I went to rehab three times in my life.
The first two times that I went to rehab I did not follow through at all when I left. I basically just ended up relapsing almost immediately.
The third time that I went to rehab I followed through.
This begs the question: “What does it mean to follow through when leaving treatment?”
I have since learned the answer to this question and I have also learned a lot by watching my peers in recovery as well. Sometimes knowing what NOT to do in recovery is almost as important as knowing what to do.
With that said, here are my top 5 recommendations for after you finally walk out of short term residential treatment (you know, the 28 day program that includes detox).
#1 – Follow through with your aftercare recommendations
First of all your therapists and counselors at rehab are going to advise you to “follow through” (there is that term again!) with certain aftercare recommendations.
So they will give you instructions on what they recommend for you to do when you leave treatment. For example, your aftercare plan could potentially include things such as:
1) Going to AA or NA meetings every day (typically they recommend that you do 90 meetings in 90 days).
2) Going to outpatient therapy (this may involve doing groups or lectures at a rehab center each day but then going home each night, or something similar).
3) Counseling or therapy. Again, this is essentially on an outpatient basis. Maybe an hour or two each week.
4) Following up with more treatment, such as by going to a long term treatment center for several weeks or months.
And so on. These are just some examples and your aftercare might involve some other things as well.
Every time that I have left rehab, everything from that list above was recommended to me at one time or another.
Essentially what it boils down to is this:
If you ignore all of these recommendations, or even some of them, you will probably relapse. On the other hand, if you follow all of them with serious dedication and real willingness, then you have a decent chance at remaining sober.
Most people who leave rehab do not really follow through with the suggestions. What happens a lot of times it that they will start off strong when they first leave but then their efforts will slowly taper off. Before you know it they will fall into their old patterns again. This is very, very typical. The fact is that it takes a great deal of effort to change your whole life, and it just takes a few days of laziness and everything will revert back to the “old you” (meaning you will drink again). Change is difficult.
#2 – Start seeking feedback from others about what you should be doing on a daily basis
This is a really tough one.
No one likes to be told what to do.
Yet this is one of the biggest keys to early sobriety. If you can let other people tell you what to do in recovery then you will likely do really well.
In order to reach this point myself I had to surrender totally to my disease. This means that I had to be totally miserable with my life and I had basically lost all hope. I did not really care about myself and I did not trust myself to be able to make decisions any more. I knew that my life was a train wreck and I no longer thought that I could produce my own happiness. I had proven that I was no good at making myself happy. Whenever I tried to become happy I just got more and more miserable. So I had to become willing to hand the controls over to someone else for a while. This means handing over control of my entire life. This takes guts. You have to surrender fully and completely in order to do this.
Even after you have achieved some stability in early recovery, you still have to learn how to give up control and seek help from others. This is really the only way to challenge yourself and move forward in recovery. You see, much of the growth that recovering alcoholics make is based on observations from their peers. We often cannot see our own biggest flaws and problems because it is we ourselves who are closest to the problem. Therefore we need our peers to help guide us, to give us direction. If you rely only on your own thoughts and ideas in recovery then you will be shorting yourself a great deal.
You have to learn to trust other people in recovery. You have to learn to be able to ask for advice and for constructive feedback. Then you have to actually have the willingness to follow through when they give you advice. You have to be willing to take action. Most people who ask for advice in this world are not actually looking to act on the advice, and what they really want is to affirm their own ideas. They want to hear what they want to hear. They want people to validate their ideas. This is not how recovery is going to work for you though. You must prepare yourself for the fact that when you seek advice and feedback from other people in recovery, they are going to challenge you and push your buttons in ways that make you uncomfortable.
It is uncomfortable to make real growth in recovery. It is uncomfortable to seek real guidance and advice from others in recovery and then act on it to try to fix your life. This is hard to do and that is why most people do not do it. Instead they leave rehab and they slip back into their old ways rather than to push themselves to make uncomfortable changes.
#3 – Start modeling someone who has the life you want to live
The idea of sponsorship is a powerful one if you use it correctly.
Find someone who is clean and sober and who is living the kind of life that you want to live. Ask that person if they will give you advice on how you can achieve similar results in your own life. Ask them to give you guidance and direction. Ask them to tell you what to do.
This is modeling. You simply do what they did, and you get similar results. This is a fantastic “shortcut” if you have the willingness to actually put your life into the hands of someone else. You have to trust that what they tell you to do is not going to make you unhappy in the long run. Because everything that you do has a cost, everything requires effort. No one wants to just spin their wheels for no good reason. So you have to trust that this person that you are modeling has your best interests at heart. Deep down most alcoholics believe that no one could possibly care about their life as much as they themselves do. But in reality if you model someone else and you do what they tell you to do then your life will get better and better.
I know this is true because I have done it myself. I have taken suggestions that I though were probably stupid at first but because I trusted the person (the sponsor that I was modeling) and I also had no better alternatives (my ideas were making me miserable) so therefore I followed their advice and slowly my life started to get better. I was actually shocked at this because I did not think that it would really work.
So if you have just left rehab then I strongly suggest that you find someone that you can model your actions after. That means you need to see that they have the kind of life you want, and they have to be willing to tell you how they did it. The rest is up to you. You must then take their suggestions and turn them into daily action. If you just talk to them but then don’t take any action based on their guidance then you will end up relapsing as a result.
#4 – Create your map of negative attributes (internal and external) and start eliminating stuff from your life
You have two options if you are pursuing personal growth in recovery:
1) Eliminate negative stuff from your life.
2) Chase positive goals.
Eliminating negative stuff is way more powerful than chasing after positive goals.
Pretty counter intuitive, huh? But it’s true. If you work really hard at eliminating the negative stuff from your life, then things will get better and better in a hurry.
Alternatively, if you decide to ignore the negative stuff (that everyone has some of) in their life, and you chase after positive goals, guess what will happen?
You will fail. You will be miserable and you will relapse. This is because if you are ignoring all of the negative stuff, it will feel like you are taking two steps forward and then three steps backwards all the time.
This is really hard to grasp at first, because we are normally told to “focus on the positive,” right?
Not true in this case.
In early recovery from alcoholism, you have all of these negative problems and issues in your life. Your job is to start hammering away at that negative stuff and fixing it at as quickly as possible.
Once you have the garbage cleared out of your life, then you can build something amazing. Then you can chase after positive goals, and actually achieve them and move forward in your life. But it all starts by cleaning up the negative stuff first.
For example, when I first got clean and sober I was suffering from two major problems other than my rampant alcoholism. One was an internal problem and the other was external.
The internal problem was self pity. It was consuming me and threatening me with relapse.
The external problem was cigarette smoking. It was also consuming me and holding me back from all other sorts of personal growth (fitness, health, etc.).
In order to move forward and achieve other goals in my recovery, I had to take care of these “big negatives” first. I had to quit smoking before I could become a distance runner and run 2 marathons. I had to stop engaging in self pity before I could muster the courage and strength to do all sorts of things (such as go back to college, build new relationships, etc.).
You will also find that there are both internal and external problems that need to be addressed in your recovery. You cannot ignore some of these problems and just focus on other things and hope to stay sober. You must seek to improve both your life (internal) as well as your life situation (external). In recovery you have to do both. If you fail to address one of these things then that is how relapse will creep back into your life eventually.
Therefore you need to make a list when you first get out of rehab.
The list should have two sides to it. One is changes you want to make internally (such as fixing resentment, self pity, guilt, shame, etc.).
The other side of the list should have your life situation changes on it. Things in your external world that you want to change in order to become more healthy and more stable in recovery.
On a regular basis you should review this list with someone else in recovery who you trust (like a sponsor). After you make progress and create change in your life, it is easy to get lazy and become complacent. By periodically reviewing your list, you can keep pushing yourself forward.
It is also important that you have someone else go over these changes with you so that you can get added perspective. If you only rely on your own ideas in recovery then you will miss out on a lot of potential growth and possibly relapse as a result.
#5 – Commit to finding your daily practice through positive habit development
This is all a lot to take in, isn’t it?
The final thing that you want to do when you leave rehab is to establish a daily practice.
What, exactly, is the daily practice?
The daily practice is the set of positive habits that you engage in on a daily basis in order to stay healthy in recovery.
This needs to be a holistic practice. In other words, you must not neglect any one area of your health when you are living your day to day life.
If you do neglect one area of your health for too long then this will open the door up for relapse to occur.
The way that you stay strong against the threat of relapse is for you to keep pushing yourself to grow in all of these different areas of your health.
Do not limit this to just your physical health, or being free from illness. We are talking holistically here. So that means mental, physical, spiritual, emotional, social, and so on. If something is bringing you down, making you feel bad, or negatively impacting you in any way, then you need to figure out what that is and fix it really fast. You cannot afford to be sick in any way while you are living out your day to day recovery.
Your disease wants you to relapse, and it is trying any which way that it can to trip you up and cause you to drink or use drugs. Some people get sick and wind up taking addictive drugs. Some people become spiritually bankrupt and go back to drinking because they no longer care about themselves or others. Some people find a new relationship in early recovery and when it doesn’t turn out well they use that as an excuse to drink. Some people get injured or suffer physical pain and they get hooked an addictive painkillers which then lead them back to the bottle. Addiction can take many forms and you never know from which direction it may try to infiltrate your life.
And this is why recovery demands a holistic approach. If you are not using a holistic approach then you will eventually get tripped up somehow and relapse as described above (or in some way that no one has conceived of yet).
The only way to really protect yourself is with a proactive approach. You have to assume that your disease is out to try to kill you, each and every day. Instead of shrinking in fear you must rise to meet the challenge with action. Go through your checklist and see if your life is suffering in any way from the sort of negativity we have discussed here. See if you are isolating at all. See if maybe you are slacking off on your spiritual practice. See if maybe your physical health could be better in some way. What can you do to be healthier in one area today? What have you neglected lately? How can you turn that around? How can you push yourself to improve?
And perhaps more importantly: Who can you talk to today about your path of personal growth? Who can give you honest feedback and let you know if you are deluding yourself? Who will tell you that you need to get cracking on something and get to work so that you don’t end up becoming lazy and relapsing as a result?
When you leave rehab your goal should be to find the daily habits that will create a positive life in the long run. You will need to draw from all of your resources to figure out what that is, which means you will also have to trust in others and accept their advice and guidance. Results will not be instant for everything that you seek to accomplish so you will need to have some degree of faith. For example, I had to have faith that if I started exercising and did it every single day that eventually it would become easier and make me feel good about myself (it did eventually, but it took quite a long time!). In the same way, you may have to build up the discipline in certain areas of your life so that you can keep going through the tough times in order to reap the benefits down the road. This is as true with spirituality as it is with physical exercise as it is with most forms of relationship-building. You can’t get something for nothing and everything that you do in recovery will require some serious effort. Of course in the end it is always worth it (or at least it has been for me).