Addiction is a highly complex disorder that traverses across various aspects of a person’s life — emotional, psychological, social, physical, and even spiritual. Developing an addiction isn’t limited to just the common tropes of drugs or alcohol, it can be due to any substance or activity that the brain begins to associate a dependence with. People get addicted to everything from computer games to sex to certain foods and even more unusual behaviors such as sniffing nail polish.
It is very easy for people who do not suffer from any addiction disorders to turn up their noses and scoff at these people for having low self-control and functioning. However, a bit more compassion is needed to understand addiction, and the severe damage it can do to someone’s life. Addiction is not merely some dysfunction of the mind or body, it can affect people in very harmful ways that can lead to both deterioration of mental and physical health.
Rehabilitation or recovery programs are very important in treating addiction. It is often said that addiction forms biologically but must be cured psychologically. That is very true indeed — addiction develops when the brain reward system begins to associate a certain activity or substance as positive, leading to higher levels of dopamine (the pleasure chemical) being released in the brain.
Over time, the brain starts to reinforce that engaging in this addictive behavior is good for the individual, resulting in dependence and addiction to this substance or activity. When recovering from an addiction, the initial withdrawal is extremely difficult for a person because they have psychologically built up a world for themselves in which the addictive substance/activity is the main focus of their life. Everything they do is centered around sustaining this addiction. By removing it, their world has essentially been shattered. Therapy is hence a method of guiding and helping these individuals rebuild their world and find new ways of gaining meaning and happiness.
The type of treatment will vary across addiction, and it first requires understanding the causes of the addiction as well as what areas of a person’s life have been most heavily impacted by it. There are different methods of therapy available to effectively treat addiction. In this article, we will go through some of the main kinds of therapy there are.
Cognitive Behavioral Therapy (CBT)
Cognitive-behavioral therapy (CBT) is a form of talking therapy that involves efforts to change thinking and behavioral patterns that drive addiction. It is an effective treatment for substance abuse and is also commonly used to treat other problems such as depression, post-traumatic stress disorder, phobias, and eating disorders. CBT is a combination of two therapies, ‘cognitive therapy’ and ‘behavior therapy’, and is centered around the idea that a person’s behaviors and feelings are influenced by internal factors such as one’s thoughts, attitudes, and beliefs.
In order to change unhelpful behavior or negative feelings, you have to change the way you think. The goals of CBT for an individual undergoing it are to increase self-discipline, becoming more aware of situations that trigger the addiction, coming up with coping mechanisms and strategies to deal with risky situations, and learning to become more resilient to life’s challenges without turning to an addictive substance as a self-treatment.
Motivational Interviewing (MI)
Motivational interviewing for individuals who still have an element of ambivalence towards changing their addictive behaviors. The goal of motivational interviewing is to strengthen their motivation for change. A key aspect of motivational interviewing is there is no sense of coercion, but rather the interviewer will both recognize that the individual has valid reasons not to change and also to change. Motivational interviewing works with ambivalence through respect and honor for the person’s psychological world.
In other words, motivational interviewing somewhat guides participants to recognize for themselves that they need to change. This is done by encouraging the patient to explore the potential conflicting feelings towards change. The therapist essentially helps the patient work through their conflicting feelings in line with their deeper-set concerns and potential past trauma.
Contingency Management (CM)
Contingency management is a type of behavioral therapy that is based on the classical theory of operant conditioning, the concept that people learn based on rewards and punishment. It posits that people respond positively when provided with rewards, and negatively when presented with a punishment. It is used to encourage sobriety by providing tangible rewards for good behavior, for example when a breathalyzer test for a drug addict comes back clean. It is quite effective for treating substance abuse disorders like alcoholism and drug addiction. The tangible rewards are a very big incentive for these individuals, and it has proven to be effective in both reducing the rates of clients dropping out of their treatment programs as well as incidences of relapses.
Dialectical Behavior Therapy (DBT)
Dialectical behavior therapy (DBT) is another form of cognitive-behavioral therapy. It seeks to foster mindfulness and living in the present, developing healthier methods of stress management, emotion regulation, and relationship-building with others. It is particularly used for people who exhibit self-destructive behaviors such as drug addiction. DBT can be conducted in a few different settings, ranging from group sessions to individual coaching to even over-the-phone therapy for individuals to call their therapist should they find themselves in a risky situation. However, the key skills and traits of DBT across all types of therapy settings are pretty much standard. DBT focuses on fostering the following elements:
Acceptance & change: Patients learn strategies to accept themselves, their life circumstances, and their own emotions. They also learn skills that will help them in making positive changes in their behavior and ways of interacting with others.
Behavioral: Patients learn to identify, evaluate, and analyze problematic behavioral patterns and what kind of behaviors to replace them with.
Cognitive: Patients are guided to change their belief framework about the world and themselves that do not help them.
Support: Patients will be encouraged to see their strengths and positive attributes to help them grow in self-love and their journey.
Therapy is a very effective and essential part of the addiction recovery journey as it gives patients a support system to feel seen and heard. Recovery from addiction often involves a lot of shame and guilt, and having a non-judgmental voice to help them through these tough times will strengthen their mental health and recovery journey.