Week 7

Question 1

What happens with New Years Resolutions? (3)

Answer 1

Between 40-50% of Canadians set NY resolutions

But a lot of Canadian break them just as quickly because changing our behavior is hard

Only about 19% of those who set them are successful even a few months after (and that doesn’t even include all the people who should set resolutions but don’t)

Question 2

How hard is behavior change for people living with addiction? (3)

Answer 2

Only about 1% of addicts seek the necessary treatment and care

Even negative effects from addiction do not push them towards change

Much research has been done on barriers to change like fear, lack of finances, lack of support and reinforcing relationships with other addicted people

Question 3

What are the 4 common barriers to addiction recovery?

Answer 3

Denial or unwillingness to seek treatment

Stigma or shame about addiction

Lack of access (real or perceived) to a quality treatment program

Financial concerns about how to pay for a treatment

Question 4

What is the treatment common denominator of looking forward? (3)

Answer 4

Many treatment modalities start with a premise that people who are engaged in addictive behavior can lose their true sense of self (meaning, life, motivation)

Treatment providers try to motivate them by building a proverbial bridge to a more positive future, focusing more on their future life goals

This is an attempt to restore a sense of self-continuity or wholeness to the self that has been eroded by addiction

Question 5

What is self-continuity? (2)

Answer 5

A sense that there is a core aspect of the self that traverse time and space

Who you are at your core, even as you change and learn

Question 6

What does addiction do to self-continuity? (2)

Answer 6

It shatters that continuity and created a sense of self-discontinuity

Undermines you who are and who you want to be by centering your self around the substance/act

Question 7

How do treatment providers utilize self-continuity? (3)

Answer 7

Tries to rebuild that sense of self-continuity by making them think about the future and who they want to become and have always wanted to be

Want people to focus on the future possibilities to bridge the self of the past to the self of the present to the self of the future

Focused on how current behavior is undermining who they are and who they want to be in the future

Question 8

What are the benefits of feeling self-continuous? (3)

Answer 8

High levels of psychological well-being

A desire to achieve and maintain well-being

Elevated levels of self-esteem

Question 9

What is motivational interviewing? (3)

Answer 9

One of the most popular treatment modalities

Trying to reduce or minimize resistance to change

Explores discrepancy between the behavior that they are engaged in right now and their future goals to resolve ambivalence to change

Question 10

What is the problem with focusing people on the future? (3)

Answer 10

There is often a reason for the addictive behavior as it is helping them cope with something in their current life

A future without the addictive behavior can be very anxiety inducing

The future is vague and intangible as we haven’t lived it yet so asking people to focus on the unknown can actually make it worse as it could be better or worse

Question 11

What is the new denominator of looking forward? (4)

Answer 11

We need to focus them on the past instead

The past is concrete as you know what your life was like before the addictive behavior

You can highlight the discontinuity between the present self and the person they were before

Even people with negative past situations can remember a time in their life that was better than now

Question 12

How does self-discontinuity affect behavior change? (3)

Answer 12

When unwanted change has befallen the self, people see a disconnection between the present and the past

Pointing out this discontinuity can be a motivator for change

There has been some anecdotal evidence from the clinical setting that this disconnection from who you really are is motivating

Question 13

What is nostalgia and how does this impact behavior change? (3)

Answer 13

Nostalgia is sentimental longing for the past

When you experience that sentimental longing and revelry for the past, it motivates you to reclaim that part of the past and bring it into the present

Highlighting self-discontinuity with the past should elicit nostalgic revelry for the past, which creates motivation for change to bring the past to the present

Question 14

What are the proven effects of nostalgia on behavior? (4)

Answer 14

Positive affect and self-regard

Strong sense of belonging

Meaning in life

Self-continuity

Question 15

What did the Kim and Wohl study on self-discontinuity and readiness to change do? (2) What did it find? (2)

Answer 15

Asked if feeling self-discontinuity created nostalgic revelry for the pre-addicted self and if that nostalgia motivated and readies people for change

Measured self-discontinuity, nostalgia and readiness to change of people with gambling disorder

Found that people who felt their addiction has created a sense of self-discontinuity experience nostalgic revelry for their life before gambling

Also found that the more they nostalgized, the more they were ready to change their gambling behavior

Question 16

What did the second Kim and Wohl study on nostalgia and readiness to change do? (2) What did this one find? (2)

Answer 16

Created a manipulation that highlighted the addictive behavior as either creating self-discontinuity or not (a little paragraph that either states that gambling is proven to change your sense or self or that it is proven to not)

Also measured nostalgia and readiness to change

People in the discontinuity condition reported that gambling ruined their lives and their entire being

These people nostalgized more and were more ready to change their behaviors

Question 17

What is the problem with the first 2 studies? (2)

Answer 17

There is a big difference between readiness to change and actual change attempts (see New Year’s resolutions)

Does it impact their actual attempts to change behavior?

Question 18

What did the Kim, Wohl and Salmon study on nostalgia and attempted change do? (3) What did it find? (3)

Answer 18

Divided the study into 2 phases with people with gambling disorder

Phase 1 measured their disorder severity, used the manipulation from the last study and measure nostalgia

Phase 2 called them back a month later and determined whether they had made a change attempt in the last month

Found that people who measured high in disordered gambling in the discontinuity condition had an increased readiness to change and were more likely to report a change attempt

There was no effect for people low in disordered gambling (they don’t have a problem so they don’t need to change)

This study was replicated with alcohol and found this high correlation again

Question 19

What are implicit theories of behavior? (4)

Answer 19

From a theory of intelligence and learning that analyzes how people think about change

An incremental theorist believes that behavior is malleable and capable of change

An entity theorist believes that behavior is fixed and cannot change

This mindset can affect people’s ability to change their behavior

Question 20

What does the Salmon, Kim and Wohl hypothesized model on mindset for change impact state? (4)

Answer 20

Incorporates implicit theories into the self-discontinuity and nostalgia studies

States that the link between nostalgizing and attempting to change may be influenced by their mindset

People with an entity mindset don’t feel the impact of nostalgia because they think change is impossible

People with an incremental mindset feel the impact of nostalgia because they believe they can change

Question 21

What did the Salmon, Kim and Wohl study on mindset for change do? (3) What did it find? (3)

Answer 21

A longitudinal study that recruited gamblers and split them into 2 phases

Phase 1 assessed self-discontinuity, nostalgia and implicit theories

Phase 2 asked if they attempted to change

Found that there is basically no effect of nostalgia on probability of a change attempt among entity theorists

The greatest probability for change exists when gamblers experience high nostalgia and are incremental theorists

There were some incremental thinkers who had low nostalgia and low probability of change attempts but that could be because they think they can change at any point in time but don’t have the motivation to start now due to lack of nostalgia

Question 22

What did the Salmon and Wohl study on past vs future for readiness to change do and what did it find? (6)

Answer 22

A qualitative study on gamblers that asked people to think about their past and write about it

Found 2 clusters of people: people with a positive past who thought life was better before gambling and people who had difficult pasts and thought their life was no worse now since it was always bad

Then had them fill out a bunch of measures which found people in cluster 1 nostalgized more and long for their past more, meaning they were more ready for change

They then asked them to think about the future

Once again found 2 clusters: people who were optimistic about the future and how will it change and people who were ambivalent about the future and were resistant to change

Had them fill out a bunch of measures and found cluster 1 could see their future more vividly and found it to be very motivating

Question 23

So is nostalgia good or bad for one’s health? (4)

Answer 23

It depends

Need to take an adaptive approach as one size does not necessarily fit all

Past focus may work best for people with positive pasts and who are ambivalent towards the future

Future focused may work best for people who anticipate positive futures and with difficult pasts

Question 24

What about people in recovery? (2)

Answer 24

Many people feel disorder related nostalgia (longing for unhealthy behaviors, the thrill, the escape, the taste, the smell, etc.)

Could nostalgia pull people back to the addictive behavior?

Question 25

What did the Bossom, Wohl, Dowson, Salmon and Tabri study on nostalgia and recovery do? (2) What did it find? (2)

Answer 25

Looked at people in recovery from an ED to determine the potential impacts with nostalgizing for the benefits they perceived when they engaged in their disorder

Hypothesized that nostalgizing could result in self-continuity with the ED self, which could affect intention to remain in recovery

Found that people who still felt a sense of connection to that person they were at the heights of their ED do nostalgize more for the perceived benefits of their ED

This in turn reduces or undermines intentions to remain in recovery

Question 26

What did the Dowson and Wohl study on nostalgia, ambivalence and recovery do? (2) What did it find? (3)

Answer 26

Argued that while nostalgia might pull you back towards the unhealthy behavior, optimism can drag people towards and through recovery

Feeling both of these at the same time can in turn create ambivalence about the recovery process, which can ultimately undermine recovery

Found that people who are high in optimism and low in nostalgia are low in ambivalence, meaning they wanted to stay on the recovery path

People who were low in optimism were higher in ambivalence, regardless of nostalgia, which reduced motivation to stay in recovery

People who were high in optimism and high in nostalgia experienced higher rates of ambivalence as nostalgia undermines their commitment to recovery

Question 27

What are the 5 key lessons of this week?

Answer 27

Nostalgia facilitates healthy behavior change when focused on reclaiming life lived before the unhealthy behavior began

Nostalgia undermines healthy behavior change when focused on reclaiming the perceived benefits of engaging in the unhealthy behavior

Facilitating people to see the past self as a different and better version of the self motivates readiness and attempts to change

Small changes can create a butterfly effect, yielding disproportionate changes elsewhere

Nostalgia needs greater attention in the treatment of unhealthy behavior and the facilitation of healthy behavior