Sometimes the pattern of alcohol and rehab can become a trap for the struggling alcoholic.
After going to 3 different rehabs in order to seek my own sobriety, and also working in a rehab for 5 plus years, I can definitely say that there is a vicious cycle for many people that involves rehab.
Many of these people who are trapped in this cycle do not even realize it. Furthermore, they have no idea how to break through the cycle and get different results than what they have been getting in their life (constant relapse and struggle).
How people get trapped in a cycle of treatment and relapse
Going to rehab can be comforting to some people. It is the calm among the storm. Even if you have no real intention of staying sober, it can be a nice break to check into rehab for a while and at least “pause” your disease.
People do this without even realizing it. They tell themselves that their intentions are good and that they would like to stop drinking forever, but deep down they may not be anywhere near true surrender. They just want a break in the action.
Another interesting phenomenon is that of tolerance. If you go to rehab for a few weeks (or even just a few days) then suddenly the alcohol or drugs that you use will have a much greater impact on you. This is because you have cleared your system out through detox and now you are ready to get totally wasted all over again. If you drink every single day then it tends to lose the “fun factor’ due to your increase in tolerance. Yet after a short trip to rehab you have effectively “reset” your tolerance and suddenly you get to have a little fun again. But do take note of how quickly you end up being miserable after that initial relapse, and how quickly your old tolerance returns. By the end of the first day you will likely be completely miserable again, and if you happen to be younger then it may take up to a week or so. But the “fun window” is closing up quickly and that is a function of your increasing tolerance over time.
They have a saying in AA, and in rehab: “Keep coming back.” If you actually work in a rehab for several years you will be amazed at how many people treat the rehab center like a revolving door. This can be a real eye opener. What are these people missing who continue to relapse and then come back for more treatment? What is the critical piece of the puzzle that they are missing out on?
How to break out of the cycle of relapse
The way to break the cycle of relapse is to surrender fully and completely.
This may not be a conscious decision that can be made. Instead it is a process that must be completed before you can get to the result that you are looking for. In other words, you can’t just rush this idea and say “OK, I want to surrender now and get this whole thing over with!” It doesn’t work that way.
So what can you do as a struggling alcoholic? I would say that your main objective is to break through your denial so that you can reach a state of total and complete surrender. This is how it worked for me anyway. I had to get to a point where I finally broke through my denial. This took a whole lot of pain and chaos and misery. In fact, things did not really turn around until I had sort of given up hope and I was welcoming the idea that I could not control my alcoholism. I had to sort of let go during my addiction in order for things to get truly bad enough for me to surrender. I had thrown caution to the wind and I was just letting myself drink as much and as frequently as I wanted. I had given up on the idea of control. This is when things got bad enough that I was able to see my problem clearly.
The problem is that our natural instinct is to fight against surrender. Our natural instinct is to try to control our drinking so that we do not lose total control. We struggle against our addiction and this is why we lose the battle. You cannot beat your addiction head on. You cannot confront it directly and win. That would mean that you could learn to control your drinking and thus be able to learn moderation. I do not believe that this is a realistic goal for any true alcoholic.
Our denial tells us that we don’t really have a problem. Or it tells us that we have a problem but that there is no way that we could solve it through treatment. Our denial convinces us that we are stuck, that we are unique, that we are destined to be a drinker for life. This is what my denial was telling me anyway. It was telling me that I was too nervous to ever go to AA meetings and that was the only possible solution that was being offered. My denial told me that I was unique and that I was the only person in the world who loved alcohol so much that it was probably going to kill me. I actually believed these lies because it was easier to believe the lie than it was to take action and try to fix the problem.
I went to rehab twice and then relapsed right after. I was stuck in a cycle of relapse because I was so concerned with my happiness.
I told myself that I just wanted to be happy. I could not figure out how to be happy without drinking or using drugs. And when I stopped taking drugs and alcohol I went into a very uncomfortable state known as withdrawal.
Now one of the big mistakes that I was making was that I was projecting the discomfort of withdrawal on to the rest of my recovery. So before I had become clean and sober and I was still struggling with alcohol, I imagined that the rest of my life in recovery would be completely miserable. I was basing this assumption on the fact that when I suddenly stopped drinking for a day or two during my addiction that I went into withdrawal and felt miserable. I was projecting the misery of withdrawal on to the rest of my life in sobriety. This did not make any sense and it was not a fair thing to do but I was doing it nonetheless. This was a big part of why I stayed trapped in my addiction for so long. I really thought that I would be miserable forever if I gave up alcohol.
For several years I drank in order to be happy. When I first discovered alcohol I was not a very happy person. I had been searching for something. And alcohol and drugs suddenly fixed me, they made me happy and they allowed me to medicate my mood at a moment’s notice. I could create instant happiness in my life just by taking a drink. This was amazing. I was fascinated by the magic of alcohol and drugs, that they could change my mood so quickly and thoroughly. I was impressed that I could be having a bad day and then all I had to do was buy this pint of liquor and drink it very quickly and suddenly I was happy again. It was pure magic. I loved it.
Now the key thing to note here is that alcoholism is a progressive disease. So this little trick that I had learned to make myself instantly happy eventually stopped working. The only problem is that I clung to the belief that it still worked. For many years I refused to see the truth. That alcohol no longer did the job that I wanted it to do. An increase in tolerance had robbed me of these pleasant effects. Now in order to become “instantly happy” I had to take a few days off of the stuff (while being completely miserable, mind you) and then drink a whole bunch and maybe use some other drugs on top of that as well. Then I would be “instantly happy” for maybe an hour or two. After that I returned to being miserable again.
In order to break out of this cycle I had to break through my denial.
I had to realize that I was thoroughly miserable due to my addiction.
I had to blame alcohol. I had to stop blaming other things, other people, for the fact that I was not happy.
I had to take responsibility for my unhappiness. I had to place the blame squarely on alcohol.
This took several years before I would be willing to do this. I had to become really miserable. I had to exhaust all of my options first. I guess I am just stubborn that way. But perhaps all alcoholics are stubborn in the same way. Perhaps we all have to fight with denial before we can reach the point of full surrender.
When I finally broke through my denial I became willing to seek help. I asked for help and I followed directions. This is very different from the kind of “help” that I normally wanted during my addiction. The help that I sought during addiction was always manipulation. When I reached true surrender I was done manipulating people. I was ready to follow directions. That is how you will know that you have reached a point of true surrender in your life. You will not be trying to manipulate anyone or anything. You will humbly ask for help and you will follow directions.
It is not easy to follow directions. Simple, but not easy. Just let go of everything. Be humble. Take orders from others who would try to help you.
What could treatment centers do differently to encourage more success?
I am definitely not knocking the treatment industry. Rehab centers do everything that they can in order to help the struggling alcoholic or drug addict.
If I could change one thing then I would encourage rehabs to focus more on the denial aspect of the disease. This is because I have worked in a rehab for 5 years and I now know that there are many different levels of denial.
The obvious level of denial is the person who is in the waiting room lobby of rehab and they have their arms folded and they refuse to even check in. They are saying “I am not alcoholic and I don’t need this place!” That is what we think of when we talk about denial.
But there are many more levels of denial. For example, I was in rehab (a second time) and I knew that I had a problem. If someone asked me what my problem was, I would tell them “I am a hopeless alcoholic. I can’t stop drinking.” That does not sound like denial, right?
But the fact was that I was still in denial at that point. It was a deeper, more insidious level of denial. What was I in denial of?
I was in denial of the solution. I had accepted my problem. I had accepted my disease. But I had not accepted the solution yet.
Any solution. I had not accepted any solution that was being offered to me.
So the solution might be AA meetings. Or it might be a religious based treatment program. Or it might be counseling or therapy. Or it might be living in long term rehab or a sober house.
So I was at this point where I fully admitted to myself and others that I was a hopeless alcoholic. Yet I was not willing to accept any of those potential solutions into my life. I rejected them all and clung to the belief that I was different, that I was unique, and that none of those treatments could possibly help me. I was stuck in denial even though I accepted my alcoholism.
Now I worked in a rehab facility for 5 years. While I was there I got the chance to see a whole lot of denial in action. I watched hundreds of people come through the rehab center, many of which relapsed and then came back again later for more treatment. In fact I would guess that over half of the people followed this pattern.
So my thought is that treatment centers should prepare themselves for this cycle in advance, and try to break it. They should realize that their biggest challenge are these multiple levels of denial. That just getting someone to admit to their disease and to go to rehab is not enough.
Rehabs need to focus on busting through denial. Because most people who end up in rehab are still clinging to some level of denial, even if they don’t realize it. Even if they admit to their alcoholism. They may still be in denial about potential solutions.
So how do you work through denial? You talk about it. You explore the idea. You get people to confront their denial head on. You explore the various layers of denial that seem to hold back the struggling alcoholic. The first layer of denial is obvious. The deeper layers of denial have to do with the solution.
Is it all up to the individual to surrender to their disease completely?
In the end it is all up to the individual.
Either they surrender fully, or they do not. If they reach a point of total and complete surrender then it does not even matter what you do for them. They are on the right path to sobriety because they are open to positive change.
On the other hand if someone is still stuck in denial then I am not sure there is much that you can do for them. The best I can figure out is that you must confront their denial as directly as possible and try to get them to work through it. If a person is in denial about something then the solution is for them to confront that problem and see the real truth. That is all that matters. If they can get honest with themselves and see the truth then they can make a breakthrough. Otherwise they stay stuck in their old pattern.
Ultimately it is always going to come back to surrender, and that is a very individual thing. You cannot force surrender on someone. You cannot teach surrender. You cannot put a gun to someone’s head and get them to surrender by yelling commands at them. It doesn’t work that way.
Surrender happens based on experiences. The struggling alcoholic has to reason through their own denial. They must reach the conclusion for themselves.
Ultimately the struggling alcoholic has to realize at least these two things:
1) That they are a real alcoholic and that they will never be able to control (and enjoy) their drinking.
2) That they must accept an outside solution fully and completely, without hesitation, and follow through if they want to get better.
So it is a two part process of surrender. It is not enough to admit to the problem. The alcoholic must also embrace a solution as well.
The actual solution is not as important as you would think. There is more than one recovery program that can (and does) produce sobriety. The key is that the alcoholic must accept and embrace that program without abandon. They have to “get out of their own way” and allow a new solution to work in their lives.
How might we improve success rates in the future?
The problem may be one entirely of surrender, and therefore treatment centers cannot possibly do anything different that would help.
One idea is that if you screen potential rehab clients for being in a state of full surrender then you would theoretically increase your success rate. But this might reject people who need to be exposed to the ideas initially, even if they are not destined to stay sober right away. Most people have to go to treatment more than once. I had to attend three rehabs before I “got it.”
Another idea is to focus almost entirely on denial, and exploring the multiple levels of denial. Get people to realize that admitting to their disease is not enough, and that in order to succeed they have to embrace a solution as well.
It is not rehab itself that perpetuates the cycle of addiction, it is a lack of full surrender. Most treatment centers have the right idea and are set up to help people, but it is the individual lack of surrender that perpetuates the cycle of relapse.
In other words, don’t blame the rehabs. If the alcoholic truly embraces the solution and learns to “let go” entirely then they can transform their life in recovery. Most alcoholics struggle on at least two levels though: Admitting to their disease, and then accepting a solution. There are at least two parts to denial and most people are only aware of the first part.
Once you move past all denial your life will transform. Taking direction from others is never easy at first. Once you give it a chance though you will likely see that your life is rapidly improving. In order to get this ball rolling you must become willing first. Willing to face your disease and willing to embrace a new solution in life.