The psychology of prevented suffering

I have a lot of student loan debt. In my process of decision-making about how much to pay off, when, and what the consequences of all of my options might be, I noticed a familiar grief, a flavor I hadn't felt since the first time I got serious about committing to eating disorder recovery. I realized that in both scenarios, Present Me was paying the price for decisions that were adaptive to Past Me, for the benefit of Future Me. Past Me didn't accumulate debt or engage with an eating disorder because she was irrational. She was meeting the needs she had with the information and resources she had available. Both served critical purposes, but neither decision was free. As a result, both loan repayment and eating disorder recovery feel more like paying an invoice for my survival than building a future to look forward to. That's painful.

The second parallel I noticed was the counterfactual nature of the benefits. If recovery works, you'll never know exactly how miserable the eating disorder would have made you otherwise. If I pay off my loans, I'll never know whether my life would have been as limited by the monthly payments as I feared when I made the decision not to risk it.

Imagine a version of eating disorder recovery that comes with a monthly itemized statement: "This month you avoided: 1 hospitalization, 47 hours of obsessive food thoughts, 3 panic attacks, 1 canceled vacation, and 1 osteoporosis diagnosis in 20 years."

Instead, you're expected to simply trust that these invisible possibilities are in fact being evaded, that your efforts are not all for naught. In that way, recovery feels like buying insurance you hope you never use. The product you're sinking money into is a future that never requires the product. The ideal outcome is that your premiums disappear into the void forever. That doesn't feel good in the present. It's psychologically unsatisfying because our minds like tangible returns. We like buying a couch and sitting on it, buying a vacation and remembering it, buying a meal and tasting it.

The valuable of insurance, in contrast, is invisible. Recovery looks similar. What are you "buying" with recovery? Not happiness, necessarily, but the possibility of happiness. Perhaps the possibility that you'll be able to make spontaneous plans with friends because food isn't terrifying; the possibility you'll be able to reallocate the hours of negotiating with yourself every day to fun; the possibility that your body remains functional decades from now. The possibility that relationships may one day not be organized about hiding symptoms. These are all absences.

You don't wake up every morning thrilled about the time you're not spending thinking about food. You just live your life. The more quickly you adapt to change, the more rapidly those absences become invisible. Recovery, like insurance, is often successful precisely because you stop noticing what it's protecting you from. That can be infuriating for those of us who strongly value evidence to support our decision-making.

Why does preventing pain feel less rewarding than escaping it?

It seems that collectively, most people are pretty terrible at appreciating outcomes that consist of something bad not happening. This is a central challenge the public health field faces: how do they convince people that inconvenience, or even temporary suffering, is worth it if they have nothing to show for it (even though "nothing" is a marker of success)? Think of all the places this shows up:

• Wearing sunscreen (reduce risk of sunburn and skin cancer)

• Completing physical therapy excercises (reduce risk of permanent injury)

• Getting your annual flu shot (reduce risk of contracting the flu)

• Brushing your teeth (reduce risk of cavities)

• Wearing a seatbelt (reduce risk of fatal car crash)

• Leaving an abusive relationship (reduce risk of it getting worse)

• Saving for retirement (reduce risk of future poverty)

In every case, success creates an epistemological problem: we erase the evidence that the intervention was worthwhile. Because we can never observe the alternate timeline, these choices are uniquely vulnerable to doubt.

Neither eating disorder recovery nor many of the above interventions provide positive reinforcement. Instead of "I do X and I immediately feel" good, it's "I do X and nothing happens." Because nothing happens...that was the goal. They remove negative reinforcement, sure, but there's a huge difference to our reward systems, especially those of ADHDers, whose brains prioritize giving attention to the things that spike our dopamine...the things we've learned to associate with a reward. We seek activities that trigger dopamine release. "Nothing" doesn't tend to make the cut.

Where am I supposed to find motivation, then?

If you're waiting until the future feels certain to justify the sacrifices you're making today, you may end up waiting forever. The average self-help resource will suggest you work on getting better at delayed gratification....AKA "willpower." But that's not actually the problem. It's that you're being asked to invest in a future you'll never be able to compare against the alternative. You'll enver get proof that paying off the debt was better than keeping the money. You'll never know exactly how much your eating disorder would have taken from you had you never recovered. The evidence disappears the moment prevention succeeds.

Most hope is built on probability. "Most people are glad they recovered." "Most people don't regret paying off debt." "Most people find this strategy helpful." But if your life has consistently involved discovering that you are not "most people," or at least that generic nuggets of wisdom, reassurance, life hacks, and platitudes don't tend to feel useful or applicable, probability brings a sense of bracing to be misunderstood rather than hope.

So, if certainty isn't available, what is?

Shifting the goal from becoming certain to becoming more comfortable making decisions under uncertain conditions is a lot more feasible. Instead of asking myself, "how do I know this sacrifice will be worth it?" I try to focus on what choice best aligns with the kind of life I want to make possible. I answer this question using only the information I have.

For me, this has also meant letting go of the expectation that motivation must come from imagining how wonderful the future will be. Sometimes it doesn't. Often, actually, the future feels too abstract, too uncertain, or too far away for that to be meaningful. Instead, I've found it more helpful to think of choices like the decision to pursue recovery as expressions of my values, not predictions about my future happiness. I can't know for sure that recovery will look the way other people promise it will (and they can't either, hard as they try to convince us; they are neither inside our minds nor psychics). But! I can know that I value having more options than fewer; I value making decisions from a place of freedom rather than fear; I value caring for the version of me who will have to live with the consequences of today's choices, even if she experiences those consequences differently than I imagine. Those values are available to me right now, even though the future is not.

Stop expecting motivation to do the heavy lifting

What if, instead of aiming to feel more motivated by invisible rewards, we were to stop expecting motivation to do so much work in the first place? It's common that we internalize the belief that if something is important enough, we should feel inspired to do it. But many of the mundane, day-to-day choices that shape the trajectory of our lives (taking medication, wearing a helmet, eating enough) aren't powered by inspiration as much as by a commitment to a direction.

What if motivation isn't an emotion but a compass? In this conceptualization, you don't have to feel convinced that the future will be amazing. You just have to decide which uncertainty you're more willing to live with (your direction) and move toward it.

Imagine this thought process: "If I recover, maybe I'll still struggle with my body image. Maybe I'll really letting go and accepting the changes to my body. Maybe I'll never experience the freedom everyone talks about. What if I give up the only coping mechanism I've ever trusted, and recovery isn't even worth it?"

Here's your compass. In one direction, you've got Uncertainty # 1: "I don't know whether recovery will be everything I hope it will be." In the other, you have Uncertainty # 2: "I don't know what my eating disorder will continue to cost me if I stay where I am." Neither comes with a guarantee, so the question becomes, "Which unknown feels more consistent with the life I want to move toward?" Instead of asking what's "better," you're asking, "Which risk am I more willing to take?"

On a hike, a compass doesn't tell you what the terrain will be like, promise sunshine, or tell you where to go to avoid steep hills, dead ends, or blisters. It just tells you which direction is north. Your values do the same thing. Rather than telling you how recovery will or won't feel, whether moving to a new city will make you happier, or whether ending your relationship will solve your problems, your values tell you only, "When I don't know what's going to happen, this is the direction I want to keep walking."

Motivation implies that you feel like moving, but a compass doesn't care how motivated you feel. It points north on the days you're excited and the days you're grieving alike. It points north on the days you're convinced you've made the wrong decision. Values do not remove uncertainty. They remove indecision.