Cognitive Behavioral Therapy (CBT) is a goal-oriented short-term psychotherapeutic approach to treating many psychological and behavioral disorders, including alcoholism and drug addiction. It’s focused on results, and that makes it a good match for Pure Life Recovery. CBT is present-oriented, practical and hands-on. Unlike Freud or Jung’s approaches, CBT is focused on how our consistent ways of thinking control what we do. CBT takes the position that most of us have thought processes that are so automatic they seem instinctual. These same thought processes can be detrimental and cause our behaviors to be repetitious and harmful. CBT indicates that we can’t make long term, lasting changes in addictive behaviors until we change the thinking that underlies our addictive behaviors. CBT is concerned with changing behaviors.
A quick way to wrap your mind around CBT is to think of the old saying that in life, it’s not so much the things that befall us that cause us pain, but our attitudes about those things. Our ideas, our concepts, when based on faulty perceptions, cause us intolerably high levels of stress. CBT puts forth that we all have well-established patterns of thoughts that continue all the time, repetitively affecting how we interact with other people, our environment, and our emotions. How we think affects our behavior, so it’s reasonable to see the connection between what we think and what we do CBT isn’t some kind of “think positive” gimmick. It’s a psychotherapeutic approach founded on the belief that people can better their lives by changing their repetitive, destructive thinking patterns and behaviors.
Cognitive Behavioral Therapy is designed to last anywhere from a few months to a year, with clients meeting with a therapist once or twice a week. It’s often integrated into residential inpatient rehabilitation, where it teaches clients new coping behaviors, effectively giving them new tools to apply to many different situations that will emerge after the client leaves rehab. This is a feature of care here at Pure Life, where treatment equips our guests with new life skills to take with them upon discharge.
Here at Pure Life Recovery, you’ll find CBT used in group counseling, individual therapy, family, and especially relapse prevention treatment.
CBT sees psychological problems like an addiction as being based at least partially on unhelpful, negative ways of thinking and learned patterns of destructive or harmful behavior. In therapy, the client focuses on what’s going wrong in their lives. The therapist helps the client discover what thought processes are accompanying the client’s distress and then work to confront, challenge, and change those thoughts. The goal of CBT is to produce behavior changes by teaching the client different and more adaptive ways to think, and problem solve. CBT teaches people to observe how their own thoughts and feelings affect—even control—their behavior.
Steps in the CBT Process
The following processes are steps commonly found in CBT:
• Identify the troubling or maladaptive behaviors and issues in your life. Addiction is a common psychobehavioral disorder, but it’s also a maladaptive behavior. Drug or alcohol abuse is a malformed attempt to relieve excessive stress.
• Become aware of your feelings, consistent thoughts and beliefs about your issues.
• Identify cognitive distortions, inaccurate, negative or abusive thinking. Your therapist will help you learn how to listen to your own thoughts so that events stop controlling you. Instead, you learn to weigh and decide what actions you want to take
• Reshape inaccurate or negative thinking. A great deal of CBT is learning to make sure our perceptions are based in fact. We have to learn that even though our feelings are real and deserve being honored, our thoughts and feelings are not necessarily based in reality.
CBT therapists emphasize the now; that is, what’s going on immediately in the client’s life. Although it’s necessary to get a good grasp of the client’s past history, CBT therapists focus on how our behaviors today affect what we want to have tomorrow. CBT’s usefulness centers on its emphasis in teaching clients how to discover and notice their own automatic, ingrained through processes that keep the client stuck in the repetitive behaviors of addiction.
Changing and challenging destructive thought-patterns is at the heart of CBT. Addiction changes the addict on both a physical and psychological level, with negative thinking at the heart of addiction. It takes some time and patience, but clients learn to perceive when a destructive thought is happening and how to challenge it. Irrational negative thoughts keep people down but learning how to replace those thoughts with practical and positive thoughts is something every client can take with them.
CBT helps patients learn to identify the emotions and situations that prompt them to use. It doesn’t take much. A single negative event is enough to make many addicts feel an irresistible compulsion to use. In CBT, a therapist will ask the client about situations in which they used to escape psychological or emotional pain. What are the circumstances of those situations? Consider the following:
People: using buddies, family members, people who don’t like us or who we feel judge us
Painful emotions: Boredom, sadness, loneliness, anger, anxiety
Hurtful memories: Memories of loss, abuse, trauma, grief, pain
Locations: Places where the client uses or buys drugs, bars, clubs
Circumstances: Holidays, weddings, funerals, other situations
CBT tells us that it’s not the triggers themselves that cause a relapse, but the way in which the person who’s trying to get into recovery reacts to those triggers. CBT teaches people new ways to cope. For example:
• When tempted to use, the recovering addict repeats to himself all the consequences of his drug use. (“I lost jobs, lost my home, had to go to jail”)
• By replacing high-risk behaviors with low-risk behaviors (“I want to go drink when I go to a bar; I’ll find a sober activity that’s fun without involving bars or clubs”)
• By reshaping one’s environment (“I will associate with different people, go to different places, and do different things than I did when I was using”)
• Replacing using activities with sober activities (new hobbies, new interests, renewing old sober fun activities). This is important because free time is an enemy of recovery. It’s essential to fill time up with healthy activities.
• Developing a social support system. CBT helps recovering addicts improve their communication skills so they can express themselves in all situations, but especially when they’re feeling the need to use or need to reach out to others for help.
At Pure Life Recovery, all the skills noted above are practiced over the months of treatment at our exclusive treatment centers. We work on paying attention to our thoughts and feelings in all situations, across the boards, from one-on-one individual therapy to support group meetings, relapse prevention groups, and family counseling sessions. Getting into recovery and staying there requires people to practice their new skills, the skills that CBT brought them.