How does addiction treatment therapy work?
While the exact treatment modalities used vary from treatment center to treatment center, and depend largely on each facility’s approach to addiction therapy. Factors such as therapist quality and experience level, as well as staff-patient ratio and financial investment in client care, all contribute to the availability of specific more advanced treatments. Still, there are many treatment modalities that are more commonly available and are known to up-to-date therapists.
In this article we take a deeper look at many of the advanced therapies and treatments used in the addiction recovery process. Beginning with some of the most basic therapy models commonly used, continuing through some of the more unique and cutting-edge methods, and culminating with listing some of the more alternative holistic and spiritual treatments, we provide a thorough but brief overview of the concept underpinning each therapy as well as its application.
Among the treatments methods used at Addiction Centers and will be described in this review are:
- Medication-assisted treatment (MAT)
- Cognitive Behavioral Therapy (CBT)
- Rational emotive behavior therapy (REBT)
- Dialectical behavior therapy (DBT)
- Internal Family Systems (IFS)
- Trauma Informed Stabilization Treatment (TIST)
- Emotional Freedom Techniques (EFT)
- Eye Movement Desensitization and Reprocessing (EMDR)
- Compassionate Inquiry (CI)
- Trauma Therapy
- Neurofeedback –EEG (Biofeedback)
General Holistic Therapies:
- Sampoorna Yoga
- Biodynamic Craniosacral Therapy
- Sound Therapy
- Breath Work
- Mindfulness Routines
- Gymnastic Therapy
- Nature Therapy
- Art Therapy
Individualized therapies are all almost exclusively evidence-based treatment methods provided in a one-on-one setting with a skilled therapist. The therapist works with the client to understand his full story well and then naturally weaves different techniques into their therapy sessions as needed. Together they seek to bolster the true, remarkable but often buried or unrecognized Self, and address any underlying stresses, traumas or feelings that may be causing an addiction, and provide resolution as well as life-long recovery tools.
General auxiliary Holistic therapies, however, are usually done in a group setting, with the direction and assistance of a trained and experienced teacher. During these sessions each client uses the therapeutic and meditative environment it provides to help remain centered and access deeper inner feelings he seeks during his recovery process, often with the personal help and guidance of the therapist. These therapies also afford excellent long term behavioral, focus and emotional management skills which each client learns to integrate into their life in recovery.
Medication-assisted treatment (MAT):
What is MAT? How Medication is used to help with addiction.
MAT is the use of medications in combination with counseling and behavioral therapies, to provide a “whole-patient” approach to the treatment of substance use disorders. Research shows that a combination of medication and therapy can successfully treat these disorders, and for some people struggling with addiction, MAT can help sustain recovery.
The prescribed medication operates to normalize brain chemistry, block the euphoric effects of alcohol and opioids, relieve physiological cravings, and normalize body functions without the negative and euphoric effects of the substance used. Commonly used medications are Suboxone, Vivitrol and Methadone. However, Methadone is usually dispensed at dedicated Methadone clinics or in hospital settings rather than at typical addiction rehab centers.
MAT provides a comprehensive, individually tailored program of medication and behavioral therapy that address the needs of most patients. The ultimate goal of MAT is full recovery, including the ability to live a self-directed life.
Cognitive Behavioral Therapy (CBT):
What is Behavioral Therapy? How therapy works to alleviate addiction, anxiety and mood-swings.
A common type of talk therapy (psychotherapy) that combines cognitive therapy with behavior therapy by identifying faulty or toxic patterns of thinking, emotional response, or behavior and substituting them with desirable patterns of thinking, emotional response, or behavior. This approach is based on the concept that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a vicious cycle. CBT aims to help you deal with overwhelming problems in a more positive way by breaking them down into smaller parts. It also focuses on replacing unhelpful thoughts and behaviors with new actions and ways of thinking.
This therapy focuses on changing the automatic negative thoughts that can contribute to and worsen our emotional difficulties, depression, and anxiety. These spontaneous negative thoughts also have a detrimental influence on our mood. CBT helps you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way. It’s often the preferred type of psychotherapy because it can quickly help you identify and cope with specific challenges.
Analyzing the individual’s environmental and social factors that elicit unwanted patterns is the first step in understanding the source of negative thinking. Together, patients and therapists will examine the person’s daily routine and identify environmental factors, people, or stressors in their lives that prompt self-doubt and perhaps poor choices. Working with the therapist, the patient finds effective and personalized coping mechanisms which will ultimately help them identify and manage thoughts, emotions, and behaviors in real-world situations.
Learning to take control of one’s thoughts will help to instill the willpower and strength to overcome any mental or emotional disorder.
How does addiction therapy work with underlying emotional and relationship struggles?
REBT & DBT
Included in this class of behavioral therapy are a few sub-modalities that address specific emotional struggles and habits, most common are:
A) Rational emotive behavior therapy (REBT) involves identifying less rational beliefs, actively challenging them, and learning to recognize and change these thought patterns. This therapy focuses on differentiating between self-destructive, inappropriate negative emotions vs. helpful, appropriate negative ones. REBT works to uproot one’s sometimes absolutistic mental rules, allowing cognitive twists to get corrected.
REBT aims to ultimately get you to the point of unconditionally accepting yourself with your flaws, unconditionally accepting others with their imperfections, and accepting life unconditionally with its discomfort, hassles, and unfairness.
B) Dialectical behavior therapy (DBT): A talk therapy for people who experience emotions very intensely, may have difficulties with their relationships, and their actions are often very impulsive. The term “dialectical” comes from the idea that bringing together two opposites in therapy — acceptance and change — brings better results than either one alone.
DBT, is a modified alternative to CBT, and while CBT focuses on thought patterns and their redirection, DBT focuses more on internal balance and emphasizes the relationship between acceptance and change. DBT stresses the practice of mindfulness, increasing distress tolerance, strengthening emotional regulation skills, and growing relationships.
Individuals have the opportunity to examine a deeper meaning of their lives through the DBT process of recovery. They will set goals for themselves, incorporate activities they enjoy, and mindfully understand their process of struggle. A positive self-identity is created in these sessions in which the person establishes self-compassion, acceptance, and an increased sense of self-worth and purpose.
Advanced Holistic Addiction Therapies and Treatments
In addition to the fundamental therapy techniques universally prevalent as the basis for almost all behavioral, mental as well as emotional health management or treatment, numerous treatment programs also use many of the most advanced, innovative methods and therapies to bring about the most robust and enduring positive outcomes for clients.
Some techniques are used seamlessly by the therapists during regular therapy sessions, while others are utilized individually as stand alone therapies or as relaxation and meditation enhancers.
Treatment methods are usually evaluated based on a person by person basis, considering -in collaboration with the client himself- which methods are most appropriate for him, and those often used include:
Internal Family Systems (IFS):
What is IFS therapy? Addressing your Self to resolve addiction caused by internal conflict
IFS is an approach to psychotherapy that identifies and addresses multiple sub-personalities or “families” within each person’s mental system. These sub-personalities consist of wounded parts or painful emotions such as anger and shame, and also parts that try to control and protect the person from the pain of the wounded parts. The sub-personalities are often in conflict with each other and with one’s core Self. The “Self” is a concept that describes the confident, compassionate, whole person that is at the core of every individual, a genuine self waiting to be accessed. The Self can identify, observe, and help these parts become less extreme, more productive, and coexist effectively.
“Protective” forces are activated when the wounded parts of the personality produce overwhelming, painful, or threatening emotions of trauma or anger or fear. These often overwhelmingly strong forces aim to inhibit those difficult emotions by any means necessary, such as substance use which distracts the person from facing those difficult emotions.
IFS focuses on healing the wounded parts and restoring mental balance and harmony by changing the dynamics that create discord among the sub-personalities and the Self.
Our clients work together with a therapist to identify and understand the specific sub-personalities or families that make up their internal mental and emotional system. Once these parts are identified, the therapist will help the client acknowledge his feelings about suppressed emotions, learn how to release these feelings so he is freer to address the actual underlying problem, and ultimately, to find more positive ways to manage and resolve such internal conflicts on his own.
What is TIST? A fresh therapeutic advance on Inner Child Work and Trauma Therapy
Trauma Informed Stabilization Treatment (TIST): An advanced twist on the aforementioned IFS concept, TIST focuses on redirecting past traumas -large and small- from promoting internal conflict among the internal parts, to contributing positively to an improved personality and character. More of a healing process than a neutralizing therapy, this method’s approach is to focus on the legacy of deeply embedded trauma carried now by young, traumatized parts.
This therapy is based on the theory of “Inner Child Work” which recognizes the inner child or young past-self still extant in the physically grown man often as an undeveloped and clamoring emotional component in the current sub-personalities. TIST penetrates into the deepest levels of personality, helping clients to resolve developmental trauma, addictions, feelings of emptiness, depression, anxiety, interpersonal issues and more.
A troubled part can be a problem or a solution: a part with a defensive or combative posture, for example, can harm the body and mind or harm others, or alternatively, it can contribute strength, courage and energy for the challenges ahead. The sought outcome of healing is when the adult individuals they are today accept and welcome each part as a contributor to their survival and when they can make use of the gifts of each part to forge a life beyond trauma.
EFT and releasing anxiety and trauma clamps to help relieve addiction struggles
Emotional Freedom Techniques (EFT) is a clinically researched method of Energy Psychology that is used to help eliminate stress, fear, anger, sadness, cravings and much more. EFT uses intentional tapping on acupuncture meridians to disrupt painful patterns, and allow new freedom from emotional trauma. The technique is based on the theory that disruptions in the body’s energy system which may come due to trauma, anxiety or stress among other triggers, cause disconcerted emotions from “blockages” and tightening in our fluids and energy flow.
This therapy involves gently tapping on certain known points of the body while the recipient of the treatment is encouraged to focus on any specific problem causing his disturbing emotions. During the tapping of various clog points, the person will bring up a thought or issue that is bothering or stressing him -essentially “knotting” him, and remind himself that he is and will be OK despite whatever issue may be putting this pressure on his emotions.
The process aims to relieve recurring distress by isolating the memory of the underlying issue and eliminating the disruptive emotional charge that usually comes with it. The patient learns to remove the emotional energy response to the memory, resulting in positive changes in thinking and healthier energy distribution.
(EMDR) Eye Movement Desensitization and Reprocessing:
How trauma memory is remedied with EMDR memory reprocessing
This therapy is primarily used to address trauma, presuming that prior trauma, large PTSD like trauma or even milder ones, is often the cause for much of the mental and emotional challenges we experience. When you undergo EMDR, you access memories of a trauma event in very specific ways that produce a healthier storage of those memories. During normal events, our brain stores memories smoothly and also networks them, so they connect to other things we remember. During deeply disturbing or upsetting events, that networking doesn’t happen correctly. Often, the brain stores trauma memories in a way that doesn’t allow for healthy processing or healing.
Harnessing the utilization of both sides of the brain and its functions to process a memory, EMDR works to induce a mental balance which facilitates healing. Combined with eye movements or other physical attention controls, and guided instructions, accessing those memories under these specific conditions helps reprocess what is remembered from a negative event. Methods for EMDR can involve vision exercises, using motions or specialized light devices. Other techniques might use sound, where speakers on either side of your body play tones. Healthcare providers might also use your sense of touch , tapping on your hands, arms or feet to activate your sense of touch on both sides of your body.
EMDR temporarily slows your over-stimulated amygdala down and synchronizes your brain waves, helping you process the traumatic memory properly in healthier memory language. That reprocessing helps uproot the destructive coding and repair the mental injury from that memory. Remembering what happened to you will no longer feel like reliving it, and the related feelings will be much more manageable.
Compassionate Inquiry (CI):
What is Compassionate Inquiry? Compassionately recognizing buried emotional needs
The basic premise of Compassionate Inquiry is that the primary cause of our suffering is because there is some form of disconnection from the truth of ourselves. During therapy sessions, a therapist aims to separate the “stories” that we tend to tell ourselves about ourselves and our lives -often out of necessity due to pressure, shame, guilt, or low self-esteem, from the truth that is the core personality and characteristics of each person.
CI assumes that underlying unfilled emotional needs can cause harsh self-loathing and strong discontent, as well as unhealthy habits of emotion “burying”. The aim of Compassionate Inquiry is reconnecting with our own truths: compassionately identifying why we feel and react in certain ways to specific happenings or situations, understanding and acknowledging the underlying deep emotions, anxieties or worries, and thereby facilitating liberation from internal disruptions.
A person suffering emotionally and responding in certain unwanted ways, may just be struggling with old and forgotten unmet emotional needs for connection, love and acceptance, even beginning as early as toddlerhood. The unprocessed emotional pains and wants eventually sink-in crudely and get buried deeply across the physiological system, and may produce continuous and varied emotional, mental and even physical disturbances as a result, throughout life or until these emotional voids are recognized and accepted so that they are no longer hidden, untranslated vexing feelings.
A shift in tone and perspective in the inner voice, changes the nature of the harsh internal narration of an individual, affording himself at least as much understanding and empathy as he often allows others and their emotional weak points, and ends the problematic burial of broken emotional pieces across all parts of the internal system.
How does trauma cause anxiety and addiction? What does Trauma Therapy mean?
Trauma Therapy is a general term, referring to many different therapies which address past trauma fundamentally. Most of the therapies and methods described thus far are recognizably highly trauma oriented and are prominent parts of this class of therapies..
At the heart of the development of Post Traumatic complications is the avoidance of memories and feelings we perceive as too terrifying to re-experience safely. This avoidance, the lid we hold on the pot, comes at a terrible price—exhaustion, depression, shame, irritability, and an inability to ever really be at ease in the world. But since it can feel like the only way to survive, we naturally continue this avoidance, even as our health, relationships, and stable daily lives, are all gradually worn down.
Therapy makes those seemingly overwhelming memories tolerable enough to experience safely, so that they lose their frightful power and become transformed into painful but manageable parts of our past. The traumatic experience then becomes a part of our autobiography—unpleasant to recall, but not overwhelming or deeply distressing.
Assisting with addiction and brain activity regulation: Neurofeedback
EEG (Biofeedback) -Neurofeedback is a self-treatment method of managing or regulating the workings of the brain so that it functions in a more desirable manner through a non-invasive treatment that encourages the brain to develop healthier patterns of activity. This is achieved by repeated training sessions using a computerized neurofeedback program applied externally on the head.
This Neurotherapy program includes CES (Cranial Electrotherapy Stimulation), Binaural Beats, and several other similar techniques using auditory or visual signals to help patients modify their thought patterns. This teaches the central nervous system to reorganize and regulate brainwave frequencies, and may even help teach the patient to recognize their own unhealthy thought patterns when they become activated.
This cutting-edge approach has both an immediate use, as well as an enduring effect. Neurotherapy aids in grounding and self-regulation, helping an individual to confront deeper issues with a calmer spirit. It also addresses the neuroscience of trauma by attempting to better regulate the limbic system in the brain.
As a component of Biofeedback -the belief in the capacity to train various bodily features and organs to adopt certain behaviors, by means of stimuli patterns, Neurofeedback harnesses the brain’s neuroplasticity – its ability to change itself – in order to bring about improvement. As the therapy helps you harmonize your brain waves, naturally the brain learns to function more efficiently.
Auxiliary Holistic Therapies used in addiction recovery
What are Holistic Therapies?
Other Holistic Therapies commonly used to address addiction and emotional/mental health range from more traditional Yoga and Nature therapy to the more alternative Biodynamic Craniosacral Therapy and Aromatherapy, as well various spiritual therapies. The availability and application of any of these methods depends on the treatment facility and their resources, and must consider the personality type of the client being treated and his specific issues.
Among the therapies and healing techniques used to compliment the aforementioned individualized, evidence based therapies are the following listed:
- Biodynamic Craniosacral Therapy
- Sound Therapy
- Art Therapy
- Breath Work
- Gymnastic Therapy
- Nature Therapy
- Equine Therapy
- Canine service Therapy