Inside the Brain: Why Relapse Triggers are Difficult to Resist

Weakness or lack of willpower often get the blame when sudden cravings lead us to the next drive-through window for a tasty burger or a milkshake – even when we know the food isn’t good for us.

Maybe we should be easier on ourselves.

A recent study conducted by the School of Psychology at the University of South Wales suggests that flashing neon signs, enticing advertisements, and other powerful attention-demanding tactics can be extremely difficult to resist, especially when we’re stressed or tired.

Before the study, researchers weren’t sure if our inability to resist the cues is beyond control, or if we can use our brains to work against the distractions. Scientists refer to the thought processes that help us resist tempting cues as executive control, which allow us to organize our thinking, focus, pay attention, and regulate emotions.

Executive control kicks in when we make decisions, plans, correct errors, or solve problems. It also helps us resist temptation and think things through before we act.

Neuroscientists indicate that executive control is required when we must concentrate and pay attention. It kicks in when acting purely on instinct would be ill-advised or impossible. Brain scientists also note that using executive control requires effort and that giving in to temptation or acting on automatic pilot is nearly always easier than resisting.

According to the Center on the Developing Child at Harvard University, executive function enables us to focus, plan, remember, and juggle multiple tasks, much like a busy air traffic controller manages arrivals and departures. Without this skill set, the brain has a difficult time prioritizing tasks, filtering distractions, and controlling impulses.

Harvard’s child psychologists also say children aren’t automatically born with this ability, but that it develops over time, as the physiological structure of the brain grows and matures. In certain situations, including abuse, violence or neglect, the ability to resist immediate reward may become compromised due to impairments in the brain areas responsible for executive control.

Paying Attention: The Study

Researchers at the University of South Wales believe those executive-level functions play an essential role in our ability to resist those signals, but resisting them becomes harder when we’re tired or stressed. That’s when we tend to give in and reward ourselves with french fries, sugary soda, or the burger and shake we mentioned earlier.

The UNSW experiment was relatively simple: participants were asked to look at a screen that included various shapes, including a colorful circle and a diamond. If participants could locate and look at the diamond, they would earn money, but they would lose their chance at the money if their eyes were distracted by the colored circle.

Study participants were also told that once they completed the diamond task, they could earn even more money if they found a blue circle instead of an orange circle. Researchers monitored their attention with eye-tracking technology.

To determine if study participants could perform the test when they were under pressure, participants were asked to perform the test while memorizing a sequence of numbers at the same time.

Researchers discovered that it was difficult for participants to ignore the colored circles, even when they would earn money by doing so. The task was even more challenging when participants attempted to memorize the sequence of numbers at the same time. Only about half were able to ignore the colored circles.

The takeaway, according to researchers, is that without full executive control, we have a difficult time resisting signals that promise immediate rewards. This is true even when we’re working hard to improve ourselves by ignoring those powerful cues.

How this Knowledge Affects Addiction Treatment and Recovery

Although we have the ability to resist powerful signals, stress and worry create a greater demand on our memory, which impacts our resistance and ability to manage unwanted cues. One researcher involved in the study notes that it’s wise to avoid temptations when we’re feeling stressed or tired.

This may explain why it’s harder to resist alcohol, drugs, or unhealthy food when we’re anxious or stressed, and why we’re more likely to avoid temptation when we’re well-rested and in a better frame of mind.

Strengthening Executive Control

The next step is to determine how those cognitive processes can be strengthened and how the findings apply to the treatment of alcohol and substance use disorders. For example, the study has already indicated that directing focus from pictures of alcoholic beverages to nonalcoholic beverages can reduce the risk of relapse in patients treated for alcohol use disorder.

Researchers have identified various programs and strategies that improve executive control in children and adolescents, while mindfulness practices have been shown to improve executive control in all age groups. Increased self-awareness through targeted exercises can also help us learn that feeling good now often means we’ll pay later.

Harvard’s Center on the Developing Child says the brain is dynamic, and it’s never too late to learn new skills, even those that can be extremely difficult, such as self-control and emotional regulation.

Licensed mental health professionals such as psychiatrists, therapists, and counselors can use primary techniques like Cognitive Behavioral Therapy (CBT) to help people in recovery develop new coping mechanisms, while licensed and qualified mindfulness practitioners such as yoga teachers or meditation instructors can help people in recovery learn techniques to increase self-awareness and improve the overall ability to recognize and interrupt automatic responses that may lead to relapse.