A Cognitive model of addiction recovery

There are a number of different approaches to the treatment of addictions. The most well known approach is promoted by organisations such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), and is known as The Disease Model. This model suggests that addictions are the result of a lifelong disease that is biological in origin and exacerbated by environmental  factors. It goes on to suggest that addicted individuals are essentially powerless over their problem and will be unable to remain sober by themselves, in the same way that a person with a degenerative illness is unable to fight their disease without medication.

The Cognitive model of addiction proposes a different view. Aaron Beck, the Father of Cognitive therapy, suggests in his 1993 book on Cognitive Therapy and Substance abuse, that addictions stem from addicted individuals not having a biological disease but rather being in possession of negative and painful psychological 'core beliefs', which are often unaccessible to immediate consciousness without the support and guidance of a therapist.

These painful 'core beliefs' tend to be short rigid statements such as 'I am unlovable' or 'I am a failure'. When these beliefs rise to the surface a system of addictive beliefs are activated. The addicted individual will start to believe there will be significant benefits to using their substance of choice. For example, the individual may believe 'I cannot cope with this situation, if I have a drink/use a drug I will cope better'. These beliefs result in increased drink/drug cravings. Once craving begins, an individual may start to engage in 'permissive thinking', such as "I'll just have one drink tonight to help me through this. I can handle drinking just this once." Following permissive thoughts, the likelihood of drink/drug seeking and consuming behaviour is greatly increased and the addicted individual may begin to use.

The work of a client and therapist in a Cognitive therapy for substance abuse setting is to uncover and intervene in these unhelpful underlying systems of beliefs.

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