After watching the season finale of Mad Men, Tom Jacobs considers Don Draper’s chances for self-improvement:

Draper’s self-destructive behavior—including serial philandering, arrogance bordering on contempt for his colleagues and clients, and propensity to self-medicate to avoid feeling shame—has finally caught up with him. He has reluctantly admitted to himself that surreptitiously adding alcohol to one’s morning orange juice is not sustainable behavior. So now he’s ready to get help. Right? Maybe not. A 2007 study published in the journal Drug and Alcohol Dependence questions the commonly held notion that “hitting bottom” is a potent catalyst for getting one’s act together. …

They found “negative associations between motivation to change and current distress,” suggesting that addicts who are in the depths of despair are often unable to summon the will to make the necessary changes in their lives. “The notion of bottoming out implies that intervention should not interfere with the disease process in that experiencing negative consequences leads to increased motivation to change,” they note. “In contrast, these data suggest that early intervention and reduction of problems associated with substance use may increase motivation to change.”