Drug Rehab: Cognitive Dissonance in Addiction Treatment programs

March 29th, 2017

Cognitive dissonance is an uncomfortable feeling we get when we notice that our actions are not consistent with our beliefs. This negative feeling is much stronger if we don’t have any strong reason to behave in such a way.

There are very few drug addicts that are unaware of the risks associated with drug use. Yet they manage to somehow reconcile this knowledge with ther dangerous behaviour. This post seeks to look at how they accomplish this.

So what happens when physical addiction and cognitive dissonance collide?

American studies showed that even though 99% of Americans believe that smoking is harmful 20% of them still smoke regularly. Clearly that 20% must be finding a way to reconcile the contradiction between their beliefs and their behaviour.

The optimistic bias is a commonly employed tactic. People like to believe that somehow the risk doesn’t apply to them.

For example: The risk of heart-attack is increased by smoking, being overweight, high serum cholesterol levels (or more accurately the ratio of high density lipoproteins to low density lipoproteins), age, gender, socio-cultural background, diabetes, and other factors.

A smoker displaying the optimistic bias will believe that she can offset one risk against the other. So she could argue that because her cholesterol levels are healthy she is able to take risks in other areas. Such an argument will not stand up to rational inspection but it will help to silence the cognitive dissonance.

Alcoholics often also use the optimistic bias and tell themselves “it won’t happen to me”, even though in many cases “it” already has.

They also use denial to convince themselves that there is no problem. This denial is often deeply entrenched and takes a skillful counselor to deconstruct. In treatment, asking the alcoholic to look at the consequences of her behaviour is a way to start chipping away at denial. Members of the therapeutic group are able to expose logical fallacy, draw attention to blind spots, and confront denial head on.

Alcholics may be also angry with the world and blame others for their drinking (“I wouldn’t drink if you didn’t do whatever”). This provides them with a “reason” to drink which would diminish cognitive dissonance according to theory. It also helps them to play the victim which diminishes their perception of their responsibility in the behaviour.

Or maybe the physical addiction just overrides the sensation an addict may have of “I am doing something wrong”. Withdrawal symptoms are very uncomfortable and are probably a good enough reason to overcome dissonance. An addict might say something like “I was turkeying so bad that I had to steal that money to buy a hit”. Even though she might know that stealing and using drugs are bad behaviours they are excused by the physical and mental discomfort she was experiencing.

Alcoholics and addicts often construct elaborate mechanisms to protect themselves from the uncomfortable feeling of cognitive dissonance. Deconstructing these mechanisms and highlighting the dissonance of addiction can help motivate alcoholics to remain sober.