Even for mental health professionals, it’s a puzzle to determine what draws people to addiction and how to tell when they are engaging in addictive behavior. What I’ve found in my own practice and research is that all addictive behaviors have two things in common: (1) they help people cut off painful feelings; and (2) they are strongly influenced or controlled by a destructive thought process that both seduces the person into the behavior and punishes them for indulging in it. Like an insidious dance partner, an addiction finds a pattern by which to step seamlessly into a person’s life, luring and condemning, comforting and destroying.

People who engage in drug or alcohol abuse, who have an eating disorder, or who struggle with any addictive pattern or behavior are acting according to the prescriptions of a destructive thought process, the critical inner voice. If someone struggles with an alcohol dependency, this internal enemy may try to tempt them with seductive, seemingly friendly thoughts (or “voices”) saying, “You’ve had a rough week. Have a drink. You really need to relax.” If someone is dealing with a food addiction, it might lure them with rewards: “Have a piece of cake. You did well on your diet all week.”

The critical inner voice always plays two roles in an addiction: seducer and punisher. After indulging, the deceptively soothing voice transforms into a cruel enemy, tearing the person apart and maliciously punishing them for indulging in the very behavior it encouraged. “You weak-willed jerk. You said you weren’t going to drink anymore!” “You’ve ruined everything. You’ll always be a fat cow.”

Addictive behaviors and the thought process that accompanies them represent a direct assault against a person’s physical health and emotional wellbeing, while limiting one’s ability to pursue meaningful personal goals in life. Therefore, it is important that a therapist help a client to identify the critical inner voices that govern these habit patterns and to challenge their dictates by learning more constructive ways of dealing with emotional pain.

In Voice Therapy, a therapeutic approach developed by my father, psychologist and authorRobert Firestone, therapists help clients pinpoint the specific triggers that precipitate the painful emotions and negative thought patterns, which, in turn, influence them to engage in addictive behaviors. In addition, by encouraging the pursuit of genuine wants, desires and goals, therapists strengthen clients’ real selves, a process that enables clients to achieve freedom from addictive, self-destructive behaviors. Here I have outlined the steps of Voice Therapy that are valuable to the therapeutic process of treating addiction.

The techniques of Voice Therapy consist of five steps: (1) the process of eliciting and identifying negative thought patterns and releasing the accompanying emotions; (2) developing insight into the origins of one’s voice; (3) answering back to the voice from one’s own point of view; (4) understanding the impact of the voice on one’s behavior and lifestyle; and (5) counteracting behaviors regulated by the voice through the collaborative planning and the application of appropriate corrective experiences.

Step 1: Identifying and Verbalizing Destructive Thoughts, or “Voices”

The principal technique of Voice Therapy consists of verbalizing negative thoughts in the second person, as though someone else were speaking the thoughts. For example, the statement, “I feel so stupid and worthless” would be changed to “You’re stupid and worthless.” This particular format is important for two reasons: (1) this is the form in which most people think critically about themselves (as though another person were talking to them, coaching, accusing, and enticing them in ways that are self-defeating and often self-destructive); and (2) this technique usually brings out considerable affect (often anger and/or sadness).

Step 2: Developing Insight into the Origins of One’s Voice

After clients have verbalized the voice and expressed the accompanying feelings, they frequently develop insight spontaneously into the origins of their negative thought processes. They may recall events from their past, names they were called as kids, or ways parents or influential caretakers treated them that left them feeling self-critical or unkind toward themselves. The understanding that they gain from this process enables them to develop compassion for themselves.

Step 3: Answering Back to the Voice from One’s Own Point of View

It is important that, after verbalizing their self-attacks, people answer back to these voices with a compassionate and realistic appraisal. Answering back always takes the form of offering a rational, realistic evaluation of one’s actual point of view. It can also involve countering each attack by responding with strength, anger and emotion. The point of the exercise is not to feel victimized by one’s critical inner voice, nor is it to build oneself up. Rather, the goal is to separate from this destructive point of view and see oneself through caring and truthful eyes.

Step 4: Understanding the Impact of the Voice on Present-Day Behavior

Through sensitive questions, therapists can encourage clients to identify the connection between their destructive thoughts and the addictive behaviors they wish to change. What kinds of thoughts lead up to the behavior? Do certain events trigger self-soothing thoughts and self-destructive behavior? By identifying these triggers, a person can become more conscious of his or her voice and better able to act against its directives.

Step 5: Collaborative Planning of Corrective Experiences

Client and therapist collaborate in planning suggestions for behavioral changes that correspond to the client’s special interests, goals and motivations. These generally fall into two categories: (1) corrective suggestions to help control addictive habit patterns; and (2) corrective suggestions that expand the client’s world by encouraging him or her to gradually overcome fears related to pursuing wants and goals.

Taking actions that break a self-soothing, tension-reducing habit pattern is often a first step toward change. The next step is dealing with the emotions that the addiction has been keeping at bay, most often pain and wanting. The therapist can help the recovering addict grieve for past losses and process old hurts. Clients can learn to expand their window of tolerance for pain, and develop healthy coping strategies for dealing with pain when it arises.

As individuals combat an addiction by challenging their destructive inner voices, they strengthen their true selves. They achieve a better balance that leaves them stronger in the face of destructive temptations and hurtful behaviors. Most importantly, they break free from any internal chains that hold them back from experiencing who they are at their fullest potential and from actively pursuing what they aim to accomplish in their lives.