Co-Occurring Connection


Suffering Has No Boundaries

For the past several decades, both clinicians and research-based practitioners have maintained the profound interplay of human suffering, what our society calls mental illness and Substance Use Disorders[67][68][69][70][71][72]. For example, Beck, Wright, Newman, Liese, (1993)[73], as well as several other CBT scholars and practitioners, have documented the efficacy and implementation of their philosophy in both individual and group therapies for this population.  Some of the concepts described by Beck (1993)[74] and his peers[75][76][77] are similar with at least two concepts found in Khantzian’s (2007)[78] “self-medication hypothesis” and the work of Gabor Mate (2011)[79].

One in the Same

Both may argue that a person’s efforts to avoid suffering (e.g. the “symptoms” of mental illness) and enhance pleasure, (and the latter is in itself is a form of avoiding suffering, e.g. deprivation, boredom, wanting, frustration), are two primary reasons for substance use behaviors, which also create and perpetuate cognitive belief systems [80][81][82][83]. These ideas are strongly and thematically related to Hayes, Strosahl and Wilson’s (2009)[84] term “experiential avoidance,” a main focus of the assessment and interventions in Acceptance and Commitment Therapy (ACT), a “Third Wave” form of CBT [85][86][87]. This suggests a rationale for applying both Evidence-based practices with traditional methods and theories.