How Cognitive Behavioural Therapy (CBT) Helps Addictions

Reasons People Use Substances

Substance addiction includes alcohol addiction, illicit, and prescribed drugs, and chemicals like vapes and coffee. There are many reasons why individuals start on the winding road of substance use and end up at the dead-end of misuse. Some people use substances for social bonding, due to peer pressure, or for fun. Others use them to provide physical and emotional relief. This might be due to chronic pain or negative feelings relating to trauma, depression, or anxiety.

The Risks

But when this escalates into a substance use disorder, one that denotes a psychological, or physiological dependency, or both, it can impair function, relationships, mental health, and send one down a spiral of misery, and shame. In an ironic twist, the drug becomes the cruel taskmaster of life, no longer offering the sweet relief it once did, but instead creating a new, ruthless kind of pain.

Reasons People Develop Misuse

Behaviour expert, Bruce Liese (whose work this article is based on) highlights how alcohol and other drug addictions are poorly developed coping strategies for life, as this kind of self-medicating is an attempt to avoid, escape, and even heal from the pain of a spiralling existence, but instead, accelerates it deeper downward.

The Help Available

There are some highly effective organisations out there for addiction treatment, the NA, AA, 12-step programmes, and more. But for some individuals, these just don’t ‘fit’ for them. Another option is cognitive behavioural therapy (CBT) for addictions which can help people work toward abstinence, and not just regain control of their lives, but save their life.

Treating Addiction With CBT

Cognitions relate to thinking processes, and the benefits of CBT to treat addiction has been highly researched. It proposes that individuals experience maladaptive thinking and that this can lead to emotional problems. Essentially, the meaning we give to things that happen impacts thoughts and feelings in situations. By identifying negative thoughts and thought patterns, thinking styles, and the beliefs that underpin these ways of thinking, one can learn about core beliefs.

How CBT Helps

Core beliefs are the ways we think about ourselves, others, and the world, at a fundamental level, and are often hidden from conscious awareness. We can also learn about how these sedimented beliefs were developed over the life course. By bringing forth this kind of knowledge about the self, one can understand how he conceptualises these aspects, and notice areas that could be influencing choices, behaviour, and therefore distress. This kind of CBT work enables the reframing of ‘maladaptive’ thoughts into more helpful ones which can bring about new coping skills in situations.

Thus, cognitive therapists will seek to understand clients’ thinking processes, especially around substance, and addiction. By developing a collaborative treatment plan, therapists and clients can understand how the client thinks about the problem. This is very important for understanding if an individual will remain addicted, as thoughts reveal the mechanisms that keep the addiction going.

CBT Sessions

Cognitive therapy also offers structured sessions so sessions normally start with agenda setting, this is the plan or list of topics that will be covered in the session. This is useful because the work involves tasks and techniques. It is also important to highlight that clients are encouraged to add to the agenda, therapists will often ask what clients would like to cover as well, this could even be something unrelated to the ongoing work.

Hopefully, this emphasises that cognitive therapy is not just about practical aspects of the work, it is also relational and collaborative if done well. Another distinct aspect of the work is the teaching aspect. Cognitive therapists, as mentioned impart techniques and skills for clients to do in and between sessions as much of the work is done outside therapy, and this is crucial to the success of the work.

Motivating Clients

Clients with substance problems are relatively young in the grand scheme of life. For example, a person aged 50 years, potentially has between 30-45 years left on this planet. The cognitive therapist will want to learn about the things they could be doing in those years if they were to achieve abstinence. For this reason, it is important to ask the client what they stand to gain from giving up their addiction. This can help individuals start to walk the path of hope and new possibilities, to begin to create new ways of thinking about their lives.

A cognitive therapist will want to instil in clients that they are who they think they are, if they think they are an addict, they will act like one. But, if individuals believe in the possibility of life without substances, then they will achieve it. This is not positive psychology, it is cognitive therapy for addiction, described in brief. There is much power in understanding the thoughts and core beliefs that have led to, and maintain a problem, this significant insight forms the initial steps necessary for lifelong change.

Get in touch today if you think you, or someone you know might benefit from this kind of help.