Cognitive Theory and Addiction (Thoughts, Beliefs, Expectations)
A. Tom Horvath, Ph.D., ABPP, Kaushik Misra, Ph.D., Amy K. Epner, Ph.D., and Galen Morgan Cooper, Ph.D. , edited by C. E. Zupanick, Psy.D.Over time, our life experiences form the basis for a well-organized and relatively stable set of beliefs and expectations. These may include beliefs about ourselves and the world around us. These beliefs and expectations operate to influence our behavior. This happens without our full knowledge and awareness of them. In fact, these beliefs are powerful enough to distort how we perceive ourselves and other people.
One instance of this powerful effect is the self-fulfilling prophecy. The self-fulfilling prophesy suggests that whatever I expect will happen; will actually happen, just as I expected. This is because my expectation (anticipation) of what will happen causes me to behave in a particular way. Subsequently, I behave in a way that causes certain things to happen in response to my behavior. An example will make this much more understandable. Suppose I attend a party and expect no one will like me. I will probably be anxious because of my expectation. Since I don't expect people will like me, I don't smile at anyone. I stand off by myself. In the event someone does come over to talk to me, I am so nervous that I chatter endlessly. I'm not even listening to what they are saying. Because of my anxious, unpleasant behavior, people at the party avoid me. I may also misinterpret the interactions I have, because I expect people will dislike me. So suppose a woman has been talking to me at the party and then excuses herself. I will immediately assume she departed because she didn't like me. Because of my expectation, I will not search for any other reason for her sudden departure. Thus, I won't notice that someone had just joined the party and waved to her. She simply stepped away to greet them. Upon her return, I look away because I am embarrassed that she doesn't like me. When she sees me look away, she logically assumes I no longer wish to talk to her. So, she walks away. Notice that my expectation "people will dislike me" caused me to behave in a manner that actually created what I expected.
The self-fulfilling prophesy can serve to maintain someone's addiction. This is particularly true if they do not believe that recovery is possible. If I expect that I will fail, this expectation forms a self-fulfilling prophecy. I will not put forth any effort to recover. What's the point? My lack of effort dooms any feeble recovery attempt I make. This further solidifies my inaccurate beliefs and expectations. Therefore, when strong cravings arise, I won't make any effort to cope with them. I might think to myself, "I can't stop anyway, what's the point in fighting it?"
Cognitive-behavioral therapists help people to identify unhelpful beliefs. Next, the therapist encourages people to evaluate the accuracy and helpfulness of their beliefs. Additionally, the therapist guides participants to test the accuracy of their beliefs in the real world (outside the therapy office). These real world "experiments" help people to update their faulty beliefs. For example, suppose someone believes that there's no sense fighting cravings because the cravings never stop. The therapist will ask them to conduct an experiment to see if this notion is true. They will discover it is not. Cravings subside.
Beliefs and expectations also dictate the way we will interpret a particular event. Our interpretation of an event determines how we feel about it. Although beliefs and expectations heavily influence our feelings, most people are not usually aware of these beliefs. Nonetheless, we are usually aware of our feelings. Usually, this lack of awareness is not a problem. This is particularly true for happy well-adjusted people. It really isn't necessary for me to become aware of the beliefs that cause the good feelings I usually have!
What about the person who frequently has negative feelings and doesn't cope with these feelings very well? This person is at greater risk for becoming dependent on addictive substances and activities in order to feel better. Indeed, people often use addictive substances or activities for this very purpose. In these cases, it's important to become aware of these beliefs. Without this awareness, these inaccurate beliefs cannot be updated and corrected. With an accurate perception of the world, and a positive outlook, negative feelings diminish. When negative feelings subside, so does the reliance on an addictive form of relief.
In a similar manner, most people believe that external events, and other people, "cause" their feelings. This is a problematic belief. It leads to feelings of helplessness and the false conclusion that we can do nothing to feel better. Such a belief strengthens the reliance on addictive substances (or activities) as a means of relief from unpleasant feelings. Cognitive therapy teaches people to realize we cause our own feelings, not other people. It is what we think and believe about things that causes our feelings. By changing our thoughts and beliefs, our feelings will change accordingly. Let's use a simple example to illustrate this important concept. Suppose someone has just stepped on my foot. One thought I might have (particularly if I believe that people are out to get me) is the foot-stepper did this on purpose. "I can't believe that idiot just stepped on my foot, how dare he!" These thoughts naturally lead to feelings of anger. Conversely, I could instead think (particularly if I believe most people are kind) the foot-stepper's action was clumsy and accidental. "Whoops, that guy sure is clumsy." This thought might lead to feelings of compassion. Notice the exact same event, caused two opposite feelings; just by the way I think about it. Thus, the situation did not "cause" my feelings. My own thoughts did.
Resources
-
Articles
-
What is Addiction?
- Introduction to What is An Addiction
- Definition of Addiction
- Definiton of Addiction Continued
- The Addiction Definition Compared to Other Addiction Terms
- How Do I Know if I Have An Addiction?
- Why Don't They Just Stop? Addiction and the Loss of Control
- Is Alcoholism a Disease?
- Addiction Statistics: How Big of a Problem Is It?
- A Brief History of Alcoholism
-
What Causes Addiction?
- Introduction to Causes of Addiction
- The Many Causes of Addiction and Bio-Psych-Social-Spiritual Model
- Biological Causes of Addiction
- Disease Model of Addiction and Recovery Implications
- Evolutionary Model of Addiction and Recovery Implications
- Psychological Causes of Addiction
- Learning Theory of Addiction and Recovery Implications:
- Social Learning Theory of Addiction and Recovery Implications
- Cognitive (Expectancy) Theory of Addiction and Recovery Implications
- Educational Model of Addiction and Recovery Implications
- Developmental Model of Addiction and Recovery Implications
- Sociological Causes of Addiction and the Temperance Model
- General Systems Theory of Addiction and Recovery Implications
- Sociocultural Model of Addiction and Recovery Implications
- Public Health Model of Addiction and Recovery Implications
- Moral and Spiritual Causes of Addiction
- Addiction and Personal Responsibility: A Fundamental Conflict
- Personal Responsibility and Locus of Control
- Controversies in the Addiction Field: Change Versus Acceptance
- Conflict between 12-Step Anonymous Groups and Science: A Historical Perspective
- Conflict between 12-Step Anonymous Groups and Science Continued
-
How Do You Get Addicted?
- Introduction to How Do You Get Addicted?
- The Biology of Addiction and Recovery
- How Does Addiction Affect the Brain?
- Addiction Changes the Brain's Chemistry
- Addiction Changes the Brain's Communication Pathways
- Addiction Changes Brain Structures and Their Functioning
- Impaired Decision-making, Impulsivity, and Compulsivity: Addictions' Effect on the Cerebral Cortex
- Drug Seeking and Cravings: Addictions' Effect on the Brain's Reward System
- Habit Formation, Craving, Withdrawal, and Relapse Triggers: Addictions' Effect on the Amygdala
- Stress Regulation and Withdrawal: Addictions' Effect on the Hypothalamus
- The Good News: The Brain Also Helps to Reverse Addiction
- The Psychology of Addiction and Recovery
- Learning Theory and Addiction
- Classical Conditioning and Addiction
- Operant Conditioning and Addiction
- Social Learning Theory and Addiction
- Cognitive Theory and Addiction (Thoughts, Beliefs, Expectations)
- Cognitive Theory and Addiction Continued
- Cognitive-Behavioral Therapy: Improving Coping Skills
- Addiction and Other Psychological Disorders
- Developmental Theory and Addiction
- Recovery from Addiction: The Psychology of Motivation and Change
- Addiction: Social and Cultural Influences
- Addiction and Sociological Influences: Culture and Ethnicity
- Recovery from Addiction: Becoming Aware of Cultural Influences
- Recovery from Addiction: The Powerful Influence of Families
- Recovery from Addiction: Social Support
- The Spirituality of Addiction & Recovery
- The Spirituality of Addiction & Recovery Continued
- Incorporating Spirituality into Recovery from Addiction
-
Signs and Symptoms of Addiction
- How Do You Know If You Have An Addiction?
- The Diagnostic Criteria for Substance Use Disorders (Addiction)
- The Diagnostic Criteria of Substance-Induced Disorders
- Alcohol-Related Disorders
- Caffeine-Use Disorders
- Cannabis-Related Disorders (Marijuana)
- Hallucinogen-Related Disorders
- Inhalant-Related Disorders
- Opioid-Related Disorders (Heroin, Oxycontin®, Vicodin® and other pain medications)
- Sedative-, Hypnotic-, Or Anxiolytic-Related Disorders
- Stimulant Use Disorder: Amphetamine Type (e.g., methamphetamine)
- Tobacco-Related Disorders
- Other Substance-Related Diagnosis and Unspecified Other Substance-Related Disorder
- Activity Addictions (Behavioral Addictions)
- Gambling Disorder (Addiction)
- Sexual Addiction and Pornography Addiction
- Other Activity (or Behavioral) Addictions: Internet Gaming Disorder (Addiction)
- Other Activity (or Behavioral) Addictions: Food Addiction
- Addiction and Other Psychological Disorders
- Addiction and Eating Disorders
- Addiction and Personality Disorders
- Addiction with Depression, Anxiety, and Compulsive Disorders
- Summary of the Diagnostic Process
-
Treatment for Addiction
- Treatment for Addiction
- Natural Recovery: Recovery from Addiction Without Treatment
- Natural Recovery Continued
- Choosing An Effective Treatment Approach: Evidenced-Based Practices
- What Makes An Addictions Treatment Effective?
- Biological Approaches to Addiction Treatment: Medications
- The Role of Medication in Addictions Treatment
- Pharmacologic Medications for Addictions Treatment
- Pharmacologic Medications for Addictions Treatment: Part II
- Psychological Approaches to Addiction Treatment
- Motivation for Change: The Stages of Change Model
- Motivation for Change Continued
- Types of Evidenced-Based (Effective) Treatments for Addiction: Motivational Interviewing
- Relapse Prevention Therapy
- Contingency Management
- Cognitive-Behavioral Therapy
- Dialectical Behavioral Therapy
- Acceptance and Commitment Therapy
- What The Pros Know: The Practical Recovery Model
- Social Approaches Addictions Recovery
- A Cultural Approach to Addictions Treatment: Harm Reduction
- Family Approaches to Addictions Treatment: CRAFT, Intervention And Al-Anon
- The Social Support Approach to Addictions Recovery: Recovery Support Groups
- Self-Empowering Support Groups for Addiction Recovery: Smart Recovery
- Moderation Management
- Women for Sobriety
- LifeRing Secular Recovery
- Summary of Self-Empowering Support Groups
- Spiritual Approaches to Addiction Recovery
- 12-Step Support Groups: Groups That End With "Anonymous"
- 12-Step Support Groups: Part II
- 12-Step Support Groups: Part III
- Expanding Addiction Treatment Choices in the United States
- Developing a Personal Action Plan for Addiction Recovery: Part I
- Developing a Personal Action Plan for Addiction Recovery: Part II
- References
- Resources
- Frequentlly Asked Questions about Addiction
-
What is Addiction?
-
Questions and Answers
-
Tests
-
Book & Media Reviews
-
Self-Help Groups
-
Links
-
Videos
- Technology Addiction
- Why People Can Become Addicted to Opioids
- The Swiss Cheese Model of Drug Addiction
- The 7 Skills for Addiction-Free Living: Alternatives to Substance Abuse
- Teen Drug Use: 2014 Monitoring The Future Survey Results
- Sex and Gender Differences of Importance to Addiction Science
- How to Tell if a Loved One is Abusing Opioids
- Why Addiction is a “Disease” and Why Is It Important
- NIDA Emerging Drugs-Methylone and Molly
- Designed to Drink? The Genetics of Alcoholism
-
39 more
- Women and Addiction: Why Gender Matters
- Designed to Drink? The Genetics of Alcoholism
- Gaming disorder: questions and answers
- ADHD & Risk of Adult Drug Use
- Energy Drink Sparking More ER Visits
- Why are Drugs So Hard To Quit
- Anyone Can Become Addicted to Drugs
- Substance Use: Addiction Theories New Treatments and the Role of Doctoring in Society
- The Impact of Changing Social Behaviors on Teen Drug Use
- Teen Substance Use
- Cannabis Effects on Driving Performance
- Epidemiology of Tobacco Use
- Addiction: Learning to Forget
- Addiction: What Can I Do About It?
- Addiction: Treat It Like a Disease
- Addiction: What Is It?
- One in 4 People Prescribed Opioids Progresses to Longer-Term Prescriptions
- NIDA’s Dr. Phil Skolnick discusses intranasal naloxone
- "Eyes On" Research in Drugged Driving
- How Will Anti-Drug Vaccines Be Used? An Interview With Dr. Thomas Kosten
- Opioid Use in Pregnancy: A Community’s Approach
- Naloxone Rescue Kits
- Living Without Fear
- What You Need to Know About Internet Addiction
- Hooked, Hacked, Hijacked: Reclaim Your Brain from Addictive Living
- The Neuroscience of Internet Addiction
- Internet Addiction: Signs You Need to Shut Down
- What the Internet is Doing to Our Brains
- Addressing Suicidal Thoughts and Behaviors in Substance Abuse Treatment
- The Reward Circuit: How the Brain Responds to Cocaine
- The Reward Circuit: How the Brain Responds to Methamphetamine
- The Reward Circuit: How the Brain Responds to Marijuana
- The Reward Circuit: How the Brain Responds to Natural Rewards and Drugs
- Mindfulness-Based Relapse Prevention (MBRP) for Addictions Video (vol. 1)
- Mindfulness-Based Relapse Prevention for Addictions (vol. 2)
- Prescription Opioid Misuse
- Substance Use Disorders/Addictions - Clinical Overview
- Addiction in the Elderly
- Teenagers, ADHD, and Substance Abuse
Topics
-
Related Topic Centers
-
Addictions
-
Aging & Elder Care
-
Assessments & Interventions
-
Career & Workplace
-
Emotional Well-Being
-
Life Issues
-
Parenting & Child Care
-
Abuse
-
ADHD: Attention Deficit Hyperactivity Disorder
-
Adoption
-
Autism
-
Child & Adolescent Development: Overview
-
Child & Adolescent Development: Puberty
-
Child Development & Parenting: Early (3-7)
-
Child Development & Parenting: Infants (0-2)
-
Child Development & Parenting: Middle (8-11)
-
Child Development & Parenting:Adolescence (12-24)
-
Child Development Theory: Adolescence (12-24)
-
Child Development Theory: Middle Childhood (8-11)
-
Childhood Mental Disorders and Illnesses
-
Childhood Special Education
-
Divorce
-
Family & Relationship Issues
-
Intellectual Disabilities
-
Learning Disorders
-
Oppositional Defiant Disorder
-
Parenting
-
Self Esteem
-
-
Psychological Disorders
-
Anxiety Disorders
-
Bipolar Disorder
-
Conversion Disorders
-
Depression: Depression & Related Conditions
-
Dissociative Disorders
-
Domestic Violence and Rape
-
Eating Disorders
-
Impulse Control Disorders
-
Intellectual Disabilities
-
Mental Disorders
-
Obsessive-Compulsive Spectrum Disorders
-
Personality Disorders
-
Post-Traumatic Stress Disorder
-
Schizophrenia
-
Sexual Disorders
-
Somatic Symptom and Related Disorders
-
Suicide
-
Tourettes and other Tic Disorders
-