One of the questions that alcoholics and drug addicts often struggle with is the issue of addiction treatment.
It can be a deceptive question because most of us realize exactly what we need to do in order to turn our live around. In other words, it is not really for lack of knowledge that we continue to abuse drugs and alcohol. The struggling alcoholic knows what the solution is–they need to become abstinent.
But just because you know what the solution is does not mean that it is easy to implement, or that you will know how to do so. The real trick is not in quitting drinking, but in learning how to live a happy life while you are sober.
The learning process that is recovery takes place after you find yourself becoming stable in sobriety. The real issue is: “How do you live your life in such a way so as not to need to self medicate all the time?”
There are really two things that can lead you to a solution, and they should both be emphasized in recovery because they can definitely both help you to stay sober:
1) Learn new ways to deal with stress, anxiety, anger, and frustration–other than to self medicate it with alcohol or drugs. Alternative coping mechanisms.
2) Minimize the amount of stress and negative stuff that you are dealing with to begin with. Improve your life situation so that you don’t have as many excuses to self medicate.
In the first case you are changing yourself. You are working on the inside. You are changing how you deal with life.
In the second case you are changing your life situation. You are changing your everyday experience.
The first case is internal. The second case is external.
I believe that both of these are important. Most recovery programs also seem to touch on both the internal and the external as well. For example, if you go to enough AA meetings then you might hear someone suggest that you need to “change the people, places, and things in your life.” This refers to the need for external change, the need to change your life situation. Of course, most of the AA program actually deals more with internal changes based on the 12 steps. So in effect you will probably be advised to change both the internal and external parts of your life.
When you go into residential treatment they try to do a few things along these lines. First of all you are put into a controlled environment and you typically stay in rehab for a few weeks or so. So right off the bat you are making an external change. In fact you are making quite a few changes. You are staying in a protected environment, you are associating with a new set of (more positive) people, and you are not being exposed to temptations and triggers for a while. So going to treatment is, first and foremost, about making these external changes. You are changing your environment so that you know that you will remain clean and sober while you are in rehab.
Second of all the treatment center has a number of groups, lectures, and meetings each day. What is the point of these? The point is that they are going to try to educate you as to how to go about making internal changes. Everyone has to walk out of treatment at some point. Everyone has to face their drug of choice, alone, without the help of others, at some point in their life. Every recovering alcoholic and drug addict will eventually face temptation. No matter how hard you try to protect yourself from temptation, it will happen eventually. This is the price that you pay in order to be free. The alternative would be to lock yourself up in a place where you have no freedom.
One of the challenges of treatment is that they have to try to teach you how to remain sober both on the day that you walk out of rehab, but also for the rest of your life. These are two different challenges and they require completely different approaches (in my opinion). The day that you walk of treatment requires a much different approach than, say, 5 years down the road.
What have you tried so far in order to overcome alcoholism? What has worked?
If you are asking yourself the treatment question (i.e., should I go to rehab?) then you might first consider what you have tried so far and what has worked for you?
There will be two special cases here of people–those who have never been to treatment before in their lives, and those who have already been to rehab but have since relapsed.
At one point I had never been to rehab before in my life, and I was struggling with alcoholism. I did not want to go to rehab because I was essentially afraid of what it would be like. Up until this point I had been seeing a counselor on a regular basis, and that person was encouraging me to go to treatment. They knew that it was obvious that I needed serious help, but I did not necessarily agree with this because I was in denial.
One thing that you might ask yourself if you have never been to treatment before is this:
“How many people are suggesting to you that you might need help?”
The theory is that you are not going to be right while everyone else in the world is wrong. In other words, if 2 or 3 people in your life believe that you should seek help and go to rehab, then they are probably right. As an addict or an alcoholic in denial, we will often believe that the entire world is “out to get us” and that we are right while everyone else is wrong. If you have ever watched a person in denial who thinks that it is “them against the world” then you know how wrong this stance usually is.
If everyone thinks that you need help, then everyone is probably right. It is rare for several people to all be “wrong” while the one person is justified in their denial.
So you need to consider the possibility that you may need treatment if you have never been there before. This is especially true if you are struggling or unhappy in any way. Ask yourself: What have you got to lose? If you are unhappy due to your addiction, then you have nothing to lose and everything to gain by giving treatment a chance.
Now the second type of person is someone who has already been to rehab in the past, but they are still struggling. Obviously just going to rehab is not a magic bullet, and something more has to happen in order for long term sobriety to manifest. So to those people I would suggest the following:
1) Not everyone gets sober after one trip to rehab. In fact, my informal observations tell me that the average number of visits before achieving long term sobriety is probably around 3 times. Everyone that I have met who is clean and sober in recovery had gone to rehab at least twice, the vast majority at least three times. This is not a knock against rehab. Instead, it is a glimpse into the true process of recovery and what it takes to break through denial.
2) Just because you have been to rehab before does not mean that you “know it all.” Obviously if you had learned it all the first time then the outcome might have been quite different, right? It is not what we learn necessarily but in how we implement it. In other words, there is a difference between sitting there and memorizing the 12 steps versus actually implementing those steps into our daily lives. The former is not really “learning.” Applying knowledge is applied learning, and that is what keeps people sober. Just because you absorbed the material does not mean that you applied it in a meaningful way.
So whether you have been to rehab before or not, you could most definitely benefit from going back if you continue to struggle with your addiction.
Why I could not change my life just by going to meetings
At one point it was suggested that I go to AA meetings. This was before I had been to rehab.
I suppose that there are some people out there who can actually get sober this way. They stop drinking and just start going to AA.
If that is the case, then good for them. I am glad they have found such an easy solution. But for my own purposes, this did not work for me, and I it never would have.
For one thing, I was far too afraid to attend meetings and to start being social. I am a shy person to begin with. Going to treatment forces you through this shyness and gets you into meetings anyway.
Second of all, I was still drinking. I did not feel like I could attend these meetings while I was still drunk. Nor did I want to. Going to rehab eliminates this problem as well. You go through detox, then you start attending groups and meetings.
Third, I did not have any resources or help in place to facilitate my transition into recovery. I had no way of reaching out for help. My only option would have been to just barge into my first meeting and somehow ask for help. Probably possible, but not realistic. Going to rehab can fix this problem, as you will be exposed to meetings and also probably have outpatient treatment afterwards. Or you may meet in groups with people post-treatment and you may also meet a set of peers who can help you once you get out. So in going to treatment you have options, you make contacts, and it helps to ease you into a support system.
The need to disrupt your patterns
Going to rehab is a form of pattern disruption.
This is really important in early recovery. In fact, you can’t really get sober unless you disrupt your patterns.
Our addiction is fueled by pattern and habit. These patterns become deeply ingrained and we need to take drastic action in order to break free from them.
For example, driving home from work each day and seeing the same old liquor store or corner bar. This can be a very difficult sort of pattern to break free from, because it makes our drinking automatic. We may have to drive home a different way. Or we may have to get a new job entirely, as there may be triggers and patterns there too that can cause us to struggle.
When I finally became clean and sober, I had to take a massive amount of action in order to disrupt all of my patterns of addiction. I ended up living in long term rehab for almost two years. I never saw any of my friends that I used to drink with. Instead I had to get a new set of people to hand around with, people who were a much more positive influence on me. I don’t see how this would have been possible unless I had gone to treatment.
In order to overcome any sort of pattern you need to make changes. Those changes need to be massive if the problem is related to addiction or alcoholism. The reason that you need massive changes is because alcoholism affects nearly every area of your life. It is a pervasive disease in that it affects each and every part of your world.
This is why I tell people that they need to take “massive” action in order to recover. It is not enough to make a change. It is not enough to make a small effort. Instead, you need to make huge changes and really do a lot in order to disrupt those old patterns.
Going to rehab is a shortcut to this idea of pattern disruption. You could probably accomplish much of the same disruption in some other way, but it would take a whole lot of effort. The easy way is to simply go check into rehab. This is the shortcut that disrupts the pattern in all of the right ways (because rehab has been designed to do so).
It is more than just disruption. Consider the lousy success rates of long term rehab
At one point in my journey I lived in long term rehab. This turned out to be the right choice for me, and I have not taken a drink or a drug since I moved in there.
But while I was there in long term treatment I lived with a total of approximately 35 other guys. Out of those 35 guys maybe 3 of them are still clean and sober today. All the rest of them have since relapsed at least once.
If short term rehab is a form of pattern disruption, just imagine what long term treatment is like. The program that I was at had an average length of stay of over one year (and up to 2 years).
My theory when I first started living in long term treatment was that:
1) These people were more serious about their recovery than people who went to short term rehab.
2) The odds of remaining clean and sober would be much higher for people who are living in long term treatment.
Both of these assumptions turned out to be false, from what I later observed.
You do get a slightly higher rate of success with long term rehab as compared to short term, but in most studies I have seen the numbers are very close.
Why is this?
I think it is because pattern disruption is not enough.
Just because you have this amazing amount of support and you go out of your way to really disrupt your addiction pattern (by living in rehab), that does not insure your sobriety.
Obviously, it takes more than that. A lot more.
If long term rehab were a cure then the success rates would be significantly higher than short term rehab. But the fact is that they are roughly the same in most studies.
Therefore “extended pattern disruption” is not enough to produce success in recovery. It is not enough to tip the scales and help people to stay sober.
So what is missing? What it the key to sobriety? If long term rehab is not the answer, then what is the real key?
It all comes down to surrender, and willingness.
Believe it or not, many people who go to long term treatment are not in a state of total and complete surrender just yet. They have not yet hit bottom.
Successful recovery is a combination of things:
1) True surrender. Hitting bottom. Willingness to do anything to recover. Willingness to destroy your own ego and take advice from others.
2) Physical detox. Short term rehab. Initial pattern disruption. The first month of sobriety.
3) Support systems as part of your pattern disruption. Going to AA every day is an example of this. The first year of sobriety.
4) Personal growth. Pushing yourself to make positive changes in order to learn and to grow in life. The rest of your life in recovery.
So when we talk about “disruption,” realize that this is really just a starting point of sorts.
We need disruption in order to get through certain parts of our recovery (such as detox), but we also need a lot more than that.
Many people go to rehab when they are not fully committed to making the difficult changes that are necessary to remain sober. Many people go to treatment before they have the willingness to take direction from others and to follow through on those directions.
You have to be in a state of willingness in which you will listen to other people and take advice and direction from them. This is a rare state for many people to be in because we tend to have pride in ourselves and we like to think that we are in control of our own lives. It is difficult to give up that control and let others dictate our path in recovery. But this is exactly what we need to do in order to move forward.
If nothing else has helped, why not give rehab another chance? The worst you could do is to go back to where you are now
I used to believe that rehab was a complete waste of time, and that I would be making a huge sacrifice if I were to go to a 28 day program. As if I were missing out on these precious 28 days of my life that I would never be able to get back, and I could have used those days to sit there and drink myself stupid!
How ridiculous that was of me. The reality was that I was miserable, and that 28 days of sobriety was actually a gift and a welcome change. But I could not see that at the time because I was stuck in denial and I just wanted to keep drinking and self medicating every day.
Remember that you can always go back to drinking later if sobriety does not work out for you. Seriously! What would stop you from just going and buying more alcohol later on if things don’t work out? Of course that will always be an option.
I do not say this to encourage relapse….I say that to give the alcoholic permission to give sobriety a chance. Realize that you are never trapped in sobriety and you are always in control of your life. Just ask for help and give sobriety a chance and if things don’t work out then you can go right back to drinking or taking drugs later on. No one can stop you from that decision.
If you are not happy today, then why not give rehab another chance?