There is an organization called SMART Recovery which has applied the principles of RET (Rational Emotive Therapy, aka CBT or Cognitive Behavioral Therapy) with a good deal of success to quitting drinking. It strikes me that these same principles can be used to good effect by someone taking a Harm Reduction approach.
Let us take the case of a person who has decided that it is a bad idea to drink when feeling angry or depressed or sad or anxious; a person who instead has decided that the only appropriate time to drink is when one is feeling good and celebratory. A person who has adopted the motto “Drinking when you feel bad is bad drinking.”
The RET model create by Albert Ellis uses something called “ABCs”. Let us see how these ABCs can be applied to Harm Reduction:
A) “A” stands for “Activating Event”. An activating event can be anything that happens in the world around you–or even an internal state. An activating event can also be thought of as a “potential trigger” for the behavior which the person is trying to change. Let us look at a concrete example. Say that at work your boss reprimanded you for something which was not your fault and also did not allow you to explain the situation. When you leave work for the day you are extremely angry.
B) “B” stands for “beliefs”. In the old behaviorist model people only looked at stimulus-response pairs. The Ellis RET model differs from the behaviorist model in that the Ellis model states that a person’s response to a given stimulus is contingent on what the person believes. In the Ellis model Activating Events correspond to what the behaviorist call stimuli. The Ellis model calls those beliefs which lead to the undesired behavior “Irrational Beliefs” (IBs). Beliefs which lead to the desired behavior are referred to as “Rational Beliefs” (RBs). Let us see how this applies to the scenario about being yelled at by one’s boss. You leave work extremely angry and the following are your Irrational Beliefs: “I deserve a drink so that I can forget my sorrows.” “My boss was an asshole and I will get drunk to get even with him.” “I can’t stand to be this angry and I deserve to get drunk over it.”
C) “C” stands for “Consequent Actions”. Consequent Actions correspond to what the behaviorists call “response”. If you follow through on the Irrational Beliefs given above then as a result you get very drunk. Perhaps as a result of your angry drunk you get into a fight with someone and are thrown in jail. Perhaps you are just too drunk to wake up and go to work the next morning. Whatever happens, the end results of this angry drunk are not likely to be pretty.
D) “D” stands for “Dispute”. RET asks us to dispute our Irrational Beliefs and to replace them with Rational Beliefs. In the above scenario some Rational Beliefs are the following “Getting drunk will not eliminate my anger; it is likely to make my anger worse.” Getting drunk will certainly not hurt my boss–but it may well hurt me if I am too drunk to go to work in the morning.” “A better way to manage my anger is to go out jogging rather than to wallow in it.” Etc.
E) “E” is for Effect. The Effect of Disputing your Irrational Beliefs with Rational Beliefs is that you decide to not get drunk just because you are angry. Instead You decide to save your drinking until Saturday night when you are relaxed and can really enjoy it.
This is one example of how a person practicing Harm Reduction can use RET to maintain their abstinence days.
RET is about learning to monitor one’s thoughts from the outside and to change bad thoughts into good thoughts when they occur.
RET is quite solidly based in the Stoic philosophy of Epictetus.
I will end with two quotes:
No man is free who is not master of himself.
Epictetus (55 AD – 135 AD)
A wise man is he who does not grieve for the thing which he has not, but rejoices for those which he has.
Epictetus (55 AD – 135 AD)
Copyright © 2008, The HAMS Harm Reduction Network