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Metacognitive Training

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  1. Introduction
    Identify your fire
  2. Choose your own adventure
  3. Self-Esteem & Stigma
    Introduction
  4. What are self-esteem and stigma?
  5. Self-esteem, stigma and substance use
  6. Activity 1- Communication tools
  7. Activity 2- Creating a positive self-concept
  8. Activity 3- Focusing on your strengths
  9. Summary
  10. Quiz
  11. Explaining Situations
    Introduction
  12. What are attributions?
  13. Attributional styles and substance use
  14. Activity 1- Balanced explanations Part 1
  15. Activity 2- Balanced explanations Part 2
  16. Activity 3- Practicing explanations
  17. Summary
  18. Quiz
  19. Worrying & Coping
    Introduction
  20. What is rumination?
  21. Worrying and substance use
  22. Activity 1- Observe your thoughts
  23. Activity 2- Postpone rumination
  24. Activity 3- Shift your attention
  25. Activity 4- Sensory grounding
  26. Activity 5- Relaxed breathing
  27. Summary
  28. Quiz
  29. Attention & thinking
    Introduction
  30. Terms are related to thinking and memory
  31. Attention and substance use
  32. Activity 1- Card games
  33. Activity 2
  34. Activity 3- Problem Solving
  35. Summary
  36. Quiz
  37. Relapse
    Introduction
  38. What is relapse?
  39. Cravings, triggers, and relapse
  40. Activity 1- Managing triggers
  41. Activity 2- Alternative strategies
  42. Activity 3- Emergency plan
  43. Activity 4- Learning from each relapse
  44. Summary
  45. Quiz
Metacognitive Training Worrying and substance use
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Lesson 21 of 45
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Worrying and substance use

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Intrusive thoughts/rumination and relapse/cravings:

Physical and psychological dependence is common among people who use substances. Dependence describes the unpleasant symptoms you get when you try to avoid or cut down the use of a substance. This can lead to intrusive and intense thoughts about the substance, including a strong need to use again. 

These thoughts can also lead to rumination when people relapse, or use drugs again after choosing to stop. People can self-blame, regret, and worry about relapsing again in the future.

Thought suppression is a common strategy people use to try and control their unwanted thoughts. This is when someone actively tries to stop thinking about certain thoughts, like cravings for drugs or past relapses. It is important to recognize that this is not an effective strategy.

Try this exercise for yourself: for the next 30 seconds, try NOT to think of an elephant. Close your eyes and think of ANYTHING except an elephant.

Were you able to avoid thinking of the elephant?  

You probably immediately thought of an elephant or something related to an elephant, like the zoo or circus. 

 Thought suppression often results in more of the unwanted thoughts, not less. This means that attempting to suppress your thoughts about using substances may actually lead to increases in substance use. The harder you try to suppress your thoughts, the more frequent and intense your thoughts may become.

If avoidance is not a good strategy, what can we do about intrusive thoughts?

Mindfulness-based strategies can help you be aware of these unwanted thoughts, but not judge them. Here are some key principles of mindfulness:  

  • A thought is just a thought and not reality.  
  • A thought is only an “experience” in your mind. You can observe it without intervening or judging them for being negative. 
  • A thought about doing something does not mean that you have to, or will do, that action. 
  • E.g. If you are having intense thoughts about using substances you are trying to remain abstinent from, this does not mean you will relapse!

Mindfulness-based strategies are helpful to engage in when you are feeling cravings, as well as if you are stressed or distracted. The following activities will guide you through some examples.