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The Art of Cognitive Reframing in Addiction

Viewing the world from 30,000 feet changes our worldview.  As a clinician, my ability to support change with my clients requires first that I fully understand my client’s worldview.  For many, their belief about their problem is critical in determining and supporting the change process. A powerful technique which allows me to make positive use in fully understanding my client’s worldview and moving towards long lasting behavioral change in recovery is that of cognitive reframing.  Cognitive reframing is a clinical technique which spans across a number of evidence based practices and its effect in reducing distress and distressing behaviors can be immediate and powerful. Just as changing the frame of a painting can greatly alter the appearance and feel of that same painting, helping client’s change their frame can offer them a new lens or perspective from which to view their problems, shortcomings or frustrations, many of which are shared in therapy sessions at rehab centers.

“Addictive” thinking, (also referred to as “stinking thinking”), generally includes rigid and self-centered perceptions which leads to resentments and great potential for relapse.

In contrast, “recovery” thinking is expansive and resilient. “Recovery” thinking leads to mindfulness and gratitude.   Positive reframing is “recovery” thinking!

Here is an example;

“Ever since my parents learned I was using, my mother has been trying to rule and control my entire life.  She hovers over everything I do or try to do.”

A clinician’s response using reframing would be;

“It sounds like your mother cares very much and is struggling to learn how to best parent you upon learning about your substance use.”

Regardless of the effectiveness of the parent’s response, the therapist shifts client’s interpretation to something his mother is doing “to” him versus something his mother is aiming to do “for” him.

Wearing a pair of glasses which no longer support one’s vision can cause a host of problems through gradual decline of visual clarity. With a fresh new lens comes fresh new action. Offering a fresh new lens or interpretation of a long existing or recent distressing experience can facilitate immediate relief and divert clients from a negative path of behavior to a more productive and health engendering path in recovery.   Addiction is often described as a thinking disease rich in conflict and negative narrow and rigid perceptions.  Reframing techniques can be a powerful anecdote to both resentment and shame, both which prohibit growth and positive change.  Recovery thinking is flexible and expands beyond rigid and self-centered fear based perceptions often characterized in addictive thinking.  Reframing is not just positive thinking. Reframing is offering a refreshing lens which unfurls a new set of possibilities and supports one’s ability to deal with difficult experiences and move towards productive and workable set of skills to promote acceptance, hope, health and healing.


Jessica Hamilton, LCSW
Primary Therapist