The liberating dimension of human habit in addiction context

The notion of habit has acquired an important role within studies of drug addiction and dependence. In general, classical models of addiction conceive of learned compulsive behaviors in terms of a unidirectional stimulus-response model, for which habits are behavior patterns based on studies of animals and are considered to be purely automated— that is, inflexible, highly stimulus bound and insensitive to associated outcomes (Tiffany, 1990; Miles et al., 2003; Everitt and Robbins, 2005). For this approach, learning converts behavior into an automatism, or what some have termed an addictive habit (for example, Hogarth et al., 2013; Sjoerds et al., 2013). Some of these models have been expanded to incorporate motivational aspects of addiction. Such models regard reinforcement (positive or negative) as the initial and central drive for drug abuse (Robinson and Berridge, 1993; Baker et al., 2004) and are situated in a context of a larger, goal-directed, decision-making framework (Cox and Klinger, 1988; Siegel, 2005; Wes, 2006). Within this overall picture, Sjoerds’s team has proposed to expand the habit formation model by distinguishing between motor habits and motivational habits (Sjoerds et al., 2014). In the case of motor habits, behavior is based on a stimulusresponse model, while motivational habits refer to compulsive behavior that is controlled by an emotional/motivational state and seems to be at least partially goaldirected. Sjoerds’s proposal is a marked improvement over a strictly motor-habit notion of addiction, but we believe that it still falls short of the full context in which the notion of habit acquires its full significance. Let us examine this context more closely. To be sure, all existing theoretical models have contributed to the understanding of drug consumption, abuse, and addiction. Generally, they affirm that habitual addictive behaviors are related to reinforcement and are conditioned by the presence of diverse environmental and motivational factors associated with the moment of consumption. With continuous consumption, the subject gradually consolidates a behavior associated with the results of consuming and, with time (a period which some designate as the appearance of substance dependency; Peer et al., 2013), the behavior becomes more and more compulsive and less flexible. Studies point out that the routine behavior responsible for addiction leads to the appearance of a state of allostasis wherein individuals take drugs no longer to feel “high,” but just to feel “right” (Koob and Le Moal, 1997, 2001, 2005; Piazza and Deroche-Gamonet, 2013). We find it interesting to note how habits are understood within this context. In studies of addiction, “habits” typically refer only to acquired behaviors that incite the subject to consume. That is, regardless of their flexibility and their relation to motivational states, habits acquired by drug addicts are considered to be those specific pathological behaviors that must be eliminated or counteracted. However, within a therapeutic framework, we find a much richer picture of habit. Basically, such therapies pursue a modification of all the behaviors that are responsible for the consumption of drugs. The principal objective of many approaches is to fight addiction by means of learned techniques for avoiding stimuli associated with the substance (e.g., substance availability, conditioning social and living places, social groups, etc.; Tucker et al., 1990-1991). The problem is that techniques that focus on the elimination of addictive habits do not reinforce the essential supports for what is referred to as personal re-education. In the therapeuticeducative context, it is evident that one of the central consequences of addiction is the loss of habits that are necessary for personal and social realization and which are normally acquired over the course of a healthy life. Of course, if the only objective of the consumer is to obtain the substance so as to avoid the symptoms of withdrawal, any routine behavior that does not have this objective will be useless. But the problem—and here is the crux of the question—is not that addicts have lost or forgotten their daily routines. From a neuropsychological perspective (Robinson and Berridge, 2003; VerdejoGarcía and Bechara, 2009; García et al., 2011), it has been shown that continuous consumption of drugs deteriorates certain executive functions such that, even after abstinence has begun, cognitive flexibility in the motorization of strategies is reduced and, as a result, the capacity to organize, plan and supervise one’s own daily behavior is diminished (VerdejoGarcía et al., 2004; Verdejo-García, 2005). The addict cannot effectively