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Cognitive Theory and Addiction Continued

A. Tom Horvath, Ph.D., ABPP, Kaushik Misra, Ph.D., Amy K. Epner, Ph.D., and Galen Morgan Cooper, Ph.D. , edited by C. E. Zupanick, Psy.D.

Now let's examine a more complex example to illustrate how thoughts influence our feelings. Let's try a little experiment of our own. Imagine a middle-aged woman's husband of 20+ years, out of the blue, tells her is divorcing her. How might she feel? Pause for a moment and try to imagine this before you read on.

couple fightingHow you answered, reflects your own beliefs and expectations. Your own life experiences caused you to imagine her feelings in one way or another. Realize that you could have imagined this woman feeling a wide range of emotions. For instance, she could be angry, fearful, sad, relieved, happy, elated, excited, curious, jealous, ashamed, guilty, etc. We don't know how she is feeling because we don't know how she interprets this situation. If she has uncomfortable feelings, she and her therapist (and/or her good friends) can take stock of her relevant beliefs. If she is convinced his decision is final, but doesn't want the relationship to end, she may initially feel quite sad. It is natural to feel sadness over a loss. Perhaps she is mad because of a sense of injustice or betrayal. It is quite normal to feel anger over betrayal and injustice. Even so, these natural feelings would occur only if she experienced this situation as a loss or a betrayal.

Nevertheless, we can influence even the normal feelings of grief and sadness by the way we think. If she believes she'll live alone for the rest of her life, and can't take care of herself, she's likely to become quite depressed. Her friends and therapist can help her to develop beliefs that are more accurate. She might need to remind herself that she was previously able to live alone. She was once happy and content. "I'm a competent woman." "I can make it on my own." "I've done it before, I can do it again." "What I don't know I can learn." "I have other people who love me and support me." "It will be exciting to date again when the time is right." "Someday, if I want to, I can have a great marriage." "Even if I don't, I have other relationships and activities that make my life enjoyable."

Our beliefs, expectations, and thoughts powerfully influence our feelings and behavior. Addiction is a behavior. Therefore, this behavior has some beliefs and expectations associated with it. In addicted people, the most common problematic belief is: "I need this addiction in order to be okay." or "My life would be miserable without my addiction." This kind of belief is termed inaccurate or unhelpful because it is nearly always false. It serves to support a behavior (addiction) that is harmful. The good news is that a person can change these unhelpful thoughts. They can be replaced with thoughts that are more accurate. These new, more accurate thoughts support and promote recovery.

Here are some examples of these more accurate thoughts. "Lots of other people don't need to rely on an addiction to cope with life. I'm sure I can learn new ways to cope too." "I can relax and socialize without the addiction." "I can find other interesting ways to fill my time" "I can sleep better and feel more rested without the addiction." "I enjoy exercise." "I enjoy the company of people who don't have this addiction."

In a similar manner, it is essential in addictions recovery to have accurate beliefs about cravings. Cravings are the intense desire to engage in the addiction. If a recovering person does not address and correct these inaccurate beliefs about cravings, it will typically lead to a relapse. Accurate beliefs about cravings include:

1) Cravings are time-limited. They go away.
2) Cravings are not harmful. They are annoying, distracting, and perhaps uncomfortable, but they do not cause harm.
3) Cravings do not force people to engage in their addiction ("I still have a choice.").
4) Cravings create anxious feelings. It is helpful to learn specific techniques for relaxation and self-soothing. These techniques include slow deep breathing, meditation, taking a bath, going for a walk, playing with the dog, etc. These techniques are often called coping skills. We discuss coping skills in the next section.