Cognitive Behavioral Therapy (CBT) has been around for a long time and has shown significant success in use for the treatment of difficult to treat disorders such as depression, impulse disorders, addictions, obsessive-compulsive disorder, anxiety, and others. That said, for those of us who are deep thinkers – who are always asking “But why?” – the idea of changing our lives for the better by simply changing the way we think or behave feels superficial, overly simplistic, or even distasteful.
In truth, there are values to all types of therapy, and because of this many therapists who consider themselves to be psychodynamic and relationship-focused have incorporated techniques that involve CBT – especially the “cognitive” part that addresses reflexive thinking. But research continues to demonstrate that behavioral modification techniques can help a great deal – for people of all ages. In spite of wanting to use our capacity for insight, thought, and reasoning to place ourselves above our fellow animals, it turns out we are also subject to the same basic behavioral conditioning that teaches a dog to “sit” using a treat, or training a cat to stay off the dining room table by using a squirt gun.
An example of this was demonstrated in recent research published in Psychological Science. University of Amsterdam experimental psychologist Reinout W. Wiers and his associates had alcoholics practice “pushing away” images of alcohol with a joystick when they appeared. When studied originally, those addicted to alcohol had an immediate impulse to “pull” these images towards them when they appeared. Through the very simple practice, that impulse was re-trained as one that would reflexively push the image away. They were then given the standard abstinence-based, cognitive behavioral three month program with everyone else.
During the follow-up study it was found that there were expected relapses by all groups. However, the group with the cognitive-bias modification (CBM) or “pushing away” technique had significantly lower incidents of relapse. One still-abstinent patient told a story illustrating how the technique had worked for him. At a party, looking for a soda, the man opened the refrigerator, but found it full of beer. “Immediately, he made the push movement” — he closed the door. Certainly, in the moments following he would have to think about whether or not he wants to take a drink and will have a decision to make. But it appears that this CBM technique enabled people to reverse their initial impulse, giving them the time to think and make the choice not to drink.
This reversal of impulse has tremendous implications in the treatment of other addictions and impulse disorders. This study will not be news for those who treat sex offenders and have used aversive techniques for years. However, it does open the door for those who suffer from addictions to drugs and alcohol, or process addictions such as gambling or stealing. These simple techniques might help, in the moment, to give people who suffer from these impulses the time they need to make a better choice.
Samantha Smithstein, Psy.D.
