by Erin Oden, ASW, Clinical Director
Cognitive Behavioral Therapy (CBT) is a type of psychotherapy that is frequently used at ARS. While it was originally formulated as a treatment for depression, it is now involved in the treatment of many different disorders, including addiction treatment.
CBT is based primarily on the idea that our thoughts lead to our emotional response (feelings), which then leads us to take action (behaviors) in efforts to move away from or toward the emotion that is elicited. Therefore, when our thoughts are not positive or are not based in fact, then our feelings are negatively affected; this can lead to inappropriate or maladaptive behaviors.
THOUGHTS, FEELINGS, & BEHAVIORS
In cognitive behavioral therapy, we try to first help clients to notice their inaccurate thoughts, which oftentimes are due to the lessons of one’s childhood or one’s lifestyle prior to entering treatment (example: I am a bad person, I don’t deserve love, I should be able to just stop on my own). CBT identifies many different thought distortions, which cloud a person’s judgment.
Here are some of the main thought distortions that we notice our clients struggling with at ARS:
- All-or-nothing thinking: Leaves no gray area or space for change.
- “I’ll never get clean,” “Life is always going to be hard for me.”
- Mind-reading: One asserts that he knows what others are thinking, without checking his reality with them.
- “I can tell she hates me because she looked at me in a weird way,” ”I don’t want to ask him for help because I know he will say no.”
- Minimization: Downplays the impact of one’s experience or actions, which allows him or her to justify maladaptive behaviors.
- “I haven’t really had any consequences from my addictive behavior.” “It wasn’t a big deal when I was arrested in front of my family.” “My overdose wasn’t that bad.”
- Catastrophizing: Believing that the worst case scenario is inevitable – leading to anxiety and fear.
- “If I tell my girlfriend I can’t see her tonight she is going to break up with me and my life will be over.” “If I don’t pass this test I’ll never get a job and be homeless.”
- Labeling: Similar to name-calling, stating facts about others or self in order to put them into a sub-group. Labeling can cause one to feel that their entire identity is in their label.
- “I’m stupid,” “He’s a jerk,” “I’m a screw-up,” “She’s an addict.” “I’m an outcast.”
- Should statements: oftentimes are based in judgment and critical voice. Can lead to feelings of shame;
- “I should have been there for her.” “I should have known better,” “I should be employed and moving on.”
- Blaming: One of the most present distortions in many addicts and alcoholics; utilized to divert attention from self and avoid taking responsibility for one’s actions.
- “If I had a girlfriend, I wouldn’t need to get high.” “If you had my childhood, you’d drink too.”
- Personalization: blaming self for things outside of your control.
- “He relapsed, so I must be a bad mother,” “I must be unlikable because my father chose drugs over me.”
This type of thinking is not only present in addicts and alcoholics; it is existent in all human beings. The important part of CBT is the learning to first recognize maladaptive thought patterns as they arise, and then to challenge them with opposite, positive and/or factual declarations. Instead of, “I am doomed to fail,” someone could reframe his/her thoughts to be, “I have the power within me to change,” or “I am no different from anyone else who has gained recovery in his life.” Just by changing the way you think, you will elicit different feelings within yourself, hopefully leading to positive and healthy behavior.