My Own Cigarette Story

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27Oct2019

My Own Cigarette Story

  • By Ian Bradley
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As psychologists, sometimes we don’t realize the importance of some of our work. Here’s my own vignette.



Many years ago, and at a relatively young age, I was appointed Chief Psychologist at the large university teaching hospital in Montreal. I was suddenly faced with many daunting tasks not the least of which involved transforming a psychology staff used to performing “psychological testing to aid the psychiatric diagnostic process” into something more functional and modern. The task represented a change in culture as well as practice. In the process, I had to develop or revise manualized interventions for many conditions including phobias, OCD and social phobia.

 
In the midst of all this “heavy work” I had a doctoral intern who had a strong interest in smoking cessation and a desire to develop a psychological program to a address a habit that at the time affected over a third of the Quebec population. I really wasn’t that keen. I was working on developing “heavy-duty”interventions for schizophrenic patients with delusions and dismissed the smoking thing with something like “why don’t they just quit.”


However, as a leader who, in theory, espoused the idea of letting people pursue their interests, I went along, and we worked to develop a ten session group-based package. Surprisingly, I really enjoyed it.

I was fun to think about what things might increase the motivation to quit- perhaps scary pictures of disease lungs- or what might make the habit change less severe, such as progressively switching people to lighter and lighter cigarettes.

 
In the course of the program, I almost got kicked out of my golf course because I kept on stealing those small score-card pencils.  You see, we wanted to make the habit less automatic so we asked the participants to classify each cigarette they smoked as to its psychological function;



“was it a stress reliever?” 
“was it to celebrate completion of a task?”
“was it something to delay performing a task?
etc.  


We printed small paper recording forms to each package and needed a corresponding small pencil. I stole tons.

 

As I said, I began to view the whole smoking cessation things as a fun diversion. However, at the same time I was worried about image. For background, I was hired for the chief job because of my training in what was at that time was an upstart therapy competing against traditional psychoanalysis – something called Cognitive Behaviour Therapy (CBT). Although CBT is now mainstream, in this early era, it was viewed as addressing only superficial symptoms and its proponents were seen as somewhat as mental lightweights.  As a result, we kept the CBT-based smoking cessation program in the background.

 

Two years later, I happened to do something I rarely did – eat in the hospital cafeteria.  I rarely eat there since my traditional eating place was on the street walking to the gym to play squash.  But that day,I was at eating alone in the cafeteria – and just to illustrate how long ago it was, there was a special section of the cafeteria reserved just for physicians.  Can you image!

 

I was sitting there when I saw a scrubs-attired guy approach my table with a funny look.  I soon recognized him as The Physician at the hospital -someone with family pedigree at the hospital as well as international reputation for teaching and research. I thought for a moment that he was going to chastise me as a mere psychologist for sitting in the physician section but when he sat down briefly, his words were something to the effect of “thank you.”

 

Turns out that he had a twenty-year old daughter who had smoked since teenage years and who had joined one of our cessation programs and successfully quit.  He told me something that I have never heard in my life, something to the effect that I had saved her life.  He said these words with rather moist eyes and then left.


At that time, I realize that as psychologist one never knows what impact we have on people. It opened my eyes to the idea that the value of what we do should be judged by the beneficiary of our work- they’re a better judge than I was.

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