Life

I Hated My Painful Meds. Here’s How I Tricked Myself into Taking Them.

On How To!, behavioral scientist Dan Ariely opens up about how studying procrastination helped him survive a difficult illness.

Man holding a pill and cup of water.
Photo illustration by Slate. Photo by Getty Images Plus.

On a recent episode of How To!, Dan Ariely, professor at Duke University and author of Predictably Irrational: The Hidden Forces That Shape Our Decisions, opened up about how an accident early in his life led him to study human behavior like procrastination. When he was a teenager, Dan was in a building when magnesium flares ignited. He had to run through the flames to escape, burning about 70 percent of his body. In this episode of How To!, Dan shares how conquering procrastination helped him take his medicine, overcome an illness, and look at the world in a whole new way. This transcript has been condensed and edited for clarity.

Dan Ariely: I spent almost three years in the hospital. Hospitals are places that you can observe a lot of human irrationality. The thing that was very difficult for me was the bath treatment every day. If you’re a burn patient, you have bandages and they need to come off every day. It’s very, very painful to take them off. And because I had so many burns, it would just take forever. The big thing that I used to have debates with the nurses about was whether we should take the bandages off slowly or quickly. You can imagine that if you take them off slowly the pain, the momentary pain is not as high, but it takes much, much longer. If you do it quickly, the momentary pain is terrible, but it takes less time overall. The nurses believed in the quick ripping approach—I didn’t believe in that. But they were in charge.

Charles Duhigg: Once he recovered, Dan went on to study psychology and things like how we make choices when we’re in pain or we’re confronting pain. And he learned that, contrary to what his nurses believed, it’s best to minimize the intensity of the pain, rather than how long it lasts. 

I proved that the nurses were wrong. That kind of got me thinking more generally about what are the beliefs that we hold that are just wrong—that we think we’re helping people out by doing X, Y, and Z, but in fact, that’s not in people’s benefit.

One of the irrational behaviors that Dan spent a lot of time looking at is procrastination. The first big insight he had was that, for our brains, procrastination is about making a calculation.

It’s about now versus later—the cookie now versus health later, watching something fun on television versus getting some more progress toward the project later. The reality is that we fail on this in all kinds of ways. We fail on this because we’re not good at it to start with. There was this analysis that looked at what percentage of human mortality happens too early—we accelerate our death because we make bad decisions. When they estimated this data about 100 years ago, it was about 10 percent. Think about a hundred years ago: How could you make a bad decision and kill yourself? Now, it’s likely more than 40 percent. What happened? Are we are we more stupid? No, we’re not more stupid. We just surround ourselves with better temptation.

Moreover, when it comes to rewarding ourselves for not giving in to temptation, we want to feel progress. And sadly, there’s lots of things that we need to do that don’t give us progress indicators.

Dan is familiar with this problem of not getting immediate rewards. When he finally got out of the hospital, a few years after he was burned, he found out that he had become infected with hepatitis C from a blood transfusion. He had to inject himself with this medicine every other day. If he did these injections it would eventually cure his hep C, but in the short term the injections were incredibly painful and caused terrible side effects.

I basically made a deal with myself. I like movies, so when I was on this hep C regimen, I made a deal with myself that every Monday, Wednesday, and Friday—which were the injection days—I would go to the video store first thing in the morning. There were video stores at the time. I would rent two or three videos I really wanted to watch. I would carry them in my backpack the whole day, looking forward to watching them. I would get home in the evening. I would put the video in the VCR. I would take an injection. I would inject myself and then I would press “play.”

I arranged my bed in front of the TV. I had a bucket and a blanket—I was all ready for the shivering, the side effects, and the vomiting. The thing was that I connected something I did not want—the injection—with something I wanted—the videos. The idea is that being healthy in 30 years is just not that motivating, but doing something that is an immediate reward is motivating. We call this reward substitution. The idea is that the real thing is sometimes just too far in the future. When it’s too far in the future, its reward power is not high enough. You need to create an immediate reward for doing the work, not for the outcome.

So if you’re putting off a long term project—particularly one where the result is uncertain or the reward will take a long time to arrive—find a way to reward yourself as fast as you can for getting it done. That short-term anticipation will keep you going, even if it’s hard to see your long-term progress. 

The enemy of big projects is the fear that this is just too big—I don’t know how to start. I don’t want to look foolish. I don’t want to make a mistake. Breaking it into small components and just starting is really important.

We’ve been talking about procrastination as this calculus in people’s heads between short-term rewards and long-term rewards. But then there’s this backdrop of being scared about trying something—because we might learn that we made a big mistake. 

Regret is a really interesting emotion. Regret is about the fact that we compare ourselves to a different state that we could have been in. If you don’t do anything new, there’s never an opportunity for regret because you didn’t do anything. You did the same thing every day. But when we make big, courageous steps, there’s a chance for failure. We often don’t do enough of those brave steps.

To hear Dan help a listener overcome procrastination in order to save her dog training business, listen to the episode by clicking the player below or subscribing to How To! with Charles Duhigg wherever you get your podcasts.