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Societal Addiction Therapy: from Motivational Interviewing To Available online at www.sciencedirect.com ScienceDirect Societal addiction therapy: from motivational interviewing to Community Engaged Scenario Planning 1,* 2 1 1 Robert Costanza , Paul WB Atkins , Mitzi Bolton , Steve Cork , 3 4 1 Nicola J Grigg , Tim Kasser and Ida Kubiszewski Societies, like individuals, can become addicted to patterns of society still not taken appropriate action and changed its detrimental and unsustainable behavior. We can learn from one behavior accordingly? of the most successful therapies at the individual scale, motivational interviewing (MI). MI is based on engaging addicts In this paper, we draw an analogy between defensive in a positive discussion of their goals, motives, and futures. One denial at the society level and defensive denial from drug analogy to MI at the societal level is community engaged or alcohol addicts when warned about the long-run impli- scenario planning, which can engage entire communities in cations of their behaviors. It is well known in addiction building consensus about preferred alternative futures via therapy that it is rarely effective to directly confront public opinion surveys and forums. Effective therapies for addicts concerning the damage they are causing to them- societal addictions are possible, but require re-balancing effort selves and others. Rather than motivating addicts to away from only pointing out the dire consequences of current change, such interventions often result in a reactive behavior and toward also building a truly shared vision of a denial on the part of the addict and lack of progress positive future and ways to get there. toward overcoming the addiction. Yet, such a confronta- tional approach is typical of the strategies used by scien- tists and activists who try to effect change at the societal Addresses 1 level regarding climate change, overconsumption, over- Crawford School of Pubic Policy, the Australian National University, population, inequality, misplaced use of GDP growth as a Canberra, Australia 2 Australian Catholic University, Sydney, Australia societal goal, and many other issues. From a psychological 3 CSIRO Land and Water, Canberra, Australia perspective, then, the lack of progress in ameliorating 4 Knox College, Galesburg, IL, USA these issues is to be expected as long as these topics continue to be approached in a confrontational, judgmen- Corresponding author: Costanza, Robert ([email protected]) tal way. Perhaps more progress would be made with a * After the first author, the remainder are listed in alphabetical order. different way of framing and discussing the issues that is more analogous to the practices that help people over- Current Opinion in Environmental Sustainability 2017, 26–27:xx–yy come individual addictions. This review comes from a themed issue on Open issue, part II We begin this paper by first defining addiction at the Edited by Eduardo S Brondizio, Rik Leemans and William D Solecki individual level and then exploring how entire societies Received: 10 June 2016; Revised: 08 February 2017; might also be thought of as addicted to specific modes of Accepted: 24 February 2017 behavior. We then consider some of the characteristics of therapeutic approaches that have been successful for treating addictions at the individual level. Finally, we http://dx.doi.org/10.1016/j.cosust.2017.02.011 propose an approach to ‘societal therapy’ for problems 1877-3435/ã 2017 Elsevier B.V. All rights reserved. facing contemporary society and conclude with sugges- tions for how this approach might be implemented. What is addiction? Addiction is typically understood as encompassing several Introduction features [2,3]. For example, the most recent edition of the The need for human society to rapidly deal with climate Diagnostic and Statistical Manual of Mental Disorders (DSM- change, limit population and material consumption V) specifies that people suffering from substance-use growth, transition to a renewable energy path, distribute disorders often experience a lack of control (manifest wealth more equitably, and deal with a host of other in cravings and in failed attempts to quit or regulate interrelated problems is widely accepted in the scientific intake of the substance), negative consequences (such community and, increasingly, in the policy community [1 as problems in work and relationships), and a failure to ]. However, movement toward these ends has been slow. quit using the substance despite negative consequences To many, this lack of movement is hard to understand. (like physical and psychological problems). Addiction to Given the increasingly obvious warning signs, why has drugs (and apparently to gambling as well) occurs because www.sciencedirect.com Current Opinion in Environmental Sustainability 2017, 26:47–53 48 Open issue, part II short-term rewards provided by the ingestion of the It is worth pointing out that most of the existing research substance have become so powerful and enticing that has studied how individuals respond to entrapping incen- an addict’s life becomes increasingly oriented around the tives, rules and norms. In essence, to remove the trap, one substance, such that other, healthier behaviors diminish has to change the rules and incentives that set the trap in in frequency and substance use behaviors persist even in the first place. In this paper we are concerned with how the face of (sometimes dire) negative consequences. societies can go about changing these entrapping rules and incentives, rather than changing individual behaviors in How can a society be thought of as spite of the entrapping rules and incentives. ‘addicted’? Unfortunately, many 21st century social institutions and It is also true that it is not easy to predict individual incentive structures parallel those found in addicted behavior in response to different societal incentive struc- individuals, in that short-term rewards are sometimes tures from simple ‘rational’ models of human behavior so powerful that other, more adaptive actions are dimin- prevalent in conventional economic thinking. The exper- ished and damaging activities continue despite evidence imental facts indicate the need to develop more realistic of longer-term negative consequences. Individuals (or models of human behavior under uncertainty, acknowl- firms or communities or countries) pursuing their own edging the complexity of real-world decisions and our narrow self-interests in the absence of mechanisms that species’ limited information processing capabilities account for community and global interests frequently [14,15]. The limitations of the current economic approach run afoul of these more adaptive long-term goals and can have been recognized by some economists, and there is often drive themselves, and the communities of which growing academic and government interest in behavioral they are a part, to less desirable ends. and experimental economics approaches that seek to understand how people actually behave, rather than The inconsistencies of these short-term rewarding goals how an idealized ‘rational’ individual should behave for individuals and incentives with long-term adaptation [16–19]. for the community have been described many times before, beginning with Hardin’s [4] classic paper on What has not been adequately addressed in the social trap the tragedy of the commons (more accurately, the tragedy or behavioral economics literatures is the question of the of open-access resources) and continuing through work on methods that can be most effective for escaping these ‘social traps’ [5,6,7 ,8,9 ]. Social traps occur when local or traps. ‘Traps’ are obviously best avoided, and strategies individual incentives that guide individual behavior are that help avoid traps and prevent addictions are preferred. inconsistent with the overall goals of the individual, But little has been done to design effective escapes or society or system. Cigarette and drug addiction are exam- ‘therapies’ once the societal level trap has been entered. ples at the individual scale. As has been noted, addicts Fortunately, much has been done to help individuals often know full well the harmful effects of their substance escape their own traps or addictions. We now turn to a use but they nonetheless continue to use the drug. Similar discussion of one of the most effective of these therapies examples at the societal level include overuse of pesti- before discussing how these results might be applied at cides, fetishization of GDP growth, over-consumption, the societal level. privatization of information, fossil fuel consumption lead- ing to climate change, and overfishing. In the example of Therapies that work to treat addictions at the overfishing in an open-access fishery, by following the individual level, and analogies to the societal short-run economic incentives, fishers are led to exploit level the resource to the point of collapse. Because social traps One of the most successful treatments for addictions is have many parallels with societal addictions, in that both Motivational Interviewing (MI) [20 ]. Unlike many provide immediate gratification and are accompanied by other forms of therapy, MI is rated by Division 12 hurdles to sufficiently regard future costs, we will use the (The Society for Clinical Psychology) of the American terms interchangeably in what follows. Psychological Association as having strong research sup- 1 port for mixed addictions. Several review studies have Social traps, or addictions, are also amenable to experi- documented the relative effectiveness
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