Alcohol addiction counseling sounds like a great idea for some struggling alcoholics. Just go talk to a therapist for a while each week and all of your problems will (hopefully) be solved. Because counseling exists, I have to assume that it actually works like this for some people. But I cannot imagine many people are truly self motivated enough to pull themselves out of an addiction on their own, with only the help of a one hour therapist session each week.
Before I ever went to treatment and became sober, I attended counseling for quite a while. In a nutshell, it didn’t work.
My personal story with alcohol counseling and why it failed
When my family found out that I was using drugs and alcohol on a regular basis, they urged me to get help. At the time I was nowhere near true surrender and so one of the only things that I was willing to do was to go to a counseling or therapy session. Instead of actually addressing my problem of addiction I was content to go see a therapist once each week and talk about my problem.
A typical pattern played out at this point. The therapist attempted to figure out just how deep my problem was so that they could determine how much help I needed. I was terrified of actually confronting my problem and doing anything to fix it so I would basically hedge my story a bit. The therapists tended to recommend inpatient rehab and I was terrified of going there. In reality I was terrified of the mere thought of facing life without drugs and alcohol.
I was trapped in addiction and talking to a therapist about it was not helping me. At the time I believe this is because I was simply at the wrong phase of my journey to be able to benefit from counseling or therapy. I could not really benefit from any of it because I had not yet surrendered.
Before a struggling addict or alcoholic can benefit from counseling they have to be:
1) Willing to make changes in their life.
2) Willing to go to any length to make those changes.
3) Willing to embrace serious disruption in order for big changes to occur.
In other words, you cannot go into counseling and be holding on to these ideas about how you are not going to change, or how you don’t want to do certain things, or have all sorts of limits placed on the experience. You have to be fully willing to do whatever it takes in order to get clean and sober.
Counseling is not a cure for addiction. And ultimately going to inpatient rehab is not a cure either. But both of those things can point you in the right direction if you are willing to take directions. But most people who go to counseling (or rehab for that matter) are not yet willing to take directions. They are holding on to reservations.
This is what I was doing when I went to counseling myself. I had reservations. I was holding on to certain ideas in the back of my mind. I had this kung-fu grip on the idea that I was not going to check into a rehab and be locked up as if I were in jail. I was just completely against the idea and so in the back of my mind I would twist and turn in any which way so that I could manipulate myself out of having to go to treatment.
When I was in counseling (before ever going to rehab) I was actually doing a form of self justification. I was sort of patting myself on the back because I went to counseling even though I still continued to drink and use drugs on a regular basis. But because I was in therapy I told myself that I was making an effort. It was completely foolish of course, but this is how the addict mind works. I held on to the idea that I was making an effort and that I was justified in “trying to get help for my problem” even though I had no intention of actually stopping at the time.
This is why counseling failed for me. It is not because counseling does not work, it was because I was not ready to change. I was just using the therapy as a way to justify that I was making some sort of effort. I used it to feel a bit better about myself even though I tried to get completely wasted every day.
Furthermore, even if there were a few times where I felt miserable and desperate and like I really did want to change my life, going to counseling for an hour each week was not any sort of real solution for someone in my position. I was trapped in a cycle. I was hopelessly dependent. I was not about to just pull myself out of that hole with a one hour per week commitment.
It was going to take more than that.
How counseling helped me after my “disruption phase”
Recovery can be split up into phases.
You have your initial phase of recovery, we might call that “disruption.” You go to detox and you completely disrupt your pattern of drinking every day.
Then you have your learning phase where you are trying to learn how to live a sober life. This might also be the support phase, where you are going to AA meetings every day. Learning/support.
Then you have your personal growth phase, where you are stable in your sobriety but you still need to work on yourself and improve your life. This phase might be after your first year of sobriety or so.
Then you have long term sobriety. Call this “the rest of your life.” You are in maintenance mode, doing what you can to avoid complacency. At 12 years+ sober I am definitely at this stage. The more I focus on personal growth, the more I can fight back against complacency.
So what you need to ask yourself is this:
“At what phase of recovery is counseling going to be the most helpful to you?”
The answer (for me anyway) is that counseling is helpful at every phase except for the first one (disruption).
Counseling has no place in the disruption phase. Why not? Because it is not extreme enough! It just doesn’t have a big enough impact at that stage of the game.
If you are struggling with alcoholism like I was, then you need a heck of a lot more than just a one hour therapy session each week. I was getting totally smashed on drugs and booze every day of my life. It was a miracle that I could show up to counseling sober at all. Certainly I had to use marijuana just to get up the courage to go see the therapist in most cases. So how much good is that really doing during the pre-disruption phase of recovery?
In other words, if you are still using drugs and alcohol, you don’t need counseling just yet–you need disruption. Counseling and therapy are very helpful, but not so much if you are still getting drunk or high every day. At that point your life is still a mess and no amount of talking is going to fix it overnight. You need massive action and massive disruption. You need to take serious action and break free from the cycle you are trapped in.
For me, that meant going to rehab. I needed detox, not talk therapy. The counseling was just a big excuse for me to continue to drink. What I really needed was to slam into the wall and arrest my disease in its tracks. I needed a way to break free, and I was not going to be able to figure that out on my own, or by simply talking with a therapist each week. I needed disruption.
Start with counseling but be realistic and honest with yourself
If you are too afraid to go to inpatient rehab then I would still recommend that you go see a counselor. It is certainly not going to hurt you.
The key of course is to be honest. You have nothing to lose by being honest. I know it is difficult though because I spent much of my time in counseling trying to justify my addiction and avoid going to rehab to actually do something about it. So I was dishonest in counseling, but here I am not telling you to be as honest as possible.
There were times in the future where I was back in counseling and I was able to be completely honest with myself. This was when I started to make serious growth in my life even though it was very uncomfortable to be that honest with someone and show them the real me. But that is where the growth is at and that is why I can tell you now that you should be honest if you go to therapy.
If you are dishonest while in therapy then it does not help you at all. It only hurts your chances of getting healthier. There is no point to going to therapy and not being honest. But I realize that it does happen because I did it for a long time in order to justify my addiction to myself.
So you need to be honest in therapy and you also need to be realistic. If you are drinking or taking drugs on a regular basis then your counselor or therapist is probably recommending that you go in to an inpatient facility. They will urge you to get a higher level of help than what they can provide alone. This is where you have to be realistic. If your life is out of control or you cannot say “no” to alcohol on your own then you probably need more help than weekly counseling sessions.
Real alcoholics will likely need more help than one hour per week counseling sessions
This is all about disruption. If you can detox completely on your own (potentially dangerous and not recommended) then you might be able to benefit from weekly counseling sessions as your recovery solution. But this creates at least two major hurdles if you try to rely on counseling alone as your solution:
1) You don’t get help with the disruption phase by going to detox or inpatient rehab.
2) You don’t get any support outside of counseling, such as by going to AA meetings or outpatient therapy groups.
Counseling is just that–a one hour session each week where you get to talk about your problems. That is not going to be enough to help most alcoholics unless they have already conquered the two problems I listed above. That is, they have been through detox safely and are currently sober, and they also have a support system in place (such as by attending daily AA meetings).
If you don’t have those things in your life then you probably don’t have much of a recovery going on yet. And that means that you will likely just be spinning your wheels when it comes to counseling.
In order to really benefit from counseling you need to have a foundation. You need to have a baseline of stability in order to benefit from counseling.
For example, let’s say that you go to rehab. You go through detox and you get sober. Then you stay in rehab for a few weeks and you learn about recovery. They expose you to AA meetings and you start attending them every day while in treatment. Then you get out of rehab and you continue going to meetings each day. You find a sponsor and you start to work with that sponsor on a regular basis. You are out of rehab and back in the real world and you have a support system around you. You have become sober and then you stabilized.
Now is the time to go to counseling! Now is the time to go get therapy for an hour each week. Because now you are in a position where you can actually benefit from the insight. Now you are in a position where you can be completely honest with the therapist, because you no longer have anything to hide.
When I was at this stage in my recovery I was actually living in long term rehab. I was talking with a therapist each week who worked for the rehab center and the sponsor that I was talking with was also a therapist as well. And this was the perfect time for me to be talking with therapists because now I was willing to take action. I was no longer holding on to reservations and fighting against change. Instead I was willing to try new ideas. I was willing to take suggestions.
For example, these therapists both suggested that I get a job and go back to work. I followed through on that suggestion and found it to be helpful. They both suggested that I go back to college and finish up my degree. I was not really planning on doing that but because I was open to suggestions and willing to try new things I actually followed through and did it.
My therapist suggested that I start exercising. So I gave that a try and eventually this became a huge part of my recovery process.
But I had to be at the right phase of my recovery in order to benefit from these suggestions. It was not helpful for me to talk with a therapist when I was still stuck in the cycle of addiction. I was just spinning my wheels and wasting time. But then after I went through the disruption phase, all of the therapy that I received after that was incredibly beneficial.
What to do if counseling fails for you
If you go to counseling or therapy and it fails to help you in recovery then you simply have to move up the chain an bit and find more help.
We can think of counseling as being somewhere along this line of treatment options.
So at one end of this spectrum we have long term rehab, where you might live in treatment for 2 full years. Next to that we might have 28 day rehab programs. Next to that we might have a 3 to 5 day detox stay. Next to that we have outpatient rehab, where you go to treatment maybe 4 or 5 days each week but still go home each night. After that we might have daily AA meetings. After that we might have counseling or therapy sessions one hour each week.
Do you see how this spectrum is arranged? From most intensive treatment (2 years of living in rehab) down to the least intensive treatment (counseling for one hour each week).
In between there are many options as well. For example, you can also find treatment centers that run for 90 days (thus falling in between 28 day programs and long term programs that run a year or more).
So there is a continuum of treatment options. At one end is very intensive treatment (such as long term) and at the other end is less intensive treatment (such as counseling).
If you try to get clean and sober and you fail, then your next obvious move is to increase the intensity of your treatment.
So if you went to a 28 day program and then you relapsed, perhaps you should consider going to a longer term rehab next time. What do you really have to lose? If nothing changes then nothing changes. If you just go back to another 28 day program then would you not expect to get the same results that you got in the past? They talk about this all the time in recovery, how “insanity is doing the same thing over and over again and expecting different results.” Well, if that is true, then don’t just keep doing the same thing in treatment and expecting for it to suddenly work for you.
In my own personal story, I had gone to inpatient rehab twice and then relapsed. The third time that I went I wised up a bit, and said “now wait a minute….I have done this before, and it didn’t work. What should I do differently this time?”
I knew what the answer was, because so many people had told me in the past that I needed long term treatment. So I had to go up along that scale of treatment options. I had to increase intensity. Short term rehab had failed twice for me already. It was time to take a bigger step, to make a greater commitment.
If one treatment option fails for you, then it is your responsibility to try a more intense treatment option the next time around. Why would you expect the same or a less intense option to work out for you, if it failed in the past? You need more intensive help!
And so this should be your response when you go to counseling and then relapse. If you fail while going to therapy, don’t beat yourself up over it. Simply take a look at the spectrum of treatment options, and choose a more intensive solution. If one option fails, then try a more intensive option. Move up the scale. Here is what the scale roughly looks like:
* Casual AA meeting attendance.
* Counseling or therapy session once a week.
* Daily AA meeting attendance.
* Outpatient therapy.
* Combination of AA meetings + therapy.
* Detox + inpatient residential treatment.
* Detox + inpatient + follow up therapy.
* Long term rehab.
What have you tried along that spectrum of treatment options? If it failed for you, are you willing to move up the scale the next time you try to get sober?