The Regulation of Cognitive States: A Cognitive Model of Psychoactive Substance Abuse

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Abstract
This paper describes a cognitive model of psychoactive substance abuse which emphasizes the ability of psychoactive substances to rapidly modify uncomfortable cognitive states. Cognitive states include any mental event of which one can become aware such as thoughts, feelings, sensations, perceptions and memories. It is suggested that substance abusers have learned to interpret such mental events (i.e., metacognitions) in such a way that they are construed as harmful, threatening, and undesirable. Psychoactive substance abuse becomes the preferred means of effectively modifying such cognitive states. A cognitive treatment of substance abuse, based on the model successfully employed in the treatment of anxiety disorders, is outlined which stresses the importance of gradually exposing substance-dependent clients to avoided cognitive states within a therapeutic environment that encourages disconfirmation of dysfunctional metacognitions and a more adaptive appraisal of their cognitive states.

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