Addiction Recovery in Dual Diagnosis has been historically viewed as a “disease” but must also be treated within a comprehensive framework. Dual diagnosis refers to an individual who has a substance addiction and a co-occurring psychological disorder. The two disorders can impact one another in a very complex and self-defeating cycle. Therefore, it is necessary to identify and to treat the emotional, cognitive, and social symptoms which are fueling the addiction. Those with certain psychological diagnoses, such as Post-Traumatic Stress Disorder, Generalized Anxiety Disorder, Bipolar Disorder, Borderline Personality Disorder, and Major Depressive Disorder, are at a higher risk for developing an addiction. This may be due to the desire to self-medicate their symptoms. Furthermore, addictive behaviors can worsen the symptoms of a co-occurring psychological disorder. While medication therapy is often chosen for dual diagnosis individuals, “talk therapy” is highly recommended as a concurrent approach which focuses upon learning and implementing more effective coping strategies. Some commonly-used approaches are Cognitive Behavioral Therapy – CBT in addiction recovery, Cognitive Processing Therapy – CPT in addiction recovery, and Dialectical Behavior Therapy – DBT in addiction recovery..
Cognitive Behavioral Therapy - CBT and Addiction Recovery
Cognitive Behavioral Therapy CBT in addiction recovery views psychological problems as based on faulty ways of thinking and on learned patterns of self-defeating behaviors. The primary CBT strategies are (1) learning to recognize the cognitive patterns which are creating problematic behaviors, (2) examining these cognitive patterns, (3) gaining a better understanding of the relationship between dysfunctional cognitions and behaviors, and (4) using problem-solving skills to cope with difficult life situations. CBT helps dually diagnosed individuals to confront fears, to communicate in a self-compassionate and assertive manner with those who are causing pain, and to calm one’s mind and body in the midst of stressful situations. CBT in addiction recovery also helps the dually diagnosed individual to specify memories or experiences which have created the unhealthy thought patterns which trigger one’s addiction. An ongoing focus of CBT in addiction recovery for dual diagnosis individuals is self-regulation of cognitions and behaviors. Cognitive self-regulation refers to having honest thought-processing skills, the ability to focus attention on the present, and the ability to ignore distractions. This also requires redirecting one’s thoughts as needed to regulate emotions and behaviors. Behavioral self-regulation refers to performing certain actions which are aimed toward one’s long-term goals. This type of self-regulation includes communication skills, nutrition and exercise management, assertive actions and words, stress management, anger management, and daily coping strategies.
Cognitive Processing Therapy - CPT and Addiction Recovery
Cognitive Processing Therapy (CPT) is a trauma-focused therapy which was originally designed to treat PTSD by challenging and modifying disturbing self-beliefs related to the trauma. CPT in addiction recovery has been successfully applied to treating dual diagnosis individuals, because they can re-conceptualize traumatic events and gain a deeper understanding of how these events have influenced their sense of self-worth. Furthermore, CPT can help greatly with addiction recovery through education about how to cope with the fear responses to traumatic memories without resorting to escapist and avoidance behaviors. CPT focuses on repeated exposure to and processing of the traumatic memories within a safe, therapeutic environment, so that fears gradually become less powerful.
Dialectical Behavior Therapy DBT and Addiction Recovery
Dialectical Behavior Therapy (DBT), a form of Cognitive Behavioral Therapy, has also been found to be highly effective in helping dually diagnosed individuals to change unhealthy ways of thinking and behaving, so that long-term recovery can be maintained. DBT in addiction recovery consists of four main components. The first component is mindfulness, which is the practice of being fully present and aware of ALL emotions at any given moment. Mindfulness requires conscious efforts throughout the day and can be a valuable path toward accepting and tolerating any of the powerful emotions which may be experienced by a dually diagnosed individual when triggered by an upsetting situation or memory. Mindfulness skills can create a continuous sense of empowerment, patience, and self-compassion in all situations.
A second key component of DBT is distress tolerance, which is the ability to tolerate painful emotions during difficult situations, not to change them. Distress tolerance is extremely important for dual diagnosis individuals, so that they can recognize and manage negative situations, rather than becoming overwhelmed to the point of using substances as escape mechanisms. A third component of DBT in addiction recovery is emotional regulation, which involves clarifying one’s emotions, allowing oneself to fully experience these emotions, and redirecting unwanted emotions during situations which could trigger substance usage. An effective emotional regulation plan for dual diagnosis individuals includes the use of personally selected mantras or positive self-talk, specific actions (taking a walk, doing deep breathing, talking to a supportive person), journaling, and reading or listening to self-help information. The fourth component of DBT is interpersonal effectiveness, which is practiced during therapy sessions through role-playing and is implemented in the dually diagnosed individual’s daily life. Interpersonal effectiveness skills include assertive communication patterns and setting and maintaining healthy boundaries with others.
In sum, addiction recovery requires a strong commitment to cognitive and behavioral goals which can provide a stable and comforting “blueprint” for a new narrative within one’s significant personal and work relationships. While there will be situations which cause self-doubt, sadness, and anxiety, long-term recovery is built upon viewing situations with no self-judgment and no impulsive pushing down of any emotional responses to these situations. Addiction can be overcome by creating a new life narrative, which is resilient to the emotional triggers rooted in one’s past. A final point is that addiction often causes much shame, regret, and self-doubt, but there are available therapeutic interventions aimed at resolving the underlying symptoms which led to the addiction.
Keep reading to learn about Addiction and Emotional Pain.
New Age Psychiatry
New Age Psychiatry offers licensed and certified psychiatric services through virtual telehealth appointments within the state of Florida. We understand the complexities that come with mental health disorders and symptoms including in addiction recovery in dual diagnosis, and we will work hard to help you manage your condition.
New Age Psychiatry is a modern mental health service in Florida that approaches addiction and other mental health issues with compassion and forward-thinking techniques. New Age Psychiatry offers certified psychiatric services through telehealth appointments in Florida. Some of the highlights of the New Age Psychiatry approach include:
- Online Screening – We will begin with certified online screening to provide an overview of psychiatric care. We also offer a personalized, specific diagnosis through our psychiatric Telehealth services.
- Diagnosis, Recovery, & Treatment – Our full range of comprehensive psychiatric telehealth services can aid in treating a multitude of psychiatric illnesses and assist in the recovery process in alcoholism.
- Telehealth Services – Our psychiatric telehealth services are available throughout the state of Florida and can assist you in psychiatric care through counseling and medication management