Overcoming addiction, step by step; and a related essay

Ignoring the specialists who claimed that drug addiction is a disease, some folks back in the 1960s set about learning what motivates drug addicts to inch their way toward recovery, using B. F. Skinner's work as a starting place. Since then, researchers have been looking at what works and what doesn't. In 2002, New York City started the modern version of "contingency management" (also called "motivational incentives") programs in seven of the city's addiction clinics. So far, so good, and the program is being extended to more and more clinics, both in New York and beyond, according to "Overcoming addiction, step by step" by Kristine Kelly for The RU Scientist Newsletter, published online by Rockefeller University.

As an aside, I'm glad it's working, but I have to wonder why it has taken so long and so much research and so much jargon to learn how to do what millions of parents and teachers do on a day-to-day basis? That is, notice the small achievements along the way instead of saving all the kudos for reaching grand goals. I think that's more or less what a lot of this seems to boil down to. Correct me if I'm wrong.

Wait. I might know part of the answer to my own question. A wonderful bit of perspective from Jane Jacobs just came to mind. In her book, The Death and Life of Great American Cities (1961), in the introduction (at least in the edition I read), she noted that much of what was wrong with urban planning was in part due to the fact that earnest and well-meaning planners - good men, you understand, who cared deeply about their cities - had gone to great pains to learn what the sages of urban planning taught about how cities ought to work. The problem was not with the intentions or the lack of professionalism of the planners - it was that the received wisdom they were spending years and years learning wasn't based on how human beings actually interact with each other and their environment. Worse yet, having invested themselves heart and soul into learning this complicated specialty, whenever reality seemed to contradict what they'd learned, the reality usually wound up being shoved aside as a fluke. (Humans will be human, after all.)

Here's my favorite part of the explanation: Jacobs likened urban planning as it stood in her day to the state of medicine in the heyday of bloodletting. No, seriously - and it makes all the sense in the world, as far as I'm concerned, the way she explained it. Bloodletting was based on superstition, but it was bolstered by elaborately learned rituals. People who spent year after year becoming experts in bloodletting, learning just which vein to draw from for which symptoms, among other things, got enmeshed in the handed down fallacies. Bloodletting physicians ridiculed, and sometimes ruined, physicians who dared to point out where draining blood didn't make sense and might even be killing people.

I have a theory, just a hunch, that much of what's wrong with modern culture is that just enough people are invested in some modern variation of bloodletting - truly dangerous stuff - and don't know how to assimilate evidence that contradicts what they've so painstakingly learned about how things ought to work, according to their sages.

We all have blind spots. But those doggone blind spots that we've acquired through earnest effort are especially difficult, I think. At a guess. Yes?