Tag Archives for " Cognitive Behavioral Therapy "

What Works

What works? The truth is that there is no easy and simple answer to that question. There is no program, drug, method, or procedure that has been proven to work for everyone under all circumstances, and there may well never be one. There is considerable commonality between the various methods used by the study subjects who quit on their own or with minimal help, and it is in these areas we will focus most of our attention.

In addition, there are many studies that try to determine the effectiveness of methods and programs employed by the various recovery groups and treatment centers, and we will draw some common threads from those as well. There will be some surprises here for those who might have some preconceived notions about certain programs, but the bottom-line is that the most successful approaches seem to involve a combination of methods, and we shall go wherever the data leads us.

The element most common to all successful recoveries is somehow finding the resolve or motivation necessary to make a major life change, such as overcoming an addiction. This is true no matter what the addiction, or the relative severity. If we are properly motivated, almost anything will work, in the absence of motivation, nothing will. The necessary stimulation may come from many different sources, in fact the most common, according to the majority of studies, is a single consultation with a trusted medical professional, such as a family doctor. Other sources of motivation that rank highly in studies are family or financial pressures, a major life event, such as an illness or the death of a using significant other, or simply a “moment of clarity” that reveals to us our true situation .

Making substantial lifestyle change is the second commonality. Such things as ending associations with using friends, finding substitute activities, (we have to do something with all that extra time), and finding ways to cope with the urges and cravings that drive many of us back into using. Studies show that the majority of us who were successful relied heavily upon a support network of friends and family members.

There are many recovery-oriented self-help books on the market, and studies show that a large percentage of us who quit on our own do so using the techniques found in such books. Many of them concentrate on 12-step programs themselves, or variations on 12-step themes, and others spend a lot of time bashing 12-step programs, and little time either explaining addiction, or presenting scientifically-proven alternatives to the 12-step method. A small but growing share of the self-help literature is devoted to programs that foster moderation as opposed to abstinence, for many of us have been able to moderate our drug or alcohol use, as the studies presented in the next chapter will show.

Learning how to get along on a daily basis without resorting to the drugs we were using to kill pain and alter reality is another important skill we must develop. Most of us have learned to see the world differently than our non-using friends. We are more susceptible to stress than most, and our belief systems must undergo a major change in order for us to obtain long-term sobriety (or moderation). To modify our belief systems, we alter the way we think about ourselves and our relationship with the world. This requires a good deal of properly-directed effort; it does not happen by itself.

Most of us who started using at a young age never “grew-up” in the sense that we failed to learn the value of working for the achievement of long-term goals. We were much more into short-term gratification, and a life spent in the pursuit of the pleasures of the moment, centered around using. In my case, as my drinking increased, my world shrank, as alcohol took away most of what I formally thought was important. Woodworking was first, reading was next, followed by sports, clubs, and finally, I withdrew from my family and most of the outside world. It amazes me even today that I accepted this as normal. When I quit, I discovered that there really is a life out there, and I could be part of it without drinking! My goodness, there is life after alcohol, who knew?

Every successful recovering person goes through this process. We learn to restore some balance in our lives, to manage short and long-term goals, and interact with other people on an equal footing. We also learn to accept personal responsibility for our actions, which we seldom did when we were using. These are learned skills; and whether we get them from a program, from friends and family, or from a professional, we need them in order to have long-term success in our new lives.

Underlying all of the above is a technique that is just beginning to be scientifically studied in the context of alcohol and drug abuse recovery, although it has been around for centuries, called mindfulness. We act as we feel, and we feel as we think, therefore our thoughts drive our behavior. The suggestions for change I mentioned above all share the common goal of changing our thinking, our beliefs and subsequently, our actions. As our wish is to modify our thoughts and feelings, it’s entirely appropriate that we adapt some reliable method of monitoring them on an ongoing basis, and that’s the object of mindfulness meditation.

The research tells us that statistically, our best chance of overcoming our substance abuse problems lies in learning techniques that alter our thought processes on a permanent basis. Learning to focus our attention upon our thoughts and emotions, as well as our actions is the key to doing this successfully; therefore, mindfulness plays a major role in whatever path we choose.

(Excerpted from Chapter 1 of the forthcoming book: “Powerless No  Longer” Copyright© 2011, Pete Soderman)