Bored to Distraction: Ego Depletion, Recovery and Relapse

During the long trek toward sustained sobriety, persistent and sustained boredom is unquestionably the feeling state that the average person struggles with most, and it is the affect that relapsed addicts invariably cite as the primary reason for succumbing to the temptation to use again. In short, when it comes to the avoidance and management of boredom — after years of regulating subjective well-being through the exclusive use of alcohol and drugs — the addict is in essence a one-trick pony (i.e., get high and stay high). So why, one might ask, has boredom been so ignored by both researchers and clinicians when it comes to drug and alcohol addiction.

Over the years, I have suggested a number of possible answers to this question and I won’t rehash them here, except to mention two commonly held misconceptions about boredom. One is the implicit but almost universal assumption that boredom is too ubiquitous an experience to be taken seriously. Hence, it is seldom measured or inquired about by clinicians. The second is the fact that in most cultures, much like the supposedly “weak-willed” alcoholic of popular literature, complaints of frequent and persistent boredom are typically viewed as a sign of a flawed character. Indeed, from the parental admonishments in our childhood to the perky exhortations of the activity directors of our retirement communities, we spend our lives being constantly implored to simply say “no” to our boredom.   Fortunately, these attitudes have been increasingly challenged by a growing body of research that suggests that boredom is an extremely important affect state that is intimately tied into the mechanisms of self-regulation and self-control, and that individuals (and possibly even cultures) vary in their susceptibility to boredom.

What is Boredom?

To better understand boredom’s, albeit underappreciated, role in self-regulation, and by extension recovery, we need first to understand a little bit about what is meant by the term “emotion”.  For starters, it is important to appreciate that the distinction commonly made in everyday language between emotion and thought (or cognition) is more illusion than reality. There is no such thing as an emotionless thought or a cognition-free affective expression. A second key point to keep in mind is that the experience of emotion is a brain-based event. Much of what is described as emotional processing takes place in the center of brain (the meso-limbic area) whereas cognitive activity is associated with a much more recently evolved part of the brain, the prefrontal cortex (PFC).  The meso-limbic emotional center, which is found in most lower animals, is designed to rapidly parse incoming sensory information into survival-relevant categories that in turn then motivate the individual to emit the appropriate survival-relevant responses (e.g., run away, fight and so on). It is a part of the brain that is centered on the here and now; it is not interested in long term goals, counterfactuals, or delay of gratification. The PFC, on the other hand, is a system that acts as the counterweight to the impulsiveness of the meso-limbic system. It attempts to inhibit rash actions in the face of insufficient evidence, weighs long term costs and benefits, and takes context into consideration.  It is the ongoing dance between these two systems that determine how and when emotions are expressed and moderated. And not coincidently, the neural pathways that link these two parts of the brain are the same pathways that figure most prominently in contemporary theories of addiction.

So what does all of this say about boredom? Well, when individuals are asked to provide a definition of an emotion like anxiety or sadness, they invariably provide a characterization of either the expressive or subjective aspects of the emotion.  In other words, they attempt to describe what it feels like or what it looks like to be sad or anxious.  And if one attempts to provide a similar type of definition for boredom, it is easy to see why it is often characterized as being too fuzzy a concept for clinical use. However, emotions also have a function. They can be defined by the role that they play in our attempts to adapt to our environments.   Anxiety, for example, signals an impending threat and serves as a trigger for the fight-freeze-flee response. The expression of depression and sadness, on the other hand, is a social cue marking an individual’s resignation in the face of a perceived experience of inescapable failure or loss. It is literally a cry for help and social support. In the case of boredom, it is generally believed that boredom is a signal that we have exhausted, or are on the verge of exhausting, all that is interesting, rewarding and potentially pleasurable in the current environment. Boredom prompts us to seek out a new and potentially more interesting and rewarding environment or to seek out yet untapped novelty and reinforcement in the current environment by changing the way we interact with it.

To the extent that survival of a species depends on exploration of the unfamiliar in the hope of finding new mates, new sources of food and water, new places of shelter, and, in general, new knowledge about the world and how it works, boredom is a critical navigational tool.  Consequently, it comes as no surprise that individuals who are frequently and persistently bored — either because they are biologically predisposed to be easily bored (i.e., boredom prone) or because of inescapable monotonous conditions (e.g., prison) – also tend to be less well adapted. For example, high levels of boredom and/or boredom proneness has been found to be associated with higher rates of depression, anxiety, hopelessness, loneliness, impulsiveness, alcohol and drug dependence, negative affect, pathological gambling, somatization, truancy, academic failure, occupational dissatisfaction and absenteeism, and psychopathology in general.  In fact, there is preliminary evidence to suggest that chronic boredom may even be bad for our physical health.

Temptation, Cravings, Relapse and Boredom

In its simplest form, the core struggle that takes place in early recovery (and often later) is between that part of the self-regulation system that we call “will power” and the temptation to use again. These feelings of temptation are referred to as cravings or urges, and they are invariably “triggered” by various cues in our environment (i.e., things that we have learned to associate with getting high).  Not surprisingly, there is considerable behavioral and neuro-imaging evidence to indicate that will power or self-control is centered in the PFC, the part of the brain that is tasked with inhibiting imprudent, impulsive behavior, whereas the visceral drive toward immediate gratification, the craving for a reward, whether in the form of drugs or food, is housed in the meso-limbic mid brain regions.  Moreover, we now know that the mental effort involved in inhibiting the cravings that emanate from the mid-brain requires a considerable expenditure of cognitive resources. When these resources are critically diminished, it is difficult for an individual to effectively inhibit cravings in other areas until the resources are sufficiently restored. This phenomenon, which is referred to as “ego-depletion”, explains why when participants in a study were asked to refrain from eating cookies that had been placed in front of them, they were less willing to exercise self-control on a subsequent task involving the spending of money. In fact, in a similar study, researchers were able to obtain essentially the same results by simply asking individuals to imagine themselves in the place of another person exercising will-power in an effort to resist the temptation to consume some food items.  And in a truly intriguing study, yet another group of researchers found that participants who had been asked to merely inhibit thoughts of a “white bear”, a homophone of the word “beer”, later drank greater amounts of actual beer when compared to a control group.

There are of course many implications that flow from these findings with respect to the recovery process. For example, it suggests that for poly-substance users, resisting the cravings associated with one substance may actually impair subsequent efforts to control the impulse to use another. However, I would like to suggest that there is one implication that is often overlooked, and that is that the exertion of effort involved in sustaining attention in the context of a boring task is also an ego-depleting activity. The bored individual is restrained (either intrinsically or extrinsically) from acting on the impulse or desire to direct attention elsewhere. In effect, a bored individual craves change and novelty. For most of us, this craving for change is normally managed by a suite of well-established and reasonably reliable boredom-management tools and strategies. They include such things as hobbies, relationships, work, and socially sanctioned behavioral addictions such as watching television, browsing the internet and even daydreaming about our past or future pleasurable experiences. However, in the case of the recovering individual, these alternative strategies have long ago dropped out of their boredom-coping repertoire, thereby erecting a strong bias toward strategies that invariably lead to drug seeking and drug use. It is therefore not surprising that studies conducted by my own research group and by others have repeatedly found that individuals who are easily and frequently bored for long periods of time are especially vulnerable to addiction and relapse.

Boredom Expectancies and Conditioned Boredom Cues

Anyone who has experienced the cycle of relapse and recovery quickly becomes aware of the role boredom and idleness plays in triggering their desire to use drugs. Moreover, boredom inducing environments, much like anxiety provoking environments can be anticipated and often avoided with enough experience. Indeed, most of us have a pretty good idea of when and where we are likely to become bored and we strive as best we can to avoid or minimize our exposure to such contexts. In other words, we develop expectancies about the boredom-inducing potency of specific environments and activities. These expectancies do not disappear, however, just because one becomes an addict. And because the recovering individual has a limited arsenal when it comes to avoiding anticipated boredom there is a greater likelihood of the individual responding to both boredom and the anticipation of boredom with a sequence of decisions that invariably lead to contexts where there is a high probability of relapse into active drug seeking and use.  In other words, I am suggesting that the relapse-prone behaviors that are commonly referred to as “Apparently Irrelevant Decisions” or “stinking thinking” are more often than not the enactment of unconscious boredom-avoidance strategies.

And why should this happen, you may ask. Well, think of it as the pre-emptive pursuit of environments and activities that have proven to be reliably interesting and pleasurable in the past, which in the case of the recovering addict are almost always environments rich in relapse triggers (e.g., old drug using relationships, neighborhoods, bars etc.).  Basically, places, practices and people that used to be fun before recovery became a goal.

This kind of behavior (i.e., “stinking thinking” or Apparently Irrelevant Decisions”) sans the role of drugs and alcohol is in fact fairly common. Consider for a moment an activity that you know will be tedious but which you are obligated to perform (for me this might be things like filling out a tax return or cleaning out the garage). What happens almost immediately after the decision is made to engage in such an activity is that your mind starts to wander to irrelevant but eminently more interesting things that you could be doing. And not infrequently, your actions will follow suit and you will actually begin to engage in an activity different than the one you set out to undertake.  A fairly common example of this phenomenon is the bane of all college students: completing the long overdue term paper. You are sitting at your desk, finally determined to write that term paper that you have been putting off for several weeks, but then your attention begins to gradually shift to a phone call you didn’t make earlier in the day or the television show that you will miss. And of course you rationalize the distraction and the delay by telling yourself that you will only spend a couple of minutes on the phone or an hour watching television. Now imagine the same scenario with a distraction one thousand times more powerful in its perceived attractiveness. Then couple this with an abnormally short list of considerably less potent alternative sources of potential distractions and I think you get the point.

Unfortunately, however, it does not end with expectancies. If it did, the boredom-relapse connection would be a lot easier to manage than it is in practice.  Less apparent than expectancies, even to veteran users, is the fact that boredom, just like an anxiety response, can become associated with environmental and experiential cues. For example, a young man who becomes reliably bored in school might eventually begin to experience twinges of boredom in response to attributes and activities commonly found in academic settings (e.g., libraries, textbooks, sitting in lectures, reading) even when they occur outside of a school environment. Unlike boredom expectancies, however, the recovering individual is seldom aware of the sources of these cued effects, but they nonetheless trigger a sequence of activity designed to remove the individual from the current environment.  And it is on these occasions, when the source of boredom is effectively hidden from the recovering user, that he or she is most likely to slide into the type of decision making in which there is truly little or no awareness of the potential risks for relapse.

Of course it is possible and common for individuals to recognize that they are putting themselves at risk for relapse, even if they are unaware of the initial conditions that triggered the high risk behavior, and to then actively resist the temptation to engage in the actions that will bring them closer to relapse. But, as I have already explained, prolonged resistance to temptation leads to ego-depletion, so if an individual is constantly expecting to be bored, it is only a matter of time before temptation prevails.

Tips for Managing Boredom

My colleague, Stanton Peele, once famously noted that individuals don’t become addicted to substances per se, but rather they become addicted to the experience of taking drugs.  I would like to elaborate on that insight a little by adding that individuals become addicted to the experiences associated with taking drugs only to the extent that they play a role in mitigating and avoiding boredom.  If we accept that very simple premise, then the potential tools for managing boredom – current, expected and cued – are fairly easy to discern.

Generally speaking, effective coping with any type stressor requires three types of knowledge: Knowledge about the self, knowledge about one’s environments and patterns of living, and knowledge of the strategies that are effective in managing and avoiding the interactions between the two that result in the onset and protraction of the stressor.  For example, if one has a phobia of rats, you would want to know whether or not you are likely to experience similar symptoms with mice or other furry animals, how severe your symptoms are likely to be,  and the kinds of maladaptive things that you are prone to do in an effort to escape or avoid an encounter with a rat. You would also want to know when and where in your typical daily routines you would be likely to encounter rats, mice or other furry animals, and the cues that would lead you to expect such encounters. And finally, you would want to know some effective/adaptive strategies that would limit your contact with rats and/or minimize your discomfort if contact with a rat is unavoidable. The same logic applies to boredom management.

Step 1: Know your Boredom Proneness Level

There is now irrefutable evidence that we all differ in our innate susceptibility to boredom. There is equally convincing evidence that those among us who are the most boredom prone are at greatest risk for a host of untoward outcomes, including addiction and relapse. Since foreknowledge is to be forearmed, it behooves us, especially if one is struggling with addiction, to know how susceptible you are to boredom. As a rule of thumb, the more boredom prone you are, the more difficult recovery is likely to be. You can determine your boredom proneness level by completing the boredom proneness scale  (Farmer and Sundberg, 1986)  which is available at http://uwf.edu/svodanov/boredom/bps.htm. (You can also e-mail me for a copy.)

Step 2:  Create a Boredom Map

Because many of the questions on the Boredom Proneness Scale tend to focus on how one typically feels in certain potentially boredom-inducing situations (e.g., looking at a friend’s vacation photos), it provides a crude and indirect index of the range of an individual’s boredom expectancies. Consequently, if your boredom proneness scale score is high, then it is more than likely that there are a large number of situations and activities in which you believe boredom is likely to ensue. It therefore seems prudent to have an actual listing of what those situations and activities are likely to be. This involves sitting down in a quiet place and trying to think of as many boring situations and activities that are likely to turn up at least once during a typical two week period.  This may take several sessions and should never be done to the point of boredom. If you happen to think of an additional item during the day, write it down on a scrap of paper and add it to your list later on when you have the time.

Once you have assembled a working list (it will never be complete and should be updated continuously), place a copy in a prominent location in your home. This is the first component of your Boredom Map.

Step 3: Monitor your boredom frequency, intensity and duration

Research suggests that when an individual is subjected to chronically monotonous conditions, even if they have low levels of boredom proneness, they will suffer many of the same negative outcomes that have been found to be associated with the trait of high boredom proneness (e.g., relapse). Some of us are fortunate to have access to living environments that are rich in potential novelty and positive reinforcement, whereas at the other extreme, a not insignificant proportion of the population find themselves trapped in dull, repetitive jobs with limited access to recreational resources.

Consequently, although it is important to know exactly when and where one is likely to be bored, it is perhaps even more important to have a sense of the frequency, intensity and duration of one’s boredom over time, as it constitutes the best measure of one’s level of success in avoiding and managing the when and where. This kind of information can only be obtained by carefully monitoring one’s boredom over several weeks using an observational/recording tool of some kind. One such tool is the State Boredom Measure -Boredom Monitoring Form (which can be obtained by contacting me via e-mail).

Step 4: Identify boredom cues

Armed with your Boredom Map and the results of your boredom monitoring, you now have a place to start in terms of identifying those hard to notice Boredom Cues. Again, taking some time in a quiet place to examine your Boredom Map and your boredom monitoring results, try to identity the elements that seem to crop up repeatedly across a variety of situations and activities. These elements may include things like having to wait for an extended period of time with strangers or an even more prosaic challenge like having to read and follow written instructions. This list would constitute the start of a crude inventory of your boredom cues. Like your boredom map, it should be a living document that grows and changes as you learn more about your boredom experiences.

Step 5: Linking Boredom and Boredom Cues to Substance Seeking Urges

Once  you have a good sense of when, where and how much you get bored over a two week period (i.e., from the Boredom Map and the Boredom Monitoring results) it is sometimes helpful to also try to identify the times when one: 1. Feels the urge to seek out and use drugs or alcohol; 2. Has thoughts of doing so; and/or 3. Absentmindedly seeks or uses drugs independently of drug-seeking urges or thoughts.   If done properly, this exercise helps to increase awareness of the interconnected nature of boredom, boredom cues and  drug/alcohol related activity. The previously mentioned State Boredom Measure -Boredom Monitoring Form can also be used for this purpose.

Step 6: Develop and Practice boredom coping Strategies and Skills

An individual’s Boredom Map is the product of their level of boredom proneness and the intrinsic boringness of their daily routines and customary living environments. Although there is some uncertainty as to exactly how malleable the boredom proneness trait is, there is no disagreement that daily routines and environments can be made less monotonous. I am also of the opinion (but can’t state definitively) that at least part of the boredom proneness trait is accounted for by differences in the availability of certain boredom-coping skills (e.g., the ability to engage in controlled daydreaming).  Indeed, it may be that the major differences between high-boredom prone and low-boredom prone individuals is in the relative sizes of  their repertoire of coping strategies, the differential effectiveness of their coping strategies and/or skill differences in selecting and executing strategies. This would mean that all things being equal, a low-boredom prone individual should be more effective in rendering their daily routines and environments less monotonous than a high-boredom prone individual, and the more intrinsically monotonous the individual’s typical environment, the more skilled the individual needs to be.

An important implication of the view that boredom coping is a skilled activity is that one canlearn to cope more effectively with boredom. It also suggests that many of the skills associated with boredom coping are probably acquired during the early stages of psychosocial development, much like other cognitive and social skills that are known to be critical for effective self-regulation in adulthood. In other words, one would expect that as one gets older, you also get better at managing your boredom; and most research seems to support precisely that. Indeed, helping our children form good boredom management skills may be one of the most lasting and beneficial gifts that we can give them, and it may well start with the quality of the early mother-child bond in infancy.

Below is a short list of boredom coping strategies that most individuals are capable of mastering. And like any other set of skills, good boredom coping takes practice. Especially, if one has been relying on a single strategy (drugs) for many years. You will notice that all of these techniques have one thing in common, and that is that they help to mitigate and/or preempt the effects of ego depletion that tend to occur with sustained periods of boredom.  They are techniques that allow an individual to parse potentially boring events and tasks into more tolerable chunks of time by deliberately shifting attention to an activity that affords a certain degree of relief in the form of novelty and reinforcement.   Of course not all techniques are suitable for all situations, but learning to apply the right technique to the right situation is part of the challenge of becoming proficient in coping with boredom.

Selected Boredom-coping Strategies

Controlled daydreaming: Daydreaming is a natural and effective method for distracting ourselves from stimuli and tasks that are perceived to be less than interesting. Experiments have shown that when individuals are physically restrained there is a corresponding increase in internally generated images in the form of fantasy and daydreams. (The most extreme example of this occurs in sensory deprivation studies where hallucinations are frequently induced.) Controlled daydreaming is a technique where one voluntarily and intentionally takes a planned “time out” from a boring activity by engaging in a short period of reverie.  The trick is to have a pre-established list of day dreaming topics to bring to mind quickly, and to keep in the back of the mind that one has to disengage and return to the task after a reasonable amount of time. The topics can be such things as “what would I do if I won the lottery” or they can be brain teasers or riddles from a book that you can work on in your head. There are also mental games, such as trying to remember the names of the state capitals or the names of academy award winning movies over the last ten years. And finally, there is the pre-bucket list. This is a list of things that you fantasize doing before you die or get too old. They can be categorized into: Places you want to visit, Things you want to accomplish and Skills you want to acquire.

Texting and twittering, Blogging: These are proxy activities for face to face social interaction, which as I explain below, is one of the most potent and important boredom-coping resources. Unfortunately, they are not always practical in all situations.

Word and number games – Crosswords, Sudko etc: These activities are often included (along with sports and reading – see below) in an all purpose category of “Hobbies”. If a person in recovery can develop or resurrect a true passion for a hobby, that’s great, but more often than not the person in recovery either never had a hobby that they were truly passionate about, and/or the ones they had are not practical for use as an everyday tool for boredom management (e.g., scuba diving, horseback riding).  Activities like crossword puzzles, however, are inexpensive, provide a fairly immediate sense of accomplishment (positive reinforcement) and they are highly portable (i.e., you can do them on the train, in the doctor’s office etc.).  Also, with repeated practice one tends to improve fairly quickly, making frustration and pre-mature giving up less and less of a concern. The downsides are: 1. They are not practical in every situation (e.g., during class); 2. Not everyone has the necessary academic or intellectual preparation; and 3. Novices are unlikely to persist on difficult problems and may experience it as failure.

Diary writing: Getting in the habit of writing about one’s life has the effect of re-exploring ones daily activities. Through this process, individuals often discover new perspectives on things that they do repeatedly and routinely, thereby restoring a certain degree of interestingness and novelty to the otherwise familiar. This kind of reflective writing can be done the old fashioned way, with pen and paper, or it can be done on a computer. It can also be done in an interactive online forum where feedback is provided by other individuals. This has the advantage of adding even more perspectives on the events of one’s life, as well as providing a source of ongoing social stimulation.

Sports: Playing a sport and keeping fit is something that everyone should aspire to, but sticking to an exercise regimen is hard for most of us and it is not a realistic goal in the early stages of sobriety. However, becoming a sports fan is within the reach of almost everyone. Vicarious participation in a sport is, in my opinion, a much overlooked boredom coping strategy. My research group is about to conduct a study in an attempt to confirm our hunch that ardent sports fans have far less boredom in their lives. The reasons that we believe this to be true include the following: 1. The weekly (if not the daily) schedule of even the casual sports fan is somewhat structured by schedules of the teams and sports that they support; 2. Support of a specific team or interest in a specific sport encourages social interaction with like-minded others; 3. There is higher prevalence of watching, day dreaming, reading and thinking about the sport and the events associated with the sport; and 4. All sports fans to some extent place an emotional wager on their sports team every week, and in so doing experience a mild but similar type of “rush” that real gamblers get when involved in waging for money.

Reading: Reading for fun is something that many individuals take for granted, but there are many more who read almost exclusively for utilitarian reasons (e.g., to get the sports scores or to set up the new DVD player). This is unfortunate because reading is perhaps one of most potent coping tools available to us. Of course reading for enjoyment presumes that one knows how to read, and how to do so fluently;  but once the skill of reading is mastered, it allows us to transcend the present and to explore places and times  that stay with us long after we have put down the book. In essence, books expand and support our imaginations, the very thing that we need most when trapped by monotony.

Books are highly portable, inexpensive (free if you use the library) and there is an endless supply of them. Setting aside regular blocks of time to read every day can remove huge swaths of unstructured time from the typical week of the recovering addict. And keeping a paperback handy when out of the home in order to keep periods of potential boredom at bay is probably one of the most useful and effective relapse prevention strategies that does not require extensive practice.

Take Steps to Implement Pre-Bucket List: Begin to implement the plans you have for Visiting the Places you always wanted to visit (e.g., Hoboken…just kidding), accomplishing the Things that you always wanted to accomplish (e.g., get a college degree), and acquiring the Skills you always wanted to acquire (e.g., learn to play the piano). In some sense this is simply setting goals and acting on them, but it is effective because it reinforces the controlled daydreaming technique discussed above and it forces the individual to organize and ration his/her time, thus reducing the net amount of unstructured time.

Step 7: Educate your support network about boredom

One of the major coping resources not included in the preceding list is social interaction. Social relationships are a major source on novelty and positive reinforcement for most human beings.  In fact, it may be the major reason why women tend to be less boredom prone than men (they tend to be more socially involved and connected than males) and why individuals with psychological disorders that are characterized by poor and unstable inter-personal relationships, such as individuals with Borderline Personality Disorder, are also subject to high levels of boredom.

I cannot emphasize strongly enough how important it is for an individual in recovery to educate the members of their social support network as to the importance of their role in helping mitigate boredom. By providing the members of the social network with information from their Boredom Map and information about when and where their boredom is likely to be most intense and sustained, they can begin to collaborate on developing patterns of interaction that anticipate and interfere with potential periods of intense and sustained boredom. Far too often the person in recovery is left to their own devices by family members and friends who typically assume that as long as the individual goes to meetings regularly, their role is limited to making sure that they are not enabling addictive behavior. The irony here, of course, is that they seldom do very much to enable the boredom-coping strategies that are needed to replace the very effective strategy that they hope to discourage. Indeed, the most effective way that a social network can help someone stay sober is to become interested in their boredom.

For the purpose of the online CE Course, the article objectives are:

  • Overview of the inter-relationships between boredom, psychopathology, addictive behavior and the relapse cycle
  • Review of the relevant research and theory  linking boredom to inefficient and maladaptive self-regulation
  • Description of the methods and strategies for assessing, monitoring and screening for state and trait boredom in clinical settings
  • Review strategies for mitigating relapse risk through reduction of boredom duration and intensity
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