Yesterday we looked at how to unlock your full potential in alcoholism recovery. Today we want to look at how the actual mechanics work in long term sobriety, and how that can be sustained.
Really there are two major challenges in recovery. Or rather, we can separate the process into two major challenges:
1) Getting clean and sober.
2) Staying clean and sober.
I like to think of the first major challenge (the getting clean part) as “disruption.” This is because it usually requires a disruptive event in order for a person to even break free from their addiction. For me, this meant going to rehab (and eventually living in a long term rehab as well). Most people don’t just drift into recovery without quite a bit of help. They either need to go to treatment, have friends who drag them to 12 step meetings every day, or something disruptive that can help them to break out of the cycle of addiction.
The second part happens after the disruption phase is long gone, and you now find yourself relatively stable in your recovery. You still acknowledge that you may relapse one day, but your recovery is not currently hanging by a thread or anything. Certainly you are not going to relapse today. But you realize that the threat could still be there in the long run.
Thus, you are wondering in exactly what the best course in your life would be in order to sustain your sobriety. How to make sure that it lasts? What is the best course of relapse prevention? These are the questions that should be driving your long term recovery strategy.
So today we want to look at how to create that sustainability.
So many examples of what doesn’t work
First of all, there are a ton of examples of what doesn’t work. Just look around in early recovery. Go to a rehab center and acquaint yourself with your peers. Follow their progress for the next six months after you all leave treatment. What do you think will happen to a group of 20 to 30 people that you met in rehab?
Most all of them will relapse within the first 90 days, and even more of them will relapse in the coming months after that. Nearly all of them will have relapsed within the first year. This is just the way the statistics add up.
You could attend a thousand different treatment centers around the world, meet a different set of peers in each one of them, and these same results would play out over and over again. Nearly everyone relapses, and only a small handful of individuals manages to stay clean and sober.
So what does that tell us? It tells us that sustained sobriety is actually quite rare, and therefore it requires a special effort. The average person who attempted to get clean and sober by going through treatment ends up relapsing. This is the average. The average person relapses within a year.
So if you want your results to be better than average (hint: you do!) then you need to put forth a better-than-average effort.
This is a key insight into sustainability. Successful recovery requires a special effort.
This is why so many people don’t “get it” on their first couple of attempts. Many people attend treatment a few times before it finally sticks. This is because they do not make any sort of special effort the first time around. Why would they? We all believe that we are slightly smarter than average, so therefore our recovery effort should not need any special effort. This is how most of us approach the idea of recovery in the first place. The concepts seem sort of basic (don’t drink or use drugs no matter what!) and so therefore we secretly believe that all of this must really be set up for people of less than average intelligence. We think that we are special and that we learn more quickly than other people and so therefore we hope that recovery will actually be easy for us.
Nearly everyone does this to an extent the first time they try to sober up. They underestimate the difficulty of the recovery process while also overestimating their own ability to conquer addiction. It is a natural mistake to make and you should assume that you will be biased in the same way if your try to sober up. We cannot help but think this way because doing so has been an efficient way to live our lives in the past. Making these sort of assumptions that I have described has saved us time and energy in many ways. The problem is that these assumptions do not work on your addiction. This really is the one thing that is going to require a “supreme maximum effort” on your part. Most people have to relapse at least once or twice before they realize this and fully come to grips with it.
Baseline of stability in recovery
If you want to have a sustainable recovery then you should start with a solid baseline. You can think of this has building a strong foundation in your recovery.
When I first tried to get clean and sober I had no foundation to speak of. In fact the first two times that I went to rehab I attended a place that was out of town, so when I came back I had no foundation for my recovery at all. Granted, I was not really ready to get clean and sober at that point anyway, but even if my heart had been in it, I would have had some serious problems. Attending rehab out of town did nothing to help me build a strong foundation in early recovery.
What makes for a strong foundation in early recovery? First you have to look at your disruption technique. For most people they will choose to disrupt their addiction by attending rehab. To some extent your foundation will be built largely on what happens after you leave rehab.
You see, while you are in treatment, everything is pretty much a given. You are in a protected environment and there are no immediate threats for relapse. In other words, it is pretty easy to stay clean and sober while you are in rehab. This should be the case regardless of where you attend treatment, and also regardless of what their aftercare suggestions are for you. It doesn’t matter while you are actually in treatment. Sobriety should be a given.
The real test begins when you walk out of treatment, back into the real world. This is where “the rubber meets the road.” How do you do then? And what is your plan for these first few critical weeks after leaving treatment? And what has the treatment center set up for you in order to help you? What is your plan for sustaining your recovery? How do you plan to prevent relapse? These are the sort of questions that you want to have answered while you are still in treatment. If you do not have a plan when you walk out of rehab, guess what will probably happen? Not good. Everyone needs a plan.
So to some extent your choice of disruption will naturally lead to a next step in the process. If you choose a poor disruption then you can expect that it might also have a lousy plan for aftercare. Therefore, let’s say your choice is between:
1) Quit cold turkey on your couch at home and plan to go to AA meetings.
2) Go check in to inpatient rehab.
Which choice do you think has more of an aftercare plan? Which choice do you think has more resources available for you to draw from? (Think too about the fact that choice #2 is going to include 12 step meetings as part of the ongoing plan).
I don’t want to imply that no one has ever got sober by simply attending AA (because they most certainly have). What I’m saying here is that you want to give yourself every opportunity that you possibly can. Draw from every available resource. Use whatever help is available.
Therefore if someone is saying “I will get sober, but I just want to go to counseling” while you are urging them to go to inpatient treatment, you can counter with “yes, but inpatient treatment INCLUDES counseling, and therapists, and so on.” Their solution is to wiggle out of it and try to do less. Your pushing them to do more, to give them a better chance at recovery. Which method do you think will ultimately work better for most people? More intensive treatment is generally better than less intensive treatment.
If you want to sustain your sobriety in the long run then you need to set a good foundation for yourself in the first 90 days of your recovery. For me this meant going to detox, going to residential treatment, and then moving in to a long term rehab. Some people may not need all of this help, but it is what I needed in order to get that solid foundation in my recovery.
Perhaps you can build a strong foundation in another way. Maybe you can just go to detox for a week, then get out and start hitting AA meetings three times each day. Maybe for you this will be enough. But I had already tried to build my foundation for recovery using short term treatment solutions and it had not worked for me. I had tried and failed twice. So for me, it was time to give long term rehab a chance, and that is what finally worked for me.
You may not need long term. Many people don’t. But you are going to need to build some sort of foundation in early recovery. Something that can give you the strength to carry you through the difficult first year of sobriety.
Your foundation is based on action. It is not just your attitude (although that is very important!). If you want to measure how strong someone’s foundation is in recovery, simply add up all of the positive action they are taking. What are the actually doing? How many hours per day are they putting into their recovery? This is why the person who attends two or three AA meetings each day is actually building a strong foundation. It’s all a numbers game. They are surrounding themselves with recovery in any way that they can.
Disrupt your addiction by going to treatment. There you should be introduced to a number of resources: AA meetings, therapy, counseling, peer support, outpatient treatment, sponsorship, etc. Use these resources. Take action every day to build a foundation for yourself. Try a bit of everything. Give every solution your full attention and your full effort. Put your heart into recovery. Dive in and use every resource that is available to you. Find what works for you by taking lots of action.
If you leave rehab and go home and sit on your couch and basically do nothing to follow up, how do you think you will fare statistically, given that nearly everyone relapses?
What do you think it takes in order to be in that 10 percent that actually maintain long term sobriety?
It takes action! It takes effort. Serious effort.
The trick for you to not underestimate your addiction is to use overwhelming force. Use more effort than what you believe is necessary. It is counter-intuitive to do so (because doing so is normally a waste of time and energy).
Think back to your greatest challenge in life. Think about how hard you had to push in order to overcome that challenge. Addiction is like that, but usually more intense. For most people, this will be the most difficult thing they have ever had to do in life.
Therefore, most people would do well to treat this as their greatest challenge. This should take MORE effort than you have ever tried to muster before in the past. This is it! Go all out. Hold nothing back. This is part of the secret to sustained recovery. You must try harder than you ever have before.
Figuring out how much support you need in early recovery
The easiest way to find out how much support you need is to try and fail a few times. Unfortunately doing this is not very convenient and it can even be dangerous or fatal. Some people don’t ever make it back from a relapse as it can kill them.
But if you try to get clean and sober and you end up relapsing, now you know what doesn’t work. Now you know what NOT to do next time. And for the most part this will include whatever form of treatment of disruption you used in the past. Whatever you did, failed. Whatever you tried did not work. Therefore you have learned that you need to try something different the next time around. If you went to rehab for a week and then relapsed, perhaps you need an even greater disruption. Or perhaps you need more intense aftercare. If you relapsed in the past, how many hours per day were you dedicating to your recovery effort? How much action had you really taken each day? What exactly did you do in order to sustain your sobriety? Obviously you should have done MORE.
This is what eventually led to my own progression into long term rehab. I had tried a 28 day program and failed. I needed something more. Plus I was relatively young and I was surrounded by negative influences. I did not have a single friend in my life who was not on drugs. How is such a person supposed to break free from addiction, unless they can somehow transplant themselves into a new life with a new set of friends? Long term rehab was a gift that allowed me to do exactly that. For my situation, long term treatment was a critical component.
Many people resist treatment in all of its forms for various reasons. One of the biggest reasons is pride. For one, I did not want to admit that I needed long term rehab. My attitude was: “How is that any different than prison or jail?” This was a poor attitude and it only served to show how much I misunderstood rehab. Living in long term was not so bad at all, and I would gladly do it again if I had to. In the same way, going to a 28 day inpatient rehab is not so bad either, but many people have attached so much shame and stigma to the idea that their pride keeps them from attending such a place. This is poison and can only hurt you, your pride can not help you. As Marsellus Wallace said: “Pride only hurts. It never helps.” He is absolutely right. Your pride cannot help you get clean and sober, it can only prevent you from taking the actions that you need to take. Pride can only prevent you from learning what you need to do in order to turn your life around.
Finding what works for you and then doing it
In the long run, honesty with yourself is very important. This is going to come down to your assessment of your own progress in recovery. How are you doing in terms of your recovery? Are you happy with your new life? Do you want to change it? Are your current actions on a daily basis helping you to do so?
At some point in my recovery I changed my overall strategy quite a bit. Or rather, my strategy probably stayed about the same but my tactics changed and evolved over time.
The strategy was to stay clean and sober through personal growth. This was my strategy right from the start whether I really knew it consciously or not. The 12 steps are an attempt to produce personal growth as well, although it is mostly along spiritual lines and via improved relationships.
My strategy today is still one of personal growth, but my tactics have changed. I no longer sit in AA meetings for an hour each day. I no longer seek help by reading recovery literature (instead, I write recovery literature!).
This does not mean that my tactics are perfect for you to follow at all points of your recovery. Rather, you need to realize that:
1) Your tactics for recovery will change and evolve over time (inpatient rehab, meetings, helping others, exercise, meditation, etc. etc.)
2) You need to find what works best for YOU and then do it. This will involve being open minded and experimenting a great deal.
If you are willing to take ideas and suggestions from others then you can really accelerate your growth in recovery. If you rely only on your own ideas and conclusions then you are going to be held back and slowed down tremendously in your recovery journey.
Embracing the cycle of personal growth
As mentioned your tactics will likely change over time. If you are sober for ten years you will look back one day and say “wow, how I have changed and grown in my recovery.”
What is important is that you thoroughly embrace the correct strategy for long term success. I believe that this is always going to be a strategy of personal growth and development. This will be true whether you are in AA, following some other program, or just doing your own thing. Whichever path you choose will still need to be strategically aligned with personal growth. This means making changes in your life and taking positive action.
If you embrace this process of change and positive action then I believe you will stay sober and do well. If you stop taking positive action at some point then I believe you will slowly drift back towards self medicating and relapse. Pretty simple really.
Relapse prevention done right
Relapse prevention is really about having the right strategy (personal growth). Your tactics will change over time and therefore your job is to embrace change, embrace growth, and go along for the ride. Recovery is a gift and an adventure. Embrace it!