Rehabs in Our Modern World and How They Fall Short of Treating Alcoholism
Many rehabs in our modern world today fall short of treating alcoholism. This is not a problem with the rehab themselves though, it is more a reflection on who is going to rehab and at what point they are deciding to go.
You see, the real problem with success rates in recovery today is not based on faulty recovery techniques. Rehabs are doing their job as best they can. No, the problem today is that we are pushing people into recovery before they are really ready to make a change. If you have not yet surrendered then there is no real hope for you to make the difficult changes that lie ahead. No one wants to change everything in their life and be told what to do, yet this is exactly what we expect of someone when we push them towards rehab. Recovery does not just “brush off” on someone because they hang around with the right crowd. In order to change the person has to really want to change for themselves, and it is hard work.
Doing the best that they can with disruption
Rehabs do the best that they can, and for the most part they do a nearly perfect job with the role of “disruption.” So in other words, when an alcoholic is stuck in their drinking pattern, they need a way to escape from this pattern and break free. They need a place to go to that is safe, that doesn’t have any alcohol or illegal drugs, and that will supervise them medically while they quit drinking. This is the basic concept behind detox and disruption. You put the alcoholic in a place where they cannot drink even if they have an intense craving to do so. Remove the alcohol entirely. Remove the temptations. Keep them safe and watch them with medical personnel. This is the basic idea behind detox and treatment centers.
For the most part, rehabs do this perfectly. If you want disruption in your life then simply go to rehab. It doesn’t matter much which one you choose because they are all pretty similar when it comes to the concept of disruption. You won’t find some rehabs that allow you to keep using illegal drugs or alcohol while you are there. You won’t find some rehabs that don’t monitor you medically during detox. They all do pretty much the same thing in regards to disruption.
Now after this “disruption phase” you will start to see differences in rehab centers. So at this point you have to ask yourself how much you think those differences are going to make in the long run. In my opinion the answer is “not a whole lot,” and I base that answer on having been to three different treatment centers in my lifetime. After the disruption phase, rehabs attempt to do a couple of things for you:
* Teach you some tools and concepts to help you to remain sober later on. Relapse prevention.
* Introduce you to support, such as through AA or NA meetings.
* Encourage you to follow up with additional after care. Plan what you will do after leaving rehab.
Teaching, support, and follow through. These are the things that most rehabs attempt to help you with after they disrupt your pattern of drinking. Most of your success in any of these areas is really going to be entirely up to the individual.
I think there is a mindset among the general public that perhaps rehab centers have vastly different approaches to how they implement these three ideas (teaching, support, follow up). As if certain rehab centers may have secret techniques that really offer something vastly different than the other rehabs. Therefore the general public has this hope that if the alcoholic only were to choose just the right treatment center, then they would be cured. Or perhaps if they only had enough money or better insurance then they could afford the best alcoholism treatment in the world and thus the person would be magically cured.
Rehab doesn’t work that way. There are no secret techniques. There is no super rehab center that costs extra money and produces extra good results. This is not how it works at all. Instead, all rehab centers are working with essentially the same basic techniques and ideas to try to help people. There are no magic cures, not at any price. If there were a method that suddenly was producing different success rates then all rehabs would start to adopt the idea.
Teaching the first two phases of recovery but not the third phase
Rehabs generally do a good job of the basic concepts. They disrupt people’s drinking pattern and they start teaching them what a sober life must consist of. Then they encourage them to get support in early recovery. They do the best job that they can at these things.
Where they fall short is in teaching people to create a new life for themselves. The hope is that the recovering alcoholic will follow all of the suggestions, get involved with a support group, and that this will be enough to create a new life for the individual. In order to overcome alcoholism you must replace it. This is an important concept. You might call it “the replacement theory” of alcoholism recovery.
In other words, if you just stop drinking and then nothing else really changes in your life then you are going to be miserable. Eventually you will get restless and that will lead to relapse. Going back to the bottle will at least provide some excitement for the alcoholic. Everyone needs to have the feeling of being alive. So if you do not find a way to create that feeling then you will become anxious and this will lead to relapse.
So rehabs have a very hard time teaching this “replacement theory.” I am not suggesting that it would be easy to do so, not by any means. But somehow you have to convince the struggling alcoholic that they have a lot of work to do, and that they need to start rebuilding their life from the ground up by making positive changes. Rehabs find this task to be so overwhelming that they basically encourage the alcoholic to start attending AA, get a sponsor, and then they hope that in going through those motions that the alcoholic will rebuild their life. Of course it doesn’t always work that way and I think this is a function of personality.
For example, I attempted to rebuild my life using the AA approach in early recovery. I got a sponsor and I went to meetings every day. In fact I was actually chairing one meeting each week by taking a meeting into a rehab center to people who could not get out to outside meetings. I did this for over a year straight. So what I was trying to do essentially was to take the suggestions that I had received in rehab earlier and apply them in my life. They told me to get involved in AA and to use the daily meetings for support. This was my plan to rebuild my life without alcohol. And to be honest it wasn’t really working.
It wasn’t working even though I was still sober, because I could tell that it was not sustainable for the long run. I wasn’t happy with it. I was bored. I was frustrated with the meetings. I wasn’t getting what I needed out of recovery. I had support but I did not have excitement in my life. I was not building the life that I really wanted to live yet, not by following this path and taking the suggestions that I had been given. I needed to create a different sort of life in recovery, one that was actually exciting to me.
What I needed to do was to find my own path in long term recovery. I had to find a way to create the life that I really wanted in sobriety. I did this eventually but it was not by going to AA meetings every day or by talking with a sponsor. Instead, I started taking positive actions and pursuing healthy habits outside of the recommended recovery programs. I was taking action but I was not following the traditional suggestions. I found a different path for recovery outside of the traditional wisdom.
Later on I learned that many people do the same thing, and find a path in recovery that is not based on daily meetings, sponsorship, and 12 step work.
Now if you look at the success rates in recovery and in AA, you will see that there is probably some room for improvement (success rates tend to vary widely but on the whole they are not encouraging. Go look them up and see for yourself).
And this is what is so hard to teach. This is where modern day rehabs fall short in teaching people about recovery. It is very difficult to describe the process of creating a new life and actually replacing alcoholism. The best most rehabs can do is to try to outsource the job entirely to AA. They disrupt your pattern and they teach you some things but ultimately they realize that they cannot show you how to rebuild your life from scratch. The task is too difficult and too overwhelming for the most part.
What the alcoholic must do in order to overcome their disease in the long run
The alcoholic has to rebuild their life in recovery.
How do they do this?
They first concept is that of change. This is pretty basic, right? In order to create a new life in recovery, the alcoholic is going to have to make some changes.
So there are two types of changes we need to deal with: Internal changes and external changes.
I like to label these as “changing your life” (internal) and “changing your life situation” (external).
It is important that the alcoholic understands that they are going to need to do BOTH of these things in the course of the their journey. It is not enough to make only one type of change and ignore the other. Doing so will always result in relapse eventually.
So the question is: How does the alcoholic go about making these changes? And how do they prioritize those changes? What do they focus on first? Why should they make a given change now in recovery as opposed to focusing on other potential changes?
First of all the alcoholic can go to rehab and start with the most basic disruption. You check into detox and suddenly you are no longer drinking alcohol. This is the first and most important change.
But obviously it cannot stop there. If it stops there then we all know that the person is bound to relapse at some point.
So they must make more changes. This is what the rehab attempts to teach. The treatment center starts suggesting changes that the alcoholic should make.
Allow me to make a few suggestions about these initial changes in very early recovery:
* The alcoholic would do well to ignore their own ideas about making changes and only take other people’s advice. This is very hard to do and requires humility. If the alcoholic has truly surrendered to their disease then they will be able to do this. They must get out of their own way and stop relying on their own decisions. This is hard to do.
* Consistency. The alcoholic should commit to making positive changes every single day in recovery. They cannot wake up one day, feel lazy, and decide that they do not want to work on this recovery thing any more. In order to build a new life in recovery you have to push yourself each and every day towards better living.
* Holism. The recovery effort must be holistic. Many people get this wrong by focusing exclusively on spiritual growth. Instead, you should view your entire life and your overall health in recovery as being important. That means that you must make changes in all areas of your life, from your physical health to your spirituality to your social networking to your emotional balance and so on. You cannot ignore huge areas of your overall health and expect to do well in recovery. It must be a holistic effort to improve your health in every possible aspect.
If you only followed these three concepts regarding change in your life then you would do well. But doing so is certainly no easy feat as it requires dedication and consistency.
Remember that positive changes in recovery are cumulative. This is hard to grasp for the newcomer in recovery because they are generally pretty miserable and they are not seeing instant results in early sobriety. In other words, you go to rehab and you start trying to build this new life and at first, nothing is really working. You don’t feel good because you cannot use your drug of choice to medicate yourself any more. You are suddenly cut off from your “happiness potion.” So you are in treatment and you are taking suggestions from other people but it is not like you are magically happy in sobriety all of a sudden. It takes time.
The reason that it takes time is because recovery is cumulative. Your positive actions and changes that you make accumulate just like all of the negative stuff was accumulating during your drinking days. It takes time for it all to add up to something significant. How can a rehab really teach you this? They can’t. They don’t have enough time. All they can really do is try to get you to start taking positive action every day and hope that you will have faith that it will all work out in the end. Because really that is what they are counting on, that you will rebuild your life through taking positive actions every day and that eventually you will look back and realize how far you have come. It is not realistic to walk out of rehab after two weeks and suddenly be filled with joy in your life. It takes time.
How can modern day rehabs teach long term personal growth?
One way that rehabs can teach long term personal growth might be to shift their focus on to habits and habit formation. To some degree they already do this when it comes to finding support in recovery by encouraging people to get involved in programs such as AA and NA.
But I think they could go a step further than this by encouraging people to create positive habits in their life that would help to rebuild their happiness in the long run. For example, take exercise. This is one of the pillars of my own recovery and doing some form of exercise every day has gone a long way in creating this new positive life for myself in recovery. Did I learn this in rehab though? No, it was not realistic at the time and they were focused on teaching me other things (such as spirituality, AA meeting attendance, etc.).
The tragic thing is that we probably don’t know what sort of habits are going to click with most people in recovery. So instead of teaching specific habits (such as exercise or meditation for example) the rehab must somehow teach people to explore the possibilities in recovery. This is hard to do because the recovering alcoholic must leave rehab and start taking suggestions from other people.
How specific do you get when teaching this concept? How general can you be and still have people doing it effectively? If someone had told me to exercise every day when I had 2 weeks sober I would not have been receptive to that. Instead I had to find this information out as I moved along the journey. I don’t know if you can teach people how to recover in this way and rebuild their life without talking in generalities. If you try to get specific then you are going to have to customize with each person and explore what really makes them tick. And this is the essence of the recovery process, each alcoholic must figure out what they want in life and then start building that from the ground up. Not only must they rebuild their life, but they must do so both internally and externally. They must work on the inner stuff to clean up their mind, and they must work on their life situation so that they can rebuild their life.
The challenge of finding positive daily habits
In order to rebuild your life you will need to establish positive habits.
I suggest that you start this process by modeling other people in recovery. Find someone in recovery who is living the sort of life that you want to live, and then ask them what their daily habits and their daily routine are. Start emulating their process.
Everything in recovery is part of a process. You will become what you do every day. This is why consistency is so important in recovery, because your final outcome in sobriety will simply be an accumulation of what you do every day over time.
Each day becomes a multiplier. You can create positive changes in the long run by taking consistent action. This is why habit formation is so important. Consistent action will produce the results that you are looking for.
Can rehabs teach this concept? They are trying.
The question for you is: Are you willing to embrace change on a daily basis? This is how to rebuild your life in recovery. This is how you accumulate rewards of a life well lived.