There are a number of key points to keep in mind regarding your visit to an addiction or alcoholism recovery center.
Many, many people who attend treatment end up relapsing shortly thereafter. Obviously we want to prevent this outcome if we can, and I have compiled some ideas below on how to help you do exactly that (prevent relapse).
First and foremost though is the reason that you are attending rehab to begin with. I personally went to rehab twice before I finally surrendered fully and went back a third time. This makes all the difference.
Reaching the point of total surrender before attending treatment
If you are willing to go to rehab, just go.
It is as simple as that. You may or may not be at the point of total and complete surrender. If you are, then great. You will stay sober, and quite possibly enjoy a long life of sobriety.
The alternative to this is that you may not, in fact, be at the point of total surrender. In that case you are almost certain to relapse at some point upon leaving rehab. Although it is up for debate, I am not sure that there is anything that you can do at that point that would change this outcome. You are either ready to be clean and sober or you or not. The only thing that separates the success stories in recovery from those who relapse (in my opinion) is the level of surrender. If you haven’t surrendered fully then you are most likely headed for relapse.
This is not necessarily the end of the world though. Relapse can be a gift in some ways, even though it is never really desirable. For example, a relapse may be just the thing that you need in order to realize just how much help you really do need. I was told that I should go to long term rehab, for example, but I ignored this suggestion. After relapsing and finding myself heaped in chaos and misery, I was much more willing to listen to suggestions in the future. Addiction has a way of correcting these things for you. If you cannot get humble then your disease will find a way to humble you. Tragic but true. The better path of course is to realize that you need help and to earnestly seek it out.
Apparently there is no way to really tell if a person is in a state of total surrender or not. And that person will not really know for sure, especially if they are NOT in a state of complete surrender. If that is the case then they will hem and haw and reason out that they probably are in a state of surrender, when in fact they are not. This is because is basically expected of them. When you go to treatment and everyone is talking about how “you have to surrender to win” and that no one can possibly stay sober unless they surrender, what do you think you are going to say? You are going to say “sure, I am surrendered to my disease!” No one wants to look stupid or stand out like an idiot.
But the truth is, the first two times I went to rehab, I was that stupid guy. Not that I was actually stupid or anything, but I was just in the wrong place at the wrong time. I was in treatment when I was not really ready to change my whole life. I was not in a state of total surrender and I was not in a position to take massive action in order to change my whole life.
So the result of this was that I felt stupid. I did not want to be the odd man out. When people were talking about how surrender was so important, I figured that I should go along with it and say that I think I am surrendered too. How else do you do it? I wanted to be sober. I wanted to be happy without having to do a whole lot of work, or make major changes. That is what I really wanted. So I was not desperate for change, I was not yet completely miserable from my drinking, and I was not willing to take massive action and do “whatever it takes” to stay sober. Therefore I felt stupid when everyone else was talking about how serious you had to be and how incredibly important it was to be “sick and tired of being sick and tired” and in a state of total surrender. I was like “yeah, sure. That’s me. I want things to be different.”
This is not enough! To just wish that things were different is NOT enough. That will never get anyone clean and sober. If that is your attitude you will relapse. I am sorry but that is just how it is. I feel sorry for that person that I was, the first two times in rehab, because it was such a hopeless situation at that time. I was simply not ready. I had not yet had enough pain and misery due to my addiction. I was not done drinking. And nothing that anyone could ever say in rehab would have convinced me to stop drinking. Which is why I felt so stupid when I was going along with the idea that I was in a state of surrender. Am I surrendered? Are you surrendered? Who knows? I couldn’t tell. I knew I was alcoholic but I was not really desperate to change my life. I was not “willing to do anything in the world to escape the pain and misery of addiction.” I just wasn’t ready yet. So I felt stupid. But the truth was, I just wasn’t done drinking yet. I hadn’t had enough pain yet.
So what was the solution? To go out and get some more pain. And that is exactly what happened. This is why I say that this surrender stuff is somewhat “self correcting.” Because I had failed to really surrender, I went back out to my drinking and my addiction and I got a whole lot more pain in my life. Things got worse. Then they got really a whole lot worse. And then finally I reached a point (about a full year later) when I really HAD had enough pain and misery and chaos.
And that was when my moment arrived. And this is the critical difference, so listen carefully. This time, I was really sick and tired of being miserable. This time, I was really done for good. I just didn’t care any more. I was sick of chasing that next drunk, that next high. And I no longer cared about myself, about my life, about my happiness. Screw it all. I stopped caring entirely. And this was a beautiful thing.
Because now I was able to face my fear. For the first time, I dropped my fear and anxiety. It just melted away. I no longer cared about myself, at all. In the past I was afraid to go to rehab, I was afraid to sit in an AA meeting (because what if I was expected to say something and I sounded stupid to people?). I was afraid of sobriety, of life itself.
But something changed. It shifted magically and I do not know how to tell you if you can reproduce this change or not. Because it was just the result of so much pain and misery and chaos in addiction. And it finally wore me down to the point where I threw in the towel. I no longer cared. I was sick of caring. About everything. About anything. I just wanted the misery to end.
Was I suicidal? No, not exactly. I was not looking to hurt myself. Nor was I seriously thinking about ending my life. But I had reached a point where I really, truly did not care any more. I was just…..done.
This is the point of surrender. And to be honest, when I reached this point I knew in my mind that I was not going to drink again. I knew that I was ready for a serious change. And I felt relief in that moment. Because I knew that the madness was over.
If you have not yet reached this point in your own battle with addiction or alcoholism, I don’t think there is much point to rehab.
Sure, by all means, go to treatment. You may get something out of it, even without this level of surrender. But if you are looking for that total life transformation, where you really stop drinking and totally change your life, then I think you will have to reach this point of total surrender first (that I describe above).
This was my experience anyway. And I have talked with many, many recovering alcoholics and addicts who describe a similar experience.
And perhaps even more important, I also watched several thousand people who had NOT reached this critical point of surrender. They are people who went to rehab and hoped that things would just magically change without a whole lot of work or effort, and were then later disappointed to find out that they were headed straight for relapse. I worked in a rehab for 5+ years and so I got to watch this happen over and over again.
At first it was very difficult for me to figure out what exactly was going on. I met a lot of neat people who were trying to recover and overcome addiction, but most of them relapsed. A handful of people “made it,” and so my mind naturally started to try to piece together what the common threads were. Why did some people stay sober, while most of them relapsed? What were the critical factors?
It took a long time for me to draw any conclusions. This is because it actually seemed quite random. People who seemed to have everything going for them and were nice people and were also confident, many of them relapsed. And sometimes people who really seemed to have the odds stacked against them for a number of reasons ended up staying sober. It made no sense.
And so ultimately as I spoke to more and more people I realized what the common thread was to success:
This is very hard to measure. It is difficult to document. It is tough to “see” it in other people. Especially in early recovery.
Only in long term sobriety can you look back and say to someone “wow, you really were committed to change, weren’t you?” Because their actions and their commitment and their consistency is a result of their level of surrender.
You see, many people in early recovery make the mistake of thinking that this critical component, this “surrender” component that leads to real commitment, that it can somehow be taught, or picked up along the way, or “let’s just go to detox and then maybe we will hear something good in rehab that will convince us to surrender later on.”
NONE of that works. It doesn’t work that way. Addiction and alcoholism are not cured. There is no cure. If it worked the way I described above then it would effectively be a cured disease. You could send someone to treatment and that person would magically WANT to surrender after they started going to rehab. Somehow the treatment would produce a state of surrender, where before there was no surrender.
This doesn’t work. I promise. We secretly hope that it works that way, or that it might actually work that way for us (or for our friend or loved one), but that is just not how it works.
You can’t sit in a group session at rehab and have that force you to want to surrender to addiction.
So if there is one thing to understand above all else, it is this:
* You must surrender to your disease before entering rehab. If you hope to surrender after checking into rehab, you are wasting your time.
Going through detox and treatment is not scary at all once you are actually there
Some people are afraid of detox.
The media has probably not helped with this. You may believe (due to certain movies, TV shows, and books) that detox is painful. Or that it is extremely uncomfortable.
Not true. Don’t believe the hype.
But don’t take my word for it. Test it out for yourself and see. Go to detox and see just how comfortable you are (or are not).
I worked in a detox unit for 5 years. I was a nurse aid. And I also went through detox myself several times before finally getting sober.
So I have a pretty good idea of what it is really like in detox, and I can assure you that it is not that bad. The medical staff in a detox unit will do everything they can to help keep you comfortable.
The same thing can be said for residential treatment (when you are attending groups and meetings). I have some amount of social anxiety myself (really because I was so used to being drunk all the time). But it was not so bad in treatment groups that I felt like I had to leave. I never felt threatened or intimidated. No one ever pushed my buttons or tried to push me over the edge. No one ever force me to “share” against my will. In that regard, being in treatment is a lot easier than you might think. Most treatment centers will even give medication for anxiety (though that will vary of course).
I used to believe that anxiety was a legitimate excuse to avoid treatment. I no longer believe this, having been to several rehabs and also working in one for several years. If you are afraid to treatment then that is OK. What I would encourage you to do is to give it a chance anyway, because I think you will be surprised by how laid back and non-threatening it really is in rehab. In most states and countries, if you feel uncomfortable you can walk out of treatment at any time and they cannot stop you from doing so (this is true at least in the state that I live in).
What you can expect as far as learning and support
There will be both learning (from groups and lectures) and support (from peers, staff, and meetings).
The whole goal of treatment is to:
1) Disrupt your addiction. Stop the pattern of drug or alcohol abuse. Actually detox your body and stop putting chemicals into it.
2) Learn some new ways to live your life, so that you do not have to constantly dump more chemicals into your body in order to feel good.
3) Find support so that you are strong enough to live with your decision to remain clean and sober. Also so that you will not feel like you are crazy, or that you are the only one who is dealing with such feelings while you are going through recovery.
Disruption is pretty simple. You check into rehab and you go through a medical detox. They search everyone coming in for drugs and alcohol so it is a controlled environment. There is no temptation to drink or use drugs because they are not available to you. You hopefully stay for 28 days or so. This is disruption. You disrupt your addiction by removing the drugs and the alcohol.
Learning is a process that will take you a lifetime. I am still learning about recovery after 12+ years of recovery. In rehab you will start this process. One thing they will try to teach you are some things that you can do instead of use drugs or alcohol. In other words, active strategies for relapse prevention. But they will try to teach you much more than that as well. To be honest it is an awful lot to take in all at once, especially when you are coming off of drugs and alcohol. But recovery is definitely about learning. If you don’t learn anything in rehab then you cannot expect much to change after you leave.
Support is the final piece of the puzzle. Your peers support you in recovery as you help each other to stay sober (and also identify with each other). The staff at the rehab are part of your support system. In some cases you may even do some follow up counseling with a therapist or counselor that you meet in treatment (depends on how the rehab is set up).
Most people follow the path of AA and 12 step meetings in order to get continuous support after they leave treatment. But there are other ways to get support that do not necessarily depend on mainstream recovery necessarily (for example, through a religious community).
Follow up in recovery is entirely your responsibility, and it will make or break your recovery
Aftercare is what happens after you leave treatment in terms of counseling, therapy, meetings, or outpatient treatment.
The data on this is pretty illuminating. If you follow through with your aftercare recommendations then there is a much, much higher chance that you will stay clean and sober. Skip out on aftercare and it is almost certain that you will relapse. It is not quite a certainty but the data is so scary that you should let it intimidate you into taking massive action.
My theory is that taking action is the key to recovery. Take massive action. Really get into it, commit fully, and then follow through with it. This is the path to success with addiction treatment.