Cognitive Behavioral Therapy — CBT — has been in use at Cornerstone of Recovery since the doors of our facility opened in September 1989. CBT’s roots, however, can be traced back to Greek philosophers who believed that logic could be used to identify and change false beliefs and destructive emotions. In the substance abuse treatment field, it’s used as an effective and evidence-based psycho-therapeutic tool for a number of addiction- and behavior-related issues since the 1960s.
Cornerstone’s Cognitive Behavioral Groups are “specifically designed to address negative thought patterns that influence attitudes, behaviors and feelings; often hindering patients from moving forward toward change,” says master’s level therapist (and doctoral candidate) Danyelle Smith, who employs CBT in her work with Cornerstone’s Newcomer’s Program. “These negative thinking patterns can be immensely deceptive and persuasive, and change is rarely easy for patients on their own.”
In other words, Smith says, those with addiction issues have developed maladaptive behaviors – poor coping skills and destructive habits – to cope with the inner beliefs they have about themselves. These beliefs may stem from toxic relationships, anger issues, verbal and/or physical abuse or clinical depression; regardless of the source, they create distorted beliefs that are attached to intense emotions that influence and motivate maladaptive actions and responses, which in turn lead to emotionally damaging consequences.
The only problem is that those memories are improperly stored; they’re memory fragments, drawn from a place of pain, and the feelings they trigger drive a reaction that often has a cascading effect of negativity. A classic example is when a patient declares himself or herself a “failure.” Such an identification can be a driving force in a number of poor coping skills, from self-harm to substance abuse, but what Smith finds – and what she helps patients discover – is that such a label rarely aligns with reality.
“We look at these labels and where they come from, and what we often find is that a patient’s definition of these defects is based on information they’ve received throughout their lives,” she says. “But do they match up? For example, I’ll have the individual who thinks of themselves as a ‘failure’ to read the dictionary definition of that word, and then I’ll ask them, ‘Does that line up? No? Then take that label off! That’s not you; that’s a label someone put on you.’ That’s the basis for all of CBT.”
The cascade effect is triggered by an event — something the patient is experience at the moment, which pulls the stored memory of a similar event, which precipitates a negative feeling. Those feelings are what drive the behaviors that CBT seeks to change. The CBT process allows patients to change the way they think vs. simply addressing the behavior, Smith said; by changing the thought process, the behavior follows, and the cycle is broken.
But how does CBT relate to addiction?
“We can become addicted to anything we use to regulate ourselves,” Smith says. “Addiction is something we use to fill a void within us. But until we fill that hole with healthy emotional dirt and spiritual fertilizer to produce a healthy fruit, nothing is going to grow.”
There is a spiritual component to CBT, which aligns with the Bio-Psycho-Social-Spiritual approach to Cornerstone’s treatment philosophy. The goal of treatment is to address the root cause of addiction, but while addiction is a problem, it’s not the problem.
“CBT is an internal change, because even if you stop the behavior, it doesn’t change what’s wrong on the inside,” Smith says. “If we don’t treat the underlying ‘dis-ease,’ all we’re doing is treating the symptoms. Our goal is that our patients are happy, healthy, at peace and have everything they need to go out there and be successful when they leave. We believe that when you know better, you do better, and we teach them how to do that.”
The end result of CBT, combined with other therapies and 12 Step work that Cornerstone embraces as part of a multi-faceted approach to substance abuse treatment, is to give patients who seek our help a life of recovery that’s accompanied by happiness, health and peace of mind.
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