Some years back, I worked for the National Health Service helping people quit smoking. Breaking free of nicotine addiction is incredibly difficult and rates of success for any individual attempt to quit are very, very low.
However, over time I noticed that by far the most effective formula for success was the following: get a group of people who are strangers to attempt quitting together, all on the same day. They would have had a week to prepare themselves by getting rid of all lighters, ashtrays and other smoking paraphernalia around their homes prior to coming to the clinic on the big quit day. They would be tasked to start a quitting diary so they could record, and reflect on, their experiences. They would bring their last three cigarettes with them. I would ask them to go outside and smoke those three cigarettes as completely as possible and as quickly as possible. Following this ‘farewell smoke’ they would come indoors, invariably a little green around the gills (even the most ardent smoker has their limit). We would then get down to the business of distributing nicotine replacement medication and formulating strategies for the inevitable cravings that would be on the way.
The group were then invited to stand up in front of everyone and make the following pledge:
‘I promise I will not smoke for the next seven days’.
‘Only a week?’ You snort. Yes, the intention was that the group would be quitting forever, but the pledge was for just seven days. They were then asked to buddy-up with one other person from the group and together as a pair they would be invited to contribute a small financial stake, say a pound each, to a group fund that I would look after.
The deal was, that if an individual broke their promise before the next week’s meeting, they would lose their pound, but crucially, so would their buddy - whether the buddy had lapsed or not! Furthermore, buddies were asked to call each other on the telephone every day, taking turns to make the call - just for mutual encouragement.
At subsequent meetings, the group would share accounts of their experiences, the challenges, the strategies they used, what worked, what didn’t.
It was not uncommon, in my admittedly limited experience, for the approach described above to result in 70% of participants quitting – an incredible level of achievement in smoking cessation.
But what’s this got to do with Nietzsche?
In the past couple of posts we have been considering how one optimises the body as the first and most foundational requirement for comprehensive Nietzschean self-actualisation. Having grasped the importance of the mind-body unity and the benefits of becoming as physically robust as we can, we must turn to those factors that damage our health and weaken and sap our strength. I’m talking about our negative drives; our little vices: alcohol, junk foods, drugs, tobacco etc.
Changing unhealthy behaviours is not easy, as we know. The reason I mention my old job of helping people quit smoking is that the approaches described above worked for most people despite the intensely addictive nature of tobacco. The reason they worked is because they were all applications of evidence-based medicine - multiple research studies had proven their effectiveness. To explain:
Getting people to quit smoking together built a sense of group rapport and a network of mutual support that facilitates behaviour change.
The week of preparation allowed people to get ready in practical terms - including removing from their lives all the objects that act as behavioural cues or triggers to smoke.
The quitting diary encouraged reflection, self-examination and a better understanding of how thoughts, feelings and external stimuli affect behaviour to aid self-control.
The rapid, forced smoking ensured that their last memory of tobacco before embarking on the quit attempt was not a positive one – this helped them to stay strong when they inevitably started obsessing about cigarettes later on. It was a mild hit of aversion therapy.
Devising strategies to deal with cravings ensured there were clear steps that they could take when they were desperate to smoke – it’s important just to have something, anything, to do.
The public pledge not to smoke was a powerful way of getting people to stick to their commitment. Evidence tells us that people tend to be very averse to reneging on a commitment that has been made publicly. We are much more likely to lapse if no one will find out our little indiscretion but ourselves.
The modest seven-day commitment was about breaking an enormous and potentially overwhelming challenge into manageable chunks. When the desire to smoke hits, the idea of holding out against nicotine cravings forever seems just so impossible that our resolve can crumble. Holding out until this time next week, on the other hand, is a more manageable goal.
The little bet was just another way of enforcing the public commitment, as well as utilising our sense of a ‘social contract’ - we may shrug off losing our own pound, but people hate the thought of losing someone else’s – especially in the early stages of knowing them.
The daily phone call between buddies was a way of reinforcing awareness of the commitment that was made – a regular reminder, if you will.
Strangers work better in such an approach than people who know each other. People who know each other can collude in lapsing or even subtly sabotage each other’s attempts. Strangers tend to be much more concerned with displaying consistency and rectitude in a group. More than once I heard participants say that they held out against an urge to smoke because ‘they didn’t want to let the group down.’
As you can imagine, these people, all toughing it out in the same boat, built an incredible sense of rapport over the weeks. At the end of their treatment groups would always say that they didn’t want the meetings to stop. It was heart-warming stuff, seeing these ordinary folk overcome their addictions.
Changing entrenched negative behaviours is quite obviously key to self-overcoming. Nietzsche writes in The Antichrist:
‘What is good? - All that heightens the feelings of power, the will to power, power itself in man. What is bad? - All that proceeds from weakness. What is happiness? - The feeling that power increases - that a resistance is overcome.’
This passage is often cited by those who wish to denigrate Nietzsche’s thought as though it were evidence of the tyranny implicit in his philosophy, but it is so obviously the case that the greatest power is power over one’s self. Remember ‘he that cannot obey himself shall be commanded.’ Overcoming one’s own resistance to change is challenging but offers the greatest rewards.
We are going to stay with behaviour change for a while in this blog, as self-overcoming is so fundamental to Nietzschean self-help. In his book Daybreak, Nietzsche enumerates the techniques he believes are effective for changing undesirable behaviours and in the next post we will take a look at them and compare them to the best and latest scientific evidence around what works.
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