Creating a new path with CBT

by Ned Wicker

Carl described his thinking process in terms of his computer background—garbage in, garbage out. He talked about faulty thinking and the need to replace the misinformation with good information. His professional success had given him the resources to partake in his favorite recreational activity, cocaine.

A new way of thinking

But it was new information and a new way of thinking that led him to recovery. He learned those new skills through Cognitive Behavioral Therapy (CBT) he received during a 16-week program at a local treatment center. Carl explained that the CBT wasn’t the only component of the program, but in his mind, the most effective for him.

It its core, Cognitive Behavioral Therapy (CBT) helps addicts recognize moments in time when they are most likely to use, how to avoid using and cope with their behaviors that contribute to their addiction. According to the National Institute on Drug Abuse (NIDA), CBT centers on a learning process. “The underlying assumption is that learning processes play an important role in the development and continuation of cocaine abuse and dependence. These same learning processes can be used to help individuals reduce their drug use.”

CBT is often a promising addiction treatment

The NIDA lauds CBT as a promising treatment option for several key reasons, including its short-term approach, its extensive clinical evaluation in trials over the years, its usefulness in treating users with mild to severe addiction, its goal-oriented approach that focuses on the immediate problems of addicts and its flexibility in individualizing the treatment.

CBT can be used in conjunction with other treatments.

Carl said his situation was exacerbated by what he called “wrong thinking.” His first experience with cocaine was “intense” and he knew that he wanted more. What he didn’t realize at the time, and what he learned through CBT, was that his own thinking, his attitudes and the way he processed information, as it related to his addiction, was completely counterproductive.

Cocaine was filling some voids in his life, masking emotional pain, but it didn’t remove any of the problems. For Carl, CBT was a precursor to a 12-Step group he joined after his treatment.

Often helps to improve self-awarenes and insight

In particular, Carl said the CBT experience heightened his self-awareness, giving him a solid base from which to navigate each step. He took risks and allowed himself to explore his own deeply-held attitudes and prejudices.

Rather than allowing the cocaine to give him an escape route, he could recognize, in the moment, what was driving him to use and use new knowledge to fight off the temptation.

First step to saying NO!

Carl described CBT as his first step towards learning how to “say no” and feel confident that he could. He learned how to make different choices, based upon entirely new criteria for what he wanted in life and why he wanted it. That motivation, he said, was the key to getting through the most difficult situations.

“What I needed became stronger than what I wanted,” he said in talking about the tug-of-war between using and abstaining.

The educational goal was to enable Carl to eliminate the bad thinking and replace it with the good thinking. Through his therapy he was able to reconnect with friends, go back to former activities that the cocaine replaced and, in general, regain social and emotional balance in his life.

For Carl, his treatment also included medication. The combination of the medication and CBT worked well. Carl says the meds were helpful in giving him the ability to focus on CBT tasks.

Not easy at all!

“It’s sounds simple, just think the right way, but it’s not that easy when you’re using,” he said. “I couldn’t just stop. My therapist didn’t hammer stuff into me. But he helped me to find out for myself by pointing things out to me as we talked. I was saying and thinking things without really understanding why. I think I needed everything they gave me.”

One of the keys for the effectiveness of the CBT, according to Carl, was a good relationship with his therapist. Although he is not longer receiving the CBT in a formal setting, his continues to “check in” with his therapist and considers him a friend.

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