Addiction Treatment

alcoholism and tikvah lake

How Cognitive Dissonance relates to Alcohol Abuse

The relationship between Cognitive Dissonance and Addiction is an emerging topic of fascination, particularly for addiction specialists who perhaps are seeking new ways to treat clients (it’s also helpful for those in addiction recovery).

What is Cognitive Dissonance?

Cognitive Dissonance happens when an individual holds a series of contradictory beliefs, values and ideas – and is overcome by psychological stress when they partake in any action that goes against one or more of those beliefs.

As humans, we tend to strive for whatever makes us feel comfortable. Therefore, we are driven (consciously or not) by consistency.

Cognitive Dissonance theory holds the principle that when two ideas or actions clash (i.e. they are inconsistent with each other) people will do everything in their will to change these ideas until they become compatible.

Broadly, cognition is a strand of knowledge; these include:

  • Personal values
  • Behaviours
  • Thoughts
  • Attitudes

Let’s say, for example, a person discovers new information that challenges a deep-rooted belief.

They may even behave in a way that is incongruous to their perception of self, in this case, the individual (to restore Cognitive Dissonance) will often become motivated to change those negative feelings, which ultimately soothes psychological stress.

Cognitive Dissonance in Social Psychology

Cognitive Dissonance theory belongs to the sphere of Social Psychology.

Social psychologists believe Cognitive Dissonance to be a mental conflict that occurs when an individual’s beliefs and behaviours are misaligned.

Leon Fester, psychologist and author of the book; A Theory of Cognitive Dissonance (1957), proposed that people experience psychological unease when their beliefs are conflicting or when their actions and behaviours contradict each other. 

Once individuals realize just how conflicting their beliefs are, they work hard to relieve the discomfort in an attempt to resolve Dissonance – this is titled “The Principle of Cognitive Consistency”.

According to mental health experts, mental health is the ability to handle uncertainty – and those with a higher threshold for delay tend to experience less distress and Cognitive Dissonance than those with lower scores. 

Symptoms of Cognitive Dissonance

Cognitive Dissonance can create a series of unpleasant symptoms, such as:

Frequently, individuals experiencing Cognitive Dissonance may try to conceal their feelings or beliefs by covering them up. All this is done by:

  • Refusing to absorb new information that goes against their ideas, such as a refusal to watch the news or read an article.
  • Concealing their beliefs and behaviours from other people.
  • Excluding themselves from taking part in discussions about specific topics.
  • Condoning their decisions, actions and behaviours.

When a person ignores information and facts in a bid to retain their beliefs, this often results in stagnation.

For individuals to resolve Cognitive Dissonance, they must be willing to do the work required to shift their beliefs, attitudes and behaviours into alignment with each other.

Seeking professional help for Cognitive Dissonance allows those with mental health conditions such as anger issues, personality disorders and addictions to make positive changes to their lifestyle, allowing them to move forward.

Alcohol Abuse and Cognitive Dissonance

Alcoholics (and other substance abusers) often experience Cognitive Dissonance. Addicts are fully aware of the dangers of alcohol and drug abuse but will find new and creative ways to justify their self-destructive behaviours.

Alcoholics with Cognitive Dissonance will often do what they can to overcome feelings of unease by:

  • Being in denial about the dangers of alcohol abuse (or minimizing the risks) in an attempt to view their actions as less dangerous
  • Abstaining from alcohol altogether
  • Adopting the belief that although excessive alcohol consumption might be hazardous to others, they will be fine as it won’t affect them as much (if at all)

Risks associated with Cognitive Dissonance

In alcohol recovery, Cognitive Dissonance presents many risks and challenges for both the addiction recovery specialist and patient.

Since addicts with Cognitive Dissonance indulge in patterns of delusional thinking, they often go to great lengths to protect their current understanding. 

All this might explain why certain concepts and ideas appear rational to some people and entirely irrational for others (such as an addict’s ability to justify their excessive drinking). This type of thinking makes no sense to the addicts family.

This type of increase in delusional thinking often creates many challenges for those in addiction recovery, and those hoping to avoid relapse.

The key is to notice when the pattern of delusional thinking starts to exacerbate and to challenge the feelings and thoughts to prevent relapse from occurring.

Examples of Cognitive Dissonance in Alcoholism

There are plenty of examples of how Cognitive Dissonance shows up in alcohol addiction – they include:

  • The addict believing that life is miserable and dull without alcohol
  • Giving up a habit means that life is inevitably devoid of any joy or happiness
  • Developing the belief that medical advice such as awareness campaigns against alcoholism is propaganda and that the media has indoctrinated people 
  • Believing that teetotalers are boring and since they do not abuse substances they must lack character or personality
  • Adopting the belief that it’s cool to abuse substances and only those with imagination or artistic flair will fully understand the concept of substance misuse

Treating Cognitive Dissonance in Alcohol Abuse Recovery

Fortunately, there is a wide range of treatment options available for addicts with Cognitive Dissonance such as therapy and residential treatment programs.

One on one therapy is the most effective form of treatment.

However, the addict must start with a clean slate or “beginner’s mind” for the methods in therapy to be effective. All this involves putting aside any previously held beliefs that may have been limiting or self-destructive in any way.

When people in addiction recovery begin therapy with a beginners mindset, this allows them to adapt to new thinking styles and healthier ways of behaving.

In therapy, Cognitively Dissonant individuals will start to notice a shift in previously held beliefs, and begin to acknowledge how they have justified their addictions in the past. 

Therapy is delivered in a supportive, encouraging environment where people get the opportunity to share ideas and stories. This collaboration leads to mutual understanding, paving the way for recovery from alcohol (and any other substance) addiction.

If you would like to address any self-limiting thoughts and beliefs that might be holding you back in your recovery or if you would like help with an addiction – the team at Tikvah Lake Recovery are here to help.

Contact the team today to find out more. 

Childhood trauma and addiction

Borderline Personality Disorder: A link to childhood trauma

Borderline personality disorder (BPD) is a condition featuring persistent and ongoing patterns of varying behaviours, moods and a distorted self-image.

BPD can lead to a series of relationship problems as the symptoms of the condition often result in impulsive actions and drastic mood changes.

It is not uncommon for those with a borderline personality disorder to have intense episodes of anxiety, anger and depression that may last from a few hours to days.  

Sign and Symptoms

Those with a borderline personality disorder often experience intense shifts in mood and have an overall sense of uncertainty about how they see themselves and the role they play in the world.

Since having the ability to deal with uncertainty is an element of psychological well being, those with borderline personality disorder tend to suffer in extremes.

For BPD sufferers, everything (and everyone) is either good or bad. There is no middle ground.

Those with BPD often experience drastic and sudden mood changes, which can shape their relationships in negative ways.

BPD sufferers often change their perceptions of friends, lovers and family members quite frequently, leading them to either over love (idealize) or discard people according to their fluctuating moods and perceptions.

Some of the symptoms associated with borderline personality disorder include:

  • Impulsive behaviours such as substance abuse, unprotected sex and dangerous driving
  • Suicidal thoughts and recurring thoughts of suicidal behaviours or threats
  • Intense and highly fluctuating moods ranging from a few hours to a few days
  • Dissociation – this means feeling cut off from oneself, or a person feeling as though they are outside of their own body, and feelings of unreality 
  • Self- harming, such as cutting oneself or harming oneself in any way
  • Intense feelings of anger and an inability to regulate or control the anger

Other symptoms may include:

  • Issues with trusting others
  • Distorted perception of oneself including self-image
  • Unstable relationship patterns with relatives or loved ones which can swing from extreme like (idealization) to extreme dislike (devaluation)
  • Cutting people off to avoid future abandonment
  • Anxiety
  • Loss of interest in hobbies and activities that once were pleasurable

It is also important to mention that not every person will display each of the symptoms of borderline personality disorder. Some people may only experience a few.

Those suffering from BPD are easily triggered, events such as a temporary separation from a loved one or an event that might leave them with feelings of uncertainty can cause a trigger response.

The duration of an episode in BPD varies from person to person as does the frequency.

The link between childhood trauma and borderline personality disorder

Numerous studies have shown that childhood trauma leads to brain damage and can create altered brain wave patterns affecting the way a person sleeps.

One particular study conducted in 2012 found a correlation between altered brainwave patterns during sleep and adults with a borderline personality disorder.

The study illustrated that those with altered brain waves tended to suffer from insomnia more than a person without BPD.

It also showed that patients suffering from BPD took less time to enter into REM (a state of deep sleep where people dream).

BPD patients also had long periods of REM sleep at the beginning of the night, compared to normal sleep function where people enter REM at the end of the night.

The study hypothesized that BPD is likely caused by functional changes in the brain, through the balance of neurotransmitters or structural alteration of synaptic pathways.

Risk Factors

When it comes to a person’s Childhood, there are several risk factors for those with BPD:

  • Damaging parenting styles: This involves being exposed to a disorganized or dysfunctional household such as witnessing conflict and disharmony, even if the conflict between family members was subtle, children are very good at picking up on cues
  • Childhood trauma and child abuse: Adverse childhood experiences (ACES) are known to cause BPD – this is especially true if the abuse was from a close relative or trusted family friend. Although, not all children who experienced child abuse will develop BPD as other factors such as genetic resilience often play a role
  • Loss and separation: Since a person’s developmental bonding process was likely to be disrupted by either the death of one or both parents or separation of some kind, they are more likely to develop anxious attachment styles as adults. All this can manifest as a person being dependent, clingy, or, fearful later on 
  • Invalidating emotions: If a child is told off for crying, or made to feel guilty about being anxious or upset, they may resort to extreme measures to get the emotional validation they crave. This scolding might manifest as episodes of explosive anger and an inability to trust their feelings and perceptions as adults. All this is to gain the recognition they failed to receive

According to the University of Manchester, research shows that those with borderline personality disorder are 13 times more likely to report child abuse compared to those without mental health problems.

The report shows that 71.1% out of the 5,000 people that were studied, were diagnosed with BPD and reported at least one traumatic childhood experience with the most common form of adverse experience being physical neglect (found in 48.9% of cases). 

Genetic factors also play a big part in the development of BPD as studies of families (particularly in twins) have proven that there is a strong link between genetics and borderline personality disorder.

Other Factors

A borderline personality disorder is a common condition with over 20,000 cases a year in the UK alone. The condition can be lifelong or last for several years depending on whether a person has received treatment.

Treatment

There are a wide range of treatment options available for people suffering from borderline personality disorder. These include:

Psychotherapy

There are many different forms of psychotherapy, but most involve the patient coming to an understanding about themselves, their behaviour, and any patterns they might want to address.

Psychotherapy aims to seek a deeper understanding of the self and, ultimately, seek long-term resolution.

Essentially, the therapy enables those with BPD to develop a sense of control over their thoughts and behaviours.

Psychotherapy is usually delivered by a psychiatrist, psychologist or other mental health professional.

The duration of psychotherapy can last a year or longer, depending on a person’s requirements.

Dialectical behaviour therapy

Dialectical behaviour therapy (DBT) is a form of therapy designed to treat BPD.

DBT operates on the principle that the following two factors may have contributed to the development of BPD:

  1. The person’s emotions were dismissed in Childhood, and they were likely told that they were “silly” for crying or for feeling vulnerable in certain situations
  2. The person tends to be emotionally vulnerable and therefore low levels of stress tend to make them anxious

These factors can create a vicious cycle as an individual may experience intense and upsetting emotions and subsequently feel guilty and worthless for having them.

The cycle then comes full circle since the person was brought up to believe that having emotions is bad or shameful.

Self-fulfilling beliefs can become destructive as someone develops the sense that they must be a bad person for feeling the way they do.

DBT aims to challenge any unhelpful thoughts and beliefs that were created during the developmental phase in two ways:

1. Through validation: Accepting that emotions are acceptable, valid and real.

2. With dialectics: By banishing ‘black and white’ thinking styles, a person will eventually learn that not everything is as cut and dry as they were taught to believe.

This method teaches people to be more receptive and open to new ideas, thoughts and ways of behaving.

Dialectical behaviour therapy is proven to be very effective in treating those with BPD and those with a history of suicidal behaviour and self-harm.

Group therapy and counselling might also be alternative options for those seeking treatment for BPD.

Medication

Certain types of prescribed medications can help treat BPD, such as:

  • Certain antidepressants
  • Antipsychotic drugs
  • Mood stabilizers/anticonvulsants
  • Anxiolytics (anti-anxiety drugs)

Getting help

If you think you might be experiencing any of the symptoms associated with a borderline personality disorder, then perhaps it’s time to reach out and speak to a professional.

The team at Tikvah Lake Recovery are trained specialists who are always on hand to support you and discuss your treatment options. Contact the team today to find out how we can help.

tikvah lake focus on recovery

The importance of relapse prevention in addiction recovery

A relapse is not a random occurrence or event – it is a process that a person goes through during a period of abstinence before a relapse occurs.

Some of the symptoms associated with substance misuse relapse include:

  • Intense or uncomfortable emotions (H.A.L.T – Hungry, angry, lonely, tired)
  • Post-acute withdrawal symptoms (poor sleep, anxiety, mood swings, agitation)
  • Personal relationship and intimacy problems (increased levels of stress if things go wrong)
  • Isolating from others
  • Negative self-care (poor sleeping and eating habits and poor stress management)
  • Nostalgia over people (including addicts that the person once used with)
  • Nostalgia about places (such as where the addict used)
  • Intense withdrawal symptoms (nausea, exhaustion and anxiety)

Relapse Prevention

Since preventing relapse takes a cognitive-behavioural approach – the objective when it comes to relapse prevention is to identify intensely high-risk situations which often involve:

  • Substance abuse
  • Obesity
  • Depression
  • Obsessive-Compulsive Behaviour

Relapse means that a person goes back to using again after a period of sobriety.

According to the National Institute on Drug Abuse, 40 – 60% of people are likely to relapse after a period of sobriety.

One of the aims of preventing relapse is to create a new understanding of what triggers a person to want to use again and helps them to understand the kind of environments, people and situations that motivate and encourage them to use.

Everything and anything can act as a trigger for someone, and a former addict will likely come up with plenty of excuses for wanting to drink or to start drugs again.

Getting clean is one element to recovery. The other is staying that way – both are not easy processes. As a result, an addict may begin an internal bargaining process.

They may tell themselves that one drink won’t do any harm, or that indulging in porn today, won’t happen tomorrow. These are the kinds of bargaining statements that often lead a person to begin the stages of relapse.

How to stop relapsing

One of the first keys of relapse prevention is to recognize the stages of relapse:

  • Emotional Relapse: This is the phase where a person may not be thinking about using. However, the behaviours and thoughts that occur during this phase are gearing the person towards relapse. These include a person suppressing their emotions. The person may even be isolating themselves. This stage often involves feelings of anxiety and anger.
  • Mental Relapse: During this stage, a person may become nostalgic about their former life as an addict. They may reminisce about the good old days of using these may involve the people and places that were associated with the addiction. In this phase, an individual will see their former life as an addict through rose-tinted specs. Essentially, they are planning to start using again.
  • Physical Relapse: It is in this stage that the person has started using again. It may start with one pill, one drink, one bet, and then, eventually, lapse back into regular use.

Several ways that an individual can stop relapsing include:

  • Reminding themselves of the reasons they quit in the first place
  • Seeking help from counsellors, support groups and 12 step programs including Narcotics Anonymous and Alcoholics Anonymous (A.A.)
  • Distraction techniques – this may involve talking to a trusted friend, going for a walk, meeting someone for coffee or watching a favourite film
  • Reward strategies such as having a relaxing massage or booking a day trip for each recovery gain
  • Consistent self-care which involves getting enough sleep, eating a balanced diet and following a daily exercise plan
  • Understanding triggers – this is a crucial element to stopping relapse as the person comes to recognize what led them to abuse substances and identify healthier ways of coping for the future

Relapse prevention plan

the road to recovery teens and adolescents

Recovering from addiction is rarely a smooth process. Therefore, addicts in recovery need to recognize just how tough recovery can be.

Alcoholics who relapse, for example, may punish themselves when they start drinking again. Although this self-loathing can only make things worse and continue the cycle of addiction.

Therefore the process of relapse prevention should begin with self-forgiveness. Once a person recognizes just how common it is for addicts in recovery to relapse, they set themselves on the path to long-term abstinence.

Recovering from addiction must have a tailored treatment plan. In this case, a relapse prevention model of some kind.

So far, we have established the three stages of relapse (emotional, mental and physical) and identified several ways that an addict can prevent themselves from relapsing in the future.

Let us look at some other helpful ways that a person can prevent themselves from a future relapse:

Lapse vs relapse

There is a marked difference between someone lapsing and someone having a full return to previous addicted behaviours.

Lapsing is considered a slip, something that happens in the spur of the moment. A lapse is a temporary blip, but one that does not compromise or prevent full recovery.

A relapse is a complete return to past behaviours, thoughts and addictions.

Knowing the difference between the two can be extremely helpful for addicts in recovery as this often limits the amount of guilt whenever a lapse takes place.

Mindfulness-based relapse prevention

G. Alan Marlett, PhD, coined the term urge surfing which he developed as a mindful practice to help curb the urges, cravings and impulses that are associated with addiction.

Marlett teaches those with addictions to view their urges like waves at the ocean’s edge, the waves follow a natural progression, then peak in intensity, before crashing and receding.

The aim is to bring about conscious awareness in addiction recovery, allowing individuals to observe their cravings and urges, accept them, be present, and ride them out as opposed to resisting them.

The duration of cravings usually lasts around 10-20 minutes before dissipating.

Urge surfing offers addicts in recovery the opportunity to observe their cravings without judgement and without becoming too attached or trying to repress them.

If a person can practice observing their urges for this short duration, the urges will eventually pass. Surfing an urge involves becoming consciously aware of any thoughts, emotions and physical sensations that might be attached to a craving.

By visualizing the urge as a wave whilst focusing on breathing, each breath becomes deeper and slower.

Intentional breathing such as exhaling and inhaling through the abdomen can help individuals to be fully present with their cravings and ride them like waves as they rise, peak and eventually subside.

Relapse programs

12-step programs are helpful when it comes to preventing relapse – many of the strategies often involved in relapse prevention programs include:

  • Deep breathing and meditation
  • Group therapy
  • Exercise routines
  • Rehab aftercare

Other beneficial therapies for addicts in recovery involve:

If you think you might be showing signs of relapse, it might be time to contact a specialist who can help you get back on track. Contact the team at Tikvah Lake today and find out how we can help you through this process.

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