I’m not sure if you have seen the numbers or heard the statistics, but a whole lot of people tend to relapse in addiction recovery. This is especially true in very early recovery, when someone is just getting started. Something like 8 or 9 out of 10 people will relapse in the first year alone. After that, people will still relapse even though they made it past the one year point.
Now we can argue over the numbers a bit and look at different sources of data, but the picture is fairly grim everywhere that you look. No one is claiming that, say, 50 percent stay clean after a full year. That would just be outrageous. The numbers are worse than that.
So this begs the question: “Why do so many people relapse in addiction recovery? Why do so many people struggle to remain clean and sober in the long run? What is the big problem?”
Let’s try to dive in and find some of the major reasons for this.
Believing that they are unique
First of all, many people who are hopelessly addicted to drugs or alcohol do not believe that they are like other addicts in the world. For some reason they believe that they must be completely unique, and that no other person has ever loved drugs or alcohol as much as they do.
This becomes a major stumbling block in early recovery because in order to get help and hope from a program, you have to buy into the idea that other people who have the same problem as you have done it before. If you don’t believe in that possibility then there is no way that you can follow in their footsteps and thus get the help that you need. This is why people tell their story over and over again in AA meetings–so that the newcomer has something to identify with. This identification starts the healing process because the newcomer will then realize that other people have been in their position and have been able to find a new life.
So this particular stumbling block occurs in early recovery, when the addict or alcoholic is fist trying to get help for their problem. If they believe that they are unique then this can prevent them from doing well in recovery. They are setting themselves up for failure because they are determining that the program cannot help them due to their special needs. They believe that they are a special case and that other addicts and alcoholics are not like them. Therefore they are arguing that the program will not work for them because they are different.
I know that this can be a problem because I did it myself for a long time. I was terrified of AA and NA meetings and I had a great deal of anxiety about sitting in them and being expected to say something. In fact I was so nervous that I did not even want to have to say “I’m just here to listen today” or anything like that. So because of this anxiety I believed that my situation was totally unique and that no other addict or alcoholic had ever tried to get sober who had this level of anxiety (in truth my anxiety was not even that extreme). So I told myself that the meetings would never work for me because I was unique.
Eventually what happened is that I got miserable enough in my addiction that I no longer cared about the anxiety or my unique situation. I just wanted the pain and misery to stop. So at that point I became willing to do anything, including attending meetings. So I went to rehab willingly and I attended AA meetings and I forced myself to get through the anxiety. In the end I still found a path in recovery that did not depend on daily meetings, but I think it was important that in the beginning I had to become willing to face this fear. I had to become miserable enough to get past my denial, to stop caring about my anxiety, and to just go ahead and do it anyway (go to rehab and face the meetings).
Thinking they can do it on their own
This article is turning out to be a list of apparent contradictions. In my recovery today I most definitely “do it on my own” and have my own personal path in sobriety. I do not rely on other people today to keep me clean and sober. This works well for me in long term recovery. But in order to enjoy this level of freedom I had to build up to this point.
In early recovery I believe this sort of approach is a mistake. Instead you must work up to this level of independence. In early recovery you need help. In early recovery I needed a lot of help.
This is mostly because you need new information in early recovery. You need a way to lay a foundation for the new life you are going to be living. In order to do that you need to get some structure in your life and take direction from other people. I had to ask for help and then listen to the advice that I was given. I had to seek help from others and then follow through when they told me what to do. This was hard on the ego and it is not a fun path to take! This is why surrender is so important in early recovery–if you have not fully surrendered then you will not be willing to go to this extreme length in order to stay sober. Taking direction from others is not easy (though it is fairly simple!).
I have watched many people who thought that they could do it on their own who only ended up relapsing. Eventually such people may “come back to a group” in order to get new information and start moving forward in their recovery again. When they are off by themselves they cannot do anything right, and they cannot discover the secrets of recovery on their own. This has to be taught and learned and experienced through the help of other people. Later on in recovery they can be as independent as they want, but in early recovery they will fail if they try to do it alone. This is just what I have observed, and also was true for me in my own journey.
Leaving rehab early and ignoring advice
If there is one major piece of advice that I could give to help others avoid relapse it is this:
* Go to rehab and don’t leave early. Do what they tell you to do. Follow through.
This is not rocket science, folks. It is in fact very humbling, because we don’t like to be told what to do. But if you take this simple advice and follow it exactly then you will likely be able to avoid relapse in early recovery.
Go to rehab. Let go of the need to control everything. Check into rehab and start listening to what they tell you. Take action. Start taking suggestions. Follow through on the suggestions. Note what they tell you to do when you leave rehab. Embrace the solutions you are given. Follow through. Actually do what is suggested.
Because I worked in a rehab center for several years, I got to watch hundreds of people leave treatment. Many of them ended up coming back again later, and such people obviously had relapsed (otherwise why would you come back for more treatment?). So over time I observed and watched many people who got caught up in this cycle. And when you are watching all of this for several years in a row, day in and day out, you start to notice trends.
For example, I noticed pretty quickly that no one who ever left treatment early came back later and said it was a good decision. In fact, nearly everyone who had left treatment early came back later to get more help and noted that leaving early was a big mistake. I watched this story play out over and over again, and then I also had the challenge of trying to talk people into staying who suddenly wanted to leave early. If you are in rehab and you suddenly want to leave early, don’t. It is as simple as that. If you leave early then you are setting yourself up for certain relapse. Every single person who wants to leave rehab early denies this, or flat out really believes that they will not relapse. But it became painfully obvious over the years that every single person who wanted to get the heck out of rehab RIGHT NOW was always, always, always headed for relapse. It did not matter what their attitude was or what their plan was. They were headed for certain relapse.
The lesson of this story is that you need to slow down in early recovery. Really this is about letting go of the need for control. If you leave treatment early then you are in control. If you stay in rehab and follow all of the suggestions that you are given then you are surrendering and letting go so that you can discover a new path in recovery.
Lack of full surrender is the number one cause of relapse
The core of the problem above (leaving treatment early) is actually a deeper problem known as “lack of surrender.” This lack of surrender can manifest itself in several different ways, and ultimately it is the number one cause of relapse.
The plain and simple truth is that you cannot recover if you have not surrendered fully to your disease. The foundation of your recovery is built upon surrender.
What happens when you surrender is that you let go of all of your ideas about how to be happy in life. You let go of all of it and let it all disappear. This creates a blank slate inside of you that you can then fill up with new information.
When you go to treatment and meetings and talk with your peers or a sponsor you are gathering new information about how to live a happy life. Your old ideas about how to live a happy life basically meant that you self medicated into addiction. Your old ideas were not working for you. They made you miserable and so you eventually surrendered to the disease.
When you surrender to the disease you are essentially saying “I now realize that my drug of choice is no longer working. It no longer does what I want it to do. I don’t know how to make myself happy any more.”
This full admission to yourself is critical because then you clear the way for new ideas. In fact you have to be desperate for new ideas about how to live. Otherwise you will not be willing to take orders from other people and implement them in your life. Normally we have too much pride to allow that sort of thing. We normally think to ourselves: “How is someone else other than me really going to know what is best for me and what would make me happy? They don’t know me!” This is how we stay stuck in addiction, because we do not believe that other people could instruct us to the point that we become happy again. We don’t trust. We think that only our own decisions can lead us to happiness.
But obviously this has failed. We are stuck in addiction and we are miserable. So this creates the need for surrender. When we surrender, we let go of the idea that only we can solve our happiness problem. We let go of the idea that no one else could possibly give us advice that would lead to happiness. We break through our denial and admit to ourselves that we do not know how to make ourselves happy any more. We used to know how–when our drug of choice still worked for us. But over time it stopped working and now we are miserable.
Pretty much all problems with relapse can be traced back to a lack of surrender. If you relapsed it just means that you did not surrender deeply enough, because if you had then you would have followed other people’s direction and advice, which would have kept you sober. Your relapse is always due to a lack of a surrender. Full surrender leads to successful recovery.
Not taking suggestions from other people
Again, this is another problem that can be framed in terms of surrender. This happened to me once when I went to rehab before I was really ready to get clean and sober. It was suggested that I live in long term treatment after I left short term rehab. I was shocked and horrified at this idea because I equated long term rehab with going to prison. Of course this was just part of my own denial and in all reality long term rehab is nothing like prison. But that is what I told myself at the time because I was simply not ready to follow through. I had not yet surrendered fully. Later on when I reached a point of full surrender I would have no problem with going to long term rehab.
When I worked in rehab for several years I got to watch this play out over and over again. People would either take suggestions from others and do well in recovery, or they would ignore the suggestions, try to do their own thing, and relapse. There seemed to be no middle ground with this. You were either in a state of surrender or you were not. You were either open to new ideas or you were closed off and stuck in denial.
Not following through with suggestions
Just taking suggestions (or appearing to do so) is not always enough in early recovery. In order to avoid relapse you actually have to follow through on those suggestions.
What does it mean to “follow through” on a suggestion?
It means that you stick with it and see it through to completion. It means that you dive into the suggestion fully and embrace it with enthusiasm.
For example, when I was reading recovery literature I read a lot of it. In fact I read several books in the first few months of my recovery. I dove into the literature and actually studied it. I also started writing about recovery and keeping a journal.
When I went to meetings I would go to lots of them. In fact I remember one day I went to four meetings! There was a midnight meeting in town that I enjoyed because it had a diverse crowd. So instead of just doing the bare minimum with things I tried to dive in and really explore each suggestion I was given.
I was told to meditate. So I read books about it and experimented with different techniques (I eventually settled on distance running as my preferred method of meditation).
I was told to exercise. So I dove into it and I tried weight training and running. I settled on running and eventually ran a few marathons. Since I started running I have not stopped for over 9 years straight, and I run six miles every other day or so. I took a suggestion and I ran with it.
My suggestion to you would be to take this feedback from other people and then dive in and really explore it. Not every suggestion will be a perfect fit. But if you want to avoid relapse then your job is to get your hands dirty and start exploring options. Get more feedback, get more ideas, and then experiment some more. Find what works for you. Obviously this is different for various people. Not everyone can stay sober through exercise and writing like I do. Your path may be different. But in order to find that path you need to listen to other people, take their suggestions, and start experimenting to see what works for you.
Failing to embrace personal growth for long term recovery
I watched one peer of mine relapse who had fallen victim to this concept. He had done all of the right things in early recovery and he had several years sober. But the problem was that he was not embracing personal growth in the long run. He was not pushing himself enough to make the important changes that he needed to make in order to avoid relapse.
There is a “secret path to relapse” that no one will tell you about in the 12 step meetings, and that is illness. People get sick. And when they do, the chance for relapse increases a great deal.
Because of medication. Because they feel miserable. Because an illness can weaken our resolve. Because an illness can cut us off from our support systems–sometimes for a long period of time.
People get sick. And at some point, if they have been sick for long enough, their illness can wear them down and they will say “screw it, I am going to self medicate.” They may feel miserable at that point anyway.
I first noticed this trend when I was just a few years into my recovery. Ten years later I have watched it pop up again from time to time. Falling ill is a danger point in terms of relapse.
This is yet another reason why you must embrace personal growth in long term recovery. If you are focusing on things like exercise, quitting smoking, nutrition, emotional balance, and so on–then you will not be as likely to fall ill. And this could be the key that keeps you clean and sober.
For the first 20 months of my recovery I lived in a long term rehab with 11 other people. If you had asked me at that time what the number one cause of relapse is, I would have told you “relationships.” Specifically I was referring to the fact that many of my peers in early recovery would run right out and find a new relationship with a significant other, and I could not help but notice how incredibly dangerous this was. As soon as the relationship went bad, one or both of the people involved would typically relapse. And it happened so frequently that it was downright alarming. You could not ignore the correlation and the conclusion: in early recovery, relationships are dangerous.
This is why you hear advice in AA that you should not start a new relationship for the first year of your sobriety. They are not trying to be mean to you or make you miserable, they just don’t want to see you relapse. And if you stick around and watch other people, you will see how relationships tend to do that.
So these are the major hurdles that I see in recovery that lead to relapse. Addressing them all is no easy task and requires conscious effort. But making it into long term sobriety is well worth the reward. The benefits of sobriety are multiplied over time, so avoiding relapse should be everyone’s number one priority.