We have been following along in Dr. Reinout W. Wiers’ forthcoming book, A New Approach to Addiction and Choice: Akrasia and the Nature of Free Will (Routledge, 2025). We first looked at the model of addiction as a cognitive brain disease, followed by a post on why addiction is not a chronic brain disease, and then a post on Dr. Wiers’ preferred hybrid model of addiction, biased choice.

Today we are moving on to Chapter 6 of the book, “Development, vulnerability and prevention.” I might have to swing back to the development part because I have so much to cover from the second half of the chapter on strengthening resilience in children and adolescents. Let’s look at some of the critical takeaways.

Children in Problem Environments

Children who grow up in problem environments, including caregivers with substance use disorders, poverty, food insecurity, shelter insecurity, or broken homes, are at greater risk of developing mental health disorders including substance use disorders. But it is not by any means all children in such situations who will develop future problems.

For children of alcoholic parents, the likelihood of becoming an alcoholic is four times that of children of non-alcoholic parents. However, fewer than 4 in 10 children of alcoholics become alcoholics. The great majority do not, according to Dr. Wiers. He looks at one study of 700 children in Hawaii and what helped the children in troubled environments make it through.

The Importance of a Good Teacher

“All resilient children [in the study] could name at least one teacher who listened to them and challenged them in a positive way,” writes Dr. Wiers. The resilient children in the study latched onto a functional adult when their own families demonstrated dysfunctionality. This adult(s) enabled the child to feel listened to and to have a positive view of himself or herself in the future.

We have discussed episodic future thinking on AddictionNews and using the power of imagining yourself positively in the future to resist urges and avoid relapse. Dr. Wiers cites the work of Dr. Kenneth Kendler at the Virginia Institute for Psychiatric and Behavioral Genetics, summarizing:

[P]eople can indeed use their conscious thought processes to influence behavior if they imagine the future scenarios associated with either choice.”

Part of stimulating the imagination is a good teacher. Dr. Wiers goes into length describing a unique study to test the efficacy of a Montessori education as compared with a standard public school education in Milwaukee, Wisconsin. Since the school assignment was by random lottery, the study is deemed “scientific.” The results are worth quoting at length:

The children assigned by lot to Montessori schools did better on a whole series of tests than the children in the control group, both on school-related skills, such as reading and math, and on social behavior and on various tests measuring executive functions, which enable goal-directed behavior… The results are important because they show that education that encourages goal-oriented and social behavior in young children has positive outcomes.

Developing a Growth Mindset

There is more to building resilience than one good teacher. It also matters what is taught. In middle school, the lecture about using drugs might work a little, says Dr. Wiers, but by high school it is viewed with contempt. He has an interesting digression into testosterone, which is elevated in both boys and girls during puberty and results and a distinct desire to not be told what to do. However, if you treat teens with respect and offer them ways to enhance their social status without indulging in forbidden substances, they actually do listen and moderate.

One effective strategy is the use of positive games. Dr. Wiers gives many interesting examples of games that reward players for holding back on their impulses, and games that reward the use of the imagination. When children feel listened to, respected, and challenged in a positive way, they develop a “growth mindset,” a term Dr. Wiers credits to Stanford psychologist, Dr. Carol Dweck.

Another important factor in strengthening resilience in children and adolescents is providing positive critical feedback. Dr. Wiers was involved with a study that showed some success when children who scored high for impulsivity and sensation seeking were invited to group sessions exploring the possibility of using that energy to launch exciting careers. The intervention showed long-term positive effects up to two years later. “Positive development spirals can emerge as well as negative ones,” writes Dr. Wires.

Dr. Wiers describes something called “the good behavior game” that shares a lot with the BrainWeighve app created by Dr. Robert E. Pretlow, publisher of AddictionNews. In this game, “[C]hildren set their own goals,” writes Dr. Wiers, “and work in groups, and positive behavior is consistently rewarded at different levels (the individual, group and class)… The result is a positive, constructive work atmosphere that benefits children and reduces aggression.”

Film Script Intervention

All this positive energy culminates in the ultimate self-confidence booster: the film script intervention. This begins with “motivational interviewing,” which is conducted in a non-threatening manner that encourages the subject to envision themselves in the future. Wiers notes, “heavy-drinking students who received such motivational interviewing still drank less even two years later” than the heavy-drinking control group.

However, nothing appears to have a bigger bang than having subjects work with a trained counselor to write a script for a film of their life. Taken seriously, this requires students to imagine themselves in multiple situations, strengthening that all-important ability to see a different life for themselves. It also requires them to think through how they see themselves getting from the present to the future, thus strengthening goal-setting skills.

And that brings us back around to resilience: how anyone, no matter what their circumstances, has a shot at resisting addiction. It is not easy but it can be done, and it’s done all the time. In order to steel yourself, you need to see yourself in a future that you design.

Written by Steve O’Keefe. First published September 10, 2024.

Sources:

A New Approach to Addiction and Choice: Akrasia and the Nature of Free Will, by Reinout W. Wiers, to be published by Routledge in 2025.

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