Changing Thinking Patterns

Cognitive-behavioral therapy (CBT) is one of the most common and successfully used therapeutic methods for treating addictions. CBT is based on the premise that dysfunctional beliefs lead to forming unrealistic expectations and negative thought patterns.

Unrealistic expectations and negative thought patterns then lead to painful emotions and problematic behaviors. These dysfunctional beliefs, unrealistic expectations, and negative thought patterns are typically based on lies, assumptions, and distortions that the addict has accepted as true.

Lying is often an essential part of addictions. One lies about using the substance or engaging in the behavior, lies about the consequences incurred as a result of the addiction, and lies to maintain a façade of respectability. Honesty and truth are foundational components of successful recovery. This means that thinking patterns and beliefs must change to reflect truthfulness.

What are some of the common dysfunctional thoughts and beliefs about addictions? Here are some examples:

  • The addiction is not my fault.

  • The addiction is the only way I can cope with my painful emotions.

  • The addiction enhances my creativity and performance.

  • The addiction enables me to fit in socially.

  • The addiction is not a problem.

  • The addiction is a character flaw and I don't deserve to recover.

  • Using is fun, not using is boring.

  • I need the addiction to relax.

  • The addiction is in control and is stronger than I am.

What is cognitive-behavioral therapy (CBT)?

CBT was developed by Aaron T. Beck in the early 1990s. It is a short-term, focused approach to treatment that involves both functional analysis and skills training. Negative beliefs and thought patterns, which result in uncomfortable emotions and dysfunctional behaviors, are addressed. Coping and change strategies help the addict make rational, healthy choices.

One can see that as long as these notions are entertained as true, it will be very difficult to engage in successful recovery. How does CBT help with changing dysfunctional thinking? There are several techniques that may be helpful when used appropriately by a professional trained in CBT.

One technique is asking leading questions that challenge dysfunctional, negative beliefs and thoughts. Addicts commonly adopt thinking patterns that reflect an “all-or-nothing” or “black-or-white” perspective. These perspectives are seldom accurate and need to be challenged.

A CBT therapist may also have the addict analyze the advantages and disadvantages of the addiction, encouraging logical re-evaluation of the addiction. Identification of dysfunctional beliefs is key to successful change. These beliefs must be reformulated to become accurate and honest.

Another technique of CBT is helping the addict reassign responsibility for the addictions. An addict will frequently blame people and circumstances outside of himself for his addiction. Until the addict can recognize his internal motivations for the addictions, he will be unable to modify his own addictive behaviors.

Guided imagery and role-playing are techniques designed to help the addict visualize himself avoiding the addiction and making healthy choices. Rehearsal is a technique that helps the addict cognitively practice healthy, honest thoughts and beliefs about his addiction. Here are some examples:

  • I don't have to lie about my addiction.

  • I will feel better physically without my addiction.

  • I can accomplish more of my goals without my addiction.

  • I can have better relationships without my addiction.

  • I will be better off financially without my addiction.

  • I can think more clearly when not focused on my addiction.

  • I will have more time to pursue hobbies and interests when not involved with my addiction.

  • I will have more self-confidence when I've overcome my addiction.

  • I will not have to worry about getting into trouble with the law when I'm no longer involved with my addiction.


Daily thought records (DTRs) are often used by CBT therapists in treating an addicted person. This is a type of homework assignment completed by the addict with the purpose of helping her to analyze and change her thinking patterns. The addict is to write about situations, automatic thoughts, emotions, rational responses, and outcomes related to troubling moods and circumstances.

Healthy behaviors are more likely to follow accurate, positive, goal-oriented thoughts. While initially CBT may focus primarily on developing control of the addiction, subsequent CBT therapy will focus on the development of skills that will result in a lifetime of healthy recovery.

Cognitive-behavioral therapy alone may not be enough to promote healthy recovery. Medications, group support, and other treatment modalities may also be necessary. This is especially true if addictions are complicated with co-occurring mental health or physical problems. The good news is that CBT is highly effective used in conjunction with other therapies.

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