Addiction

Nov 3, 2023 • 9 min

Using Cognitive Behavioural Therapy (CBT) and Mindfulness to Tackle Addictions

CBT helps us reflect on our habitual thinking and behavioral patterns, look at what is keeping them going and identifies areas to challenge, spurring us on to increase flexibility or set firmer intentions and boundaries. I’m personally going to be using this to tackle my deeply shameful smoking habit. I hate it. It makes me feel rank and I'm much too vain to be smoking at this age. There’s nothing cool or experimental about it anymore and I don’t like being a slave to an addiction. So much paraphernalia to remember and keep track of, the expense is huge and I don’t want to die early. I’m going for abstinence but you could of course try for moderation. I’ll be very jealous if you’re the sort of person who can pull that off. 

Why do some of us get addicted and others sail through? Why are we more likely to feel hooked at certain times than others? Why do some substances get us and others hold no allure? It’s important to look honestly and kindly at what your fix is doing for you, prepare to be surprised.  Whether it’s online shopping, gambling, phone use or crack; the roots are the same. A hungry soul. If you’re not sure what it’s doing for you, what happens when you don’t do it? This gives us valuable information. Emotional overwhelm? Lack of feeling? Boredom? Tension in your body? Difficulties with sleep? Overwhelmed by negative thoughts? Make a list of other activities that can give you the required hit. For example - emotional overwhelm - mindfullnes of breath. Lack of feeling - music, a conversation with a friend you love talking to, making something, watching a great emotional film. Tension in the body - go for a run, swim, stretch. Sleep difficulties? Meditation, exercise. Overwhelmed by negative thoughts? Talk to someone, mindfulness of thoughts, unhook deliberately and see if you can get lost in the flow of pleasant simple every day activities. Keep your personalised list handy for now and work on it while you get ready to take the plunge.  

If you’re using substances to manage flashbacks or panic attacks you might need some professional help. The principles are all the same but it can feel too scary to try alone. 

Use a baseline diary to keep a track of your patterns of usage - I’ll be posting some on my website soon or any diary will do. Keep a track of your mood over the week rating anxiety and depression / low mood and craving out of ten, at least every few hours and before or after using your tipple. Eg. Monday 9am. A8 D3, C9. Smoked. A5 D6 C2. This is interesting because it reveals that smoking is at least temporarily bringing down my anxiety levels but making me feel low, and worse about myself. My craving subsides after a cigarette but not completely. I’m left wanting more! I don’t think smoking actually helps my anxiety, it’s more that when i’m craving my anxiety levels go up. The cigarettes are creating the problem here, not me. When you have a week of data, spend some time reflecting on it. Which are the sticky spots? Which would have been hardest to abstain from? What could help? How might you need to structure your week differently for the first few weeks of abstinence? 

While you’re completing your diary, it’s a great idea to collect thoughts that steer you towards or away from your addictive patterns. In CBT we call these task interfering cognitions, and task orientating cognitions, or TICS and TOCS. Spend some time working through your TICS and considering if a more balanced thought could be used to answer back the addicted one. I’ve shared my list below. 

Giving Up Smoking

TICS

I won’t manage it, I might as well treat myself. Noone ever scored a goal they didn’t shoot.

Everything is so awful now i’m not really missing opportunities. All the more important to grab/create them. Or chill out.

Sod it. You deserve it. To die younger? Unfit? No thanks.

If i’m going to smoke I might as well do it now. Let’s get this over with. I could think this for the next million cigarettes if i’m not careful.

I always quit quitting eventually, so far at least. I’ve quit for long periods in the past and loved it.

I don’t want to take my stress out on my children or myself any more. They need a non smoking role model.

What else is there to look forward to? Friends, family, hobbies, nature, my career, the future, growing and learning.

How will I relax? Meditation and exercise. Read a book.

Emptiness and sadness might overwhelm me. Not smoking might help. Lets see. I can get some professional help if i need it. 

Will I get fat? This didn’t happen last time. I was more able to exercise and felt better.

It might be hard seeing smoking friends. Hardly anyone smokes any more. Those that do probably wish they were able to quit. 

It feels like a big part of me. Other things have come and gone that felt big. Boyfriends, houses, jobs etc. I felt whole without smoking when I did quit in the past. 

TOCS

It’s a treat to have clean lungs.

Quit while i’m hopefully ahead - I don’t want orphaned children.

My voice sounds better if I don’t smoke, quite embarrassing for my job. 

I loved being a non smoker.

I’d feel fitter and fresher.

No more waking up ‘I wish I hadn’t smoked last night’.

My throat hurts and feels gross.

I’d be so proud and feel less like a hypocrite doing my job.

These are not the family jewels - hand down better habits.

I could run far and fast.

A real treat would be some self love and practice tolerating all the emotions.

My home would be lovelier if I spent a bit less time outside smoking.

Spend some time on your TICS and TOCS and use them to come up with some short, medium and long term goals. These can be things that will support you to make change, or be the change itself. If you could make the change, what could you hope for? What are you trying to achieve? I’m going for the following…

Short term - 1 week

To not smoke and be really kind to myself

Exercise 5 times, eat healthily

To protect myself from triggers. I will not drink very much this week or see friends who I might be tempted to smoke with.

Plan in stimulation, time with others and relaxing activities. Aim for 8 hours sleep a night. 

Meditate, at least briefly, every day. 

Medium term - 3 months

To be able to run 5k

To practice relaxation and chilling. Yoga weekly at least. 

To use mediation to observe and respond kindly to any remnant cravings

To get used to being around smokers

To use money saved to treat myself to a sports massage

To look out for other addictions taking smoking’s place. I need to be mindful of my relationship with alcohol, trash foods and online shopping

Long term - 12 months and beyond

To celebrate my 12 month anniversary of not smoking with a mini break using the money saved. 

To be running regularly

To make sure i’m scheduling in rest and play. Dancing with friends, trying new things, things to look forward to. 

If you’re unlucky enough to have an expensive addiction you are likely to have a lot of flash cash to reward yourself with when you kick it. Use your baseline diary to work out roughly how much you are spending and if you possibly can, set up a direct debit to a savings account for this amount from your stop date. 

Experiments with rats given two water bottles, one containing cocaine and one with just water, initially showed that the rats would kill themself with cocaine on tap, preferring this to water. However when their environments were improved and they were given more space, rat friends and lovers, a variety of toys and activities to partake in they were moderate with their intake or abstained all together. This is something to bear in mind when creating a life that you would like to inhabit without your addiction. 

Mindfulness offers a way of noticing and dealing with cravings, a process by which to ride them out and a useful philosophical framework for coming up close to cravings, noticing them in the body without bracing against them. Being curious about where a craving is felt and how intensely helps us to notice that this is shifting and changing all of the time. You could visualise your craving as a wave and notice it as it builds and resides, feeling it in the body without judgment. My favorite practices to help with cravings are below. Good luck!

Allow soften soothe, 21 minutes:

https://eyedivision.fra1.cdn.digitaloceanspaces.com/smc/allow_soften_soothe.mp3

Self compassion break, 8 minutes:

https://eyedivision.fra1.cdn.digitaloceanspaces.com/smc/self_compassion_break.mp3

And a three step breathing space from me:

https://soundcloud.com/revivelondon/three-step-breathing-space-10