Yesterday we looked at some of the common misconceptions and false truths about addiction recovery. Today we want to look at what the most typical recovery outcomes could be.
Outcome #1: You cannot get a foothold on recovery at all.
This may not be so much an “outcome” of recovery but more of a work in progress, as many of these outcomes will be.
I would argue that every single addict and alcoholic has to go through this “stage” (not really an outcome, but certainly could be the end point for some).
Everyone who is at this point in their recovery (or who is experiencing this outcome) is most likely stuck in denial. This means that they are not relinquishing control, and therefore they have not yet surrendered to their disease. Instead they are hanging on to the idea that they can one day control their drug or alcohol intake and still enjoy it, without losing control. For the true addict or alcoholic this idea of control is pure fantasy; it will never happen on a consistent basis.
The reason that the struggling alcoholic or addict can delude themselves so easily is because of two things:
1) The upside is so enormous for them in using their drug of choice. It “fixes” all of their problems (or so they believe). In the early days of addiction, this much is probably true–their drug of choice probably does have some benefits. For example, if someone is shy then their drug of choice may help them to overcome this trait. The outsider looking in at the addict may believe this to be trivial and ridiculous, but to the addict it could be a very important benefit, something that is worth fighting for. They believe that they have conquered one of their major personality flaws and found a way to be truly happy in life, so they are not just going to roll over and give up their drug just because of a few consequences.
2) Every struggling addict or alcoholic has brief periods of control–that perfect balance that is achieved in using their drug of choice where they are both happy, and in control. These moments are rare but they will happen for everyone who abuses drugs or alcohol. They just don’t occur very often. Now here is where the denial comes into play: the addict or alcoholic clings to those moments of control and perfect happiness, and they believe that if everything were to fall into place that this would be the reality for them at all times. Their brain is remembering one of the “good times” when they used their drug of choice and everything worked out well, nobody got hurt, nobody got in trouble, and things were peaceful. Their brain stubbornly clings to that experience and so they believe that every time they use their drug of choice, that should be the outcome. They falsely believe that if their external circumstances would line up properly for them, then every high would be just as much fun as that one was. So they are pointing fingers and placing blame on everyone and everything because obviously not every single high is like this “super memory” that they have (which really resembles their perfect high, the best experience they had on the drug).
So many addicts who can not gain a foothold in recovery at all are stuck in denial, and they are entertaining the idea that they can one day perfect their technique, they can figure out this secret formula where every high is a whole bunch of fun, and there will be no negative consequences, and they can enjoy life while using their drug of choice as much as they want. This is the fantasy that is pulled over the eyes of most people who are still stuck in addiction.
The barrier to entry for recovery has to do with two negative concepts: pain, and fear. The struggling addict is dealing with both of these emotions and what has to happen is that their pain has to increase beyond their level of fear. What does this really mean?
It means that every struggling addict and alcoholic is actually terrified of recovery. Don’t ever both to put them on the spot and tell them that, they will likely lash out in anger at such an accusation, but it is most definitely the truth. Addicts and alcoholics are held back by FEAR. If they were not afraid, then they would boldly agree to just walk right on in to any rehab that you suggest–but most are very reluctant to do such a thing.
What is this fear? It is fear of facing life without drugs and alcohol. It is fear of facing life without the ability to self medicate. It is the fear of having to be non-medicated and possibly have to confront themselves, to face themselves as they really are, to accept the truth of what they have become. This is the core of the fear that holds most addicts and alcoholics back from seeking recovery.
From their perspective, it is much safer for them to continue on with their current path. They have found a system that works for them, this self medicating all the time. It may have some unintended consequences but at least it keeps them from having to face their fear. This is how the addict sees it. Addiction may not be perfect but they much prefer it to facing reality, at least for now.
Then there is also the idea of PAIN. The addict is experiencing pain in their life as a result of their addiction, and this is one of the major side effects. The consequences of abusing drugs or alcohol all the time can start to build up and negatively affect the addict. They may lose relationships, become isolated, lose jobs, lose their family, and generally destroy all sorts of other good things that would have been in their life. Perhaps they drop out of their schooling or lose their job, but they medicate this painful loss away by consuming more of their drug of choice. Their addiction starts a long and slow spiral into more and more negative consequences: as they begin to lose more and more good things from their life, they simply resort to more and more self medicating, which in turn can cause them to suffer more and more negative consequences. Thus it can spiral out of control and start to feed on itself.
One thing that they teach you in Al-anon is that if someone in your life is caught in this cycle of addiction and they are spiraling out of control, the best thing that you can do is to step back and let them experience the pain that they are calling into their own life. There is a huge tendency to want to jump in and rescue them, to save them from some of this pain, to help them avoid some of the consequences, and so on. But when we do that what is really happening is that we are just helping the person to better manage their addiction, so that they can keep it going. We are trying to help them but in fact we have helped to keep them trapped in the cycle. If we alleviate some of the consequences and lessen some of their pain, we simply help them to justify the fact that “it isn’t that bad yet.”
Therefore the solution is to NOT deny the addict their pain. Let them experience the consequences that they are creating for themselves. This is the only way that they are ever going to climb over that massive wall of FEAR that prevents them from seeking help in recovery.
And this is how pain and fear interact during this stage of “pre-recovery.” The addict or alcoholic is too afraid to ask for help and give abstinence a chance UNTIL they have experienced enough pain in their life (which will be driven by consequences).
Once they have finally had enough pain in their life, they will surrender and become willing to seek recovery.
Outcome #2: You sober up briefly but quickly relapse.
This outcome is really just variation of the first outcome: you are not yet ready to fully surrender and ask for help. Something is holding you back (a reservation perhaps?) and so therefore when you try to get clean and sober, you end up quickly going back to your drug of choice.
When I worked in an inpatient rehab facility I had the opportunity to watch this happen over and over again. In fact, I would say that–based on my observations over 5+ years–most people who come into short term rehab are not yet ready to commit fully to abstinence yet.
Why would I say that? Because the majority of people who I watched come into rehab ended up coming back at least a second time while I was still working there. I would put the number of repeat visits at OVER 50 percent. Seriously, it was that many.
And out of those people who ended up coming back a second time, some of them actually did “get it.” So it was not that they were in the wrong place, or that they were trying the wrong approach or anything. It was just the wrong TIME to get clean and sober. When they came in the first time to try to give recovery a chance, they simply were not ready yet.
They may have thought they were ready, but they obviously were not ready to surrender fully to their disease and be willing to do whatever it takes to recovery. Big difference there! Most people who first walk into rehab are at the point where they “wish that things were different.” But is this the same as walking into rehab and feeling like “I am fully surrendered and will do whatever it takes, anything in the world, in order to recover and get away from the pain and misery of drugs/alcohol.” No it is not the same thing. Not even close.
In one case, the person just has an idle wish that things were different. In the second case, the person is at complete and total surrender and they are willing to do anything to stop the pain of addiction.
And this is the key that people are missing when they relapse quickly: they are not yet fully surrendered. They have only surrendered half way. They want their life to be different, they wish that their addiction would go away, but this is not the intensity that is required for success. Instead they need to be willing to do whatever it takes to stop feeling so sick and tired from their addiction. This is the level of surrender that is needed for success.
Outcome #3: You get trapped in a cycle of relapse and sobriety.
I have never been in this stage but I have witnessed it many times while I was in early recovery. Therefore I am honestly not sure exactly what is holding these people back, other than a lack of surrender. They are still in denial and they must still be holding on to some sort of reservation.
The pattern is simple: they cannot go more than a few months to a few years without a relapse. Thus they have a condition known as “chronic relapse.” They may make it a few months or even a few years but they always seem to relapse eventually.
I found that such people existed within the 12 step program, and many of them would come to meetings every single day, without fail. They would also be sure to talk quite a bit in the meetings, in spite of the fact that they obviously were not offering any great wisdom as to how to achieve long term sobriety. I found it interesting that “chronic relapsers” seemed to have a habit of monopolizing AA meetings and taking them hostage, even though they were obviously only experts in staying sober in the short term. Perhaps they need to talk more because they need the most help? Still seems like an unfair disservice to the rest of the group though.
Most people would agree that anyone who is stuck in a pattern of chronic relapse is struggling with a reservation. Such a person is holding on to something deep inside of them that prevents them from achieving long term sobriety. In order to overcome this problem they are going to have to identify what that reservation is and then deal with it. This requires that they get really honest with themselves in order to see what their real stumbling block is. Then it also requires them to actually take action and do something proactive about their reservation which is holding them back. The 12 step program would argue that this can be accomplished by thoroughly working the 12 steps. I would argue that this can also be done outside of the framework of the steps, simply by analyzing your past missteps in life, and determining a future work around.
This outcome (chronic relapse) simply requires more of the same: get honest with yourself and “kick it up a notch.” You need to stop playing games and get serious about recovery, and this is going to require some serious honesty and maybe a little introspection.
Outcome #4: You stay sober for a significant time period but relapse due to complacency.
I (thankfully) have never experienced this outcome either, but I stay vigilant in knowing that it is a constant threat.
People who relapse after achieving long term sobriety do so because of complacency. They get lazy and they stop pushing themselves to make positive changes in their life, so eventually they revert back to what they know best, and that is to self medicate.
Every addict and alcoholic knows how to self medicate, that is what we are experts at. It never goes away, no matter how long we have been sober. We could always return to our old ways in nearly an instant, given the right chance or opportunity.
All we really have in recovery is the protection from relapse that we build for ourselves. The key is that we must keep rebuilding this protection over and over again. You might say that we have to keep reinventing ourselves in recovery if we are to be successful.
You may be able to “coast” in recovery for quite a bit. Maybe after you have a few years in recovery, you may be able to kick back, put your feet up, and stop pushing yourself to make positive changes, positive growth, learn new things, etc.
But why would you want to risk it?
Especially when personal growth is so much more fun and challenging. What is the point of life unless you are learning, growing, and loving others? What is the point unless you are engaging in positive changes?
People who relapse after significant sobriety have fallen OUT of this pattern of growth. They relapsed because they became idle in recovery.
Many will blame it on a lack of meetings, or because they fell away from “the program.” This is a misleading excuse. Sure, if you depend on AA for sobriety, then you will relapse if you leave AA. But people who become complacent in long term sobriety do so because they stopped doing anything positive. If they were still experiencing positive growth, reaching out to others, learning new things, and so on–they would not have relapsed. It is not about “working a program” when you have ten years sober. It is about embracing positive change and being open to new learning experiences. AA is just one possible framework for this to happen in, but it is not necessary. Leaving AA or quitting the meetings is not an explanation for complacency.
Outcome #5: You stay clean and sober forever
The last possible outcome is that you stay clean and sober until you die. Obviously this is what we all want in recovery and are hoping to achieve (one day at a time, of course!)
I cannot claim to have any wisdom in how to achieve this goal, because obviously I am not “there” yet! All I know is what I can observe, and what I am doing thus far is working well for me, and I also see it working for a few others. 11 plus years of continuous sobriety cannot be a total mistake. What I have found is that I create my own success in recovery, and also that I have to alternate between periods of growth and reflection.
Surely there are many people in recovery programs who live a full life and die clean and sober. This is really the outcome we are all shooting for–continuous sobriety (dare we say “permanent” sobriety?).
Totally tragic: the non-starter
One last outcome is the most tragic of all, and this is the huge group of addicts and alcoholics who never even try to get clean and sober. Ever.
I have seen government data that suggests this group of non-starters is as high as 90 percent of all addicts and alcoholics.
This is the real tragedy, because the reality is that anyone technically CAN get clean and sober, even if they do not believe that the possibility exists for them.
This is one of the biggest hurdles in our disease–that we believe ourselves to be unique, that we believe we are the first person to come along to truly love our drug of choice. Of course this is not the case, but the veil of addiction can keep us fooled from ever even trying to break free.
If there is one group that you want to avoid out of all these, it is this one. Don’t be a non-starter when it comes to recovery. At least try. I had to try a few times but it was totally worth it. Life is good again! But I had to give myself a break, and allow myself to ask for help.
If you are still struggling then you should do the same.