Your Addiction Recovery Journey: Understanding Detox and Therapy Approaches

This article is the first of two describing programs and approaches to addressing addiction issues. In it, we will discuss the importance of safely detoxifying our bodies after prolonged and excessive substance use. Then, we will discuss the three popular approaches to achieving recovery: 12-step programs, Cognitive Behavioural Therapy, and Rational Emotive Behavioural Therapy. 

We are among the lucky ones. Modern-day living offers immense options for those who have an addiction. Before the 40s and 50s, extreme measures like being institutionalized in sanitariums with poor patient treatment, electric shock therapy, and lobotomies were considered addiction treatment; we now have access to a variety of proven addiction treatment options.   

Luckily, we now have many humane addiction treatment options to consider. Key factors in selecting an approach to addressing addiction include the type and severity of the addiction, one’s overall health, and personal preferences. Combining multiple methods, like a 12-step program with individual therapy, proves particularly effective.  

First Step: The Importance of Detoxification  

There are two main areas to address if one wants to overcome an addiction. The physical body is the first to suffer, experiencing significant impacts from heavy and prolonged substance abuse. Heavy use of substances like alcohol, heroin, or painkillers, the body itself develops a dependency in addition to the psychological factors involved in addiction. Anyone with a long history of use must seek medical help before attempting to stop the use of these substances.  

Importantly, going through detoxification and experiencing withdrawal from certain chemicals can be life-threatening and requires professional medical care for a safe cessation. This is not a question of whether one should seek medical assistance or not; life is at stake. Detoxification, the process of freeing your body of chemicals, is the initial step in addressing the emotional and other underlying factors driving addictive behavior.  

Physical withdrawal symptoms during detoxification can include a range of issues such as headaches, low energy, shaking, fever, nausea, diarrhea, a runny nose, abdominal cramps, and muscle and bone pain. How severe these symptoms are often depends on the length of time, frequency, and volume of substances consumed.  

Additionally, psychological symptoms may encompass intense cravings, anxiety, depression, brain fog, mood shifts, irritability, confusion, and insomnia. Those with advanced symptoms may experience delirium, hallucinations, or even seizures.  

Exploring Various Addiction Treatment Options  

Now, let’s consider the variety of treatment options available to those suffering from substance abuse disorder. This overview provides a sense of the traditional methods studied and proven effective for a measurable portion of people. There are many other options to discover, but they are less well-known.  

12-Step Programs: A Community Approach  

12-step programs have developed into one of the most enduring and practical approaches. These programs, rooted in mutual support and spiritual growth, provide a structured framework for individuals seeking recovery.  

Bill Wilson and Dr. Bob Smith created the 12-step model in the 1930s, first introducing it through Alcoholics Anonymous (AA). The program has its roots in one alcoholic helping another. They found that one who has alcoholism was far more likely to listen to a fellow traveler who has found a solution than to the medical or religious communities.  

Their goal was to offer a reliable support system for people struggling with alcoholism, and they discovered that helping one another benefitted and supported both the helping and the helped.   

The success of AA led to the development of various other 12-step programs, such as Narcotics Anonymous (NA), Cocaine Anonymous (CA), and Al-Anon, which support friends and family members of those with addiction issues. These programs have collectively helped millions of individuals around the world.  

Central to the 12-step philosophy is the belief in a higher power and the concept of surrender. Typically, people do not enter a 12-step program until their lives have become unmanageable due to their substance use. The program encourages participants to acknowledge their powerlessness over addiction and seek guidance from a higher power, interpreted in various ways based on personal beliefs. 

The 12 steps are developed as a guide to living without the crutch of substances that leads to personal growth and healing. They begin with admitting powerlessness over addiction and recognizing one’s life’s unmanageability. Many consider this admission the first and most critical step. Without this step, there is no foundation upon which to build.   

From there, individuals progress through steps that involve taking a moral inventory, making amends for past wrongs, and continuing personal reflection. The final steps focus on maintaining spiritual growth and helping others who are struggling with substance abuse disorder. Helping others is the power that turns the wheels on the cycle of recovery and support.  

Attending Meetings is a core component of 12-step programs. Meetings occur in nearly every major city and most small towns, from early morning to late night. At meetings, people in the program gather to share their experiences, strengths, and hopes, which is a foundation of the program. Passing along the gifts one receives in recovery supports newcomers and reinforces lessons learned for those longer in recovery. 

A potent component of the program is sponsorship. Experienced members, known as sponsors, pair with new members to provide guidance and hold the newcomer accountable. Sponsors are like personal coaches available to the newcomer anytime between meetings. This one-on-one mentorship benefits both individuals and is a lifeline for the newcomer, who will one day become a sponsor.  

Many reject 12-step programs due to their spiritual aspect; however, they are designed to be inclusive and open to people of all faiths and backgrounds. A higher power is a personal decision, so people are free to define their higher power so it resonates with them. This adaptability has contributed to the worldwide success of 12-step programs.  

To summarize, 12-step programs offer a structured design for living to help people escape their reliance on substances to deal with life’s issues. For a decade, countless people have benefited from 12-step programs of all varieties, which have transformed countless lives. The 12 steps combine personal accountability, spiritual growth, and community support to achieve sobriety.  

Cognitive Behavioral Therapy (CBT): Reframing Thoughts  

Cognitive Behavioral Therapy (CBT) is a popular and effective therapeutic approach for addressing substance abuse disorders.  Born from cognitive psychology, CBT focuses on isolating negative thought patterns and behaviors that drive addiction and then taking a structured approach to modifying the thoughts and behaviors. The aim is to develop healthier coping mechanisms and foster resilience.  

CBT was developed in the 1960s by psychiatrist Aaron Beck. He observed that emotional and behavioral problems have their root in distorted thinking by the person with substance abuse issues. Beck’s pioneering work laid the foundation for CBT, which combines cognitive and behavioral techniques to modify distorted thinking. 

In CBT, thoughts, feelings, and behaviors are interconnected, and a holistic approach is needed to achieve long-term change. Unaddressed, harmful, or irrational thoughts lead to unproductive behaviors and emotions that drive addiction.  

For example, an individual struggling with substance abuse might have automatic thoughts such as “I can’t cope without using” or “I’m a failure.” These distorted thoughts reinforce the desire to use substances as a way to escape or numb these negative feelings.  

CBT’s goal is to guide people in challenging these distorted thoughts and replacing them with more realistic and positive ones. This is referred to as the cognitive restructuring process and involves several key techniques:  

Cognitive Restructuring involves identifying irrational or harmful thoughts and reframing them more positively and realistically. For example, changing the thought “I can’t handle stress without drinking” to “Drinking will not help manage my stress long term. I have better alternatives.”  

Behavioral Activation: We can reduce our reliance on substances when we engage in activities that promote positive feelings. These activities include exercise, writing, meditation, hobbies, or anything we enjoy.  

Exposure Therapy: Exposure therapy functions like a vaccine, gradually exposing individuals to triggers in a controlled environment to help them confront and overcome their fears. The inability to deal with conflict may drive someone to use substances to cope. A therapist may role-play with the person, introducing them to different forms of conflict. The controlled experiences reduce the power of the triggers.  

Skills Training: CBT also focuses on teaching practical skills to manage cravings, cope with stress, and navigate social situations without resorting to substance use. These skills can include problem-solving, assertiveness training, and relaxation techniques.  

Therapists deliver skills training over 12 to 24 weeks of the program. Someone can sign up for individual or group therapy, making it a flexible option for many individuals. This collaborative process involves the therapist and the individual to foster a sense of ownership and empowerment in the recovery process.  

Many substance abuse disorders involve co-occurring mental health conditions. Depression and anxiety are common issues with those suffering from a substance abuse disorder. People can address the symptoms of various problems in the same setting using this holistic approach.  

In conclusion, Cognitive Behavioral Therapy offers a straightforward and structured approach to overcoming substance abuse disorders. By directly addressing and modifying distorted thinking, a person effectively breaks the cycle of addiction. CBT is a well-researched and proven approach to treating addiction issues.  

Rational Emotive Behavioral Therapy (REBT): Tackling Irrational Beliefs  

Rational Emotive Behavior Therapy (REBT) is another cognitive-behavioral approach that has proven effective in addressing substance abuse disorders. Psychologist Albert Ellis developed REBT in the 1950s. This therapy proposes that our emotional and behavioral responses are driven not by events but by our beliefs about them.  

This therapy involves challenging and dispelling irrational beliefs to help people develop healthier thinking patterns and behaviors. REBT posits that external circumstances do not directly lead to emotional distress and maladaptive behaviors but rather the interpretations and beliefs about these circumstances.  

The ABC model of REBT encapsulates this concept where:  

• A Stands for Activating Event,  

• B represents Beliefs about the event and  

• C denotes the Consequences, which include emotional and behavioral responses.  

For example, an individual might experience a stressful situation (A) and believe (B) that they cannot handle the stress without using substances. The irrational belief leads to the use of substances, and they experience the consequences (C). The approach identifies and disputes these irrational beliefs (B) and replaces them with more rational and constructive thoughts, resulting in healthier emotional and behavioral outcomes (C).  

A person with addiction may resort to absolutist thinking. “I must be perfect,” “I should always be happy,” or “I can’t stand discomfort” are all examples of absolutist thinking. These thoughts are not rational and destructive. When the person inevitably fails to meet these expectations, they may return to substance abuse as a coping mechanism.  

The goal is to challenge beliefs and reframe a person’s thinking to develop better-coping mechanisms than substance use. This process is referred to as cognitive Restructuring. We will review the different approaches involved in this method. 

Disputation of Irrational Beliefs: This involves questioning the validity and utility of irrational beliefs. For example, if an individual believes “I can’t handle stress without drugs,” the therapist might ask, “What evidence do you have that you can’t manage stress in other ways?” This process helps individuals see the flaws in their thinking and develop more rational alternatives.  

Cognitive Reframing: Once individuals identify irrational beliefs, they replace them with rational ones. For instance, “I can’t handle stress without drugs” can be reframed to “I can manage stress in healthier ways, and using drugs is not the only solution.”  

Behavioral Techniques: Therapists often use stress management techniques, problem-solving skills, and controlled exposure to substance-use triggers to help individuals change their behavior. Developing and practicing these techniques reinforces new thinking patterns, eliminating the need to use substances to deal with situations. 

Emotional Regulation: For those suffering from addiction, managing their emotions is a significant challenge. The use of mindfulness and relaxation exercises helps individuals manage their feelings. The sessions require full participation as the exercises require action and interaction to be successful. 

In conclusion, Rational Emotive Behavior Therapy offers a robust and practical approach to treating substance abuse disorders. By focusing on changing irrational beliefs and developing healthier thinking patterns, taking this approach empowers individuals to break free from the cycle of addiction and build a more resilient and fulfilling life.   

Its evidence-based techniques and emphasis on personal responsibility make it a valuable tool in the journey toward recovery. For those seeking a structured and empowering method to address substance abuse, REBT provides a pathway to lasting change and emotional well-being.  

Conclusion 

This article has laid the foundation for understanding three popular approaches to addressing addiction issues. We also covered how critical it is to take the detoxification period seriously and to seek medical advice and assistance before completely abstaining from substance use. 

Part two of this series will cover the contingency management approach, inpatient treatment, outpatient treatment, and aversion therapy. We will also cover “cold turkey” as a method. While it is a dangerous and low-success rate approach, it is an important option to understand. 

Resources

National Institute on Drug Addiction – Home Page

Alcoholics Anonymous – Home Page

Narcotics Anonymous – Home Page

 Detoxification – National Library of Medicine

Cognitive Behavioral Therapy Article – Mayo Clinic 

Rational Emotive Behavioral Therapy – Psychology Today