A behavioral psychologist on the very fancy neuropsychiatric team once explained to me "Once you get them addicted to tokens, you can do anything." We had a community team "return" a developmentally delayed patient when the program we had designed for him in the six weeks we had him "didn't work." We always know why that is, when something works in the hospital but doesn't the moment they go out the door. It's because the community team wanted some other answer, and sabotages the plan almost immediately. It always sounds plausible at first glance that it is only because in the hospital we have complete control over the patient, and they don't on the outside. Inside and outside the hospital are different, certainly. That is why we designed our programs with the community in mind. If they would just do that, it would work, as we repeatedly proved with the teams who did do what we recommended.
I always chuckled to myself on these "returns" If you didn't want our first-best advice, why do you want our second-best? A few days after the admission, when their team would come down to meet with us and everyone buckled down for an all-morning meeting, the patient had immediately gotten back into the program and had stopped hitting people, screaming uncontrollably, grabbing females, or whatever. It would take 30-60 minutes of discussion about exactly what they had been doing back in the community that we would elicit that no, they hadn't been implementing the program as designed. They had kept a few decorative items, but had gone back to doing what they were before, because that's the right thing to do, dammit! There were a very limited number of ways in which they justified this to themselves, but those all boiled down to the idea that they didn't want Jeremy to do things to get rewards, they wanted him to "get it" that you shouldn't hit people or grab women. These are DD and brain-injured people they are talking about here.
The neuropsychiatrist once resorted to pulling out his wallet and opening it it, saying "I come in here every day to earn these green paper tokens. If they stop giving me these tokens, I don't come in anymore." They sullenly got the point.
I talk a lot about how genes matter far more than environment, but there is a big exception to that, which is incentives. We sell out our upbringings far more than we care to admit. There is a psychology to it as well. We might refuse to engage in criminal activity for $5000, but over a year, with ten $0.25/hr pay increases, we might well arrive at the same place.
It has long been noted that people will believe what they see on the screen more than reality. "Didn't you see Deliverance?" Lots of people go on Twitter looking for humor, because that is a chemical hit we crave. While there, we also find things that outrage us, another chemical hit. Those of us who dimly remember that there used to be another world before social media - before "likes," and emojis, and "reply alls" and RTs - have some awareness that we are growing addicted and force ourselves to fast from our devices or limit our use (though nowhere near as effectively as we expected). There was a world before that world as well, before television and movies. Even movies used to be something you might see once a week at most. In the 30s, a kid might get to see three movies in a year - or none. But children now have almost no idea what even the world before devices was. Jonathan Haidt pinpoints the increase in snowflake activity to the high school classes of 2013 and 2014, that is, the group which had devices since fifth grade. The depression, anxiety, and suicide rates soared right at that point.
They are addicted to a toxic chemical. The devices provide the tokens, the chemical rewards that also carry poison. Their parents are less addicted, but somewhat, and they themselves were screen-addicted. Computer screens, and before that TV. Radio was similar. They were installed in cars for a reason. Once addicted, people had to have them. I am screen addicted to this device I am typing at now; less so to the new device that I text the family all over the country with throughout the day; podcasts and learning tapes for driving or walking is an addiction just getting under weigh. TV, radio, and movies, very little. The world of books, less than before, because of eyesight, but also because of my new addictions.
As the psychologist said "Once you get them addicted to tokens you can do anything." And we just about anything.