Overview
Gratification is defined in the American Psychological Association’s Dictionary of Psychology as:
“the state of satisfaction following the fulfillment of a desire or the meeting of a need.” 1
There are several dimensions of gratification:
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Instant/Immediate Gratification vs. Delayed Gratification, with the former driven by the limbic system chased dopamine and the latter managed by a prefrontal cortex with high executive function
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Intrinsic Gratification vs. Extrinsic Gratification, determined by whether the satisfaction is the result of performing an action because it aligns with personal values or growth or the result of achieving some external benefit or validation, including avoidance of a negative outcome. Intrinsic gratification engages the parts of the brain involved in self-schema while extrinsic gratification involves the reward pathways in the ventral tegmental area (VTA)
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Sensory Gratification vs. Social Gratification, which depends on whether the satisfaction is tied to physiological/physical urges or positive feedback from another human or social structure. Vicarious gratification is closely related to social gratification, except that it comes from witnessing or knowing that someone else is experiencing gratification, like a parent feeling happy about their child’s success. Social gratification involves oxytocin and dopamine pathways.
Note that “gratification” is not strictly synonymous with “pleasure.” While pleasure is a state of feeling good, gratification is the satisfaction following the fulfillment of a desire or action. This distinction is observed at a neurobiological level, with endogenous opioids and serotonin being responsible for what we explicate as pleasure and dopamine being associated with gratification. For many chronic substance users, the brain begins to separate “liking” and “wanting” along these lines; even if using a substance no longer delivers the experience of pleasure, the brain still experiences gratification from acting on the compulsion that signals an intense reward.
In SMART Recovery, the Problem of Instant Gratification describes the urges, cravings, and/or compulsions to engage in harmful behavior and is appropriately abbreviated as the PIG. A common saying you might hear is “don’t feed the PIG, starve it” as a reference to slowly and incrementally training the brain away from chasing gratification based on instant impulses and towards exercising delayed gratification that triggers ordinary pleasure.
Within behavioral economics and its intersection with psychiatry, we can frame the loss of delayed gratification capacity as a form of hyperbolic discounting in which the brain perceives the immediate reward of substance use to be preferable to the goals of sobriety. One of the reasons that Contingency Management (CM) is so effective as a behavioral intervention is that it seeks to directly substitute for the short-term gratification of substance use.