Drug Rehab Center

Welcome to the 4th segment on what researchers have observed when addiction treatment works. A common thing researchers find is that there is often a shift in thinking, that people begin to think in a new way. This new way of thinking involves the ability to see another perspective, even someone else’s perspective. For example, those successful in recovery may no longer take it personally when they get cut off in traffic, realizing that it is a complete stranger in the other car. In those instances when it may be personal, for example when a friend offers them a beer after completing treatment, instead of getting offended or hurt they may consider the possibility that the person thinks that treatment cures addiction, that those cured can drink again. Maybe the world is not out to get you.

Psychologist Dr. Albert Ellis used to say that if a person can change the way they think about things it will help them feel better about themselves. When a person feels better about themselves the way the react in life (their behaviour) will also change for the better. The technical term for a shift in thinking is ‘cognitive restructuring’.

Cathy Patterson-Sterling, Director of Family Services for the Sunshine Coast Health Centre, discusses negative thinking in addiction recovery and what can be done about it.

By Geoff Thompson – MA, CCC
Program Director
Sunshine Coast Health Center

If you are in early recovery, you may be familiar with the social pressure that comes along whenever we see others drinking or partying. This could be at a wedding, during the Grey Cup or Super Bowl, or the Christmas season. Sadly, some people in recovery talk themselves into joining the party. They seem to forget what they learned in treatment or at a 12-step program.

But we know from psychology it’s not really a matter of forgetting or ‘being an addict’ or ‘stinkin’ thinkin’’. In psychology we call this “confirmation bias.” A few years back, there was a shift in psychology known as the “cognitive revolution.” What this meant was that we began to get quite good at figuring out how individuals process information—how your brain works. One of the things that we discovered is that the brain is not like a computer.

Information goes into your brain and gets processed. That’s true. But we learned that the brain is not particularly logical. You have a natural tendency to pay more attention to and overvalue things that confirm how you make sense of the world, and you tend to dismiss or undervalue those things that contradict it. This is ‘confirmation bias’.

Here are two examples of confirmation bias that might affect you. Maybe a family member picked up on one single thing you did—such as miss an AA meeting or have a slip—and then let you know that your recovery is all a sham. They see the single incident as confirming what they already think about how well you are doing. Another example: Perhaps in recovery you got angry at your family for an incident when you felt they were trying to control you, just as you thought they did when you were in active addiction. They may have treated you as the author of your life 50 times in a row, but you jumped all over that one incident because it seemed to confirm how you make sense of their attitude toward you.

Confirmation bias works both ways because all human beings do it. And it can lead us into all sorts of difficulties. One of the more public examples that psychologists have pointed out is the decision to invade Iraq after 9/11. Although it later became obvious that there was no evidence of weapons of mass destruction, because of confirmation bias many in the Bush Administration pursued information that seemed to confirm their preconceived ideas and discounted evidence that there were no weapons…

The real trick to deal with confirmation bias is to see it in yourself. That’s a lot tougher than seeing it in others. But since everyone has it—it’s a human thing—then you have it, too.

Confirmation bias is complicated, but two of its dynamics are known as ‘defensive motivation’ and ‘accuracy motivation’. Defensive motivation means that the person becomes very skeptical of information that contradicts his attitude, beliefs, or actions. This is usually because the information threatens him in some way. Let’s say that you are skeptical of information that says if you hang out in bars they you will likely be lured back into addiction. You might dismiss the idea of keeping out of a bar or away from a drinking party because you believe it’s the holidays and that’s where all the fun is; in fact, if you don’t go to the bar or drinking party, then you will miss out.

Accuracy motivation means that a person sees some value in the information. As one researcher described it, the person has a tendency to process information in an “objective, open-minded fashion that fosters uncovering the truth.” You may believe that the bar is a dangerous place, because you get caught up in the music, sexual interests, and camaraderie. If you believe this is dangerous for you, then you will pay more attention to information that tells you that you are right. You don’t need to drink to be in the festive spirit at a social gathering.

In this article we’ll look at confirmation bias and your recovery. With the wedding season and summer holidays coming, this topic is very important. So we’ll provide a few things you can do to deal with it.

Part One: Defensive motivation: Wrestling with your addiction

Cognitive psychology—the psychology of how we process information—has taught us that confirmation bias appears when we confront information that is threatening to us. We tend to take a defensive stand, becoming more skeptical. In psychology, we call this “defensive motivation.”

In a typical experiment, psychologists ask participants to write down what they are passionate about. A normal topic is capital punishment. Then the experimenters present studies for and against the idea that capital punishment deters criminal behavior. Inevitably, the participants are skeptical about the study that disagree with their stance but fully endorse the study that agrees with them.

Here’s an example of defensive motivation from the world of drug use. Although there are many reasons why those in early recovery wrestle with their recovery, a common reason is that they try to pin their addiction to their drug of choice. If you believe that it’s okay to have a couple of beers because your drug of choice was cocaine, then you will likely be skeptical of any information that says a drug is a drug is a drug. Or you will likely remember information about someone’s uncle who was an alcoholic but who now drinks with no ill effects on his life. If you are an alumni of Sunshine Coast, all that scientific information you learned at the Drugs & Your Brain workshop won’t make much of an impression on you, because of confirmation bias.

Logically, of course if you pin your addiction to your drug of choice, then you fly in the face of all those scientists. If you were being very logical, you’d have to say, ‘I’m right, and all those research scientists at Harvard and Johns Hopkins universities are wrong’. But people are not particularly logical, so they pretend the science doesn’t exist or, at least, doesn’t apply to them.

On the other hand, if you are firmly convinced that all drugs will hurt an addict, then you will likely pay more attention to articles and narratives that promote this; and you will likely shake your head and smile when someone says that it’s okay to drink because their drug of choice was cocaine.

Part Two: A solution to wrestling with your addiction

If you are debating with yourself on whether to join in the drinking festivities or be one of the sober ones, then here are some ideas that might help you choose the latter. These tactics are merely tricks to disrupt confirmation bias—the tendency to grasp hold of information that confirms your preconceived ideas.

Tip #1 – Get involved with a recovery support group – AA and NA have many activities throughout the year, particularly during the holiday season. In larger cities, they run meetings 24 hours a day, seven days a week. They usually provide Christmas dinners at the local Alano club or recovery center. Many groups have service activities that you can join, such as helping out those less fortunate. Most recovery centers have dances and music and other social events.

Tip #2 – Be grateful – If you were a client at Sunshine Coast during the past year, you will remember the power of being grateful. Psychology has confirmed that being grateful for what you have—your sobriety—will help you feel better. The 12-step program has a saying that those who are grateful do not relapse. The reason for this saying is that those who recover through AA or NA tend to think that their sobriety was a gift from their higher power.

Tip #3 – Make a decision to not drink for the holidays – This is a remarkably powerful tactic because it takes the pressure off.

Tip #4 – Remember the racehorse – This is psychologist Paul Wong’s saying: “Everyone has a racehorse and a donkey. If you don’t pay attention to the racehorse, you’re stuck with the donkey.” If you don’t pay attention to your goals and dreams, then the little things (immediate boredom, immediate loneliness) will take on a power that they don’t have in reality.

Part Three: Accuracy motivation: Remembering what you want

One of the interesting dynamics of confirmation bias is that people are more open to reality if they see some positive outcome in the information, even if it disagrees with them. During the holidays, it’s important to remember what you want in life.

Clients come to Sunshine Coast because the lives they have been living are not working out for them.

If you were a client in the new program, you learned that your suffering was due to the fact that your addiction did not allow you to be true to yourself, disconnected you from family and friends, and disconnected you from any sense of meaning and purpose. If you were a client under the old program, you discovered that the suffering from addiction came from the addict’s self-centeredness.

In either case, you were hardly living a live that was full and vital and satisfying. Your life was likely, as NA says, “meaningless, monotonous and boring.” In fact, people come into recovery because they begin questioning how they make sense of their lives.

So, they might be more willing to listen to Drugs & Your Brain, Medical Aspects, Relapse Prevention, and other workshops. They might be less skeptical when they hear that Viktor Frankl defines addiction as a response to living a life that has little personal meaning.

They might be willing to take Frankl’s advice that means “that being human is always directed, and pointing, to something or someone other than oneself: to a meaning to fulfill or another human being to encounter, a cause to serve or a person to love. Only to the extent that someone is living out this self-transcendence of human existence, is he truly human or does he become his true self.”

Part Four: Accuracy motivation: Overcoming barriers to the truth

Most people in early recovery have barriers that get in the way of allowing them to take an objective look at the facts. In 12-step programs, these barriers have been called “stinkin’ thinkin’” or “old behaviors” or “character defects” and so on. In psychology we assign them different names: “unhealthy coping skills” or “ego-driven life” and a bunch more.

It is fundamentally important for those in early recovery to deal with personal barriers to their recovery. We have lots of information from researchers and from those who have good recovery on what the individual has to do to recover. And we know that when a person is selective about what his recovery will demand, he usually runs into trouble. As we’ve remarked many times, one of the most common things we hear from alumni who have slipped is that they did not follow their aftercare plans. They decided, against all evidence, that they really didn’t need a support network or that they could go back to their old environment, and so on.

There are lots of barriers to being objective about information. Some examples: playing the victim of others (I can’t be the author of my life because my family won’t let me), living life lamenting the past (“what if” or “if only”), wallowing in self-pity (I don’t deserve a good life, so none of the scientific research applies to me), I can’t handle cravings (I have no self-control), I can still drink because cocaine was my drug of choice (neuroscience doesn’t apply to me), I can’t handle curveballs in life because that’s just who I am (even though the information tells me that this is a learned coping skill, in my case it’s my personality), and so on and so on.

Addiction physician Dr. Donald Hedges believes that fear is the primary motivator of addictive behavior and the greatest barrier in recovery. Many agree with him: fear of financial insecurity, fear of success, fear of responsibility, and so on. At Sunshine Coast we would say that the greatest fear of someone in early recovery is the fear of change. If you are motivated by fear, then you will likely be skeptical of information that might truly help you.

Conclusion

Confirmation bias, confirming preconceived ideas and discounting accurate information that goes against those beliefs, is powerful. This is because change is difficult. And, if you are a Sunshine Coast alumni, you learned that changing the way you make sense of yourself and how you fit in the world around you is very difficult. But recovery demands change.

By Cathy Patterson-Sterling – MA, RCC
Director of Family Services
Sunshine Coast Health Center

Introduction

I have been thinking a lot lately about the power of thoughts and the impact of our thoughts on our own personal realities. Much of our own experiences as people in life are really quite innocuous in that such situations are not really bad or good. Therefore how we interpret our own experiences in life is the key to empowerment. We can create a happy existence by manifesting pleasant thoughts, turning negatives into positives, and so on. Another alternative is to view the world as if we are “being done to” or that someone else is purposely trying to upset us. Even in relationships impacted by addiction, families often feel like the addicted people in their lives are purposely trying to destroy relationships by choosing drugs and/or alcohol. Every addicted person I have met has never woke up each morning with the intention of upsetting everyone through their usage of mood-altering substances.

This does not mean that we as loved ones have to tolerate relapses or other similar forms of behaviour, but if we want to find happiness in life then we must release ourselves from self-defeatist ways of thinking. We are not victims and much of our happiness comes from the ways we think. Therefore in this article we will examine different types of negative thinking traps as we continue on our own personal journeys toward empowerment.

The thinking traps described below come from a brand of therapy called Cognitive Behavioral Therapy with influences from Aaron Beck, Albert Ellis, David Burns, etc. These thinking traps are also outlined in a book by McKay, Davis, and Fanning called “Thoughts and Feelings.”

Thinking Trap #1: Filtering

You take the negative details and magnify them, while filtering out all positive aspects of a situation. A single detail may be picked out, and the whole event becomes coloured by this detail. When you pull negative things out of context, isolated from all the good experiences around you, you make them larger and more awful than they really are.

Have you ever done something and received a lot of compliments? Then one person makes a criticism of you or your work and you forget  about all the compliments as you focus on that one negative criticism? This is filtering. We can defeat ourselves by focusing just on negatives and disregarding any positives.

Thinking Trap #2: Polarized Thinking

With this type of trap, you really buy into the idea of dichotomous choices. Things are black and white, good or bad. You tend to perceive everything with these extremes in mind and there is very little room for a middle ground. The greatest danger in polarized thinking is its impact on how you judge yourself. For example, you have to be perfect or you are a failure.

This is a difficult trap because of the personal pressure that we can place on ourselves. Also, we can catastrophize life by thinking that events, situations, or people are either good or bad. When things are good, we panic that they may turn bad instantly. Also we forget about different options by living in black or white thinking. The challenge is to live in the “grey of life” and see opportunities rather than narrowing our thoughts into extremes of good or bad.

Thinking Trap #3: Overgeneralizations

You come to a general conclusion based on a single incident or piece of evidence. If something bad happens once, you expect it to happen over and over again. “Always” and “never” are cues that this style of thinking is being utilized. This distortion can lead to a restricted life, as you avoid future failures based on the single incident or event.

This is a difficult trap because we can paralyze ourselves with fear or believe we never have options because something is “always” going to happen or we believe it will “never” happen. We may even exclude ourselves from opportunities or positive situations because we believe we are not worthy of happiness and that great things, people, experiences will “never” come into our lives.

Thinking Trap #4: Mind Reading

Without their saying so, you know what people are feeling and why they act the way they do. In particular, you are able to determine how people are feeling toward you. Mind reading depends on a process called projection. You imagine that people feel the same way you do and react to things the same way you do. Therefore, you don’t watch or listen carefully enough to notice that they are actually different. Mind readers jump to conclusions that are true for them, without checking whether they are true for the other person.

A significant problem with this thinking trap is that we assume that people know what we are thinking and can fail to communicate to them our needs, wants, desires, or feelings. Instead, we set ourselves up for disappointments when we expect everyone to meet our needs all the time without first explaining what these needs are in the first place. As a result, we set ourselves up to be victims and live in a world where everyone else around us is constantly disappointing us.

Thinking Trap #5: Catastrophizing

Catastrophizing, or what I sometimes refer to as “building on negative scenarios”, is the expectation of disaster. You notice or hear about a problem and start doing the “what if” scenario building. What if that happens to me? What if tragedy strikes? What if he relapses and I do not know he has etc.? Then you begin behaving as if this negative scenario is about to come true. For example, you prepare for relapse even though he is doing well in recovery and the arguments you have as you try to manage his sobriety ensue.

The problem with building on negative scenarios is that these situations can become a self-fulfilling prophecy. For example, you create what you fear most by putting so much energy into this fear that it actually comes true. Then there are times that these greatest fears do not come true and all of this upset emotion was a waste of time. An important point is to deal with situations when they arise, rather than living a reality of always “bracing for the worst.” When we live in fear, we lose our quality of life.

Thinking Trap #6: Personalization

This is a tendency to relate everything around you to yourself. For example, thinking that everything people do or say is some kind of reaction to you. You also compare yourself to others, trying to determine who’s smarter, better looking, etc.

The underlying assumption is that your worth is in question. You are therefore continually forced to test your value as a person by measuring yourself against others. If you come out better, you get a moment’s relief. If you come up short, you feel diminished. The basic thinking problem is that you interpret each experience, each conversation, each look as a clue to your worth and value. The result is that you can end up riding a self-esteem rollercoaster as you wait for outside people, places, and situations to provide you with good feelings about yourself.

The reality is that we often live in a world where people are so absorbed into their own routines that they are not even taking the time to have an opinion about much of anything except if someone gets in their way of making their next appointment etc. A brutal reality in life is that we are often not as important as we think we are and not everyone around us is looking at us.

Thinking Trap #7: Control Fallacies

There are two ways you can distort your sense of power and control. If you feel externally controlled, you see yourself as helpless or as a victim of fate. With the fallacy of internal control you become responsible for the pain and happiness of everyone around you.

You are stuck when you feel externally controlled. For example, you do not feel like you can affect the basic shape of your life, let alone make any difference in the world. The truth of the matter is that we a re constantly making decisions, and that every decision affects our lives.

On the other hand, with the fallacy of internal control, you might feel exhausted as you attempt to fill the needs of everyone around you and feel responsible in accomplishing this task. Often when you do not meet everyone else’s needs all the time, you likely feel guilty.

Thinking Trap #8: Fallacy of Fairness

You feel resentful because you think you know what is fair, but other people will not agree with you. The problem is that fairness is individually defined by you and your sense of fairness is often self-serving. Everyone has their own version of fairness. Often it can be tempting to make assumptions about how things would change if people were only fair or really valued you. In this trap, other people likely do not act fair and you are left with resentments.

A difficulty with resentments is that we create emotional distance from others and the reality is that life is often not fair and we are not special. If we expect life to be fair, then we can rob ourselves of happiness because we are forever resenting the fact that the world is not organized in our image of what it should be.

Thinking Trap #9: Blaming

You hold other people responsible for your pain or take the other track and blame yourself or every problem. Blaming often involves making someone else responsible for choices and decisions that are actually your own responsibility. With blame, you deny your own right to assert your needs, say no, or go elsewhere for what you want. In other words, you set yourself up to be a victim because you blame others rather than taking responsibility for your own actions and decisions.

Thinking Trap #10: Shoulds

You have a list of rules about how you and other people should act. People who break the rules make you angry and you feel guilty when you violate these same rules. These rules that you set up for yourself are indisputable and as a result you are often in the position of judging and finding fault in not only yourself but others as well. You know that you are “shoulding all over yourself” when you use words like “should”, “ought, and “must”. Also you are setting yourself up to be a perfectionist and live in a type of emotional prison because with “shoulds” it becomes difficult to recognize your own accomplishments because you “should have done better.” 

With this thinking trap, we rob ourselves of happiness and can also negatively affect others if we are “shoulding on them” by telling individuals that they should do better as well. Who set these standards in the first place?  Now all of you polarized thinkers, I can hear you because you are saying…well if you don’t have standards then everything falls apart and you should do your best. Just remember that living in the “land of shoulds” is a miserable existence.

Thinking Trap #11: Emotional Reasoning

You believe that what you feel must be true automatically. If you feel stupid or boring, then you must be stupid or boring. If you feel guilty, then you must have done something wrong. The problem with emotional reasoning is that our emotions interact and correlate with our thinking process. Therefore if you have these negative thoughts or beliefs, then your emotions will reflect these distortions. Remember that what you feel is not necessarily reality!  You may just be acting hard on yourself and you are not boring, stupid, lazy, and so on.  Be careful of that internal critic.

Thinking Trap #12: Global Labelling

You generalize one or two qualities in yourself or others into a negative global judgment. You end up ignoring all other contrary evidence as you view the world in a way that is stereotypical as well as one dimensional. Labelling yourself can result in a negative as well as insidious impact on your own self-esteem because you end up limiting yourself. Also, when you label others you end up making snap judgments about other people without getting to know them. Remember not to “judge a book by its cover” and everyone is not a particular way.

Thinking Trap #13: Fallacy of Change

You expect that other people will change to suit you if you just pressure them or jolly them along enough. You need to change people because your hopes for happiness seem  to depend entirely on them. The truth is that the only person you can really have control over is yourself. The problem with this thinking trap is that you end up placing your happiness on to other people and their actions. Actually, happiness is a mindset that comes from the thousands of positive large as well as small choices that you make in your day as well as throughout your life time.

Thinking Trap #14: Being Right

You feel like life is a trial and it is your job to prove that your opinions as well as actions are right. In fact, you may even go to any length to demonstrate that you are right. A huge problem with this thinking trap is that you can selectively ignore very important details or information in your quest to be right. You are not interested in what other people have to say because you are so busy defending your own position. With this type of trap, you may even be so focused on being right that it can be at the expense of your own relationships.

In fact, with relationships, we need to take the time to validate as well as care about others. If we are so busy being right all the time, then we are constantly discounting other people’s thoughts, feelings, and experiences. A question we may want to ask ourselves is “Do we want to be right or happy?” Often the value is in listening to others so that we can connect on deeper emotional levels rather than positioning ourselves so that we have to be right all of the time.

Thinking Trap #15: Heaven’s Reward Fallacy

You expect that all of your sacrifice and hard work will pay off somewhere as if someone above you is keeping score. There is nothing wrong with having a strong work ethic or practising delayed gratification (sacrifice), but the difficulty is that we can end up viewing ourselves as victims when others do not recognize our hard work.

Conclusion

The key to empowering your life and creating your own reality really starts with managing as well as monitoring the types of thinking traps, self-defeatist thinking, and cognitive distortions that you have. When we get into problems, a starting point is not just examining what happened but also closely looking at asking ourselves “How am I interpreting what just happened to me?”

Recommended Reading

Burns, David D., Feeling Good: The New Mood Therapy
McKay, M., Davis, M. & Fanning, P. Thoughts and Feelings