Cognitive Distortions
What distortion involves seeing things as all good or all bad?
Black and White thinking
What are the three main trauma responses?
Fight, flight, freeze
What phase of relapse happens before physical use?
Emotional relapse
What grounding skill uses temperature to reset the nervous system?
Cold water or ice
Which neurotransmitter is most heavily dysregulated by methamphetamine and crack cocaine?
Dopamine
"I already messed up so I might as well keep using." What distortion is this?
Catastrophizing
What nervous system state is associated with calm and connection?
Parasympathetic nervous system
What’s one behavioral sign of emotional relapse?
Isolation, irritability, skipping support.
What CBT skill challenges “using thoughts”?
Thought challenging or reframing
What is dopamine’s primary role in the brain?
Motivation, reward learning, and drive (not pleasure itself)
You assume you know what everyone is thinking.
Mind reading
How can trauma increase substance use risk?
Substances are used to numb or regulate overwhelming emotions.
Why do cravings peak and pass within about 20–30 minutes?
Urges rise and fall like waves if not fed.
What does “urge surfing” mean?
Letting cravings rise and fall without acting on them.
What happens to dopamine receptors with chronic stimulant use?
Downregulation (reduced sensitivity)
"Using is the only thing that helps my anxiety."
Emotional Reasoning
Why might someone feel unsafe even when nothing bad is happening?
A dysregulated nervous system stuck in survival mode.
What chemical is responsible for Euphoric Recall
Glutamate
Why does naming emotions reduce intensity?
It activates the prefrontal cortex.
Which brain structure drives fear, paranoia, and emotional reactivity?
Amygdala
The belief that you are responsible for events outside of your control
Personilization
a mental health condition resulting from prolonged, repeated trauma, like childhood abuse or domestic violence
CPTSD
What is one internal boundary that supports recovery?
Saying no to urges, thoughts, or risky situations.
Why is consistency more important than motivation in recovery?
Habits form stability when motivation drops.
What is neuroplasticity?
The brain’s ability to change and adapt