How Cognitive Distortions Cause Alcohol Addiction and Sabotage Recovery

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Can how you think affect how you act, including whether you misuse alcohol? Many mental health professionals believe so. Automatic negative thoughts or beliefs are known as “cognitive distortions.” ¹

Everyone experiences some level of cognitive distortion. ² However, experts believe that deep-rooted negative thought patterns generate negative feelings and harmful or unwanted behaviors. ³

What Are Cognitive Distortions?

Cognitive distortions are the intense negative thoughts or beliefs about yourself, others, or the world that are so well established that they “sound” like your own voice in your head. Cognitive distortions may also be referred to as thinking errors or automatic negative thoughts.

This idea is rooted in the cognitive model of psychology. The cognitive model suggests that the way you think impacts the way you feel, which in turn shapes the way you act. Cognitive distortions are believed to play a role in all compulsive behavior patterns, mental health conditions, and addictions, including alcohol misuse and addiction.³

Are There Different Types of Cognitive Distortions?

There are 10 major cognitive distortions. These are:⁴

1. Mindreading—When you “mindread,” you assume that you know what other people are thinking or how things will turn out, without considering other possibilities.
2. Catastrophizing—Catastrophizing involves making negative predictions about the future without little to no evidence in reality to support that the problem will progress to that level. The idiom “making a mountain out of a molehill” describes this thought pattern.
3. All-or-Nothing Thinking—When you view events, decisions, or characteristics through a lens of either/or and exclude the wide range of other possibilities, you’re engaging in all-or-nothing thinking, also called “black-and-white” thinking.
4. Emotional Reasoning—Thinking that a belief is true based on your emotions rather than on facts presented is emotional rather than logical reasoning.
5. Labeling—Giving yourself, others, events, or things with a permanent “label” after a distressing event or experience makes it difficult to view that object in any other way.
6. Mental Filtering—Only focusing on the negative aspects and mentally filtering out any positive aspects of an experience is one example of mental filtering. You may also filter out any aspects that don’t support a belief you already have.
7. Overgeneralization—Viewing one single event as a rule that applies to all things leads to overgeneralizing about both similar and dissimilar situations.
8. Personalization—When you come to believe that you are the cause of one, or many, events of a specific kind—whether positive or negative—you are personalizing an external event.
9. Should Statements—Obsessively thinking things “should” be a certain way, you “should” behave a certain way, events “should” have gone differently, etc. leads to consuming criticism of yourself, your circumstances, those around you, and life in general.
10. Minimizing and Magnifying—When minimizing, things matter less in your mind than supported by reality. When magnifying, the importance of things is enlarged far beyond reality.

Cognitive distortions are not unique to individuals with mental health conditions. Everyone is vulnerable to developing thinking errors.² However, faulty thinking can contribute to alcohol misuse or alcohol use disorder.³

How Are Cognitive Distortions Related to Alcohol Addiction?

Cognitive theorists view alcohol addiction as a response to negative feelings stemming from thinking errors.³ Two lenses can be used to understand the role of cognitive distortions in alcohol misuse:

• Alcohol misuse is an attempt to cope with negative thoughts about events that lead to negative emotions OR
• Cognitive distortions about alcohol, sobriety, or recovery lead to alcohol misuse

Both of these can occur at the same time and influence your relationship with alcohol.³

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While every person’s thought patterns, including cognitive distortions, are different, the 10 major cognitive distortions could relate to alcohol addiction in the following ways.

Mindreading

While you can’t actually know what anyone else thinks—at least not without asking—mindreading can contribute to the development of problematic alcohol use and continued misuse.

For example, someone may assume, “People will think it’s strange if I don’t drink and everyone else is,” “No one wants to hang out with me when I’m sober,” or “I’m funnier when I drink.”

Mindreading can also be a barrier to treatment if someone thinks things like, “People will judge me if they know I’ve been to rehab” or “My friends will think I’m self-righteous if I don’t drink with them.”

Catastrophizing

Any aspect of life can be catastrophized. If a person has a regular pattern of catastrophizing, this can be a major factor in addiction and obtaining alcohol addiction help.

An example of catastrophizing is the following train of thought: I promised myself I wouldn’t drink, but I had one. I can’t control my drinking. My drinking is going to cause irreparable liver disease and rehab won’t help me.

This train of thought skips assumes the worst scenario at many future points in the person’s life, including the failure of alcohol addiction rehab and medical treatment based on a single drink.

All-or-Nothing

All-or-nothing think ignores small victories that can lead to positive recovery outcomes over time based on small setbacks.

For example, “I have been a rehab program before and I’m not abstinence now so no type of alcohol addiction help will ever work” or “I lapsed, therefore, all the work I’ve done up to this point wasn’t worth it.”

Emotional Reasoning

Emotional reasoning is often a cognitive distortion that facilitates problematic alcohol use. However, it can also hinder treatment and recovery.

Examples of emotional reasoning include thoughts like, “I’m better in social situations when drinking—I can’t give that up,” “If I can’t control my alcohol use, that must be a sign,” and “I know my alcohol use endangers my health, but I can’t make myself want to get sober.”

Labeling

Labeling thoughts turn behavior into a reflection of your or others’ behavior into a reflection of identity. For example, “I had a drink after I said I wouldn’t, so I am a failure” or “My friend brough alcohol to a party knowing I was in recovery, so they are toxic.”

Labeling can make it difficult for you to gain new perspectives on yourself, others, objects, and past events.

Mental Filtering

Mental filtering involves focusing on the aspect of an event or behavior that proves a belief you already have. For example, beating yourself up over having one drink in the last 30 days instead of considering the other 29 days—and even only having one drink before stopping—a valid victory.

Overgeneralization

While understanding patterns can be an important part of progressing in recovery, assigning importance to a fluke or small grouping of events as though they apply to everything in your life can be damaging.

Overgeneralizing can appear in thoughts like, “I used to have a glass of wine whenever I ate out at that restaurant so I can’t eat out anywhere” or “I had a drink at my friend’s wedding so I am in danger of drinking at every social gathering.”

Personalization

Personalization often comes into play when trying to work through the underlying causes of alcohol addiction. For example, blaming yourself for a pattern of physical abuse that caused trauma, which in turn contributed to your alcohol use.

While you are responsible for your choices around alcohol use—especially once you are in alcohol addiction rehab—you are not responsible for traumatic events that may have put you at higher risk for misusing alcohol.

Should Statements

Obsessive should statements can keep you from making changes or feeling satisfied with your progress. Thoughts like, “I should be sober by now” can actually keep you from seeking alcohol addiction help out of shame.

Thoughts like, “This should be easier,” “I should have done this when I was younger,” or “I should be progressing faster” can also cause mental blocks that actually inhibit the effectiveness of treatment and your progress in recovery.

Minimizing and Magnifying

Minimizing can keep a person out of treatment or keep them in treatment longer. For example, thinking, “Alcohol might be causing problems at work, but they aren’t that bad” may keep you from seeking treatment. Thinking, “I still want to drink alcohol, but I’m fine” may lead to needing more help in future.

Maximizing may lead to extreme fear of relapse due to enlarging the significance of “bad signs.”

How Can I Identify and Change Cognitive Distortions?

Even though many thought patterns are automatic, you can change the way you think³.

One of the most common types of therapy used in alcohol addiction rehab is cognitive-behavioral therapy (CBT). CBT therapy is considered a gold-standard treatment and is often used in alcohol addiction rehab.⁶ CBT is a form of therapy that aims to change behavior and negative emotions by changing the way someone thinks.³

CBT therapists who provide alcohol addiction support individuals in identifying and changing the thoughts that contribute to alcohol misuse.

CBT is an evidence-based treatment approach for substance use disorders.⁶ CBT is a goal-oriented and individualized treatment approach.⁷ CBT for substance misuse often includes the following:^{3, 7}

• Functional analysis, a process in which a therapist and client examine the thoughts, feelings, and circumstances that happened before and after substance use
• Training in how to manage thoughts about substances
• Examining thought processes related to alcohol use
• Identifying and practicing coping skills

CBT is also effective in treating co-occurring alcohol use disorder and other mental health conditions, like depression and anxiety.⁸ CBT can be used in individual therapy or group therapy sessions.

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How to Recognize a Cognitive Distortion

In addition to working with your treatment team and a specializing individual therapist, you can also work on recognizing your own thoughts. Some ideas include: ^{4, 9}

• Do you identify with any of the thought patterns discussed in this article? If some of the cognitive distortions seem to apply to you, write out examples of your own thoughts. Can you separate these negative, distorted thoughts from another, more logical “voice” in your head?
• Complete a thought record. A thought record is a log of your thoughts. Write out the thought along with facts that support the unhelpful thought and facts that don’t support it. Next, you would identify a more helpful thought to replace the distortion.
• Ask others for feedback and support. Educate your support system on the types of cognitive distortions. Ask them to point out to you when they hear you using one of them, especially to excuse or support your alcohol misuse.

If you need professional alcohol addiction help, call 800-948-8417 Who Answers? to find the help you need.

Resources

1. Rnic, K., Dozois, D.J.A., & Martin, R.A. (2016, January 22). Cognitive distortions, humor styles, and depression. Europe’s Journal of Psychology, 12(3), 348-362.
2. American Psychological Association. (2020). Cognitive distortion. APA Dictionary of Psychology.
3. Beck, J.A. (2011). Cognitive behavior therapy: Basics and beyond, 2nd ed. The Guildford Press.
4. Costin, C. & Schubert Grabb, G. (2012). 8 Keys to Recovery from an Eating Disorder: Effective Strategies from Therapeutic Practice and Personal Experience.W. Norton & Company.
5. Bradizza, C.M., Brown, W.C., Ruszczyk, M.U., Dermen, K.H., Lucke, J.F., & Stasiewicz, P.R. (2018). Difficulties in emotion regulation in treatment-seeking alcoholics with and without co-occurring mood and anxiety disorders. Addictive Behaviors, 80, 6-13.
6. Center for Substance Abuse Treatment. Addiction Counseling Competencies: The Knowledge, Skills, and Attitudes of Professional Practice. Technical Assistance Publication (TAP) No. 21. Rockville (M.D.): Substance Abuse and Mental Health Services Administration.
7. National Institute on Drug Abuse. (1998). A Cognitive-Behavioral Approach: Treating Cocaine Addiction. Therapy Manuals for Drug Addiction, No. 1. Rockville (M.D.): National Institutes of Health.
8. Yule, A. M. & Kelly, J. F. (2019, October 24). Integrating Treatment for Co-Occurring Mental Health Conditions. Alcohol Research: Current Reviews, 40(1), arcr.v40.1.07.
9. American Psychological Association. (2020). Thought record. APA Dictionary of Psychology.