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Cognitive (Expectancy) Theory of Addiction and Recovery Implications

A. Tom Horvath, Ph.D., ABPP, Kaushik Misra, Ph.D., Amy K. Epner, Ph.D., and Galen Morgan Cooper, Ph.D. , edited by C. E. Zupanick, Psy.D.

According to cognitive (or expectancy theory), addictive behaviors are chosen over healthy behaviors due to our expectations. When a person expects the pros and cons of addictive behavior favorably outweigh the pros and cons of healthy behavior, they will choose addiction. For example, someone may (mistakenly) believe that craving, if not satisfied, will result in harm. Or, they may believe that healthier choices will lead to boredom. These expectations about addiction may develop by observing others. This can be through direct or indirect observation.  For instance, a movie may portray a drug dealer as someone who is sexually popular with a glamorous and exciting life. Once these expectations develop, they are often resistant to change. This is true even in the face of new, more accurate information.

To recover, people need to develop more accurate expectations of addiction and craving. A thorough, accurate evaluation of all the pros and cons is encouraged.

Questions for personal reflection from expectancy theory: Wouldn't I benefit from examining my expectations about addiction? It does seem a bit strange that even though my addiction is no longer fun and enjoyable, I still expect it to be fun. Don't I exaggerate the discomfort of craving, imagining it will destroy me or force me to use? Doesn't it simply go away if I wait long enough?