Part of why I discovered an alternative path from AA and NA was because I had the unique experience of working a drug and alcohol rehab for about five years of my recovery.
Working full time at a drug and alcohol rehab definitely had a large impact on my recovery. Also a strong factor was that I also lived in this same rehab center for 20 months when I first got clean and sober. So even though I only worked there for about five years it actually felt like about seven years because I had been living there for the first two years!
If you just attend a drug rehab for a few weeks then you may learn a few things about the treatment process, but you gain quite a bit more insight and perspective on the industry when you live in rehab for two years and then work in the facility for another five years.
So here is what I learned and how it affected my decisions in recovery.
Living in long term treatment
When you live in long term treatment you get to see very clearly that the support and the program does not make the recovery. Instead, you learn that the commitment is what makes the recovery.
I was living in a rehab with eleven other males and we were all supposed to stay in this place for six months to two years. People came and left all the time in spite of this long term commitment. I bet the average length of stay was less than six months in all reality, simply because many people relapsed while living there.
Now you might ask yourself “How do people manage to relapse when they are living in rehab? How is that even possible?” I sort of share the same question myself because while you are living in long term treatment you are really given every advantage to overcome your addiction. If you fail it is your own fault, as you have non stop support and help that is always available to you.
The long term rehab that I was living in also had accountability built into it. There were random drops and alcohol screens every single week, so you pretty much knew that you could not get away with using drugs or alcohol while living there. If you were caught you were to be kicked out of the program. Pretty simple, right?
And this was not a punishing environment, it was not like jail or prison or a terrible place to live. We had good food and we cooked huge meals every night and people could go to work or they could go back to college and we only had a few therapy sessions each week. Plus you were expected to attend 12 step meetings. But other than that the rehab slowly gave you more and more freedom as you lived there for longer periods of time. It really was the perfect setup and I never heard anyone complain about living there, or complain that they did not like it, or anything like that. As far as a rehab experience it was very pleasant and very supportive.
And so what I learned while living there for 20 months and watching approximately 30 of my peers relapse was that it had nothing to do with the support and the great program and all the advantages that you got from living in a long term treatment facility. None of that made any difference to most of the guys that I lived with because so very few of them had truly committed to their recovery.
So this was probably the first major lesson of my recovery and I learned it very well over those first two years of my journey while living in long term treatment. There is nothing that can take the place of true commitment. In recovery they have another term for it and that is “surrender.” Most people who get to rehab have unfortunately not fully surrendered to their disease yet, and therefore they have not fully committed to their recovery.
When you commit to something it means that you make a decision that you will do whatever it takes to achieve it. The reason people fail in recovery is because they fail to commit. Living in long term treatment for 20 months taught me this lesson very well. I had committed and so with all of the support I got in rehab it was actually not so difficult to remain sober during that time. But obviously others were struggling with the process and I eventually figured out that it was not because they were not getting the proper treatment, but because they were not committed to their recovery.
Shocking repeat business
One of the things that caught me totally off guard when I worked in a rehab center was the shocking amount of repeat business that the place experienced. This is the “revolving door” syndrome that most people do not even know about or realize.
The majority of the outside world believes that rehab is an event. They believe that getting clean and sober is an event that happens and then someone moves on with their life. If you worked in a rehab for just six months you would realize that this is definitely not an accurate portrayal of reality.
Instead, rehab is a process. I should have known this going into it because I myself had been to three rehabs before I finally “got it.” But nothing could have prepared me for some of the insane amounts of repeat offenders that I saw over and over again in the rehab where I worked. Sometimes a client would leave rehab, relapse, and come back for treatment within just a few months or even weeks later. In some cases, I saw the same person come through the treatment center over a dozen times in the five years that I worked there.
But the really shocking thing was the large number of individuals that I got to know there who kept coming back. For whatever reason these addicts and alcoholics just did not “get it” and so they would repeatedly relapse and then eventually find their way back into rehab.
It clearly had become a pattern for many people. They would spiral out of control until they reached a breaking point in their lives, then they would ask for help and come back into treatment. They would dry out and sober up for a few weeks, then they would venture back out into the world and probably work half of a recovery program for a few months. Then they would slide back into their old ways, reach another breaking point, and end up coming back for more treatment eventually. It became a vicious cycle.
This was another major eye-opener for me, in that I was learning once again and reinforcing the idea that it was all about the level of commitment. It was about surrender. Most people who came to rehab did not actually want to commit to real change. They just wanted things to be different. And so many of these addicts and alcoholics could not understand why they were stuck in this cycle, why they were not getting the results they wanted, why they were still miserable and stuck in addiction.
Over the years I came to learn exactly why they were failing. They failed to stay clean and sober because they failed to make that internal commitment to recovery. It had to do with follow through. But really you could not force success on someone just by forcing them to follow through with their aftercare plan. The aftercare plan is not the secret to success. But if you look at everyone who leaves inpatient rehab and then examine the relapse rates for those who follow through with aftercare versus those who do not follow through, you are obviously going to see a pattern. But the aftercare does not produce the success. It is the commitment that causes a person to follow through with aftercare that creates the success in recovery.
I clearly did not understand this when I first got clean and sober. I had no idea that this was how recovery worked. I believed that there was magic in the program that was being taught to me and the aftercare plan that was laid out for me. I believed that it was customized and that it would work for me as an individual because professional therapists or counselors had put it together for me specifically. Later I learned just how ridiculous and unnecessary this idea was.
It has nothing to do with the aftercare plan. You can send them to meetings, or outpatient, or make them live in long term rehab, or have them go to a halfway house, or whatever. The actual treatment or therapy is very much beside the point. What really matters, and what really makes or breaks an addict’s recovery, is the level of commitment that they have going into it. If they have achieved a full level of surrender then it pretty much does not matter what help is offered to them, they will succeed in recovery. If they have a reservation or if they have NOT fully surrendered to their disease, then it does not matter what you do. It does not matter how many rehabs they attend or if they go to a world class treatment center or if they start counseling sessions with the greatest therapist in the world. None of that will save them if they have not made the commitment.
And so when you work in a rehab for several years and you start to get to know the clients and then you start to see several of them coming back to rehab, over and over again, you start to get a clear picture of things. You do not judge these people because you yourself may have been to rehab multiple times as well. There is always hope that some day a person will have the light bulb click on for them. But in the meantime you cannot help but start to see the patterns, and start to see the real truth about the process of recovery, and how it all boils down to surrender and commitment. They either have it or they do not.
And sadly enough you can even get to the point where you can be trying to work with someone in rehab, trying to help them to get clean and sober, and you just know that they are not ready yet. And you think to yourself “they are just not ready yet, they don’t get it, they have not surrendered, they are not done chasing that next high and they are going to go back out there and they are going to get some more pain in their life because they are definitely NOT done using drugs and alcohol yet. They are just not. They are simply not ready.”
And you know this because of their behavior and because you have watched hundreds and even thousands of addicts and alcoholics come into rehab. You have seen hundreds of people try and fail, try and fail, and so you get to know when someone is setting themselves up for failure. And of course the frustrating thing is that you could never say anything to change it or give enough warning to someone that they are headed down the wrong path. They will deny it all and refuse to see your logic because they are just….not….ready.
Dependence on meetings and social recovery?
There are at least two kinds of people who attend 12 step meetings and work a 12 step program. For the sake of this point here and the observations that I made while working in treatment I am going to say there are two camps:
1) People who go to meetings and actually work the program and live it outside of meetings and develop a strong recovery.
2) People who go to meetings and use them as their primary solution and use them as therapy and sort of depend on them for continued sobriety.
One thing that I noticed while working in treatment was that most people who are getting “the rehab experience” are setting themselves up to be one of these two types of people. The problem is that most of them end up being the second type, the kind who depend on meetings for their continued sobriety.
Now this is not a criticism of rehabs necessarily nor is it a criticism of 12 step meetings, because I am sure that the intention is for people to work a strong program of recovery in AA or NA rather than creating a dependency.
But part of the problem that I saw while working in rehab for five years was that the solution being proposed was far too social. If you read the literature and you followed what they were actually suggesting then the emphasis was on the step work and working with other alcoholics and addicts and actually doing the footwork to make positive changes. But if you followed all of the suggestions that you were exposed to while in rehab (and subsequently in AA meetings during rehab as well) then you would have a much greater emphasis on the social side of the solution, rather than on the “practical footwork” side of the solution.
So why am I negative about this idea of “social recovery?” What is so wrong with going to meetings as the core of your recovery and being social about recovery and getting involved with other people in the recovery community?
There is nothing necessarily wrong with it except that I do not think it should be the primary thrust of your recovery program. If you follow traditional recovery then the steps are the primary part of your program and they should be your foundation, not the social AA meeting “daily group therapy” circus we have today that passes for recovery.
Back in the beginning days of AA they did not have tons of meetings every day of the week. They were lucky to meet up once or twice a week for a meeting and they stayed sober based on a program of individual ACTION. This is how I managed to stay sober myself, by taking lots of action and making positive changes in my life. I was never big into the social scene and I eventually drifted away from meetings altogether.
When you are in rehab and attending groups and AA meetings that are part of the treatment facility, you hear a very clear message. The message is basically “These meetings are your salvation.” I think this is a mistake because people tend to focus on the meetings and on the social aspect of recovery rather than doing the steps or taking individual action to improve their life. Of course you can argue that “why not do both?” but the fact remains that many people will simply do what is easiest for them….and that is to simply show up to AA once a day, hoping that this is enough to keep them sober. In some cases it will be (if they also put in the footwork) and in other cases it will not be.
Most rehab experiences will lead the addict and alcoholic to believe that the solution is social, that the solution is daily meetings. I think this is somewhat misleading because daily meetings are at worst a dependency and at best a stepping stone to taking real action. But neither of these things are going to produce long term sobriety by themselves without additional effort being made. Recovery does not happen in the meeting halls, but most rehabs would have you believe that this is the core of the solution.
If you work in a rehab for a while then you will certainly notice this tendency for addicts and alcoholics to engage in “self sabotage.” Learning to recognize this is useful because then you can also be aware of when you might be doing it yourself.
What happens is that there is this little tiny switch in the brain of the addict or the alcoholic. It has to do with “taking back self will” and no longer being able to listen to reason.
I have seen it happen many times over again with people who want to leave rehab early. They are supposed to stay for a few weeks, and it has only been a few days and they decide for some reason that they need to go home. They want out. They want to leave, right now.
Sometimes when this situation occurs this little switch has been flipped in their brain. I guess you might call this the “self sabotage” switch. Once it has been flipped there is absolutely no talking to the person. You can talk all you want and you can bring in all sorts of therapists and you can get the person’s family on the phone to try to convince them to stay in rehab but nothing is going to work. There is nothing you can say because that little switch got flipped.
I know about this little switch first hand because there was a time when it flipped in my own head. I was about to leave rehab and I was just not ready to get sober yet in my journey and the therapists were recommending long term treatment. I was not ready and I was not willing to go to long term and this little switch got flipped in my head. I did not acknowledge it at the time but what this switch really was saying to me was “you are done with this recovery game and you are going to go get totally drunk the first chance you get.”
I had made up my stubborn little mind even if I would not admit to myself. That little switch had flipped in my brain and there was nothing that anyone could have said at the time to convince me to remain in recovery.
This happens a lot for people in rehab when things seem to be going well. But it will never happen for someone who has fully surrendered and is fully committed to recovery. Self sabotage will only happen for people who are not ready to change their life yet.