What does successful addiction treatment look like from a psychological perspective?
The fact is that many people who are struggling to get clean and sober suffer from some sort of dual diagnosis, meaning that they also struggle with mental health issues as well as substance abuse. Such individuals have a greater challenge than someone who is only dealing with a chemical dependency because any mental health instability can lead them to relapse on their drug of choice. However, anyone can get clean and sober, even in spite of a dual diagnosis, if they are willing to do the work that is required of them in their recovery journey.
Much of our battle in addiction recovery is mental. Much of it comes down to psychology and behavior hacking, if you will.
Let’s take a closer look at some of the concepts that can help us to win the mental battle against relapse.
First of all is the idea of the surrender mindset. If a person is struggling with alcoholism or drug addiction then that person is stuck in denial. They have a thinking problem that tells them that they cannot possibly be happy or content unless they are self medicating with their drug of choice. And yet in the meantime they are getting more and more miserable based on the consequences of their addiction. They refuse to believe that their substance use could be the actual root of all of their problems, and instead they see their substance as being a solution. They say things like “My drinking or drug use is the one thing that brings me a little bit of happiness.” They cannot see that it has become the cause of all the misery and chaos in their life.
So what has to happen is that the individual has to break through their denial and realize that they really won’t be achieving happiness, serenity, or peace while they are still stuck in denial. They have to have that moment of clarity in which they realize that the misery and the chaos is being perpetuated by their drug or alcohol use, and that really is at the core of their problems. Without that realization they are not going to have the proper mindset to adopt a recovery program and take it seriously.
Note that people can be in partial surrender (and therefore also in partial denial) and they can still agree to go to treatment. But what will happen in such instances is that the person will lack follow through, and they will subsequently relapse. No follow through, no recovery. The surrender mindset is what leads to serious follow through.
Now another thing that must happen mentally in early recovery is that the person must increase their awareness of mental triggers. Let me give you a specific example of this.
When I was in early recovery I realized after a few weeks that my brain was making up excuses for why I should get to relapse. Now at the time I did not want to relapse and I had no intention of drinking or taking drugs, but I noticed that my brain was constantly looking for ways to capitalize on drama, make itself out to be a victim, and find all sorts of excuses that would allow it to rationalize a relapse.
Why was my brain doing this?
The reason that my brain was doing this was because that was what it had been doing constantly for the last few decades of my alcoholism. It kept doing that because that was what worked; that was how it justified all the heavy drinking and drug use. So it just kept on doing that even though I was trying to be clean and sober now.
So I had to increase my awareness of this tendency in order to combat it. I had to notice when my brain was “fighting against me” and causing me to feel triggered. I had to wake up to this fact so that I could then decide to do something about it.
Now what did I end up doing about it? That is the next “tool of psychological warfare against addiction”: I created a zero tolerance policy.
Now let me explain to you how this worked for me, because it was very effective. When I realized that I was being triggered nearly every by my own brain which was attempting to “hijack me,” I realized that I had to put a stop to this kind of thinking.
So I made the decision that I was not going to tolerate this sort of “victim thinking” and excuse making in my own mind. I made an agreement with myself that as soon as I noticed my brain attempting to engage in this sort of thinking I would shut the thoughts down immediately or redirect myself.
In nearly every situation I could go to my therapist, my sponsor, or an AA meeting and ask for advice or help. At that moment I am no longer a helpless victim and I was empowered to create positive change in my life. The key was in remembering to remind myself that I was not a victim and that I had real choices today. The key was in remembering to redirect my thoughts towards something positive when my brain was trying to look at the negative or make excuses.
I took it a step further and made the same sort of policy for drug or alcohol cravings. If I noticed that these were happening in my mind, I agreed with myself that I would shut such thoughts down immediately and redirect towards my recovery goals. Anyone can sit there and fantasize about the good times that they had with their drug of choice, but all this can do in the long run is to make you miserable (because your mind will complain that it is in a state of lack because it is not getting drunk or high any longer). So those thoughts of “the good old days” can only serve to make you miserable; they cannot help you in any way. So you must decide to shut those thoughts down immediately, as soon as you notice them. Make a firm agreement with yourself not to tolerate such thoughts.
Another mental trick that might be necessary is to figure out how to convert selfishness into gratitude. Most of us have a number of selfish thoughts and motivations when we first get into recovery, and these can eventually trip us up and lead to relapse if we are not careful. The key is in figuring out how to be grateful instead of entitled, and to remember that each new breath that we draw is a gift, each new day is another opportunity, and the world doesn’t owe us anything. In fact, most of us could agree that our addiction could have easily “removed us” from the equation entirely years ago….but we are lucky enough to live another day in recovery. Take advantage of your good fortune and be grateful for the opportunity.