using is a bad thing (whether it’s tobacco, alcohol, or illicit drugs), why do people still choose to light up, drink up, or shoot up?

According to Kahneman (and other researchers involved in the project), it comes down to the way the brain is wired. How we perceive incoming data. We have inherent biases in our thinking that influence our memories of experiences.

He postulates that we have two systems of thinking going on. System 1 (the fast one) is pretty instinctual. It makes a decision at a subconscious level. But it works fast and cheap  — yet it’s pretty inaccurate. Example: You see a bowl of cherries with a cockroach sitting on top. You may instinctively feel intense revulsion. Your brain thinks, cockroach is bad, therefore, cherries are bad. From then on, you think cherries=bad.

System 2 (the slow one) happens at a conscious level. It’s methodical. Takes time. System 2 would sort through the information so you can see that cherries are still good even if you saw the cockroach on it. It considers that situation in a more logical, “scientific” way.

But System 2 takes time and it’s exhausting. It’s lazy. If it gives up too soon, System 1 takes over and you remain cemented in your belief that all cherries suck because… well… maybe your brain won’t even remember that cockroach after a while. You just remember knowing in your heart of hearts that cherries are gross. Period. Stuck in that belief because that’s just how it is. Harrumpf!

I’ve only started reading this intriguing book, but let me allow the New York Times to summarize what I’m trying to say:

“… the remembering self does not care about duration — how long a pleasant or unpleasant experience lasts. Rather, it retrospectively rates an experience by the peak level of pain or pleasure in the course of the experience, and by the way the experience ends.”

So… example… someone like me takes a Vicodin tablet. I’d taken Vicodin before and, while I enjoyed it, I never really loved it. It was a slow release, and even though the experience was pleasurable, it wasn’t really all that great. But I DO remember the day it hit me like a freight train! For various reasons, the drug gave me an intense high one day unlike any other — and the intensity of the experience shifted my bias. I wanted that to happen again and again and again. I pursued it into the ground despite all evidence that my life was spinning wildly out of control. I almost died trying to recreate that experience.

This is what Kahneman describes as the “Peak-End Rule” — not so much the duration of the experience, but the intensity by which it is felt — that drives my recollection and pursuit of repetition despite all logic to the contrary.

In truth, I have wondered about this theory for a long time. I’m pleased to see that a Nobel Prize-winning psychologist/economist has done the legwork for me. That perhaps it is not the length of time we do it, but the intensity of the experience that drives addiction. They don’t call it “chasing the dragon” for nothing. Always chasing that first high.

And perhaps that is why so many drug treatment plans fail — they cannot overcome that cognitive bias created by the peak of the drug experience. Going to classes all day, going to meetings, plodding along in our recovery — how can that possibly compare to the fireworks created by your drug of choice?

It can’t. That’s why healthcare workers recommend that treatment last so long even though insurance companies only want to pay for a couple of weeks or the traditional 28 days. 28 days isn’t nearly enough for System 2 to kick in. Not nearly enough. A dear friend of mine has been in treatment for almost a year now — and he does everything he’s supposed to do. He takes all the classes. He does all the work. He goes to meetings. He does every assignment he is given. Yet, while they have quieted, the urges are still there. If Kahneman’s theory of a mild experience for a long time versus an intense experience over a short time is true, the likelihood that my friend will relapse remains pretty high.

Which isn’t to say that the “System 2” cognitive version of Drug Rehab — the most common here in the United States — can’t or won’t work. It can and does for many people.  It may work for my friend. But perhaps we need to consider that if most of our patients are failing in this method of treatment, we need to reassess what we’re doing.

I wonder if that is why the controversial treatment of Ibogaine for opiate addiction has found a modicum of success as a ‘cure’ in other countries where it is legal — because it proffers an alternate psychoactive experience, one that shares a “Peak-End” in direct conflict with the original episode. Perhaps the two cancel each other out? I would be curious to find out more.

(I’m not in any way, shape, or form recommending Ibogaine, but I DO find that its results present us with new data that should be considered.)

At any rate, I think this book is a really intriguing read! Although I’ve just started reading it, I think this book is offering some real insight given our current drug crisis. Check it out! (It comes ZDoggMD recommended too!)

“Intelligence is not only the ability to reason; it is also the ability to find relevant material in memory and to deploy attention when needed.” —Thinking Fast and Slow, Daniel Kahneman.




About madmargaret

Nursing student, Mac nerd, medical 'genius', recovering addict, singer, ex-actor, and all-around swell egg. Really!
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