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How I Cured My Addiction with Cognitive Therapy
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TOPIC: How I Cured My Addiction with Cognitive Therapy 1295 Views

How I Cured My Addiction with Cognitive Therapy 12 Oct 2012 21:26 #146064

  • nederman
I wrote up my experience here. I hope it will help people who have not had success with other methods:

docs.google.com/document/pub?id=1pVbfoTbMQ0CHj61cOj4hPxhNdAc4OXU01VKkhuWFL68
Last Edit: 23 Dec 2012 19:35 by . Reason: Updated URL

Re: How I Cured My Addiction with Cognitive Therapy 14 Oct 2012 11:59 #146097

  • chaimcharlie
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I perused your essay, very interesting and insightfull.
But one question, you say that you "cured" your addiction, now you know that "cure" is past tense, which would suggest you are cured. How long have you been clean, 40+ days?, well I've done that many a time and lapsed back, and so have several million others. So how do you know so certainly that you are cured of the addiction, maybe you found a nice way (indeed, it is very nice) way to push him into the closet, but tomorrow or the next day he'll come back out, stronger than ever.

If you would believe in 12-step style recovery that wouldn't be a problem, because as you mention very often they believe that the allergy is here to stay and is completely incurable, the only solution is to learn to live far away from it. So I don't really care to say "I am cured from addiction" because that's not my goal, rather I say "I am living my life properly one day at a time as a gift from Hashem".

But either way, I'm glad to hear that your are more sober than me for the meanwhile (I don't mean ch'v that you should fall, rathere that I should get sober!), and you should have much hatzlochoh.

Re: How I Cured My Addiction with Cognitive Therapy 14 Oct 2012 12:22 #146099

  • think good
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Agreed

There is no such concept of "cured" at least not for us addicts!

What ever works for you is great - keep going and much hatzlochoh

But don't get complacent!!!!

Re: How I Cured My Addiction with Cognitive Therapy 15 Oct 2012 05:26 #146138

  • nederman
I guess the answer to your question is: I know I am cured because I no longer believe I am powerless, and I am able to control myself. As I verify over and over that I do not fall, without tefillos, meetings, friends, counselors, rabbis, etc. I strengthen this belief. Contrast this with the 12-step program where to be successful I have to strengthen the belief that I have no freedom of choice. The further in you are, the more severe the consequences if you stop going to meetings.

Re: How I Cured My Addiction with Cognitive Therapy 15 Oct 2012 06:25 #146143

  • chaimcharlie
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OK, R' Nederman, if I told you that you would say that I don't have an answer, right? Either way, I'm gonna be off the forum a while, so I wish you much hatzlochoh, and I hope that when I come back you will still be cured.

Re: How I Cured My Addiction with Cognitive Therapy 02 Dec 2012 17:07 #148796

  • nederman
I guess I got to 90 or so days (sober since 9/1/2012.) I don't mean to say that my behavior change is somehow time-related, but I think it's useful to report ninety days because I introduced a recovery method previously unknown on this site so it makes sense to report whether it worked or not.

Who Is An Addict 03 Dec 2012 01:36 #148814

  • nederman
There is a definition of an addict which is "a person who must stop in order to save his life." This definition of an addict is not a measurable definition. Even the 12-step program appears to contain two different opinions about who is an addict. Consider the following passages from The White Book of Sexaholics Anonymous:

Page 2:



Our definition of sobriety represents, for us, the basic and necessary condition for lasting freedom from the pain that brought us to SA. We have found that nothing else works. When we have tried to deny what our common experience has taught us, we have found that recovery still eludes us. And this seems to be true whether we are male or female; married or single; whether our acting out was with the same or opposite sex; whether our relationships were "committed," "meaningful," or one-night stands; or whether we just resorted to a little sex with self as a "physical outlet."


Page 3:



What Is a Sexaholic and What is Sexual Sobriety?

We can only speak for ourselves. The specialized nature of Sexaholics Anonymous can best be understood in terms of what we call the sexaholic. The sexaholic has taken himself or herself out of the whole context of what is right or wrong. He or she has lost control, no longer has the power of choice, and is not free to stop. Lust has become an addiction. [..] Until we had been driven to the point of despair, until we really wanted to stop but could not, we did not give ourselves to this program of recovery. Sexaholics Anonymous is for those who know they have no other option but to stop, and the own enlightened self interest must tell them this.


On page 8:



Twenty Questions

1. Have you ever thought you needed help for your sexual thinking or behavior?
2. That you'd be better off if you didn't keep "giving in."
3. That sex or stimuli are controlling you?
4. Have you ever tried to stop or limit doing what you felt was wrong in your sexual behavior?
5. Do you resort to sex to escape, relieve anxiety, or because you can't cope?
6. Do you feel guilt, remorse, or depression afterward?
7. Has your pursuit of sex become more compulsive?
8. Does it interfere with relations with your spouse?
9. Do you have to resort to images or memories during sex?
10. Does an irresistible impulse arise when the other party makes the overtures or sex is offered?
11. Do you keep going from one relationship or lover to another?
12. Do you feel the right relationship would you stop lusting, masturbating, or being so promiscuous?
13. Do you have a destructive need - a desperate sexual or emotional need for someone?
14. Does pursuit of sex make you careless for yourself or the welfare of your family or others?
15. Has your effectiveness or concentration decreased as sex has become more compulsive?
16. Do you lose time from work for it?
17. Do you turn to a lower environment when pursuing sex?
18. Do you want to get away from the sex partner as soon as possible after sex?
19. Although your spouse is sexually compatible, do you still masturbate or have sex with others?
20. Have you ever been arrested for a sex-related offense.


It's clear that SA holds that you can be an addict if your life falls apart, or if you resort to a little sex with self as a physical outlet, or anywhere in between. This broad spectrum of behavior can be found in regular people, not just in self-proclaimed "sexaholics." This means that the behavior itself is not enough to define who is an addict. So what is an addict?

I believe the proper way to define a lust addict is:

You are an addict if you wish you could stop.

Your life does not need to be in shambles in order for you to be an addict. Addicts may look with secret pride at their own symptoms (such as getting busted soliciting prostitution, or preying on children) and look down on "lesser" addicts, but this is just an extreme form of narcissism, it has nothing to do with the definition of addiction. The key is desperation. Do you desperately wish you could stop? Does your life have to be in shambles for you to be desperate? The answer is no. Plenty of people are desperate to the point of suicide. It all depends on their beliefs. The more narcissistic the person, the more likely they are to become an addict.

Is Addiction Fundamentally Incurable? 03 Dec 2012 01:54 #148815

  • nederman
There is a question which is not talked about enough, namely whether addiction is incurable. There is a common assumption that true addicts belong in the 12-step program. In a way it can be argued that this is true. The argument is that this program is based on accepting that you have no choice, which the addict suspects all along, and finally admits.

If you think this is not true, the White Book of Sexaholics Anonymous says it clearly on page 3:



The sexaholic has taken himself or herself out of the whole context of what is right or wrong. He or she has lost control, no longer has the power of choice, and is not free to stop [..]


Acceptance is clearly the most direct way to treating the symptoms of the underlying problem. With acceptance no fundamental change is required. This is the argument, and it is pretty solid. The great virtue of the 12-step program is that addicts can join and never make the fundamental change, and perhaps be sober for good and fully recover, except for those beliefs that keep them attached to SA, namely the belief that the sexaholic "no longer has the power of choice."

In addition, addicts in the 12-step program dare never move on to some other addiction recovery method, because the program gave them their self-respect back. Therefore anyone who got better through SA inevitably believes that they could never have gotten better any other way. This is just a rationalization, it is not a scientific fact.

Therefore feel free to pursue other recovery methods. Who knows, perhaps you'll get lucky and find one that addresses the fundamental problem.

Does Addiction Exist in the Torah? 03 Dec 2012 02:12 #148816

  • nederman
Does addiction exist in the Torah? The answer is: yes! Can you guess who is an addict in the Torah?

The nazir! The nazir makes a neder to not consume wine (as well as some additional fences.)

The point of nezirus is that Hashem steps in and uses His power to make it overwhelmingly inconvenient for the addict to act out. The gemara says that one who violates his neder buries his wife and children. We all know that violating a neder is a terrible thing. An alcoholic may not be able to keep from drinking his second or third drink, but he can keep from drinking his first one if he believes that Hashem will kill his children.

If you are familiar with addiction you may see a problem with nezirus: is nezirus recovery? The answer is no, the nazir is just a dry drunk unless he gets some therapy. He is sober by shotgun.

This problem is familiar to people in the 12-step program: just counting days and staying sober is not recovery. You can still act out - so to speak - with your resentment and other bad character traits. Therefore 12-step literature warns against just counting days.

Does the addict have a choice? 03 Dec 2012 02:38 #148817

  • nederman
It is clear from the White Book of Sexaholics Anonymous that SA holds that the addict does not have a choice (page 3):



We can only speak for ourselves. The specialized nature of Sexaholics Anonymous can best be understood in terms of what we call the sexaholic. The sexaholic has taken himself or herself out of the whole context of what is right or wrong. He or she has lost control, no longer has the power of choice, and is not free to stop. [..]


What is the problem? We see that the addict does stop, at least part of the time. And if he is honest and works the steps, he may stop for good. And he may recover, and love his life. So how are we to interpret this statement in the White Book? The answer is: the addict does not have a choice without the group.

Is this belief Torah-accurate? We know that there is a gemara that at the time of conception Hashem takes the embryo and pronounces on it, will this person be wise or foolish, rich or poor? And the only thing that is within the person's power is whether he is a tzadik or rasha. Seemingly from this gemara the Torah believes that everyone has a power of choice.

The Mesillas Yesharim hints at this problem in the chapter on Cleanliness:



You will now note the distinction between the Watchful and the Clean man (although they are closely related). The first is Watchful of his deeds and sees to it that he does not sin in relation to what he knows, and what is universally acknowledged to be sinful; however, he is still not so much master of himself as to keep his heart from being pulled along by natural lust and inclining him to rationalize in relation to things whose evil is not thus acknowledged. For even though he exerts himself to conquer his evil inclination and to subdue his desires, he will not, because of this, change his nature; he will not remove bodily lust from his heart. All he will be able to do is overcome it and be governed, not by it, but by reason.


They key rationalization is the belief that, as the White Book says, "I am not free to stop."

That this belief is not true but is a rationalization can also be seen by the fact that the Torah frowns on the nazir. Although the nazir is called kadosh, nedarim are frowned upon. What is the reason? It's because we all have the power to choose whether to be tzadik or rasha, and we need to figure out why we think we cannot choose. Why do we need to tell ourselves we cannot choose? We should not tell G-d "force me to be a tzadik through a neder, because I will not do it any other way." And yet the halacha of nezirus proves that Hashem recognizes that a person may choose this route, just as a person may choose to stop trying to save his marriage and get a divorce. Hashem gives us a break.

Although the preceding considerations are undoubtedly true, there is choice and there is choice. Seemingly Esav had the same power of choice that Yacov had, but it's pretty easy to understand that the very purpose of Esav's existence was to take on an especially large yetzer ha-ra so that it should not burden Yacov. We are a little bit like Esav today. We have the internet. We have a virtual tower of babel. People the world over are making a global village. Every place is equidistant from every other place. Every porn site is equally distant from me. And yet the Torah tells us that we do have a choice. This is not the choice to get a filter. It's the choice to not get around the filter. And the Torah tells us that we have this choice without a group. So we know that this is true because the Torah says it. But we certainly don't understand it very well, because we have so much trouble exercising this choice.

What do you believe? 03 Dec 2012 03:36 #148824

  • nederman
Do you know what you believe?

I propose the following method for figuring out what you believe, which I learned from cognitive therapy books. What you believe is not what you say you believe, and is not what you think you believe. What you truly believe can only be inferred from your actions.

In other words if you do a lot of porn, and the whole time you think "this is terrible, I shouldn't be doing this" what do you believe? You believe that porn is really good for you, and you believe that G-d is wrong to deny it to you.

You can see an example of this concept in the gemara. There is a gemara in which the owner of a field appoints an agent to take truma for him. While the agent is taking truma the owner runs down and says "you should have gone after the better ones!" The gemara says that if the owner now goes ahead and takes some better ones then the agent did take truma for him, and if he doesn't he is just being sarcastic. The question is: why can't we just ask him what he means? The answer is: because he himself doesn't know what he really believes. He may believe that a person should not give his best produce to truma, but if he also believes that a worthy person wants to give his best produce to truma, then he can never face the first belief. He wants to be a worthwhile person.

This is hinted by the Mesillas Yesharim:



THE IDEA behind the trait of Cleanliness is that a person be completely clean of bad traits and of sins, not only those which are recognized as such, but also those which are rationalized, which, when we look into them honestly, we find to be sanctioned only because of the heart's being still partially afflicted by lust and not entirely free of it, so as to incline us towards a relaxation of standards.


Rav Yonasan Eibeschutz was a master in the concept of "migu," and he talks about really convoluted and complex migus. So someone once pointed out to him that, yes, he, being the genius that he was, was able to think of such complex justifications for a person, but a regular person would not be able to do that. To this he answered "when it comes to being a thief, anyone can be Rav Jonathan Eibeschutz."

Freud reportedly said: "when it comes to self-justification we are all geniuses."

Wait a minute. This is terrible! This means that a frum yid who is a lust addict has terrible beliefs. Comes to the rescue the Mesillas Yesharim:



[..] if one is still imprisoned by his evil inclination, his eyes cannot see this truth and he cannot recognize it. For the evil inclination literally blinds his eyes and he becomes as one who walks in the darkness, where there are stumbling blocks before him which his eyes do not see. As our Sages of blessed memory said (Bava Metzia 83b), " ` You laid down darkness and it was night' (Psalms 104:20). This refers to this world which is similar to night." How wondrous is this truthful commentary to him who concentrates upon understanding it. For the darkness of night can cause two types of errors in relation to a man's eye: it may either cover his eye so that he does not see what is before him at all, or it may deceive him so that a pillar appears to him as a man, or a man as a pillar.


In other words, many of our beliefs are inaccurate, or even entirely wrong. We are a product not of the reality around us, but of how we understand it.

This concept was rediscovered recently by cognitive therapists. The following is a quote by Doctor David D. Burns in the book "Intimate Connections." Dr. Burns discusses how he healed sexual addiction in a single woman who dated married men and then felt bad about it afterwards. He says (p. 279):



I am proposing that immoral and self-destructive behavior may in part result from cognitive distortions and from psychic blindness. But unlike depression, where we sell ourselves short and focus excessively on our shortcomings and mistakes, it may be that evil behavior results in part from the opposite tendency. We look only at the positive aspects of a situation and blind ourselves to the negative impact of our actions on ourselves and others. This would be a forgiving model of human nature in that "blindness" rather than "badness" would be seen as the source of the problem. This is not to say that selfish motives and evil do not exist. However, the difficulty with these concepts is that they are emotionally colored and judgmental. Thinking of ourselves and others in these terms can make it difficult to acknowledge and accept personal shortcomings. In contrast, an understanding of the twisted, distorted thought processes that cause us to violate our own moral standards can take away some of the horror of confronting these negative aspects of our lives so we can have the courage to accept our weaknesses and grow.


We can therefore feel free to infer our true beliefs from our actions and discard our stated beliefs, because there is hope: we know that the Torah is a great wealth, as it was promised to Avraham Avinu. We know that Rav Shach zt"l said he had greater pleasure from understanding a difficult Rambam than a billionaire could ever feel from any other pleasure. We know that yiddishkeit is objectively great, so if we believe that porn is better, we must be making a mistake. Presumably if we go back to square on and rebuild our yiddishkeit from scratch we will be able to be Jews because we want it and not because we are dirt if we are not.

Common Cognitive Distortions 03 Dec 2012 03:56 #148826

  • nederman
The following are common cognitive distortions identified by Dr. David D. Burns in curing various disorders, including addiction and depression:

1. All-or-nothing thinking: You see things in black and white categories. If your performance falls short of perfect, you see yourself as a total failure.

2. Overgeneralization: You see a single negative event as a never-ending pattern of defeat.

3. Mental filter: You pick out a single negative detail and dwell on it exclusively so that your vision of all reality becomes darkened, like the drop of ink that discolors the entire beaker of water.

4. Disqualifying the positive: You reject positive experiences by insisting they "don't count" for some reason or other. You maintain a negative belief that is contradicted by your everyday experiences.

5. Mind reading: You arbitrarily conclude that someone is reacting negatively to you and don't bother to check it out.

6. The Fortune Teller Error: You anticipate that things will turn out badly and feel convinced that your prediction is an already-established fact.

7. Magnification (catastrophizing) or minimization: You exaggerate the importance of things (such as your goof-up or someone else's achievement), or you inappropriately shrink things until they appear tiny (your own desirable qualities or the other fellow's imperfections). This is also called the "binocular trick."

8. Emotional reasoning: You assume that your negative emotions necessarily reflect the way things really are: "I feel it, therefore it must be true."

9. Should statements: You try to motivate yourself with shoulds and shouldn'ts, as if you had to be whipped and punished before you could be expected to do anything. "Musts" and "oughts" are also offenders. The emotional consequence is guilt. When you direct should statements toward others, you feel anger, frustration, and resentment.

10. Labeling and mislabeling: This is an extreme form of overgeneralization. Instead of describing your error, you attach a negative label to yourself: "I'm a loser." When someone else's behavior rubs you the wrong way, you attach a negative label to him, "He's a damn louse." Mislabeling involves describing an event with language that is highly colored and emotionally loaded.

11. Personalization: You see yourself as the cause of some negative external event for which, in fact, you were not primarily responsible.

Addiction is fueled mostly by Magnification and Should Statements. Magnification can be seen in the idea that the addict has no choice, as the White Book of Sexaholics Anonymous says:



The sexaholic has taken himself or herself out of the whole context of what is right or wrong. He or she has lost control, no longer has the power of choice, and is not free to stop.


This is Magnification when you restate the belief into the following form: "The temptation is too strong for the sexaholic." We have seen before that by this the White Book means "is not free to stop without the group."

The problem of Should Statements was immortalized by the "third-step prayer" of the 12-step program:



G-d, grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference.


Should Statements are the reason why we resort to our drug, namely the mistaken belief that since our current path is blocked there is no other viable path. This is essentially the belief of a newborn baby who is granted everything he wants. He watches this happen, and he wrongly concludes that everything must be provided for him because he really cannot fend for himself. Pride covers up this belief, making it difficult for the addict to disprove it empirically. In other words an addict is a big mama's boy, and he really doesn't want to admit it.

The Cognitive Cure for Addiction 03 Dec 2012 04:47 #148827

  • nederman
The cognitive cure for addiction is described on pages 271 through 278 of the book Intimate Connections, by David D. Burns. Unfortunately, as always in life, there is no free lunch.

The method consists of two steps:

1. Rational Decision Making.

2. How to Resist Temptations.

Rational decision making is a small miracle. The way I understand it is in terms of the words of the Mesillas Yesharim:



And what is the advice that they give us'? - 'Let us enter into an accounting.' Let us come and compute the world's account." For they have already experienced, and seen, and learned that this alone is the true path by which a man may reach the good that he seeks, and that there is none beside this.

What emerges from all this is that a man must constantly - at all times, and particularly during a regularly appointed time of solitude - reflect upon the true path (according to the ordinance of the Torah) that a man must walk upon. After engaging in such reflection he will come to consider whether or not his deeds travel along this path. For in doing so it will certainly be easy for him to cleanse himself of all evil and to correct all of his ways. As Scripture states (Proverbs 4:26), "Consider the path of your feet and all of your paths will be established," and (Lamentations 3:40), "Let us seek out our ways and examine them, and we will return to God."


You can see my cost-benefit analysis by clicking on the link below. Some critical aspects of such a cost-benefit analysis are:

1. You need to focus on your feelings. The consideration "doing porn is forbidden" has little impact in this cost-benefit analysis. However, the consideration "when I study Torah I learn that porn is forbidden and I beat myself up for doing porn" is very much relevant.

2. You need to believe your cost-benefit analysis.

3. You need to somehow score the pros and cons. The proper way to score the pros and cons is by assigning to them two numbers which add up to one hundred. However this is most useful when you want to compare two different courses of action. You might see that one is 80-20 and the other 60-40. In the case of one course of action you may be able to do without the numbers. But you still need to decide if the pros outweigh the cons or vice versa. If you cannot make that determination and you still feel like you want to stop, you need to adjust your cost-benefit analysis: it is not accurate. You may also decide that you are better off leaving your addiction alone, and you may reevaluate later.

Resisting temptations requires two things:

1. You need to have a solid cost-benefit analysis to want to bother identifying and disproving your irrational beliefs.

2. You need to be able to "listen in" to your internal conversation to figure out what your incorrect beliefs are. Until you can do this you cannot proceed.

Dr. Burns lists a number of cognitive distortions with which to argue when it comes to resisting temptations. I have found that the main cognitive distortion I need to argue with is the idea that the yetzer ha-ra is too strong for me. I have found the following effective method for doing this:

1. Wait for a stimulus to occur (for example, you see a pretty girl.)
2. Think the following conscious thought: "I cannot get aroused further unless I choose to think about sex. The arousal does not grow by itself. If I engage in some activity before I know it I will turn around and the arousal will be gone."
3. Later look back and verify that the arousal went down.

The method will not work without step 2. If you do this reliably you will no longer believe what the White Book says (p.3):



The sexaholic has taken himself or herself out of the whole context of what is right or wrong. He or she has lost control, no longer has the power of choice, and is not free to stop. [..]


We have already seen that by this the White Book really means "he is not free to stop without the group."

I have found that both Rational Decision Making and Resisting Temptations had to be experienced in order to be understood. I did not understand the power of Rational Decision Making until I attempted it. Even after reading books on cognitive therapy I did not give it enough credit. The light bulb went off about half way through my cost-benefit analysis and I finally believed the words of the Mesillas Yesharim:



After engaging in such reflection he will come to consider whether or not his deeds travel along this path. For in doing so it will certainly be easy for him to cleanse himself of all evil and to correct all of his ways.


When I remind myself that I do have a choice I really don't believe it. It seems very far from me. I know I have chosen not to lust innumerable times, but I only really believe it after I look back and verify that I didn't lust. What an awesome power the yetzer ha-ra has to obscure reality for its sinister purposes.

As always, sobriety by itself is not recovery. Recovery can be gained by diligently listening to our internal conversation, identifying our cognitive distortions, and arguing with them. The best known of these we have listed above.

May you have the zechus to face your true beliefs and achieve cleanliness in the area of lust.



This trait is certainly difficult to acquire, for a man's nature is weak. His heart is easily won over, and he permits certain things to himself by utilizing the opportunities for selfdeception which they present. One who has attained to the trait of Cleanliness has unquestionably reached a very high level of achievement, for he has stood up in the face of a raging battle and emerged victorious.

Re: How I Cured My Addiction with Cognitive Therapy 03 Dec 2012 07:08 #148832

  • chaimcharlie
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Oh wow, that's a lot of posting in one shot.
I would maybe read it but I don't want to get scared away from SA.
But it it works for you - כל הכבוד!

Re: How I Cured My Addiction with Cognitive Therapy 03 Dec 2012 15:12 #148841

nederman wrote on 02 Dec 2012 17:07:

I guess I got to 90 or so days (sober since 9/1/2012.) I don't mean to say that my behavior change is somehow time-related, but I think it's useful to report ninety days because I introduced a recovery method previously unknown on this site so it makes sense to report whether it worked or not.


Congratulations and good luck!

Regardless of our method, and regardless of whether we agree, we all need Siyata Dishmaya to succeed. May we all merit that divine assistance so that we continue to do well in all aspects of our lives.

Hatzlacha

MT
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