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Many therapists and impulsive disorder experts believe that a cognitive behavioral therapy (CBT) approach may hold the most promise for effective results. The CBT approach combines a variety of techniques to be employed in conjunction to re-orient the impulsive person away from acting against their best interests. These techniques include operant reinforcement, self-instruction, problem-solving, modeling, role-playing, rehearsal, relaxation training, imagery, and group discussion. Kendra J. Garrett and K. Giddings mention one such approach in their paper entitled, “Improving Impulse Control: Using an Evidence-Based Practice Approach”, “A search for CBT programs that could be used to treat impulsivity yielded a number of possible programs and curricula aimed at improving impulse control in students. The social workers chose “Hunter and His Amazing Remote Control” (Copeland, 1998). Hunter has a series of lessons with accompanying activities that use the metaphor of a television remote control to help students regulate behavior. Students can pause, change channels (tune in after becoming distracted), fast forward (to anticipate consequences), rewind (to consider alternate options when behavior goes awry), use slow motion (to talk about emotions), coach (to use self-talk), zap (to stop negative thinking), and “way to go” (to self-affirm). Hunter was designed for elementary students, and the social workers anticipated that they would need to make adaptations for some of their older students.”
These techniques are certainly valuable tools in coping with impulsivity disorders. They all seek to re-orient the person, open the way for making choices, and encourage behavior that is truly in their best interest. There is a problem though. These tools are only valuable if used at the time of temptation. A frustrated alcoholic in bar looking at his favorite whisky will find looking to the doorway, thinking of a hang-over, talking about his feelings, telling himself ‘do the right thing,’ or any other cognitive technique a difficult task. In order for these tools to be helpful, there must be a real, consistent, persistent willingness to use them as needed. Unfortunately at the time of temptation, that willingness often disappears.
For these techniques to be used properly, a more fundamental problem needs to be addressed: the problem of the human will, that Christians realize has been weakened by the Fall. Saint John Cassian remarks that “None of the righteous are sufficient on their own to acquire righteousness, unless whenever they stumble and fall, divine mercy supports them with His hands, so that they do not utterly collapse and perish when they have been cast down through the weakness of free will.” (Conference 3, chapter 7). If such is true for the saints, how much more is this the case for those who are less intimately connected to God. The unaided human will in the impulsive at the time of temptation is just too weak and too disoriented to act in the way their higher selves know they should. What is needed is the presence and power of God to strengthen their will, so that they will reach out and use the tools at their disposal.
Spiritual activity, then, must accompany the CBT techniques if impulsive behavior is to be managed properly. The spiritual fathers of the Church remind us that impulsivity is given birth in the realm of the thoughts. It is the thoughts that lead us and seem to compel us to impulsive behavior. Saint Theophan the Recluse wrote to his spiritual children about not losing heart in this battle with the thoughts when he wrote, “You must never be afraid, if you are troubled by a flood of thoughts, that the enemy is too strong against you, that his attacks are never ending, that the war will last for your lifetime, and that you cannot avoid incessant downfalls of all kinds. Know that our enemies, with all their wiles, are in the hands of our divine Commander, our Lord Jesus Christ, for Whose honor and glory you are waging war. Since He himself leads you into battle, He will certainly not suffer your enemies to use violence against you and overcome you, if you do not yourself cross over to their side with your will. He will Himself fight for you and will deliver your enemies into your hands, when He wills and as He wills, as it is written: ‘The Lord thy God walketh in the midst of thy camp, to deliver thee, and to give up thine enemies before thee’ (Deut. xxii, 14).” (Unseen Warfare)
The battle over the impulsive thoughts is also greatly aided by the holy Mysteries of the Church, primarily because in the mysteries, God touches man and man touches God. That touch gives the will a bit more strength to again do what is right through the grace of God. According to Metropolitan Hierotheos of Nafpaktos, “When someone lives without the grace of Christ, he is completely unprotected from the devil’s attacks. When, however, he is full of Christ’s grace, it is impossible for the devil to act. St Diadochos of Photiki says that, if God’s grace does not dwell in a person, the demons lurk like snakes in the depths of his heart. But when God’s grace is in the nous, the demons move like dark clouds around the heart, taking the shape of different passions, with the sole purpose of distracting the nous from God. Someone who has the grace of God within him, even if the devil makes war on him, cannot suffer harm.” God is ultimately everything and must become everything for the impulsive. When God is everything for man, man can do anything for God. That is why seeking God’s will is absolutely crucial for those struggling with impulsivity. As Saint Leo, Pope of Rome noted “if our will is His will, our weakness will receive strength from Him, from Whom the very will came; ‘for it is God,’ as the Apostle says, ‘who worketh in us both to will and to do for His good pleasure’” Homily 19). With His strength, the tools that cognitive behavioral therapy offer can truly be effective, and we can truly do all things through Christ who strengthens us.
