The Second Stage of Alcoholism Treatment – Early Recovery

The Second Stage of Alcoholism Treatment – Early Recovery

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This is the second post in a series about the various stages of recovery (as I see them).

The first stage is disruption, or “disruption and detox.” In my mind this first stage is necessary before you can get any kind of real start on your

recovery journey. Depending on how deeply entrenched your addiction is in your life, you may have take more drastic measures in order to disrupt your

pattern and restore yourself to health. For example, some people may be able to just go to counseling a few times per week or possibly go to 12 step

meetings, while other people may need detox, inpatient treatment, and maybe even long term rehab in order to get their life back on track. The amount of

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disruption you need can vary a great deal from one addict or alcoholic to the next.

Transition out of detox and into residential treatment

The first hint that you are leaving the “disruption” stage of your journey might be if you happen to go to a treatment center, and you leave the medical

portion of the treatment. Typically what happens is that you will then transfer into residential treatment and start attending groups, learning about

recovery, interacting with a peer group, and so on. In my opinion this is all still part of the initial “disruption” which is designed to try to give you a

clean break in your life away from your patterns of drug or alcohol abuse.

The key is that you are transitioning to something other than your pattern of drug abuse. Ideally, every addict and alcoholic will some day be a functional

adult, someone who is living a life of personal growth, striving to meet new challenges, and who is not self medicating in order to deal with their problems.

Instead they will take full responsibility for their problems and they will deal with life “on its own terms,” rather than on their terms (which is to avoid

problems, hide from them, medicate them away, etc.).

In order to get to this point the person must grow in their recovery and transition into a better life. This is not a trivial thing to do and I believe that

this is where most people either make or break their recovery.

Disruption is actually pretty easy once you take the plunge; anyone can go to detox and be taken care of medically and get their body purged of chemicals.

There is no real challenge in this other than the mental barrier that prevents a person from checking into rehab. Once you are there it is as cinch to stay

clean and sober while being medically treated and kept comfortable. This is not to say that detox is the easiest thing in the world, but it is still very

simple, and once you make the decision to check into rehab the rest is, in fact, fairly easy.

The hard part comes in stage two, which I have termed “early recovery.” This is separate from “disruption” because now the addict or alcoholic has their

bearings again and can make some real decisions for themselves. Now it is up to the individual to learn how to live a life of sobriety, or to take the

easier path and return to their drug of choice. Thus, this is the “make or break” part of the recovery process.

The first thirty days of recovery

They talk about success rates of recovery and how most people relapse within the first 90 days, and of those, most of the people relapse within the first 30

days. Of course if you can go to a 28 day detox and residential program then you increase your chances of making it to this important “30 day threshold,”

but this is sort of missing the point: that month long stay in a rehab is all part of the “disruption phase,” and so it does not really count towards your

experience in the realm of “real world recovery.”

I am not saying that inpatient rehab is not helpful, all I am saying is that the real test begins when you leave out of treatment and enter back into the

real world. If you can make it 30 days clean and sober from the time you get home from rehab, then this is actually some significant time put in to your

sobriety, much more so than if you had been “protected” in an inpatient facility for the whole 30 days.

I realized this when I first left out of long term rehab after living there for 20 months…..my “real” recovery journey started on the day that I moved out

of that facility. Sure, I had 20 months of sobriety under my belt, but this was really the true test now that I was out on my own. Now there were no more

consequences hanging over my head if I were to drink or use drugs. Now I was entirely capable of doing whatever I wanted, without having to answer to

anyone.

Because I anticipated this “true test” in advance, I planned to seek out extra support during this time. I had already watched many people who left

treatment before me, and I hate to say it, but most of them relapsed. Why did this happen? Various reasons, but in nearly all cases, the people had shied

away from their support systems, avoided counseling, missed meetings, and so on. Lesson learned: if you want to do well when you leave treatment, you should

follow up with any aftercare recommendations to a “T.” If you try to skimp out on their suggestions or design your own program, you’re gonna have a tough

time.

My recovery philosophy about creative recovery eventually involves a whole lot of customization and individuality. I am all about doing your own thing and

creating your own path in recovery. But when you are in the “first 30 days,” including your first 30 days of recovery “out in the real world,” my advice to

you is NOT to try to do your own thing at that point.

It is too early for you to do your own thing. This is early recovery. Your first 30 days, in fact, is still VERY early recovery. Don’t even think about

trying to fly in face of conventional wisdom and ignore all of the suggestions from people in recovery who are only trying to help you.

My problem with traditional recovery comes after early recovery. My issue is really about how people get stuck in recovery, during long term sobriety, and

long after they have plowed through the tough early stages of their journey. It is only then that the restrictive dogma of traditional programs proves to be

a negative rather than a positive.

But in early recovery I see value in traditional recovery programs. The support is helpful, even if you do not believe in all of the ideas that may

accompany a specific recovery program. For example, a hard line athiest can still benefit from a Christian treatment center, so long as they are open minded

enough to get the support and the help that they need. Am I suggesting that you be converted in order to overcome addiction? No. I am merely pointing out

that support is critical for early recovery. This is about one person helping another, not about someone finding religion and being saved.

Early recovery is the most difficult and touchy stage of recovery, by far. The vast majority who relapse will do it within the first 90 days of recovery, so

I suggest that you get all of the support and help that you can during this time. If that support and help is not 100 percent aligned with your recovery

philosophy, WHO CARES. You need the support more than you need to be right. Later on when you have multiple years clean and sober you can design your own

program of recovery, have your own philosophy of life, and do whatever the heck you want in order to maintain sobriety. But during the first 90 days it is a

miracle if you can just make it through and get to that first year of sobriety without a relapse.

I would urge you to beg, claw, and scratch your way to whatever help and support you can get during this time. If that means going to meetings or attending

a religious function in order to stay sober, I would do it. I am not saying you have to do that, or that these are the only means to sobriety, because they

are not. There are other paths. But if you do not get support and help from AA or religious programs, then you probably need to have a plan as to where you

will get that support. Individual recovery is very possible but in my opinion it is best experienced in long term sobriety. Those who attempt to find their

own path in very early recovery do not always fare so well.

The first year of recovery

In my opinion the first year of recovery is still considered “early recovery” for most people, though it is not always clear (or consistent) at which point a

person exits this early recovery stage and transitions into long term recovery.

A lot of people say that the first year is the hardest, and also the longest. After you get to that first year of sobriety, the years just start flying by.

I have to admit now that I am over ten years clean and sober, I have no idea where all the time went.

Of course it is a “day at a time program” but everyone in early recovery has their eyes set on that one year mark. Most of us believe that if we can just

make it to one year sober then we might have this recovery thing locked up. Unfortunately the long term relapse rates in recovery are rather scary, and many

people do end up relapsing even after they have multiple years clean. On the other hand, I have seen at least one article in mainstream media that stated

“once you get to 5 years sober, the odds of staying sober for life increase drastically.” Seems like common sense, but if you stick around AA or NA for long

enough you will be amazed at just how many “old timers” end up relapsing. There are less of them with 10+ years sober, but here and there they still do

relapse. It is quite scary to think about and realize that we are always vulnerable.

I believe at some point during the first year a person who has been clinging to support has to start thinking about personal growth. This is ultimately the

driver of long term success in recovery, in my opinion. I can remember in my first year I was trying to quit smoking cigarettes, even though I failed

repeatedly to do so at that time. I also tried to start exercising during my first year, though I failed at that too. But looking back I can see that it

was important to be focused on personal growth, even in that early time when the focus was more on support and finding stability in my new life.

There is a balance in recovery that every person has to find within themselves. The balance is between:

* Acceptance (of self)
* Personal growth

You cannot really pursue both of these things at the same time. Or rather, they tend to be in opposition to each other.

For example, you might feel lazy and tired all the time in your recovery. Someone might say to you “well, give yourself a break, you are still early in

recovery, and you need to get some acceptance about this. It will get better.” On the other hand, someone else might say “you feel tired and lazy, but this

is an opporunity for growth. You should start exercising, eat healthier, and quit smoking. Then you will be energized!”

So which is right? Should you practice acceptance or should you seek to embrace change? It could be argued that this is the entire essence of recovery, and

is thus captured entirely in the Serenity prayer (to accept, or to change, and how to know the difference).

During the first year of recovery, most people start out with the focus on “acceptance.” This is normal and natural and also necessary. We have to forgive

ourselves, for one thing, if we want to have any hope of moving on with our lives. So we need to practice some acceptance just to get our bearings and get

stable in our recovery. On the other hand, I believe that we need to start gearing up for the next phase of recovery at this time, which is basically

“personal growth.” Like I said, I was dabbling in this direction myself during my first year, but I was not exactly “there” yet. It took me the first 3

years or so before I was really into “personal growth mode,” as evidenced by:

* Going back to college.
* Quitting smoking.
* Regular exercise.

So during your first year you want to focus on support from others and stability. But as you progress in your recovery and feel more and more stable, it is

time to start thinking ahead to personal growth, and what you want to achieve in your life/goals you want to accomplish.

How (and why) not to be “in the driver’s seat” during year one

During the first year you do not necessarily want to be “in the driver’s seat” in your recovery. If you are trying too hard to control things then this is a

bad sign that you may end up frustrated to the point of relapse. This is exactly what we do not want to have happen. This is why I advocate for support and

stability in very early recovery, rather than the individualism and creativity that I like in the later stages of recovery.

So how can you do this successful without sacrificing yourself to other’s opinions?

One way is to take lots of suggestions and ask for lots of advice from people you trust in recovery. This is the idea behind sponsorship, essentially,

though I do not think that you necessarily need to find a formal sponsor in order to make this work.

The procedure is quite simple. Find someone that you trust, someone who has a life that you would like to live yourself, and then ask them things like:

* “What do you think I should do with my life next?”

* “What do you think I should pursue with my time and energy?”

* “What do you think I should do in order to improve my life and my health? What should I focus on?”

* “What do you think I should do to help insure that I do not relapse?”

* “what do you think I should do in order to help others in recovery?”

And so on. If you ask for genuine advice like this and actually listen to the responses, you are bound to get some good ideas.

Even better, take one of these questions (that you are genuinely seeking direction and advice about) and then go ask several different people that you trust in recovery. Listen to all of their responses and listen carefully to see if their suggestions contain some common themes.

Doing this led me to make some important changes in my own life. One of them was in pursuing exercise for greater health. My therapist encouraged this, my family encouraged this, and a friend in recovery was also encouraging it. After a certain length of time I could no longer ignore their suggestions, and I made the decision to get into shape.

Notice that if you ask for advice from several sources, hearing the same answer more than once lends great credibility to the advice you are receiving. If everyone is suggesting something then it probably has great value, and you should take the advice very seriously.

The same thing happened to me with education. Nearly everyone that I spoke with was urging me to go back to college and finish up my degree. Doing so was a good decision because it led me to a business degree and a great deal of freedom later on in my life.

Don’t be afraid to ask for advice or suggestions from other people.

Don’t be afraid that by doing so, you will become like a robot.

The decisions will all be ultimately up to you, even if you ask for advice and guidance.

But in year one of your recovery, you will benefit immensely if you take the time to gather feedback on which direction you should be headed.

Are you getting enough support in early recovery?

If you fail during this critical stage of recovery, it is almost certainly because you did not have enough support going into it.

Your level of surrender is important, and will determine how much disruption you are willing to have, and also how much support you are willing to seek out. If you insist on figuring everything out for yourself in early recovery, things are going to be much, much harder for you.

I advocate for individualism in recovery and I am generally fairly anti-program, but early recovery is an exception to this. If you cannot do it yourself then you need help. I got a lot of help and support in my first two years of recovery, and I do not think that I would be sober today having taken that path. I lived in treatment for 20 months and I really believed that this saved my life.

Having said that, eleven years later I have been meeting and program-free for almost a full decade now. Does that make me a hypocrite? Some might say that it does. But this does not change the fact that I have experienced an awesome life in recovery without programs and meetings for quite some time now. There is a creative process of recovery that can work for people that does not require constant support, meetings, etc. for the rest of your life.

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