Over the past few days the media has been reporting that the video game Tetris may be a cure for cravings. A study published in the Journal of Addictive Behaviors reported that playing Tetris decreases cravings for drugs (alcohol, nicotine, caffeine), food and drink, and activities like sex and gaming. This follows a 2012 study which showed that playing Tetris may be an effective treatment for post traumatic stress syndrome (PTSD) by disrupting the mental imagery involved in flashbacks.
The recent study set out to determine whether playing Tetris would decrease the frequency and strength of cravings. The study followed 31 undergraduate students. The experimental group was instructed to play Tetris for three minutes when they experienced a craving, and reported a decrease in cravings by about 20% (one-fifth). The study authors suggested that the game has the effect of reducing cravings by engaging and distracting the brain’s visual and spatial systems, the same portions that are involved in the visual fantasy of a craving.
Having a person switch their focus from a craving to another activity is an example of the symptom breaking and symptom substitution that have been used in the practice of hypnotism for many decades. In Medical Hypnosis (1948) the influential psychotherapist Lewis Wolberg described giving a person with alcohol addiction the post-hypnotic suggestion that “Every time you crave a drink you will reach for a malted milk tablet, and this will give you a sense of pleasure and relaxation.” This technique is employed when a hypnotherapist suggests to a smoker that if he thinks of a cigarette he will crave water instead, or when it is suggested to the person with an eye blinking tic that she will instead twitch her index finger for one minute. In the latter example, the shift of motor activity to another part of the body, along with the mental activity of watching the minute pass, distracts the mind and disrupts the old habit pattern. When a new symptom replaces the old one, there is no need to worry, because a more recently acquired symptom usually can be removed easily.
Symptom substitution can be thought of in terms of a conditioned response, which is a new response to a stimulus that is created by training. Many people have heard of Ivan Pavlov, the Russian physiologist famous for his work on the “conditioned reflex.” Pavlov found that if a buzzer was sounded at the same time when food was presented to a dog, the dog would eventually salivate at the sound of the buzzer alone. Hypnotherapy sometimes uses conditioning specifically to create a new response to a stimulus. For the person who thinks constantly about food, cigarettes, or checking their phone, hypnosis can train them to notice the craving more immediately, interrupt the mind from reinforcing the problematic conditioned pattern (the imagery of the craving), and divert attention consistently to the new conditioned response, to the degree that the new response is experienced as “automatic.” Through hypnosis the subject experiences a new separation between thoughts and behaviors. He identifies with the more powerful role of an observer watching and examining the craving process, instead of viewing himself as a “victim” of cravings as some autonomous force separate from the power of his own thoughts. All this gives the subject enough detachment from the habit to gain control over it and let it go completely.
Wolberg also noted that alcoholics could be helped by engaging in hobbies that completely absorb them. Likewise, many smokers report that they do not think of cigarettes as frequently while occupied with work, and many people with a tic or a habit report that it disappears completely when they are engrossed deeply in an activity or conversation.
I wonder whether the effect observed in the Tetris study could be attributed to the conditioning of symptom substitution or to deep concentration, rather than the “visual cognitive interference” of the game. I also wonder to what extent the power of suggestion and expectation could have influenced the results. College students asked to report their cravings before and after playing Tetris could surmise that the experimenters are testing for a reduction of cravings and respond accordingly. On the other hand, if the result of the study is in fact due to the influence of Tetris on the visual and spatial portions of the brain, this could further suggest the usefulness of hypnosis. Cravings and addictions involve the visual imagination, and hypnosis is the best way to create vivid mental imagery.
Ultimately, hypnosis helps people to rely on their own internal resources, instead of reinforcing the notion that one must turn to an outside device to distract them from their own feelings. Cravings, like most obsessive compulsive behaviors, are often a defense against the normal human feelings of stress, restlessness, and boredom. To truly overcome cravings, these feelings must be resolved. Otherwise, success may be only temporary, or one might adopt another negative habit (unconscious symptom substitution). Turning to a video game every time one experiences a craving reinforces addictive, escapist behavior, and many people already feel compelled to check their smartphones more than they would like. I would not recommend as a substitute symptom something that already has a tendency to develop into a problematic compulsion.
While the Tetris study may have left some people wondering whether they should pull out their smartphone or iPod every time they have a craving, hypnosis remains an effective and practical way to reduce an eliminate cravings without the need to reply on a device. Hypnosis addresses multiple aspects of the habit:
• Because of the increased suggestibility characteristic of hypnosis, hypnotic suggestion can reduce or remove cravings altogether, which is ultimately what most people seeking hypnosis really want.
• Because stress tends to increase cravings and habits, the deep relaxation of trance can reduce stress to such a degree that the subject simply thinks less obsessively overall.
• Hypnosis can help a person resolve inner conflicts when an addiction or compulsion is not just an “empty habit” (i.e. when the habit is not just a reinforced pattern and has its basis in some unconscious motivation).
• Post-hypnotic suggestions can establish that the craving will trigger an acceptable substitute response. For example, the person who craved sugar craves water instead; or the person who bit their nails rubs their thumb against the side of their finger instead.
• Hypnosis can help the subject train his or her mind to divert the mind consistently from the imagery of a craving to a new, positive image, such that the new image becomes a conditioned response that is experienced as “automatic” by the subject.
Finally, there’s one more benefit to using hypnosis. It won’t leave you with that Tetris music playing in your head!