Addiction recovery

If drinking, drugs or gambling have come to take up more of your life than you intended, the pattern is probably familiar. You set a limit and pass it. A promised clear week lasts three days. The money or the hours are harder to account for than they used to be, and keeping track of what other people know has become a job of its own.

Addiction is a pattern of use that continues despite clear harm, with a growing loss of control over when it starts and when it stops. With alcohol and many drugs there is also tolerance, where more is needed for the same effect, and withdrawal when use stops. Gambling disorder follows much the same psychological route without a substance at all.

What keeps addiction going

In the short term, a drink, a drug or a bet reliably takes the edge off something, whether that is stress, low mood or a difficult evening at home. The relief is immediate and the cost arrives later, so the relief is what gets learned. Over time, ordinary cues begin to trigger cravings on their own. A time of day, payday, the journey home.

Thoughts do much of the rest. Permission-giving thoughts such as “I have earned this” or “one will not hurt” make the next use feel reasonable at exactly the moment it matters. After a lapse, another thought often follows: “I have ruined it now, so it makes no difference.” This is known as the abstinence violation effect, and it is one of the main routes by which a single slip becomes a full relapse. Shame and secrecy then keep the cycle out of view.

If part of you has been reading this looking for the detail that proves your own use is not that serious, that search is worth noticing. It is one of the most common parts of the pattern.

For people who have been through residential treatment, the first months home are often the hardest. The structure of rehab falls away, and the old cues are exactly where they were left.

How CBT is used in addiction recovery

NICE guidelines recommend offering a psychological intervention such as CBT for harmful drinking and mild alcohol dependence. NICE guidance on gambling harms also recommends CBT as a treatment option. The work itself is concrete. It maps your own triggers and high-risk situations, works directly with cravings and the thoughts that give permission, finds other ways to meet the need the substance or the betting was meeting, and plans for lapses in detail so that one does not turn into a relapse.

If you have recently left treatment and have already caught yourself thinking that one evening would be fine now that you are doing well, that is precisely the thought relapse prevention is built to work with.

How I work with addiction and recovery

I am a Consultant Cognitive Behavioural Psychotherapist with over 25 years of clinical practice, originally trained in Scotland. I have extensive experience in addiction recovery and rehabilitation. My addiction work includes my time at the Priory. Alongside CBT I am trained in REBT, which is useful with the “I cannot stand this feeling” thinking that sits under many cravings, and in ACT, which works on letting an urge rise and pass without acting on it. For the last 15 years I have been in private practice in the City of London, working extensively with professionals in banks and law firms.

I work to create a safe and supportive space where you feel able to open up, which matters a great deal when so much of addiction has been kept hidden. I take a flexible, integrative approach, tailoring my work to the individual needs of each person.

I see adults and adolescents individually, and I also work with couples and families. Partners and relatives often carry a great deal on their own, and NICE recognises that family members may need support in their own right.

If you are physically dependent on alcohol, stopping suddenly can be medically dangerous, and your GP should be involved in planning it. Therapy is not a substitute for medical assessment or treatment, and I do not diagnose or prescribe. Sessions are fifty minutes, online, and usually weekly to begin with.

You do not need to have stopped, or to be sure you want to stop, before getting in touch.