Why is it that Alcoholism Treatments Do Not Work for Some People?
Clearly, alcoholism treatment does not work for everyone.
This is unfortunate because we expect that such solutions will apply to anyone in our modern world of medicine and convenience. If you want to results, simply pay the price. Get this treatment to cure that disease. We expect for solutions in our lives–and in health care–to be somewhat straightforward.
This is not so when treating drug addiction and alcoholism. You may be wondering exactly how you can help an alcoholic or a drug addict in your life. If you dig around you will find that the best advice is to get them to go to rehab. Convince them to take action. The problem is that this rarely works, and the outcome is rarely what we expect (or hope) for it to be.
Just consider the fact that most people who go to treatment do not remain clean and sober forever. Now consider the fact that most people who go to rehab do not even stay clean and sober for one full year. Maybe half will remain sober up to around the 90 day point (depending on which statistics you believe). These are not encouraging numbers for a population that expects to be able to buy a solution or send someone to rehab and simply get results.
So why does treatment work for a select group of people, but not for everyone? Why does the treatment process fail for so many alcoholics and drug addicts? What are we doing wrong? How can we help people better to recover from addiction? What are we missing? What is the alcoholic missing when they relapse?
Let’s take a closer look at some of these concepts.
The critical and often overlooked ingredient of surrender
One of the harsh truths of recovery is that if you have to convince yourself to go to rehab then your chances of long term sobriety are somewhat diminished. On the other hand, if you are desperate for change then your chance at success is greatly increased. In other words, your level of desperation to get sober is a good indicator of your future success. If you are not desperate at all then it is not likely that you will “make it” in the long run.
Where does this desperation come from? It is born out of chaos and misery, and we have a proper label for this condition: surrender.
When you have finally had enough in your addiction, you get to a point of surrender. It is this magical point that will determine whether or not you are successful when you go to rehab and attempt to change your whole life.
Now you may be wondering why so many people end up failing if they go to rehab–after all, hadn’t they surrendered to their disease?
Yes and no. The issue here is one of “complete surrender.” Has the person surrendered fully and completely?
I know that sounds like nit-picking but it is the absolute truth. Consider the fact that I went to rehab 3 times in my life, and the first two times that I went I obviously had not surrendered in full. I was in a state of, let’s call it “partial surrender.” I was sick and tired of my addiction but I wasn’t at that total breaking point.
It’s about willingness. What are you willing to do in order to change your life? What are you willing to do in terms of taking orders and directions from other people? Are you willing to completely crush your own ego and listen to other people tell you how to live? No? Then you are probably not ready to turn your life around on a permanent basis. You may be dabbling in surrender but it sounds like you may be holding something back. You are holding on to a bit of pride. In order to truly recover you have to let go of everything, including your own ego. You must let down all defenses and allow yourself to be directed by others.
Surrender is not this place of happiness and joy. It’s about hitting bottom. It’s about being so sick and tired of your addiction that you are willing to start ignoring your own ideas in order to try to gain a foothold on your sanity again. You make an agreement to start ignoring yourself and following someone else’s idea for a recovery program instead. What you have been doing has not worked out. Time to listen to someone else for a while. This is what surrender really feels like, and quite honestly it leaves a bad taste in most people’s mouths.
If someone goes to rehab and then they relapse, you can bet that they had not surrendered fully and completely.
If you go to rehab then you are basically asking other people to tell you how to live and what to do. This is the essence of treatment. You have screwed up your life and you are not happy with your own decisions, so you agree to listen to someone else’s advice for a while. The question is: Are you going to take that advice? Or are you going to go back to your old ways? If you leave treatment and relapse then obviously you decided not to take their advice. They are telling you how to remain sober. Don’t drink, go to meetings, read the literature, get a sponsor, work the steps, or whatever the case may be–they are telling you exactly how to remain sober. You can either do it or ignore their advice. If you do it then you will remain sober. If you ignore their advice then you will relapse. And you can interview someone who has done either of these paths, and they will tell you:
1) I am grateful to be sober today, I am doing what they told me to do and my life is getting better and better. I am following through on their advice. Life is good.
2) I relapsed because I ignored their advice. I wasn’t ready to stop drinking yet. I just hadn’t surrendered fully. I still want to “have fun.” I am not ready yet.
See the difference? One person is willing to take action, the other person lacks that willingness. It is all based on their level of surrender.
Everyone can surrender a little bit. If you get caught drunk driving and your family convinces you to go to rehab for a weekend then you have surrendered. But have you surrendered fully? Are you really ready to change your life for good? Are you ready to listen? Are you willing to follow through? For many alcoholics, the answer is “not yet.”
Surrender happens on a sliding scale. In order to stay clean and sober you have to surrender fully. As in, total and complete surrender. That is one of the keys to long term sobriety.
Why a lack of follow through can be tied directly to a lack of surrender
Addiction treatment can be a bit overwhelming. There are so many things that the recovering alcoholic needs to learn in order to remain sober. It can be a bit daunting.
If you leave treatment then that is when the real test begins. It is easy to stay sober while you are locked up. It is difficult to remain sober when you have free will and total freedom. Your real test begins when you have your freedom back.
The people in treatment are trying to help you. They make suggestions such as “get a sponsor in recovery” and “go to 90 meetings in 90 days and don’t drink in between those meetings.” These are good suggestions if you are truly seeking to change your life. The question is: Will you follow through with them?
If you fail to follow through then you should not necessarily blame yourself. The problem was that you simply were not ready to get sober. And that was evidenced by a lack of follow through. You did not do the work.
Recovery takes work. You are either willing to do the work or you are not. If you are not willing to do the work then you will end up relapsing and experiencing more misery and chaos.
Some people just haven’t had enough misery and chaos in their lives yet. They want more.
I have been there myself. I simply had not had enough chaos yet. I was not done “having fun yet” in my addiction. I wanted to experience more madness in the hopes that I could find happiness there. I was not done testing out the waters. There was nothing that anyone could say that would convince me that I was being foolish. I had to go back to the chaos and learn it for myself. I had to go through the pain and misery again so that I could truly learn it for myself, so that I could really understand what a lifetime of alcoholism would be like. I was too stubborn to listen to advice, of people trying to warn me away from all of that pain and misery. I had to go taste it again for myself.
So I left treatment and I relapsed immediately. Twice. I was not ready to get sober. I was not ready to do the work.
Actually, I would have liked to be clean and sober after my second rehab visit. I would have liked for my life to be magically changed with a snap of the fingers. Deep down, I wished that I was not alcoholic.
So why did I relapse after that treatment visit?
Because I was not willing to do the work. I was closer to “true surrender,” but I was not quite there yet.
I was sick of being an alcoholic, but I was not willing to sacrifice my ego and to do the hard work that recovery required.
There is a gap there. You can be sick of your addiction but not quite willing to take the sort of action that will keep you sober. I was stuck in that gap for about a year. I was in a place where I realized that I was not having fun anymore with my drinking, but I was still not in a state of full surrender where I would be willing to do anything in order to recover.
I needed about one more year of chaos and misery to convince me. Once the misery got bad enough, it finally pushed me over the line into “full and complete surrender.”
Alcoholics do not recover because they are happy and joyous. They recover when they finally become miserable enough to face their fears. If they keep relapsing, it is because they have not had enough pain and misery in their lives yet.
What it really means to hit bottom and become open to suggestions
Here is what happened when I finally hit bottom:
I was all alone. My friends and family happened to all be on vacations at the same time. It was just sort of dumb luck that I was by myself for a few days. Had to happen eventually.
And what happened in those few days was that I finally “got my wish.” And my wish was that I could finally drink by myself without other people getting in the way. Because my excuse in life was that I was not happy, and so therefore these other people were somehow making me unhappy. If they would just go away I could drink all I wanted and then I would be happy. This was what my brain had convinced itself of.
I was unhappy as an alcoholic and I blamed anyone and anything other than myself.
But then I finally got my wish. Everyone left for a few days and I was finally alone.
I had money. I had vacation time from work. I had drugs and alcohol, all that I could ever want.
And I was miserable.
This is the critical point. I had finally arranged a situation where there were no more fingers to point at people. No one to blame. I was responsible for my own happiness, 100 percent. Just me and my drugs and my booze, with no one to get in the way and screw it up.
And yet there I was, supremely unhappy. I was miserable. And I could not drink enough or use enough drugs to escape that fact.
And so I had to face the truth. I had to face the real truth, which was that the drugs and the alcohol had failed me. My denial had me convinced that alcohol and drugs could make me happy at the drop of a hat, but this turned out to be false. All of the excuses were gone, pushed to the side. Yet my misery remained. There was no one left to point the finger at except for myself.
This is about enabling.
All of the people in my life had to go away. I had to be alone for a while in order to realize that my unhappiness was of my own making.
This was what my moment of surrender was like. After I reached this point I asked for help, went to rehab, and have not had a drink or a drug since then. That was how my life changed forever. I finally realized that the drugs and the alcohol no longer worked. They no longer made me happy. Normally I was too busy blaming others and making excuses for why it wasn’t working. After all of those excuses were removed, I had to take a more honest look at myself.
This is what they teach you at Al-anon. How to remove yourself from being one of those excuses, one of the things that the alcoholic can point the “finger of blame” at. Once they run out of things to blame, the alcoholic must consider their own fault in failing to produce their own happiness. That is when they will have to face reality, and make a change.
How can you increase your chances of being successful at rehab?
So how can you be sure that when you go to rehab, you will remain clean and sober, and your efforts will not be wasted?
First of all, your efforts are never wasted. I had to go to rehab 3 times. The first two times looked like “a waste,” but obviously they were part of the path that I had to travel in order to get to where I am today. Looking back, it was worth it. It was all definitely worth it. Many people who get sober have to try several times before it finally “clicks.”
Second of all, you have probably noticed a theme that I keep touching on, that of surrender. If you want treatment to be successful then you should make sure that you have surrendered fully and completely before you go. The depth of your surrender will determine your success in recovery. Are you willing to do what other people suggest? Are you willing to push your ego to the side and really listen to advice? Are you willing to take action, to do the work, to follow through? All of this is based on surrender. All of it is measured in willingness. You have either had enough pain from your addiction, or you want to go try it one more time. There is a line, and you are on one side of it or the other. Recovery is always pass/fail in the end. No one can “sort of stay sober.” You either are, or you aren’t. Your level of surrender determines this.
Follow through means that you take suggestions and you do the work. This is always going to be based on your level of surrender. We can look at your efforts and see if you have reached that point of full surrender or not.
I worked in a treatment center for over five years. While I was working there I had the opportunity to watch many, many people try to get clean and sober. And because it was a fairly small community I was also able to see the results in most cases (whether people remained sober or relapsed). What I noticed over those five years was this:
I could always tell when someone had NOT surrendered. They had the wrong attitude. They were too cocky, or they were not interested enough in recovery or the suggestions they were being given. So you could either be too enthused or not enthused enough. Either extreme was a big red flag. It took me a while to really learn this, because I had to watch many of the people who were overly enthusiastic (and confident, and even cocky), I had to watch a lot of those people relapse. This taught me how important it was to surrender.
If you want to succeed at rehab then you need to be desperate enough to listen and apply the advice you are given. If you are overly confident or not interested enough then you are setting yourself up for failure.
What is the secret to sustainable sobriety in the long run?
Personal growth is the key to recovery.
In the long run, you are either moving forward in life or you are sliding backwards.
There is no such thing as “standing still” in recovery. That is otherwise known as complacency.
If you get complacent then you run the risk of relapsing.
The only way to overcome this in the long run is to keep pushing yourself to take positive actions. Your life must be fueled by positive change and personal growth.
Has alcoholism treatment worked for you? Did you find rehab to be helpful, or have you recovered without attending treatment at all? Let us know in the discussion forums. It only takes a second to register!