The Addiction Philosophy Map
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Within the goal-setting conditions,  subjects adopted either distal goals defined in terms of weekly goal  limits or proximal goals specifying the goal limits for each of four time  periods during each day. Goal setting enhanced self-directed change as measured  by reductions in both eating behavior and weight. The higher the goal  attainments, the greater were the losses in weight. Proximal and distal goal  setting yielded comparable overall results because the majority of subjects  assigned remote goals altered this condition by adopting proximal goals to  augment control over their own behavior.

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The social learning theory tested here is summarized from Akers (1977:39-68). The primary learning mechanism in so-cial behavior is operant (instrumental) conditioning in which behavior is shaped by the stimuli which follow, or are conse-quences of the behavior. Social behavior is acquired both through direct condition-ing and through imitation or modelling of others' behavior. Behavior is strengthened through reward (positive reinforcement) and avoidance of punish-ment (negative reinforcement) or weakened by aversive stimuli (positive punishment) and loss of reward (negative punishment).

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As Vaillant (1995) has shown, a large share of alcoholics quit drinking without treatment and without any assistance from self-help groups or radical environmental change. Although these types of personal changes are commonly referred to as “natural recovery processes,” such successes are better explained in terms of mechanisms of self-regulation than natural occurrence. They testify to the human capacity for self-regulation. Granfield and Cloud (1996) put it well when they characterized the conspicuous inattention to successful self-regulators as “the elephant that no one sees.”

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Clearly, there are other determinants of addiction, but I believe a self-medication motive is one of the more compelling reasons for overuse of and dependency on drugs. Clinical findings based on psychoanalytic formulations have been consistent with and complemented by diagnostic and treatment studies that support this perspective, which, I believe, will enable researchers and clinicians to further understand and treat addictive behavior

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For example, Steele and Josephs’ (1990) alcohol-myopia  theory posits that alcohol ‘‘restricts attention to the salient,  immediate aspects of experience’’ and ‘‘reduces processing  capacity so that a greater proportion of this capacity has to bedevoted to the demands of immediate, ongoing activity’’ (p. 929).  Consider a man who has a bad workday and returns home to  drink. Alcohol may relieve his worry if he is distracted by  television, but he may ‘‘cry in his beer’’ if no such distraction is  available (Steele & Josephs, 1990).  Although alcohol-myopia theory continues to stimulate much  research, core elements of the theory remain unresolved. For  instance, as noted by Steele and Josephs (1990, footnote 3), it  remains unclear which cues will be most salient to a person who  is drinking (see also Sayette, 1993). In typical studies, salient  distractor cues are explicitly manipulated. For example, intoxicated  participants may be asked to prepare a stressful speech,  and during this preparation, some of these participants may be  given a series of pleasant images to evaluate. Intoxicated participants  given no explicit distraction feel at least as anxious as  sober participants, presumably because they focus on the upcoming  speech, whereas intoxicated participants who are distracted  by the images feel less anxious than sober participants  (Josephs & Steele, 1990).