One of the standard therapies used for addiction recovery and mental health treatment is cognitive-behavioral therapy (CBT). There are many versions and forms of CBT, but they share the principle that thoughts and core beliefs affect feelings and actions and that paying attention to our thoughts can help us change unwanted feelings and behaviors.
The first task of addressing problematic thoughts is learning to recognize them and the patterns around them. In substance abuse treatment, a therapist is likely to ask a patient to think about times they’ve used drugs or alcohol and answer questions about what happened before the episodes, their thinking and what they were feeling.
Common unhelpful thoughts include the following:
- Because of the challenges and traumas in my life, I have a right to balance things out by enjoying drugs and alcohol.
- I haven’t gotten sober yet, so I’ll never be able to.
- I can’t enjoy a social event without alcohol.
- If I don’t use drugs, my friends won’t accept me.
- Addiction runs in my family, so there’s no hope for me to be any different.
When people learning CBT identify an unhealthy thought, they’re taught to ask themselves questions like these:
- Why do I believe this?
- What’s my evidence?
- What’s the consequence of holding this belief?
- Is there another way to think about this?
- Is there evidence for that alternative belief?
- What might the consequences of alternative thinking be?
Therapists involved in mental health treatment and addiction recovery can help individuals learn to examine their thoughts in a number of ways. Psychologist Matthew Whalley notes that in traditional disputation, people look at the evidence for and against thought.
Court-trial style disputation involves thinking of the process as a trial, with lawyers arguing both sides of the question of whether the thought is true. Another technique is compassionate cognitive restructuring; people think about what they would say to other people in the same situation and imagine what another compassionate person would say to them.
Skills training is another important part of CBT. In addition to the skill of recognizing and changing unhealthy thoughts, people may work on skills related to coping with stressful situations. One of the many benefits of using CBT to treat addiction is that the skills learned can also be used in other situations and challenges.
As skills are practiced and mastered, people progress. JAMA Psychiatry reported a study in which participants in substance abuse treatment were treated with CBT or other therapies. The CBT group’s performance continued to improve over time, which wasn’t true for the other participants.
CBT and Neuroplasticity in Substance Abuse Treatment
CBT for addiction recovery works because of neuroplasticity: the brain’s ability to make new pathways and networks. Networks in the brain are associations of brain cells (neurons). Psychology Today reports that there are about 86 billion neurons in the brain, and each one is connected to approximately 10,000 others, forming billions of neural networks organized by topics. If you think of the color blue or the taste of a lemon, specific networks will activate.
The networks form because of repeated experiences in which neurons fire at the same time. It’s often said that “neurons that fire together wire together.” The more experiences you have, for example, that connect “snow” and “cold,” the more quickly the brain will associate them for you.
Networks grow stronger as we focus more attention on them, and neglecting networks weaken them. Meaning, we can literally change our brains by what we choose to think about. The implication is clear. If we want to change our behaviors, recognizing and changing our thought patterns is essential, which is the focus of CBT.
If you or a loved one needs help with addiction, The Right Step Hill Country is here for you. Call us at 844.675.1628.