What is the secret of successful addiction treatment?
Many people falsely believe that there is a magic cure out there for alcoholism and addiction. Unfortunately, this is not really the case. The problem is that it all hinges on the alcoholic or addict’s level of surrender. If they are not ready to stop drinking and drugging in order to change their life, then no amount of treatment is going to help them.
This is not really a secret, but even after achieving surrender many addicts and alcoholics still managed to relapse after having achieved significant clean time. So there is a deeper layer of confusion here because it seems that there are really two tasks at hand: one of them is to get clean and sober, and the other task is to stay clean and sober. While you may have success in getting clean and sober, it is another task entirely to maintain that for a lifetime. In my opinion, there is a vast difference between the process of getting clean and sober, and the long-term goal of maintaining sobriety. They are very different from each other and unfortunately many people try to apply the same principles from early recovery to their long-term journey. I have watched many struggling addicts and alcoholics failed to make it into long-term recovery. Many of them relapse and have to start all over again with early recovery.
In that sense, I believe there are really two secrets. One is the secret of how to get clean and sober, which really just involves total surrender and asking for help. If someone is not at the point of total surrender then they are not likely to do well in early recovery. This is the first secret of successful treatment.
But the second secret does not address surrender or getting clean and sober. It is more about long-term recovery and what people have to do in order to discover a new life that is actually worth living. The problem that I see happening for many people in recovery is that they do not achieve the kind of life that gets them excited. Eventually many people get bored in recovery, and so they eventually turned back to their drug of choice.
So the second secret of recovery is about discovering a new life for yourself that is actually worth living, a life that gets you excited and happy to be alive. Because I think ultimately that is what we are all looking for: that feeling and experience of being alive. When each of us first started out with drugs and alcohol, we got that feeling and experience of being alive, and it felt absolutely wonderful. Of course, in the long run, that feeling went away as our tolerance increased. This is the big lie that drugs and alcohol try to convince us of: that we can be happy whenever we want just by using our drug of choice. But in the end, are addiction wins out, and are drug of choice stops working for us. That is when we need to make a difficult decision and embrace a new way of life.
The answer that no one wants to hear
The real secret to long-term sobriety has nothing to do with many of the principles and concepts that they teach you about in early recovery. The problem is that and you go to treatment they have to teach you how to get clean and sober, but they cannot really get ahead of themselves and teach you how to stay clean and sober. This creates a problem when people are trying to transition to long-term sobriety. Many people who leave treatment will find ongoing support in places like AA and NA. But most people do not achieve full involvement in those programs, and even for those who do, this does not always ensure continuous recovery. Something more is needed in order to achieve long-term sobriety. Many people in twelve-step programs still end up relapsing.
The answer that no wants to hear is that continuous recovery requires a continuous effort. That effort is best described as being personal growth. If you are not pushing yourself to become a better person and to improve your life situation then it is going to be very difficult to maintain sobriety in the long run. Some people who attend AA meetings are able to achieve this type of personal growth, and thus they stay sober in the long run. But not everyone who attends AA is able to achieve that level of personal growth. Instead of pushing themselves to keep making positive changes, they simply attend meetings every day and this leads to complacency.
After being introduced to the AA program, many people get the idea that if they just keep coming back to the meetings, then there sobriety will work out just fine. Unfortunately this is not the case. What happens is that they come to depend on their daily meeting in order to stay sober. This is not how the program was originally intended to work. The idea instead was to work through the 12 steps and create a sufficient change in personality so that you did not fall back into your old habits. Instead of just doing something different every day, like attending meetings, you would actually change who you were as a person so that you did not return to drinking. Much of that transformation has been lost when people come to rely on daily meetings to keep them sober.
A true program of recovery, whether it is based on AA or not, needs to be more focused on personal growth, and less focused on daily meetings.
So what is the point of rehab?
You may be asking yourself: if personal growth really is the secret that everyone is looking for, then what is the point of rehab?
This is a fair question, because as I pointed out earlier, there is really no way to teach personal growth while someone is in short-term treatment. They have to focus on teaching the struggling alcoholic how to make it through the day without taking a drink. They do not have the luxury of being able to teach them how to avoid complacency in the long run. At best, they can mention the possibility that complacency may become a problem, but there is no way to address it directly in short-term rehab.
Rehab still makes a lot of sense for anyone who is struggling with drug addiction or alcoholism. This is because you still need to learn how to get clean and sober. That is a monumental task unto itself and should not be underestimated.
Even long-term treatment centers cannot necessarily teach people how to avoid complacency. I personally live in a long-term treatment center for 20 months, but while I was there many of my peers relapsed. At the time, I could not understand why this was happening, because we had so much support and help for our addiction.
What I learned later on is that the first year of recovery is really still, for the most part, early sobriety. The problem with people in long-term treatment is not a lack of personal growth, instead it is a lack of surrender. All of my peers who relapsed while living in long-term treatment did so because they had failed to surrender completely.
After leaving long-term treatment, I realized that I did not really transition into long-term recovery until I was out on my own. When you are living in long-term treatment you are still quite sheltered from the real world. The real test begins when you walk out of treatment and back into your real-world environment. This is when personal growth and taking positive action is going to make or break your recovery.
What many people fail to realize is that being in addiction treatment is like having a massive safety net. This is very important in early recovery, but it is by no means a magic bullet. At some point every addict and alcoholic has to perform without that safety net– in other words, they have to leave treatment. When they do, the techniques and strategies that they used during treatment will not necessarily keep them clean and sober forever. In order to achieve long-term sobriety they are going to have to evolve.
This is the transition into a life of personal growth. People who leave treatment and failed to make positive changes on a regular basis are vulnerable to relapse. Whether they stay in the twelve-step program is actually not a strong indicator of success, compared to their willingness to pursue positive action. For most people, AA works pretty well. But if you have the right attitude and are willing to pursue positive change in your life, you can get by without a formal program of recovery (as I have done).
Can you ever insure that someone will not relapse after attending treatment?
Remember when I mentioned that people in long-term rehab often relapse due to a lack of total surrender? This is the reason why you can never guarantee that someone will never relapse. The problem is that you never know if they have truly surrendered.
I have known people in recovery who stayed clean and sober for several months or even years and they still ended up relapsing due to a lack of total surrender. This is often referred to as having a reservation. The reservation just means that they were hanging on to a certain excuse that would allow them to relapse in the future.
When you actually surrender to the fullest extent possible, there is no room for any reservations. Therefore if someone is to relapse, it generally means that they had failed to surrender in total. Somewhere deep inside of them they were hanging onto the idea that they might use drugs or alcohol again some day successfully.
Why would someone relapse after several years in recovery? How does that even happen?
As I mentioned earlier, one of the secrets of recovery is personal growth. The reason that people relapse after several years or decades is because they become lazy. They refer to this as complacency.
The solution for complacency is continuous growth. If you are learning and making positive changes in your life then you are not, by definition, complacent.
This is the solution that people generally do not want to hear. The reason they don’t want to hear it is because it is a lot of hard work! Nobody wants to hear that they have to keep pushing themselves to make positive changes in order to stay clean and sober. But this is not only the secret to continuous sobriety, it is also the secret to enjoying your life in creating a better experience for yourself. Life gets really good if you keep pushing yourself to take positive action over and over again. In fact, you cannot imagine how good your life will be after 10 years if you are taking positive action every single day.
I referred to that concept as accumulation. When you stay clean and sober and continue to fight against complacency, you tend to accumulate positive benefits over time. Life just keeps getting better and better.
If personal growth is the solution then why is this not taught in rehabs?
As I mentioned before, rehab has to focus on the process of getting people clean, rather than keeping them clean. I think the hope is that people will leave treatment and then dedicate their lives to the AA program. This works for some people and can produce continuous growth if they take that program seriously. But many people who tried to use AA as their recovery solution eventually fall by the wayside. The real focus needs to stay on positive action and personal growth.
What can I do if I am struggling to get clean and sober, but I have failed at treatment before?
In that case you need to focus more on surrender.
The way to move closer to surrender is to deliberately break through your own denial. Yes, it is possible to be in denial and also realize that you are in denial. I have been at this exact state myself. My problem was that I just did not want to see the truth, even though I knew that I was wrecking my life.
So what I had to do was to focus on my misery. I had to really see and understand that my drug of choice was no longer working for me. And I had to realize that it was not going to ever work again in the future–not for any real length of time (maybe a fun afternoon or evening but after that you are back to the grind of daily misery).
So what you need to do is to go back to treatment, but only after you have broke through the last of your denial. You must fully realize that it is never going to get any better if you keep going back to your drug of choice. Tolerance works against you and eventually when you are “high” you will only feel completely normal….then when you are not high you will be restless, sick, and irritable. Once you realize that you are caught in this trap and that your misery will never end then you may become willing to make the necessary changes.
Recovery is all about follow-through. Addiction treatment is just the start. And that right there is the real secret of successful sobriety.