Psychotherapy

Psychotherapy is a general term to describe a number of different talk-it-out approaches; psychotherapy can be used in combination with pharmacology to treat a number of mental health problems including addiction, which often co-occurs with other mental health conditions. Individual and group therapy sessions are common components of both residential rehabs and outpatient rehab programs.  In addition, those who are close to the addict and who have been negatively affected by the addiction could also benefit from speaking with a therapist.  This article will describe how therapy can help everyone, and what types of therapy may be used to treat recovering addicts.

Benefits for Addicts

Individual Therapy – Individual therapy helps addicts in two primary ways.  First, the addict will be able to address any past emotional, physical, or sexual trauma that may have been a contributing factor in the first place.  Second, the addict can learn new, healthy coping mechanisms to replace the addiction as they prepare for living a sober, substance- or behavior-free life.  These preparations include accepting responsibility for maintaining sobriety, having a plan for responding to triggers and cravings, and understanding the importance of avoiding the people, places, and things that the recovering addict associates with his or her old lifestyle to decrease the chances of relapse. Addicts can also learn how to forgive themselves for the pain they have caused others.

Group Therapy – Perhaps the most important aspect of group therapy for recovering addicts is to see firsthand that they are not alone.  Many addicts begin to isolate themselves from family and friends; they often believe that no one could understand what they have experienced.  In group therapy, addicts discover that, although the details differ, there are many similarities in emotions and experiences among addicts and their families and friends.

12-Step and Other Support Groups – Although these groups – including Alcoholics Anonymous and Narcotics Anonymous – are usually not led by professionals but, rather, by fellow recovering addicts, they are not technically a form of psychotherapy.  However, they have therapeutic value in their own right, especially for recovering addicts who are financially unable to sustain psychotherapy over the long term.  They have the added benefit of an instant social network of others who must also abstain from the same substance or behavior, and who will not pressure the addict to relapse.

Benefits for Loved Ones

Individual Therapy – Whether or not an addict accepts the help that you offer at an intervention (that is, whether the addict is in active addiction or recovering), therapy can be incredibly advantageous for those who have been affected by an addiction.  A therapist can help those who remain in relationships with an addict to evaluate whether codependent behavior is detrimentally impacting the addiction.  They can help parents or spouses resolve emotions like anger and guilt, and they can help children and adolescents to understand that they are in no way responsible for their parent’s problem.  Especially if the addict resists treatment and denies having a problem, a therapist can help others grieve the loss of the person they once knew and forgive the addict for the pain they have caused in order to move on with their own lives.

Family or Marriage Therapy – For the loved ones of recovering addicts, this type of therapy can be extremely beneficial for healing and restoring broken families and relationships.  Having an unbiased moderator during this process can be crucial to ensuring that everyone’s voice is heard, and that love and respect remain in the foreground.

Support Groups – Sharing your experiences with others who can empathize, even if not directed by a professional, can have therapeutic value and be a more cost-effective option for those who do not have health insurance.  In the same way that Alcoholics Anonymous supports recovering alcoholics, Al-Anon and Alateen are the counterpart groups for the loved ones and children of alcoholics, respectively.  Other resources may be available in your community.

Cognitive Behavioral Therapy for Addiction

Cognitive Behavioral Therapy (CBT) is rooted in the idea that cognitions (i.e., “thoughts”) play a major role in how a person feels and behaves.  Most of us are unable to substantially change our relationships, financial status, or other life circumstances, but we can change our perspectives and, by extension, our attitudes about these aspects.  CBT is a popular treatment for anxiety disorders and depression, but is also being used increasingly in the treatment of addiction, which often co-occurs with a variety of other mental health conditions. 

When using CBT for addiction, the therapist will likely first have the recovering addict identify the circumstances, emotions, and thoughts that have historically caused that person to use a substance or engage in a behavior; this is called functional analysis.  Having insight into why and when they chose to cope with certain emotions or situations with their addiction is an important step toward getting control over that unhealthy pattern. With this information, patient and therapist work as a team to construct a plan for anticipating triggers that could make the person relapse as well as for having an arsenal of alternative responses that do not threaten the person’s recovery.  In other words, skills training deconstructs the old behavior and replaces it with options that will not adversely affect the lives of the addict and his or her loved ones.

Dialectical Behavioral Therapy for Addiction

Dialectical Behavioral Therapy (DBT) integrates CBT and attempts to help individuals who are unable to control emotions and may have the desire to harm themselves.   DBT can be invaluable in the treatment of recovering addicts who experience self-hatred, painful emotions that they cannot endure without substances, fears of being alone as a result of their choices, and many other related feelings.

In DBT therapy, a recovering addict may be asked to imagine how they would respond in specific scenarios.  In generating their responses, recovering addicts learn how to be mindful of the many facets that must be considered in any giving situation.  The end goal of DBT is to learn how to best regulate emotions when confronted with situations that cause people to have strong emotional reactions.  If a recovering addict takes a few seconds to process that they are having an emotional response, instead of simply reacting to it, they can consciously chose to not relapse.