Mental Health Continuing to use mild "crutch" substances during CBT... bad idea?

[Vastness]

I am not 100% sure what question I am trying to ask here so I am just gonna say what I'm doing and hopefully someone can offer a helpful opinion.

I have recently started getting therapy for various reasons, and I am finding it generally helpful, and I have been fairly honest about my drug use (as far as necessary anyway, no need to be talking too openly about my lifelong passion for hallucinogens). Just to clarify, drug use isn't the reason I'm getting therapy, and call me in denial, but I don't actually see my drug use of any kind as really much of a problem and think I have always had it reasonably under control. Anyway I was fairly honest about my frequency of use and that sort of thing and it doesn't seem like my therapist really thought it was that much of an issue, and it's not something we've really talked about since, so all good, one would think...

However something I am a little unsure about how to approach is the fact that I do use some "milder" and generally less recreational but still undeniably powerful substances quite often. Specifically, the "hardest" (using the term loosely) substances I do on a regular basis are Modafinil and Phenibut, maybe 2-4 times a week, sometimes but not always together, and for different reasons, but primarily to be able to motivate myself, either to work so I don't just procrastinate endlessly and do nothing, or to do something social and new instead of just deciding to be a recluse. I'm capable of doing both these things without either substance but it is obviously much harder, and I'm far more inclined just to give in to my natural avoidant tendencies. This isn't something I've admitted and I'm not really sure if I should.

I figure that these substances have been a help in my life and in terms of harm are at least on a par with, or quite likely even less harmful than being a caffeine addict or few-times-a-week binge drinker, and plenty of people are both of these things and do OK. But equally, there is a significant subjective difference in my mood when I am on one of these substances to not on it and I'm wondering if I keep using these as crutches, maybe I'm going to hamper my "recovery" so to speak from the apathetic, amotivated, anxiety ridden quagmire I seem to have allowed myself to slip into recently.

Again I'm not entirely sure what question I'm asking here but I guess it would be, does anyone have any experience continuing to use somewhat mild substances as "crutches", in a way that would usually be considered below the threshold of an actual "problem", while undergoing therapy for some kind of psychological condition, and if so, what was your experience doing this, and how honest with your therapist were you about it?

 

[Mafioso]

By CBT I assume you are talking about cognitive behavioral therapy, in which your therapist is trying to get you to recognize the connection between thoughts, emotions and actions. I would have to say using any sort of drug would be ill advised when receiving CBT if you want to be successful. Part of CBT is getting familiar with your thought process and patterns of thinking. Taking drugs will cause unnatural deviations and sway of emotions. The goal is to be able to control emotions and thus behavior by recognizing thoughts that drive your emotions, this would be very hard if you are still using.

If you are not being completely honest and open with your therapist you are making their job much harder if not impossible to do accurately. Also, I would think you are sort of wasting your time and money as it's not going to be nearly productive as it could be were you sober. I'd suggest letting your therapist know, as drug use is something people receive CBT so they can abstain from using and curb addictive behaviors.

Using a crutch is only going to slow you down or harm you in the long run, you have someone who can help you to learn how to function without it so you won't need it. Whatever sort of benefit it may be providing for you is either something you don't need or something you can provide for yourself when completely sober.

Also, 2-4 times a week is close to 50% of the time... it would probably benefit you more than you realize to abstain. it may save you from a world of hurt down the line.

 

[herbavore]

I don't have any experience with either of those drugs. What do they give you that draws you to use them?

 

[cj]

If you plan on continuing to use substances then learning to cope with yourself while on those substances makes a lot of sense to me

 

[Vastness]

Thank you all for your input.

By CBT I assume you are talking about cognitive behavioral therapy, in which your therapist is trying to get you to recognize the connection between thoughts, emotions and actions. I would have to say using any sort of drug would be ill advised when receiving CBT if you want to be successful. Part of CBT is getting familiar with your thought process and patterns of thinking. Taking drugs will cause unnatural deviations and sway of emotions. The goal is to be able to control emotions and thus behavior by recognizing thoughts that drive your emotions, this would be very hard if you are still using.

If you are not being completely honest and open with your therapist you are making their job much harder if not impossible to do accurately. Also, I would think you are sort of wasting your time and money as it's not going to be nearly productive as it could be were you sober. I'd suggest letting your therapist know, as drug use is something people receive CBT so they can abstain from using and curb addictive behaviors.

Using a crutch is only going to slow you down or harm you in the long run, you have someone who can help you to learn how to function without it so you won't need it. Whatever sort of benefit it may be providing for you is either something you don't need or something you can provide for yourself when completely sober.

Also, 2-4 times a week is close to 50% of the time... it would probably benefit you more than you realize to abstain. it may save you from a world of hurt down the line.

Yes, I am talking about Cognitive Behavioural Therapy, and I do see what you are saying... since reading this post I have decided to abstain for a while and see how that goes... I don't plan to abstain entirely however, as I think this is just going to be too hard for me, to be perfectly honest, but maybe once a week would be better than 2-4 times.

I don't have any experience with either of those drugs. What do they give you that draws you to use them?

Phenibut is a gabapentinoid in the same family as Pregabalin and Gabapentin, and produces a feeling of relaxation and general wellbeing which is highly anxiolytic but does not generally cause any coordination problems. I am pretty anxious by nature so I use it to make it easier to go to an office which I enjoy being at less and less, to make it easier to face unfamiliar social situations, and even sometimes familiar social situations if I just want to have a day where I can properly relax and dial back my natural background worries down a couple of notches. I have felt in the past that it makes me a better more open version of myself but I am wondering recently if that is a false belief and while the other version of myself is no doubt more open, I may be losing something in the process. Bluntly though it gives me a calmness and feeling of social confidence which is not easy for me to attain through other means.

Modafinil is a wakefulness enhancer which is perhaps comparable to low doses of amphetamine (not speaking from experience, just various studies and anecdotal reports) but with less CNS side effects and a longer duration. It gives me a drive and focus which I often lack but wish I did have naturally. I use it primarily to enable myself to work efficiently and effectively. I can do this without the substance sometimes but less often. It is not lost on me here either that my lack of focus may also come from a lack of interest in the work I am doing and that perhaps it is time for some kind of change. In fact I am almost certain that this is the case at least to some extent but for various reasons I do not feel able to immediately change my career path so I do need some way to be able to motivate myself for the near future.

If you plan on continuing to use substances then learning to cope with yourself while on those substances makes a lot of sense to me

I do plan on continuing to use substances in general, and probably these ones too, if more sparingly - prior to these substances I used a lot of other more mild nootropics, such as Piracetam and it's various derivatives, but those substances never really felt like they might be harmful, and sometimes Phenibut and Modafinil, although I maintain that they are still fairly mild and my own usage is still probably not really excessive, do feel like they might be harmful.



To be honest writing this out I guess my own feelings here are pretty clear. My concern is I've developed a slight psychological dependence with feeling like I can't work effectively or deal with unfamiliar situations optimally without some kind of crutch, and that I might be using them to mask discontent from other sources in my life, which if I'm honest, I am. So I guess I need to show myself that I can deal with these things using only cognitive behavioural techniques. Thank you all again for responding!

 

[cj]

There's a big difference between using for fun and using to cope with negative emotions.

 

[Mmp85]

I continued to drink (not like have a few drinks but excessive alcoholic drinking) while in therapy for several years and while taking medication that I shouldn't have been drinking with. I downplayed my drinking when asked about it and passed myself off as a social drinker. Which I was, I was just very, very social.
I still got some positive things out of therapy but I often didn't follow through with good advice or plans I would discuss in therapy because that part of my life was a mess and I wasn't interested in changing it at the time. It also caused me to be a very unreliable patient and I canceled more appointments than I went to because who wants to wake up and go to therapy when they were out all night drunk?

 

[Vastness]

As it happens I have not been particularly successful avoiding these crutch substances, after a few weeks of maybe once or twice a week I went right back to my old schedule of dosing. I have somewhat mixed feelings about this because on the one hand I do feel that I have got a lot out of therapy so far and have really worked through a lot of the stuff that I was hoping to, BUT obviously I am aware that I am potentially setting myself up for needing a bunch more (fairly expensive) therapy to get myself to a place where I don't feel like I need to use anything to be a functioning human being... I don't really feel like I am using these substances to deal with negative emotions anymore, rather, I am using them as performance enhancers, which in my mind is a better way to be using them at least.

I guess if I'm honest I am kinda doubtful that I am even capable of operating at the level I want to in life without some crutch substances, as to be honest, again, I use a whole bunch of nootropics, multiple racetams, Tianeptine, Semax, NSI-189, etc, and I have used these on and off for a long time, maybe up to 10 years now, but never in huge doses, and always watching tolerance and subjective effectiveness, always cycling... when I was younger I was very amotivated, depressed, anxious, etc, and while I did have some therapy 4 years ago, I also discovered nootropics and managed to turn around my life and my outlook. So now my baseline is a lot higher naturally but I am still not satisfied with that baseline... I think also, I have always been a fan of drugs and I think that discovering nootropics was a gateway to the idea that, actually, I CAN take A substance (even if not the same one) almost every day! Which is great... but I guess I have just been concerned that my current frequent drugs-of-choice are a little more addicting and habituating than the comparatively milder, just-above-placebo-esque Piracetam and Noopept of my past. Anyway I don't know where I am going with this rambling life-story-esque post, I guess I have to just work things out for myself really what I want to do with myself regarding this little issue or non-issue in my life, thank you again anyway to everyone who responded so far.