There are many forms of psychotherapy that are used in addiction treatment. However, there are only a handful that are often used because they have been largely successful over time. Alongside such therapies as family therapy, drug counseling, dialectical behavioral therapy (DBT), and motivational Interviewing, many treatment centers use Cognitive Behavioral Therapy, or CBT.

CBT is frequently used in addiction treatment programs to help recovering addicts identify and replace the negative and distorted thinking patterns in his or her life. Frequently negative thinking contributes to the development and cycling of addiction. Thought patterns that can contribute to addiction are those that are often unconscious for many people and usually began early in life. These patterns can become a source of deep internal turmoil , requiring one to turn to drinking or drugs for solace.

CBT can address unhealthy patterns of thought that lead to making poor choices. Let’s say you’ve just completed a project at work and when you presented it to your boss, he was sorely disappointed. It was not what he wanted. You’re disappointed because you worked hard on this and you know you need the success of this project for a raise, which you’ve been desperate for. Instead of letting your anger and disappointment drive you to drink that night with your buddies, with CBT you might be able to make a different choice. CBT helps you notice your trigger points so that they don’t get the best of you.

The underlying premise of CBT is that by changing your thinking, you can change your feelings and behavior, particularly with respect to drinking or drug use. One of the primary ways, among others, that CBT works is by uncovering hot cognitions. This is a CBT phrase used to describe the experience of a thought that leads to an emotional charge. In the example above, the thought, “I failed” as a result of the unsuccessful work project might evoke strong emotions. The thought, “I failed”, is a hot cognition because it leads to an emotional zing inside. In fact, a hot cognition is any thought, image, memory, or inner experience that leads to an emotional response within. They are the sensitive areas inside. They are none other than those buttons inside that get pushed from time to time, those that get you flared up in some way emotionally.

Once hot cognitions are recognized, the next step is to change your thinking patterns. Another tool of CBT is the thought record. This is a document used for monitoring thoughts, feelings, and inner reactions to certain circumstances. Along with noting when and where challenging thoughts and feelings arise, you would also write down the associated thought you had with that feeling, in a particular situation.  Reflecting on the self-talk you had during a specific situation can facilitate finding those thoughts that are harmful and self-defeating. Without this sort of reflection, damaging thoughts might go unnoticed. Cultivating this sort of awareness is the benefit of Cognitive Behavioral Therapy (CBT).

Furthermore, a thought record invites finding an alternative thought – one that is more helpful, realistic, and supportive. For example, instead of “I failed”; the new thought might be “I did the best I could with the understanding I had from my boss.”

A recovering addict using a thought record would likely also be encouraged to use their new, alternative thoughts, particularly when in circumstances that typically created negative thoughts. As this process continues and deepens, the next step is to distinguish feelings as well. Just as you become more and more aware of thoughts, you can also become more and more aware of your feelings and how they affect your behavior and choices. Lastly, a thought record is used to rate the intensity of emotions, further increasing your awareness of the connection between your thoughts, feelings, and behavior.

CBT’s ability to increase awareness also facilitates the ability to stop making choices unconsciously and start to making choices consciously – choices that are life-affirming, self-honoring, and healthy.

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