Self-Talk

One of the tools that may help alcoholics cope with cravings is something called Self-Talk. Some automatic thoughts clients have only lead them down a slippery slope of giving up:

"Ugh I want a drink. I won't be able to stand this. The urge is going to keep getting stronger and stronger until I blow up or drink."

Other types of self-statements can make the urge easier to handle:

"Even though my mind is made up to stay sober, my body will take a while to learn this too. This urge is uncomfortable, but in 15 minutes or so, I'll be feeling like myself again."

There are two basic steps in using self-talk constructively:

1. Have the client pinpoint what they tell him- or herself about a craving that makes it harder to cope with the urge. One way to tell if the client is on the right track is when he or she hits upon a self-statement that increases their discomfort. That discomfort-raising self-statement is a leading suspect for challenge, since it pushes their buttons.

2.    Use self-talk constructively to challenge that statement. An effective challenge will make the client feel better (less tense, anxious, panicky) even though it may not make the feelings disappear entirely. The most effective challenges are ones that are tailored to the client's specific upsetting self-statements.

Examples of challenges the client can pose to themselves:

What is the evidence? What is the evidence that if you don't have a drink in the next 10 minutes, you will die? Has anyone (who has been detoxed) ever died from not drinking? What's the evidence that people who are recovering from an alcohol problem don't experience the feelings that you have? What is the evidence that there is something the matter with you, that you will never improve? Of course you can survive it. Who said that sobriety would be easy? What's so terrible about experiencing an urge? If you hang in there, you will feel fine. These urges are not like being hungry or thirsty - they are more like a craving for food or an urge to talk to a particular person- they pass, in time.

Some of the substitute thoughts or self-statements will only be necessary or helpful initially, as ways of distracting the client from persistent urges; the client will have an easier time if they replace the uncomfortable thoughts with other activities. After a while, sobriety will feel less unnatural; many of the urges will diminish and drop out, and the client won't need constant replacements. 

Adapted from: http://pubs.niaaa.nih.gov/publications/matchseries3/project%20match%20vol_3.pdf