People in recovery from addictions who are active in 12-step programs (AA, NA) often talk about their “stinking thinking’”—a reference to a pattern of thinking that, unchecked, can lead to relapse. “Stinking thinking” encompasses everything from actual thoughts of using, outright denial or minimization of the addiction, to beliefs recovering people have about themselves and their relationships with the addiction. There is little doubt that, as an addiction takes hold and progresses, thinking changes, becoming increasingly dysfunctional and destructive. The changes are subtle at first and become entrenched over time. The following example illustrates:
You are invited to a party. Upon arrival, you look around but don’t see anyone you know. The friend who invited you isn’t there yet. Feeling a bit anxious and awkward, you see that someone has set up a bar and drinks are being served. You decide to have a drink since “alcohol is a social lubricant” and will “take the edge off” your anxiety. Having taken a drink, you now feel able to manage your anxiety and begin to work the room.
A great deal of thinking is embedded in this scenario: perceptions and reactions to the party, perceptions and thoughts about yourself in relation to strangers, expectations about social situations and relationships, expectations about what a substance will do, reasoning and decision-making, perceptions and thoughts about “feeling better.” The scenario also points to beliefs: beliefs about the ability to manage anxiety, beliefs about alcohol’s effects, beliefs about yourself and your capabilities. Many of these thoughts and beliefs are not fully conscious but are nonetheless present and have impact.
Thoughts and beliefs certainly impact behavior--and vice versa. One of the most insidious beliefs that many people struggling with addiction have centers on shame and self-efficacy: “I am inadequate and do not have enough strength in me to cope with life without the substance. I NEED________.” Or “my feelings are bigger than me, and I need _________ to manage them.” The addicted person identifies with his/her inadequacy and shame (“I AM inadequate”).
There is a kind of circularity to addictive thinking. Thoughts emerge from beliefs, which are reinforced by addictive behaviors, which leads to additional addictive thinking and further reinforcement of the beliefs. Over time, addictive beliefs tend to become reductive as addictive reasoning develops. Indeed, reasoning becomes less rational and less fact-based as addiction progresses; emotional reasoning (“If it feels good, it must be OK”) is a hallmark of addictive thinking. Indeed, it’s a vicious cycle.
Sadly, addiction ultimately reinforces the shame and beliefs about inadequacy as self-efficacy and control is lost to the addiction.
One of the reasons that “just say ‘no’” (remember Nancy Reagan?) and willpower don’t work as strategies for managing and overcoming addictions is that they don’t address the subtle thoughts and beliefs that persist long after the substance is out of one’s body. I’ve often remarked that, hard as it is to control or even stop using substances, it is much harder to change one’s thinking. And yet changing one’s thinking and beliefs is the essence of recovery.
Psychotherapy is an effective means for identifying, reflecting on, understanding and even changing “stinking thinking.” Among other aims, one goal of addiction treatment is to raise awareness about what one’s thoughts actually are. Many of us are only vaguely aware of what we are thinking at any given moment. Moreover, we are usually not aware of how our beliefs shape our perceptions and thoughts—and our subsequent choices and behavior. Therapy can raise awareness, thereby helping us to find the freedom to make different choices in response to situational challenges. While the therapist will certainly not tell you what or how to think, he/she will hold up a mirror so that you can clearly perceive your thoughts/beliefs in action, and decide whether those beliefs remain valid in your present experience and whether you want to continue to choose the same behaviors.
Psychotherapy is ultimately about helping you find and own your inner power—something that has been lost or even given away through addiction. Developing self-awareness is an important step toward changing dysfunctional thinking. And changed thinking can change your life.