4 Types of Core Beliefs in Drug Addiction – Cognitive Psychology

One of the most fundamental concepts in Cognitive Psychology is the concept of belief. According to Beck et al. “Beliefs are relatively rigid, enduring cognitive structures that are not easily modified by experience. Cognitive psychology argues that beliefs have a profound impact on feelings and behavior” (Beck et al. P. 292).

Regarding substance use disorders – according to the nomenclature of the current DSM-5 – or simply chemical dependence, psychology approaches have developed several theories about their causes and why they are so prevalent in the general population and have high rates of relapse .

The theoretical path of cognitive psychology goes, therefore, especially in the search for beliefs that maintain consumption behavior, be it tobacco, alcohol, marijuana, cocaine, crack or other types of substances.

Beliefs in Chemical Dependency

As described in yesterday’s text, the belief of being unlovable or incapable, “At the heart of the individual’s addiction problem is a cluster of beliefs that seem to derive from beliefs such as ‘I am unlovable’, or ‘ I’m vulnerable’” (Beck et al. P. 292).

In summary, the creator of Cognitive Psychology and colleagues write about beliefs in substance use disorder:

“These core beliefs interact with life stressors to produce excessive anxiety, dysphoria, or anger. These stressful situations or stimuli do not directly ’cause’ craving, but activate drug-related beliefs that lead to craving. Although we use the term ‘stimulating situation’, it should be noted that the situation itself is neutral. The meaning, derived from beliefs, which are linked to the situation is what causes the individual’s craving.

Individuals with the belief that they cannot tolerate anxiety, dysphoria, frustration, for example, will tend to be hyperattentive to these sensations and may come to create expectations that they can alleviate the sensations only through use or drinking. Then, when the unpleasant affect arises, the individual tries to neutralize it by using or drinking” (Beck et al. P. 24).

4 Types of Beliefs in Chemical Dependence

In summary, we find 4 types of beliefs: anticipatory, relief-oriented, permissive beliefs and imperative beliefs.

Anticipatory beliefs refer to beliefs that the use of the substance – whatever it may be – will bring some kind of benefit, reward or pleasure, so that there is an expectation of using and feeling a certain type of sensation. For example, the person thinks, “The party tonight is going to be great. I can’t wait to go there and drink it!”

Relief-oriented beliefs are related to the idea that use will eliminate an unpleasant state. A person who feels anxious in a group context (perhaps at the same party) can use it to relieve the discomfort of anxious feelings.

It is also very common for the use to be made from other negative affects, such as to alleviate sadness or anger. Thoughts arise from beliefs such as “I can’t stand the isolation. I need a shot (cocaine)” or “Today is horrible, I’m going to take one to get better” or “I’m stressed… I’m going to light up a cigarette to calm down”.

Relief-oriented beliefs can also be linked to craving relief, creating thoughts that the craving is uncontrollable and that there is no way to overcome it other than consuming.

Permissive beliefs are those that defend the idea that it is okay to use it or that just once – or just this once – there will be no problem or that other people can have problems, but not “me”.

According to Beck: “Permissive beliefs also have in common with what are known as ‘rationalizations. Patients have thoughts that seem to ‘justify’ drug use, such as ‘I have to use cocaine or I won’t be able to concentrate at work’. Such thoughts are tantamount to self-deception” (Beck et al. P. 292).

And finally, there are the imperative beliefs, which consist of plans or strategies for obtaining the substance, for example, borrowing money from someone to buy or joining a group with easy access.

Ambiguity of beliefs

“Many individuals have conflicting beliefs related to the pros and cons of using. At times they are so locked into the unpleasant struggle between opposing beliefs that, paradoxically, they may turn to drugs just to ease the tension generated by the conflict” (Beck et al. P. 293).

In other words, over time the consequences of frequent use begin to appear, with effects in some or all areas of the individual’s life: family, professional, academic, affective, etc. Feeling the harm, including the physical damage caused by use, alternative beliefs that using a particular substance does not bring benefits may begin to appear, although not yet with the strength to lead to the search for treatment or ask for help. The ambivalence between using and not using, paradoxically, can generate tension to the point that a new search for relief happens.

In treatments based on cognitive psychology, the therapist will try to help modify these 4 types of beliefs that appear frequently in substance use disorder.

Alternative beliefs, such as use control beliefs, and learning not to avoid unpleasant situations, exposure to uncomfortable sensations such as cravings and triggers for automatic thoughts, bring greater awareness to change and help in the remission of symptoms and prevention of relapses.

Bibliographic reference
Beck et al. (1993) – Cognitive Therapy of Substance Abuse

Related