The Behavioral Psychology Behind The Sinclair Method That Breaks Bad Drinking Habits

The Sinclair Method utilizes naltrexone to help people gradually reduce or quit drinking, but it’s only one part of the overall behavioral psychology behind TSM.

When a behavior brings about a sense of reward the behavior is reinforced in the brain. On the opposite end of the spectrum, if a behavior doesn’t result in a reward we’re less likely to repeat the behavior. Sometimes, the reward that is perceived is actually a bad thing if the behavior that led to it is negative or harmful. 

Drinking alcohol is a perfect example of this. It’s widely recognized as an unhealthy behavior, but alcohol taps into the reward center of our brain and releases endorphins. Each time a person drinks, they get the reward, and it becomes a learned behavior that can have very negative consequences. In order to overcome this, the brain has to learn that consuming alcohol doesn’t come with a reward, but that can be very difficult to do. 

You may have heard about The Sinclair Method (TSM), a treatment protocol that helps people quit drinking. Unlike abstinence-based treatment, TSM promotes a reduction in drinking over time that may or may not lead to completely abstaining.

Dr. John D. Sinclair, the neurobiologist who developed TSM, found that alcohol use disorder is a learned behavior that can be modified with medication and behavioral psychology. Being a neurobiologist, Dr. Sinclair recognized that drinking alcohol activates opioid receptors in the brain to create a sense of pleasure - the reward. Repeated use creates an association in the brain that links the act of drinking with pleasurable feelings. Each time you drink operant conditioning happens, which means the behavior is reinforced.

The ultimate goal of The Sinclair Method is to break this connection and change drinking habits by taking away the reward aspect and addressing factors that shape behavior. This is done through pharmacological extinction with naltrexone and conditioning, a process of unlearning bad habits and learning good habits. 

The Role of Pharmacological Extinction to Change the Reward Relationship 

If behavior is shaped by a sense of reward, a first step in changing behavior is to eliminate the perceived reward. However, this isn’t so simple because a behavior doesn’t have to be rewarded every time for it to be reinforced. The only way to achieve behavioral change is for the behavior to never be rewarded.

Pharmacological extinction refers to the process of using a medication to unlearn the positive associations of drinking so that overtime there’s no interest in drinking. As the interest and cravings for alcohol diminish, the habits connected with drinking do as well, particularly if the change is supported in other ways. 

The medication that is used with The Sinclair Method for the purpose of extinction is naltrexone. 

Naltrexone is a prescription medication that’s highly effective because it blocks opioid receptors in the brain that release endorphins when you drink alcohol. It literally prevents a person from experiencing a reward. Of course, one experience isn’t enough to disconnect the association and change behavior. Consistency over time is key to helping the brain unlearn that consuming alcohol leads to a rewarding experience. 

That’s why naltrexone has to be taken shortly before drinking every time. Failing to do so will allow the alcohol to create a sense of reward again and reinforce the negative behavior. It’s what’s known as variable-ratio reinforcement, and it’s a powerful mechanism for maintaining previously learned behaviors.

With consistent use, naltrexone can eliminate cravings for alcohol because the brain learns there is no reward connected to it. Once the cravings go away that isn’t the end of the extinction process. There is still work to be done to cement behavioral changes for lasting recovery. 

Conditioning to Create New Healthy Habits and Continue Progressing

To truly break free of alcohol consumption, medication alone isn’t usually the sole solution. The other half of the process is conditioning to reinforce good habits that promote an alcohol-free lifestyle. Conditioning is extremely important because a relapse can cause the bad drinking habits to quickly resurface. 

That’s where support from online programs like Thrive Alcohol Recovery can make a huge difference. They provide support and a framework for the stages before and after extinction to help people think about alcohol use in different ways, create healthy habits and connect with others who are committed to living a healthier life without alcohol. It’s the behavioral part of TSM that’s paired with the biological changes from taking naltrexone.  

Once the biological urge is broken with naltrexone you’re in a more stable position to form new habits like:

• Using mindful drinking practices.
• Planning days that are completely free of alcohol.
• Creating new routines that are devoid of alcohol.
• Increasing social confidence with others that share your new lifestyle.

Habit change isn’t easy, but it’s absolutely necessary to overcome alcohol dependence. All of the new, healthy habits that are formed change what’s associated with drinking, improving the chance of long-term recovery and truly breaking free from alcohol use disorder. 

Anyone who’s interested in trying The Sinclair Method can start the process by taking our Alcohol Use Assessment. It’s the first step in determining if a naltrexone prescription is right for you and can play a pivotal role in changing how you think about alcohol so that you crave it less.