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Tapping Into Neuroplasticity to Power Addiction Recovery
“When counselors explain that setbacks don’t erase progress but are part of the rewiring process, clients may feel more hopeful and motivated,” says Kenneth J. Martz, PsyD, MBA, psychologist at Lionheart Therapy Solutions.
Ahead of his session, “The Power of Plasticity: Paving New Neural Pathways for Recovery,” at the 2024 Cape Cod Symposium on Addictive Disorders, the Psychiatry & Behavioral Health Learning Network spoke with Dr Martz via email about incorporating innovative neuroplasticity approaches into traditional counseling methods for addiction recovery. Dr Martz explains that patients living with addiction may find the ability to “rewire” the brain empowering for their own recovery pathways. He also offers lots of practical guidance for how addiction recovery providers can integrate this clinical framework into the mental healthcare they provide.
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Editor’s note: This interview has been edited for length and clarity.
Psychiatry & Behavioral Health Learning Network (PBHLN): How can counselors integrate the principles of neuroplasticity into traditional counseling methods to enhance client outcomes?
Ken Martz, PsyD, MBA: Counselors can integrate the principles of neuroplasticity into traditional methods by helping clients understand that the brain’s ability to change is ongoing and accessible. Neuroplasticity can be introduced as a foundational concept, emphasizing that with consistent effort and new experiences, clients can reshape their patterns of thinking and behavior. As an individual learns an addictive pattern, they rewire neural pathways and neurotransmitters to align with addictive behaviors such as gambling, alcohol, other drugs, and similar behavioral patterns. As we help them journey to recovery, we are building new roads and helping to stabilize the new pathways. Here are some ways to practically integrate this into counseling:
- Cognitive Behavioral Therapy (CBT): CBT is an ideal framework for neuroplasticity since it focuses on challenging and changing unhelpful thoughts and behaviors. Counselors can explain to clients that each time they practice cognitive restructuring, they are "rewiring" their brain for healthier habits. Framing CBT in this light can empower clients to recognize that every new skill or thought pattern they practice reinforces new neural pathways.
- Mindfulness and Meditation: Encouraging mindfulness practices helps clients focus on the present moment and create new neural pathways that reduce anxiety or cravings. These practices help calm the amygdala (emotional reactivity center) and increase the prefrontal cortex’s role in decision-making and emotional regulation. Integrating brief mindfulness exercises into sessions or as homework helps create a daily rewiring process. This also helps to bring awareness to “triggers” and have the mindfulness to choose a different path when faced with a “fork in the road.”
- Emotional Regulation Techniques: Addiction often rewires the brain to respond intensely to stress or triggers. By teaching clients techniques like deep breathing, progressive muscle relaxation, or even creative expression, counselors can help clients reduce the emotional reactivity associated with those triggers, allowing for the brain to adapt to new, healthier responses.
Ultimately, integrating neuroplasticity into counseling helps clients view change not as something abstract or unattainable but as a tangible process their brain is capable of. Often, neurology can feel intimidating, but when explained in clear and simple terms, it can be empowering to know how to use science to help leverage our growth. When counselors explain that setbacks don’t erase progress but are part of the rewiring process, clients may feel more hopeful and motivated. This shift in mindset can enhance overall outcomes by making recovery feel more within reach.
PBHLN: What are some practical ways to help clients consciously engage in activities or exercises that promote the formation of new neural pathways?
Dr Martz: There are several practical ways counselors can help clients engage in activities that promote the formation of new neural pathways, emphasizing consistent, intentional efforts. These include regular exercise, diet, and mindfulness activities. I often use approaches that can be applied in sessions or as part of between-session practice.
I often encourage clients to engage in regular journaling, especially around their emotions, triggers, and thought patterns. Reflecting on these moments helps bring awareness to their automatic reactions. I typically also share journal prompts so that self-exploration can be steered from the expression of the wound areas to the creation of a vision of the next steps of growth. By consciously reframing negative thoughts into more constructive ones, clients start to create new cognitive pathways, reinforcing healthier emotional responses.
Another simple yet effective practice is a gratitude journal. Each day they can write down 3 things that they are grateful for. Like a Google search, this causes the brain to filter the day seeking positive experiences. By writing these experiences it engages the visual and motor cortex to help prolong attention on this positive feeling, reinforcing it. Practicing gratitude helps shift the brain’s focus from negative bias to more positive experiences. Encourage clients to keep a daily gratitude list or identify 3 things they are grateful for each day. This simple act can rewire the brain to become more attuned to positivity, which promotes emotional resilience.
These activities not only promote the formation of new neural pathways but also help clients feel empowered by their ability to take concrete actions to change their brain.
PBHLN: How does the understanding of neuroplasticity shift the way we approach long-standing behavioral patterns and resistance in therapy?
Dr Martz: Understanding basic learning from a brain perspective fundamentally changes how we view long-standing behavioral patterns and resistance in therapy. Traditionally, deeply ingrained behaviors and resistance to change were often seen as fixed or difficult to shift. Neuroplasticity offers a more hopeful, dynamic perspective, showing that the brain is capable of change at any age, regardless of how long these patterns have been in place.
The brain learns all new tasks in 1 of 2 ways: repetition or trauma. When we touch a hot stove, the intense pain “burns” this memory quickly into our neurology, which protects us from danger. For most things, we learn through repetition, just like we learned our multiplication “times tables” in second grade. As we learn a new skill and repeat it, the brain wires that memory to facilitate ease of use. So, the first time I rode a bike, I was shaky, but with repetition, my brain stored many micro-skills to complete these repetitive tasks. In the same way, we learn addiction with traumatic reactions and repetitive behaviors over years. We also learn recovery behaviors over time, which is one of the reasons why time in treatment is the number one predictor of treatment outcomes.
PBHLN: How can counselors ensure that the changes in neural pathways are sustained over the long term, particularly after counseling ends?
Dr Martz: Sustaining changes in neural pathways after counseling ends requires a focus on long-term strategies that clients can independently maintain. While the brain’s capacity for change is powerful, reinforcing those changes beyond the therapy room is essential for lasting impact.
A key approach is to help encourage the view of recovery as an ongoing active state. Counselors should emphasize the importance of continued practice. New neural pathways strengthen through repetition and engagement. Clients should be encouraged to keep using the tools they’ve learned in therapy—whether it’s mindfulness, cognitive restructuring, or healthy coping mechanisms. Long-term change depends on making these practices a regular part of their daily lives.
Encouraging clients to develop routines around their new behaviors is critical. Creating structure around self-care, healthy habits, and emotional regulation techniques makes it easier for clients to consistently engage in the practices that sustain new neural pathways. For example, setting aside time each day for journaling, meditation, or exercise reinforces these pathways. Just like one brushes their teeth and takes a shower, these learned health habits can lead to consistent growth and mental health maintenance.
I often say that addiction is a disease of isolation. For this reason, sustained change often requires social reinforcement. Counselors should help clients identify supportive people in their lives—friends, family, or support groups—who can hold them accountable and encourage the use of new behaviors. Connecting with others in recovery, joining peer support groups, or having a mentor can provide motivation to continue reinforcing healthy pathways after therapy ends. Furthermore, having a friend to do these activities with makes it more fun.
By embedding these strategies into therapy and long-term recovery planning, counselors can equip clients with the skills and mindset they need to maintain and strengthen their neural changes long after counseling ends. Sustained change is not just about what happens during therapy, but how clients continue to engage with their growth in the years that follow.
PBHLN: Can you discuss any specific cases where applying neuroplasticity principles led to significant breakthroughs in a client’s recovery?
Dr Martz: Applying neuroplasticity principles in counseling has led to significant breakthroughs for many of my clients, especially when they grasp the concept that their brain can be rewired through consistent effort.
For example, a client I worked with struggled with a gambling disorder for years. He had deeply entrenched thought patterns that drove impulsive behavior whenever he was triggered by stress or boredom. Traditional cognitive-behavioral techniques alone weren’t making a significant impact, largely because he believed his behaviors were beyond his control.
When I introduced the concept of neuroplasticity, it sparked a shift. I explained that each time he resisted the urge to gamble and engaged in healthier coping mechanisms, he was creating new neural pathways that would, over time, make it easier to resist those urges. This provided him with a concrete understanding of how his brain was working against him and how it could be retrained. He could then understand how his “big win” in gambling was similar to a trauma response, engraining this desire for gambling, while his years of gambling reinforced these patterns.
Notice that this works hand in hand with CBT. While CBT begins the discussion of recognizing limiting beliefs and changing them, neuroplasticity helps to understand that this change is not a “once and done” shift but rather a process of applying this new learning perspective.
We used a range of tools for emotional awareness, mindfulness of thoughts, visualization techniques, and behavioral practice to help train these positive responses of recovery.
While quickly stopping his gambling behaviors, after months of practicing these techniques, his confidence grew as he realized that his brain was adapting, and each success built upon the last. Neuroplasticity gave him the empowerment to view recovery as a process of reshaping his brain, rather than a battle of willpower.
PBHLN: What are the most common misconceptions about neuroplasticity among counselors, and how can they be addressed in clinical practice?
Dr Martz: There are several common misconceptions about neuroplasticity that can limit its effective application in counseling. Addressing these misconceptions can lead to more informed, realistic, and impactful clinical interventions.
A common misconception is that neuroplasticity is only for the young. While the brain is most malleable during early development, neuroplasticity continues throughout life. It’s true that the brain's adaptability may decrease with age, but change is possible at any stage. Older adults can still form new neural connections, particularly with consistent mental, emotional, and behavioral efforts.
Another misconception is that neuroplasticity guarantees quick or easy change like a new “tool.” Neuroplasticity does not equate to rapid or effortless change. The brain requires consistent, repetitive experiences to strengthen new neural pathways and weaken old ones. It’s easy to misunderstand neuroplasticity as a magic bullet, but real change takes time, patience, and sustained effort.
A third misconception is that understanding brain science is “hard” or scary. While many counselors did not get into the field to understand deep neuroscience, it is easy to become aware of these principles and explain them in clear terms so they are accessible to clients and motivating. By breaking it down into simple steps, anyone can use these principles more effectively.
By addressing these misconceptions, counselors can more effectively leverage neuroplasticity to guide clients through meaningful, sustained change.
Kenneth J. Martz, PsyD, MBA, is a licensed psychologist. He has worked in treatment and management of addiction (including gambling) for the past 30 years across settings including outpatient, residential and hospital settings. He was formerly the Special Assistant to the Secretary for the Department of Drug and Alcohol Programs in the Commonwealth of Pennsylvania. Dr Martz has a Doctorate in Clinical Psychology from Argosy University. He has authored a dozen publications, 6 bestsellers, including the international bestseller Manage My Emotions, translated into multiple languages. He has over 100 local, national, and international presentations in the addiction treatment field.
