There are some very unique things about rehabilitation for alcohol addiction that set it apart from other experiences.
Most people would say to this “who cares?” but it is actually a very important distinction.
Alcohol recovery is not like anything you have ever set out to try to accomplish before. Therefore you have no road map, no frame of reference for what you are up against. This makes it especially challenging.
Most people who are alcoholic have no idea what the challenge is that lays before them in recovery.
They make an assumption based on their past experiences. How could they do anything else? They are making their best guess about recovery simply based on what they have learned in life and what they have experienced thus far.
Unfortunately this sets most people up for failure. This is the reason why so many people have to make several tries in order to finally “get” sobriety. They have to try to sober up multiple times and they have to relapse over and over again before the light bulb finally clicks on. Why is this?
The reason is because recovery is so unique. It is a special challenge and most people do not have anything in their past that even comes close to the experience of recovery.
We go through various experiences throughout our lives and we are forced to make certain changes. We meet challenges. We overcome obstacles. But nothing can really prepare us for a lifestyle change as drastic as overcoming alcoholism.
In other words, the struggling alcoholic has certainly gone through changes in their past, but they have never faced a change as drastic as this before. Therefore they do not have a frame of reference for how drastic the change must be. They do not understand how deeply they must surrender.
In fact, their past experiences with change is actually a hindrance. They are overconfident because they have faced challenges before in their life and they have overcome them. So they believe that they can apply their usual tactics and their usual level of effort in order to succeed in recovery. But this is not the case, of course. Only total and complete surrender will result in lasting recovery.
And so most struggling alcoholics come into recovery for the first time with the wrong mindset. They believe that they are smarter than average and that they can apply less effort and get the same results as the average person. This is a recipe for failure. Or maybe they are more realistic and they believe that they must make the same effort that everyone else makes, and they call themselves an equal and an average person. Even if this is the case, they are still destined to relapse!
Because the average person in recovery relapses! Look at the numbers. If look at the last 100 people in your area who attempted to get clean and sober, and you make an effort that is equal to the average of those 100 people, you are going to relapse. Because the vast majority of those people are going to relapse as well. The average person…..relapses.
The numbers indicate that maybe the top 10 percent will remain sober for the long run. Even that is a very optimistic projection. So now imagine yourself among these 100 people. Now realize that in order to achieve long term sobriety and be successful with your recovery, you are going to have to try harder than 90 out of those 100 people. If you only try as hard as the bottom 80 percent then you are almost surely going to relapse at some point.
This is a very unique challenge with some very interesting numbers behind it. Most stuff in our lives does not work this way. When you went to school and tried to pass the third grade, for example, you did not fail if you were in the bottom 90 percent of your class.
Furthermore, out of all of the challenges that we face in our lives, how many of them are pass/fail like recovery? Very few of them, really. Most challenges that we face have a “middle outcome.”
Recovery is unique because there is no middle outcome. You either relapse and go back to the total chaos of addiction, or you remain clean and sober. It is totally pass/fail. There is absolutely no middle ground and anyone in recovery who thinks they have found the middle ground is definitely headed for a relapse.
Never have I found anything in my life that was as polarizing as sobriety. You are either sober or you are drunk. For the alcoholic there is no in between.
So the challenges of sobriety and overcoming addiction are, by themselves, very unique. Most of us are not used to the challenge and we are not prepared for it at all. Therefore it is difficult to even try to approach recovery with any sort of confidence when we have never been exposed to the challenge before. I went to rehab 3 times. Most people that I know who are sober today had to try at least 3 times as well in order to finally “get it.” This is not because they are stupid people! It is because the challenge of sobriety is so unique that the alcoholic had nothing to compare it to. We had to learn how to fail before we could learn what it would take to succeed.
Teaching recovery is very difficult
I think it is very, very difficult to teach alcoholism recovery.
This is because the act of becoming sober is an ongoing (and sometimes a lifetime) process.
Not only that, but I also believe that there are at least two different stages of recovery. No, make that three stages:
1) Detox – where you are basically still drunk, but you are medically supervised and sometimes given medication in order to get through the withdrawal. You dry out.
2) Short term or early recovery – where you are just out of detox and maybe going through your first 12 to 24 months of recovery. You are learning. You are seeking support.
3) Long term sobriety. You are stable now but the threat of complacency can still cause relapse.
Number one and two can be combined, they call this “residential treatment.”
But there are several problems with this setup. The first problem is that the recovering alcoholic is not always so good at acquiring new information while they are fresh out of detox. Their brain is still a bit foggy, and may be for quite some time (depending on how long and how heavily they drank). This is not always a problem though, because at this stage it is more about “monkey see, monkey do.” Just go to meetings and do what you are told for the first two years and you will do better than most people. It really is that simple–not that it is easy to take orders!
A second problem is that you cannot really teach people about how to overcome complacency while they are in short term rehab. If you do then you are probably misleading them a bit and throwing them off track. Why? Because in early recovery they need to focus on massive amounts of support. You know, like by going to AA meetings every single day and working with a sponsor. Those things are actually pretty useful if you embrace them fully in early recovery. It’s all about identification with others (so that you know you are not crazy) and getting lots of support.
But then something happens around the first or second year of sobriety. Things change. Your recovery evolves. You become somewhat stable in that you no longer feel like drinking every single day. You may still have the occasional urge or craving but it is nothing like it was in the beginning. So you realize that going to meetings every single is not going to work for the rest of your life. You have to move past the idea of “lots of support in early recovery.” Now it is about personal growth. You have to challenge yourself to take positive action on a regular basis. You have to push yourself to make positive changes in your life.
Overcoming complacency is all about personal growth. If you stop learning and stop growing then you are in risk of relapse. But it is very difficult to teach this concept in early recovery because the solution for years 1 to 2 in recovery are actually the complete opposite of this. Instead of “personal growth” what you need in early recovery is support and routine. You need to immerse yourself in recovery, in AA meetings, in sponsorship, and so on.
So the phase of recovery that you are in (early sobriety or long term recovery) will dictate to some extent what approach you are taking. There are some people who argue against this idea and so they cling to their support system without really pushing themselves to engage in personal growth. Such people are not at fault for embracing support systems in the long run (there is nothing wrong with going to meetings for life) but they will get into trouble if they never learn how to embrace personal growth in order to overcome complacency.
Specialization in recovery methods
Another problem with alcohol rehabilitation is that there is currently almost no specialization. Right now you can basically choose which rehab center that you go to, and something like 80 percent of all rehabs are based on the 12 step model. That means that your solution is likely to become the AA program. This is fine if AA works for you. This is not so good if you don’t exactly hit it off well with that particular program.
There are some alternatives, but they are very few. The other 20 percent or so of rehabs are mostly Christian based recovery centers. Again, this is fine it if works for you. Not so great if you are not a Christian. But no one is forcing you to go to a specific treatment center (well, sometimes people get forced into rehab, but this rarely works because they have not yet surrendered).
A very tiny percentage of rehabs may be based on things other than religious and 12 step recovery. For example, you may be able to find a rehab that is based only on therapy techniques. These are extremely rare though and it is likely that 90 percent of people will not even have access to these places. So for the vast majority of struggling alcoholics they have the option of either religious or 12 step based recovery.
They did a study once to try to determine if treatment specialization was useful in recovery. So they tried to match people up to their sort of recovery method that best fit their personality and their desire. What they found was that this was not really all that useful, though they determined that there was a slight edge given to the 12 step program in the results that they were seeing. Supposedly this “slight edge” was not statistically significant, however.
When they did this study they just looked existing therapy and treatment methods. But since then there have been a few new ideas in the field of recovery that may change that outcome some day. For example, there is a group of people that manage to stay clean and sober based entirely on exercise and running races. These people have found an alternate form of recovery that does not depend on group meetings, one on one therapy, or religious conversion. Obviously this is not for everyone but it certainly could open up some possibilities.
There may not be an ideal method of recovery. And it may turn out that having specialized methods of recovery to match the individual is a big waste of time and energy. But I believe that we probably need to explore this area a bit deeper and also try out more alternative methods of recovery at a larger scale.
The key is personal growth
The key to recovery is personal growth. This in itself is fairly unique. Certainly if you buy into the disease model of addiction then you have to be amazed that the “cure” for the disease is actually personal growth and development. This is bizarre and definitely a huge deviation from most other diseases.
Given the need for personal growth, treatment is not merely an event. It is a process. Just going to rehab and staying for 28 days is never enough. How could it be? We leave rehab and have to face all of the temptations again in the outside world, and deep down we are always going to be an alcoholic or an addict.
So treatment is just the beginning. The real process of recovery unfolds over the rest of our life.
Treatment is the baseline for getting a strong foundation in early recovery, though it may not be enough
I think part of the reason that so many people relapse after their first try at recovery is because they have the wrong attitude completely.
They are thinking of their trip to rehab as an event. They are treating recovery as if it were a “cure.” Like it is a one time event.
But the truth is that recovery is an ongoing process, one that lasts for the rest of your life. This is what most alcoholics fail to grasp when they first try to get sober.
So they have to try and fail. They have to make an effort and then relapse. And they may have to do this several times before they realize that they are never going to be cured.
So treatment can still be useful, and even necessary. But it is never going to be an instant cure, and that is the mindset that most alcoholics approach it with. They think they are going to go into rehab for 28 days and come out a changed person. But the changes are just beginning when you walk out of rehab. That is when the real challenge starts.
Why it has to be about more than just abstinence
If all it took were abstinence then we could easily be “curing” alcoholics left and right in this world. Just send them to jail for a weekend or lock them up in rehab. Problem solved.
Obviously we know that it doesn’t work this way. Mere abstinence does not “cure” anyone of addiction. It is only a temporary relief from the chaos and misery of their disease.
In order to achieve long term sobriety the alcoholic must take action. They must make many changes.
First they have to get sober and dry out. They have to physically get off of alcohol and drugs.
Second they have to embrace some form of support. You can’t do it alone (if you can, then our hats are off to you! And, you are probably not really alcoholic….but that is another discussion).
Third, you need to transition to personal growth, so that you can overcome complacency in long term recovery.
Abstinence is the baseline for this stuff. Without abstinence, none of these other things can happen. But always remember that merely abstaining from alcohol and drugs is never enough. That is just the start.
Treatment is an attempt to teach the alcoholic how to go beyond mere abstinence. It is an attempt to teach the alcoholic how to embrace positive change in their life so that they can overcome the urge to relapse. And the hope is that they can one day overcome complacency and find a way to push themselves to make continuous growth.
Alcohol recovery is one of the few experiences that you will have where the teacher can become the student. I have watched this happen before as I went through my recovery journey. The people in rehab who were working there and teaching others to recover had, on occasion, slipped and relapsed and eventually become “students” again. And at the same time, some of the people who went through treatment with me in order to learn to become sober eventually became “teachers” in that very rehab center. How many other experiences in life match this? How many situations can you think of where the teachers become the student? I can’t think of any examples myself. Recovery is bizarre and unique in this.
How to embrace recovery and change your life
The fact that recovery is unique is no big deal. Just because the experience is so vastly different from anything you have ever done before should not be a deterrent to you.
The way to embrace recovery is to dive in head first, with no reservations. If you are hesitant about rehab then you should try to force yourself to go anyway. Remember that it is a process, and that most people cannot fully embrace the changes on their first time around. Usually you have to try and fail at least once in order to see just how deep the challenge goes. Before you can see how deep your surrender must be and how fully committed to change you must be.
Ask for help. This is the best way to embrace change in your life. Of course if you ask for help then you also have to follow through on the advice that you are given. If you do not follow through then you are headed for relapse. But even in that experience you may learn something valuable that will allow you to fully embrace recovery in the future. I had to fail twice before I could make rehab work for me.
It is fairly simple to embrace recovery but that does not mean that it is easy to do. It takes guts to surrender completely. And, you probably cannot fake it. If you try to fake it then the recovery machine will spit you out again for more chaos and misery in active addiction. Once you are sick and tired of the misery then you have a chance at surrendering fully.