Foundations of Addiction Treatment 1: Disruption and the Safe Environment

Foundations of Addiction Treatment 1: Disruption and the Safe Environment


There are a couple of things that I believe are fundamental to addiction treatment. Those things are:

* Disruption/safe environment.
* Asking for help and the community aspect of treatment.
* Follow through and aftercare – what happens after you leave rehab.

Today we are going to look at the first fundamental, the disruption and safe environment aspect of rehab.

Why disruption is so important for early recovery

I have talked about the importance of disruption before. The problem is that your addiction has so much inertia that it is almost impossible to overcome it on your own without taking drastic action first. The tendency to continue to self medicate is just too strong. We built up habits and patterns of abuse over months, years, even decades. Reversing these patterns is not done on a simple whim decision made all of a sudden. It can be done, but it takes quite a bit of effort, and that requires you to disrupt your life.

People who try to get clean and sober but ignore the idea of disruption do not tend to do very well. The problem is that they are still stuck in the same life, doing the same behaviors, and it all leads them to the same place–a place that they don’t want to be any more. But for whatever reason these people are not willing to disrupt their life any further. The disruption is an inconvenience. Going to rehab is a chore. Going to meetings every day is a bother. They can’t allow their precious lives to be disrupted, so they stay stuck in their behavior pattern.

The way out of addiction is through massive change. The part that most people don’t get at first is the “massive” part. They are stuck in pride and are trying to save face. Their thinking is more like “Why go into rehab and make a big deal out of my problem when it is really not so bad…..I can just sober up this weekend and promise to quit drinking from now on and I will be fine. I’m no like a REAL alcoholic who is living in the alley or anything!” All they have done is minimized their addiction and argued that they do not really need to get help, that they can do it all themselves because things are “not so bad yet.” (Notice the “yet” in there!).

Addiction is this massive force that takes over your life and it eventually defines nearly everything that you do. Overcoming this force requires a great deal of change and the fact is that nearly everyone underestimates this amount of change, at least at first. This is why most people who go to rehab do not “get it” on the first time around. They are sizing up the situation and they are estimating how much work will be involved to turn their life around and they always fall short of the real mark, at least at first.

This is based on past experience. You can not really blame people. They are approaching their addiction recovery in the same way that they would approach an Algebra exam in high school. People tell them that it is tough, so they know that they need to study extra hard. They have faced “challenges” before in their lives, so they know that you just have to try extra hard, right?

Wrong. Addiction is different. This is not like other challenges that most people have experienced before. Instead, this is what you might call an “ultimate lifestyle challenge.” It is right up there with someone who suddenly has to get whipped into shape, lose a bunch of weight, and completely change their diet–all at once. It is not a little change. It is not a typical challenge.

In fact, most addicts and alcoholics who are in recovery today will tell you that getting clean and sober is the hardest thing they have ever done in their lives, ever. Really, go ask a few recovering addicts or alcoholics, and see if this is not the case! Really, overcoming addiction is the greatest challenge of your life. So the idea that you just need to try “a bit harder than usual” is completely wrong. The truth is, you need to try harder at recovery than anything else you have ever done in your life. Period.

This is it. This is the challenge of a lifetime. If you are saving anything in reserve for a challenge down the road, don’t bother. This challenge (of getting sober) is for all the marbles. Stop holding back and give recovery your best effort.

This philosophy is what makes it silly to avoid disruption. You don’t want to go to treatment? You can’t be bothered with a 28 day program? Your mind recoils in horror at the idea of living in long term rehab for more than a month?

This is a normal reaction to disruption because we naturally want to protect our ego and convince ourselves that we are OK. But if your life is a train wreck due to your addiction then you are not OK. (If you are anything like I was in addiction then you are pretty freaking far from “OK!”) And yet even though my life was crumbling all around me I stubbornly maintained the idea that I could not be bothered with rehab, that I had heard it all before, I had learned it all before, and that treatment was a waste of my time. Like my time was actually worth anything? But I thought that it was worth a lot because I wanted to keep pursuing my “happiness” by self medicating. Just leave me alone and let me use my drugs. That was my attitude, even though I was completely miserable nearly all of the time. Such is denial.

At some point though my misery became so great and so complete that it actually overtook my fear of sobriety. This is a very important concept so make sure that you understand it. My fear was holding me back from recovery. My fear of sobriety was keeping me away from rehab. My fear of the unknown prevented me from asking for help.

But at some point, I became miserable enough that I just didn’t care any more. I cast my fear aside. I was able to step back and look at my fear objectively, and I no longer cared about it because I as just so miserable. This is what it means to be “sick and tired of being sick and tired.” I was so thoroughly overcome with misery that I stopped caring about EVERYTHING. That was when I became able to ask for help. That was when I became open to recovery, even though I had been to rehab before and I hated the meetings and I knew it would never work and on and on with a list of excuses a mile long. Even though (all of that stuff), I was so miserable that I just didn’t care, and became willing to give recovery another shot.

I had to become willing to embrace a disruption in my life. For me this meant going to rehab. Treatment is a form of disruption. It is also generally the best disruption you could pursue (better than jails, institutions, etc.).

Why a safe environment is so important for early recovery

Whatever disruption you choose, it needs to be a safe environment for you. Non-threatening. Drug and alcohol free. Most treatment centers go to great lengths to help insure that this is the case.

Obviously this is important for recovery to take place. Detox and early recovery is a time of great temptation, and if chemicals are available then people will use them. People in the early recovery process do not need the added hassle of being tempted all the time.

There is also benefit to having a rehab that is away from things. If you live right next door to the rehab and your liquor store is right across the street, then this is not so good either. If someone can walk out of rehab and be self medicating in less than ten minutes then that is not a “safe environment.” Therefore it can be helpful to find a rehab that is out of the way, away from everything, and without quick access to drugs and alcohol.

There are limits to this, obviously. Anyone in rehab knows that they can eventually get out and find drugs or alcohol, given enough time. There is no “environmental cure” for addiction. You cannot just put someone in a safe environment and expect for that to cure their problems. Addicts and alcoholics are crafty, resourceful people. If they are determined they can always find their drug of choice eventually. So seeking a safe environment is not the ultimate answer, it is only part of the process. It is one small piece of what rehab should be like. If there is a liquor store right next to your rehab and there are drug dealers hanging around then you are just working against yourself.

If you have been clean and sober for several years and you find yourself suddenly in a sticky situation where there is ample threat of relapse, you will probably be OK so long as you do not keep exposing yourself to your drug of choice. But if you are still early in recovery then being in a single threatening situation like this can undo your entire recovery effort, just like that. Relapse can happen in an instant, especially when you are early in your journey.

Why the community aspect of early recovery is important

“We can’t do it alone.” Recovery requires other people to help you. We hear this over and over again.

In long term recovery this becomes less important. Once you have found some stability in recovery and you have been experiencing personal growth as a result of your recovery, the need for community and additional input becomes less and less. It is possible to become independent and “do your own thing” in recovery…..just not in the beginning.

In the beginning you need help, you need advice from others, and you need the support of an entire fellowship or community. This is important for success in early recovery because:

* Without a fellowship or community you are liable to rely on someone who eventually lets you down. Individuals can (and do) fail in recovery, but the overall community and the recovery effort will continue to thrive. You do not want to put all of your faith in one person (especially just yourself!) if that person ends up failing. No one needs such an easy excuse in recovery to go relapse.

* You need new knowledge in order to recover. What you knew about living and being happy was not working, was it? Of course it wasn’t, this is why you eventually became miserable in your addiction and decided to seek help. Every addict and alcoholic who has struggled with addiction has already tried many times to overcome their own problem. They have tried to out-think their disease and find some sort of trick to be able to both enjoy their drug of choice while also controlling it and not suffering any consequences. Of course this is impossible for any addict or alcoholic to maintain for any reasonable length of time and therefore they always return back to full blown addiction. The only way out is to try something different, to find a new way to live, a way that completely sidesteps the entire problem of drug and alcohol abuse entirely, but in order to do this you need NEW knowledge. Your existing knowledge is not enough to overcome your problem. If it was, then you would simply overcome it yourself and get on with your life without any issues. This is obviously not the case. You can’t do it alone, therefore you need help. You need other people. You need a community or a fellowship of people in recovery who can guide you in how to live.

* You need people who you can rely on in times of weakness. You need to be able to call someone up and say “I really want to drink or use drugs right now” and they will jump in their car and come rescue you from immediate danger. This is one way that we can help each other in recovery–we support each other in the simple act of not using drugs or alcohol. Again, you cannot rely on just one human being to do this for you at all times. It takes a network, a community, a group effort. Some individuals will fail but the movement will survive.

* You need multiple people who you can learn from because you have so many new things to learn in recovery. If recovery just required you to learn one single thing then it would be dead simple. But it is not simple AND it is not easy either. Recovery is complex and that is why it takes an entire community to teach you what you really need to know about living life without self medicating.

For example, you may get clean and sober at first and learn how to deal with some basic triggers and urges. You may learn how to call people for help and you may learn how to get support at meetings and such. But then you might reach a point in your recovery where you are having issues with another person and your emotions get out of control and you end up self medicating as a result of that. What went wrong? Why did recovery fail you?

What failed is that you needed to learn another lesson, and you might have learned it from experience or you might have learned it from other people. They could have taught you how to step away from a situation, how to process your feelings, and then how to communicate those feelings without it turning into a yelling match. I was lucky enough that someone taught me how to do this in early recovery, and it took me a lot of discussion and a lot of exposure to the idea before I really got it. Without doing this I may have been more susceptible to relapse later on.

The problem in recovery is that you have to relearn how to do everything without self medicating. “Just don’t use drugs” is completely useless advice, because what the person does not realize is that you have to “not use drugs” for nearly every situation that comes up. Something good happen in your life? You have to relearn how not to use drugs over that. Get in a fight with your spouse? You have to relearn how to process and deal with feelings without resorting to your drug of choice. Get some bad news at work? Again, you have to relearn how to deal with each little situation without resorting to your go-to solution, which used to be your drug of choice. In short, you have to relearn how to do everything and anything, all over again. This is a much bigger task than suggesting to someone “just don’t use drugs any more!” It’s not that easy, because recovery is a huge, endless learning process.

The revolving door of rehab and why aftercare is the most important thing

I worked in a treatment center for about 5 years and I have to say, I was shocked at just how much of a revolving door it can be. I suppose I should have known this in advance based on past experience, because I myself went to rehab 3 times before I finally “got it.”

Rehab is an important disruption and this break in your addiction can give you the chance that you need, but it is obviously not the full answer. The real answer to your problems lies in the follow through.

Without the disruption, without the clean break, you don’t really have a chance. But on the other hand, after you get that clean break and you get a few weeks of sobriety under your belt in rehab, you have an opportunity to either sink or swim.

The sad fact is that most people who walk out of short term rehab quickly end up sinking. I know that I did exactly that the first two times I went to treatment. I left rehab and promptly relapsed. I just wasn’t ready to embrace a new life. I wasn’t ready to ask for help and then take the advice and follow it without hesitation.

Twice in my addiction, I was willing to go to treatment….but not willing to follow through on the aftercare.

Twice I was at a point where I wished that things were different, and I wished my addiction would just go away, but I was not willing to take massive action in order to make that happen. I was willing to check into short term rehab, but that was it. I was not willing to take it any further than that (until I became even more miserable and then fully surrendered).

Another foundation of treatment is simply asking for help

One of the core foundations of recovery is in simply asking for help. If you do not ask for advice from others and try to learn from their experience, then there is little that can be done to help you recover. Try to do it all on your own and you will simply end up sabotaging your own efforts. In the beginning you need new information, and you can only get that from other people. Sure, you can read books or learn about programs by yourself, but this is hardly “new” knowledge. It is so much more engaging and useful to actually talk to others who have “walked the walk” in recovery and can give you direct advice.

Asking for help is a foundation of recovery. Following through on the advice is the key to success.