مساهم:روجرز للصحة السلوكية مع تشاد ويترنيك ، دكتوراه ، مشرف إكلينيكي
إذا كنت تعاني من إدمان المخدرات أو الكحول أو غيرها من المواد ، فهناك احتمال أكثر من 30 في المائة أن يكون لديك أيضًا مخاوف تتعلق بالصحة العقلية ، مثل القلق ، واضطراب ما بعد الصدمة (PTSD) ، واضطراب الأكل ، واضطراب الوسواس القهري (OCD) والاكتئاب أو اضطرابات المزاج الأخرى. يخبرنا البحث أن علاج الإدمان والحالة المصاحبة في نفس الوقت هو أفضل نهج.
إذا كان لديك تشخيص مزدوج ، فقد يكون لديك أفكار أو عواطف غامرة لا تحبها. من خلال العلاج السلوكي المعرفي (CBT) ، وهو علاج قائم على الأدلة ، يمكنك أنت وفريق العلاج الخاص بك اكتشاف أفكارك وعواطفك والعمل على تعزيز التغيير.
"أساس العلاج المعرفي السلوكي يعتمد على فكرة أن أفكارك ومشاعرك وسلوكياتك مرتبطة ببعضها البعض" ، هذا ما قاله تشاد ويترنيك ، دكتوراه ، مشرف إكلينيكي في Rogers Behavioral Health. كل منطقة لها علاقة ثنائية الاتجاه مع المناطق الأخرى ؛ تؤثر أفكارك على مشاعرك ، وتؤثر مشاعرك على أفكارك ، وما إلى ذلك. The key to understanding these connections is to slow down and examine your experiences and the relationships between these areas closely.
Like many people, the first barrier you may have is recognizing your own belief that you can change. If someone were to ask if you have the ability to change if you wanted to, you might say “I don’t know,” or “I don’t think so.” With the help of a comprehensive treatment team, you can begin building the motivation and confidence you need to get started.
Thoughts:Widening Your Gaze
When dealing with addiction and a dual condition, thoughts may be constantly swirling through your mind that you wish you could just shut off. If you have social anxiety, maybe you wish you could stop thinking everyone in the room was judging you. Maybe your thoughts are saying, “You are awkward or incompetent,” over and over again.
Unfortunately, no matter how hard you work in treatment, you can’t just get rid of these thoughts or make them permanently go away. Our minds are “additive, not subtractive;” like a computer that receives a lot of different information, anything you input may be somewhere in your mind. We can’t hit the reset button or wipe out all or some learning experiences. We can choose whether these “programs,” rules, or thoughts dictate our lives.
For example, if you’ve learned something from experience, you can’t just eliminate it. You might not have the thought in the front of your mind, but it does exist. “With CBT, you can change the relationship with many of your thoughts and the way you react to them. You can also add new learning and relationships to thoughts, images, or external information that once only had negative associations,” says Dr. Wetterneck.
One way to do this is to evaluate the accuracy of your thoughts. If you were to have social anxiety and think you are an inept person because you believe you function differently, a trained mental health professional may challenge that idea and ask, “Has anyone ever said that to you? Do you have any evidence to suggest the contrary? Have you been able to keep a conversation going, even for a short amount of time?” And some of the evidence you collect may prove your thoughts incorrect.
“By examining your unhealthy thoughts, you can gradually widen the scope of your thinking, which in turn will have an impact on the way you feel about yourself and your behaviors,” says Dr. Wetterneck. Instead of just thinking about how you’re awkward, your treatment team may help you develop experiences that prove that thought inaccurate or give a more realistic estimate of how often things do not go well, while identifying that sometimes (maybe even often times!) things do go well — through therapeutic activities, homework assignments and more.
Feelings:Rebuilding Your Relationship With Emotions
When your mind is thinking, “You are awkward or incompetent,” it hurts. You’re taking those harmful thoughts, adopting them and changing the way you feel about yourself. Over time these feelings can build up and they influence your actions. Maybe you stop going to parties, going out with friends or even avoid leaving your home altogether.
With therapy, it can be helpful to begin presenting your thoughts in a new way. Instead of, “I am awkward,” saying, “I had a thought that I was awkward,” is one method for altering your feelings about yourself. This provides an appropriate label to the experience – rather than stating you are, literally, awkward (as if it’s your new first name!), you acknowledge it is a thought. This technique creates some distance for our patients to work in – they begin to recognize how the thought may want to influence actions and are able to make a choice about what to do next.
CBT makes it possible for you to understand and work with your emotions to improve your regulation. Not addressing emotions can have detrimental effects on one’s personal well-being and relationships. “It’s likely that drugs or alcohol are currently helping you feel numb to the emotions you don’t like,” says Dr. Wetterneck. Numbing to emotions reduces effective non-verbal and verbal communication in important relationships. “But by not having practice with your emotions and connecting to the emotions of others, your relationships can begin to suffer.”
Behaviors:Engaging in Healthy Activity
Your behaviors are the most changeable aspect of your world. “CBT is useful for identifying behaviors associated with your thoughts and emotions; our goal is to reduce the amount of engagement in those behaviors and support the development of functional behaviors,” says Dr. Wetterneck.
Sometimes, you might perform a behavior as a response to a thought or feeling you don’t like. After being invited out to dinner, you may have a thought that says, “I am awkward,” and decide to stay home. While staying home and avoiding social situations temporarily neutralizes your social anxiety, it doesn’t address your anxiety in the long run.
“It also means you’re not able to live your life the way you’d like to. Things that you value are avoided due to the emotional causes you are trying to escape,” says Dr. Wetterneck. Maybe you’ve starting missing out on your child’s soccer games because you’re too nervous about socializing with the other parents. And in turn, it perpetuates your thoughts and feelings that “you are awkward,” because you don’t give yourself the chance to prove yourself wrong.
By seeking support from a comprehensive treatment team, you can combat those negative thoughts through CBT and work toward your addiction recovery.
