Sunday, August 28, 2011

Seven Days Sober: Tackling Irrational Beliefs

I have previously discussed that thoughts become cravings, and how, unless we interrupt the process, a trigger will lead to relapse. For many, the process of getting sober starts with a long series of attempts, each failing when a trigger event cascades into drinking. During this period, we have a choice; we can give up – assuming we are simply incapable of sobriety – or we can do what is necessary to stop the cycle of quitting and relapsing. Finding a program is one major step in this process, but another is working to understand the reasons for our ongoing failures.

Albert Ellis developed a model for anger management that has great application in this area (Ellis, 1979, and Ellis and Harper, 1975). His A-B-C-D model, also called the Rational-Emotive Model, is based on the idea that it is not events themselves that produce feelings such as anger, but our interpretations and beliefs about these events. According, the Ellis, as people become angry, they engage in an internal dialog which feeds their anger. I like to think of this process as a “thinking spiral”, where we fuel an initial negativity with ever greater negative thoughts. In the Trigger > Drinking cycle, this is where we talk ourselves into the relapse.

The Rational-Emotive Model uses the approach of identifying irrational beliefs and disputing them (the “D” in the A-B-C-D Method) with more rational or realistic perspectives. A rational belief is one that is measurable, objective and rooted in reality. For example, an irrational thought might be that you MUST do something perfectly or you have failed at it. The dispute would be to ask, Why? The replacement rational thought might be, “Things don’t always go the way we want. I can only do the best I can with what I have.” This thought modification is then applied to the next situation where the original irrational belief might arise.

In the A-B-C-D Model, the process goes:

A – an Activating situation or event occurs
B – your Belief system feeds you self-talk based on your beliefs and expectations of others
C – the Consequence is how you feel about the event based on your-self talk, and your reaction
D – Disputing your self-talk, examining your beliefs and expectations, and determining whether they are realistic or irrational.
I have modified this model slightly (it is for all intents the same, with different words. I make no claims of ownership or originality) to what I call Recovery CARES. In this version, the activating situation is the trigger event which leads to a relapse.

The Recovery CARES approach:

C – the Cause of the trigger. The cause can be viewed from two angles, what you think happened, and what a camera would have seen. Identifying the Who, What, When, Where and Why is important in helping uncover the specific combination of things leading to the trigger firing.
  • WHO was there?
  • WHAT was going on?
  • WHEN was it?
  • WHERE were you?
  • WHY were you there?
A – your Auto-response to the cause. What did you tell yourself? Did those thoughts lead to other thoughts, in other words, did your initial reaction start a thinking spiral?
R – the Result of the auto-response. How did you feel? How did you act? What was the end result?
EExamine your responses. Were they rational or irrational? Dispute the irrational beliefs and replace them with rational responses.
SSum it up. After looking at the trigger event and your responses step by step, make a plan to prevent a similar event from resulting in a relapse. How can you react differently in the future? What people, places, things, thoughts, emotions and combinations thereof should you be careful of in the future? What irrational thoughts do you want to work on replacing in your mind? Importantly, what affirmation will you use to interrupt the thinking spiral the next time?

It may seem that this is a long process to go through, and it is. If you are serious about getting sober though, identifying and changing irrational beliefs is vital. Spending an hour now is far better than losing a day to a hangover. If you apply this process each time you face a trigger event, you will begin to see a picture emerging of the things in your life that need to change in order for you to achieve your goal of lasting sobriety. The very act of filling out the worksheet following a trigger event, especially if it led to a relapse, is a positive step. It reinforces your intention to beat your addiction and prevents the continuation of the thinking spiral after the fact by stopping the “I am a failure” self-talk.

You have it within you to become sober. By tackling the things which lead you to drink, you embrace Statement One: I have a life-threatening problem that once had me. I now take charge of my life and my disease. I accept the responsibility.

More information on Albert Ellis and Rational-Emotive Behavior Therapy
The Recovery CARES Worksheet (PDF)

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