CBT for Alcoholism and Alcohol Abuse. Not a Magic Bullet, But……
Cognitive Behavioral Therapy – CBT – is another component in helping people to overcome their misuse of alcohol but, like every other coping skill, it is not a “fix” in and of itself. Nonetheless, it does go a long ways towards teaching people to manage emotions rather than medicate them.
Lest you have the impression that CBT is something new, let me assure you it isn’t. Some 2000 years ago Epictetus noted that “What upsets people is not things themselves but their judgements about things.” Considerably more recently Dr. Albert Ellis, President of the Albert Ellis Institute for Rational Emotive Behavior Therapy, laid the ground work for using it as the basis for brief therapy.
However, one need not dig through journals and texts to grasp the meaning and importance of CBT (or REBT, same thing, different catch phrase). Stated as simply as possible, CBT notes that we are ourselves creating the emotions which we then medicate.
That’s important because most of us believe that either our emotions spring up like mushrooms out of nowhere or, worse, other people create them. “She made me so angry!” “He cut me off!” and so on. But once you understand that you create your own emotions through your thoughts, beliefs, and behaviors then you know that you can learn to manage them and neither medicate them nor react on the basis of false premise.
There is a lot of empowerment in learning to manage your own emotions rather than being victimized by them or, worse, having them manipulated by others.
And, again, since most of us get into trouble because we have chosen to medicate uncomfortable feelings rather than address them, eliminating the symptom, alcohol excess, means addressing the emotions, their causes, and what we have been telling ourselves that has no basis in fact.
Yes, the process takes some work and the CBT process has to be internalized and yet again, we can’t do it to you, or for you, but we have a very good process for doing it with you – a process honed over more than a decade of refinement.
“I Got It. It’s a 2 Step Program. Get a Grip and Get a Life!”
One of the first things we ask on Monday morning is, “What have you been doing about the problem up until now?” Some of you have been to other programs, always 12 Step based, but most reply with some variation on, “I’ve been seeing my therapist for 5 years and nothing’s changed.”
To which we gently reply, “Seeing a therapist is a good start but it’s still talking about doing something – it’s not doing anything, at least not after the first 12 weeks of defining and planning.”
Defining and planning does cover Prochaska, Norcross and DiClemente’s Contemplation and Preparation Stages in their 6 Stage model of how people actually change. (See “Changing For Good”) Unhappily, too many of us stay locked in “contemplation hell” as we never move on to the Action stage. And far too many therapists are more than happy to help us stay there, it being easier to keep a client stuck than to have to find a new one.
Note too that this is what AA demands. Don’t fix the problem, don’t outgrow the problem, but stay stuck “in recovery” forever.
Admittedly either pseudo-fix is, like alcohol, less effort that actually changing your life circumstances, habits, rituals, and putting up with all of the temporary discomfort real change entails.
But neither approach changes your drinking, usually, and more commonly merely allows you to continue to drink with less guilt. No wonder both are popular with those who have no intention of changing their drinking but simply wish to decrease the pressure from others.
“I am doing something about it! I’m seeing a therapist and going to AA! Get off my case or it’ll be your fault when I drink!”
But if the excuses and cover-ups and pretend fixing have run out, we will be happy to help you move from Contemplation to Action. To “Get a grip and get a life.”
The choice is yours. It always is.