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Loewenstein (1996) has described the influence of drive states on decision-making behavior. Factors such as hunger, sexual motivation, pain, and drug craving are examples of such visceral influences. Loewenstein (1996, p. 273) states that the defining characteristics of visceral factors are (1) “a direct hedonic impact,” and (2) “an influence on the relative desirability of different goods and actions.” Loewenstein suggests also that neurophysiological mechanisms, perhaps a common one, underlie visceral factors. I will discuss three principles from Loewenstein’s analysis. First, current visceral influences have a disproportionately high impact on behavior. This is the reason why alcoholics find it difficult to have just one drink. The taste and smell of the first drink provoke intense motivation. Second, future visceral influences are seriously undervalued. Promises to use a condom next time are not kept, because the person making the promise doesn’t appreciate the “heat” of the future moment. Third, people cannot reproduce visceral sensations when trying to recall them. People can remember the instances during which the sensations were experienced, but the sensation itself is difficult to recreate. This is one reason why compliance with medication regimens is generally poor. After the pain subsides, people cannot recall with high fidelity the sensation that motivated them to take their medicine. Without the impetus of the visceral sensation, the patient loses interest in completing the prescription. Also, with limited ability to recreate visceral sensations, we are in a difficult position either to plan for their re-occurrence or make sense of our prior behavior while under their grip. There are some techniques that may be useful in defeating the visceral influences. Pre-commitment may be one of the more effective. Because people do not appreciate how powerful future visceral influences can be, it is best to make prior arrangements to minimize exposure to the influence. Some alcoholism treatment programs assign “buddies” to be with the patient during particularly tempting situations. One popular weight reduction program requires shoppers to put tempting foods such as desserts in an inaccessible place as soon as they are brought home from the store. In this way as dinnertime approaches, the forbidden food is less likely to fall victim to the increase in hunger. Another example of pre-commitment is taken from a seminar given by Albert Ellis, the founder of Rational-Emotive Therapy. He discussed the case of a Jewish woman who had inadequate control over an obsessive behavior. Although she wanted to stop the behavior and promised repeatedly to desist, the woman seemed not to be able to resist doing it at certain times. Dr. Ellis had the woman give him a large amount of money in order to implement the following plan, which was based upon a pre-commitment. Whenever the woman manifested an instance of the forbidden obsessive behavior, Dr. Ellis would send $50 of her money to the American Nazi Party. The patient gained control over the behavior. In medicine there are already mechanisms in place for some kinds of pre-commitments, such as do-not-resuscitate orders. Those mechanisms are typically used for patients who may not be in appropriate physical or mental condition at some time in the future in order to render an informed decision concerning their own care. Overcoming visceral influences may be a different type of instance in which pre-commitment may be a helpful course of action.
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