After working in the field of addictions for about thirty five years, there are some things I have come to believe about addiction and recovery from those addictions, especially the addiction and recovery from substances. For the last blog, I wrote an article in regard to "Instant Gratification". The ideas shared there could be part of this article. I believe the concept of "Keep it Simple" has been pretty much lost. I am hopeful the following thoughts will be helpful and simple. So here we go.
No matter how complicated or long an individual's story of addiction is, the reasons or the motivation behind the abuse or dependence fall into one or all of these three categories:
Folks are either trying to avoid something they don't want to deal with, escape something they are already in the middle of and don't want to keep dealing with, or enhance something about themselves. Simple, huh? Many times it starts out pretty good. The substance or substances seem to be working…for a while. But then, they don't work anymore. The new problem is, how to stop, now that we are dependent. Not such an easy answer.
I don't believe folks have to hit the bottom to recover. I also don't believe the bottom must be raised to recover. Hitting the bottom may be true for many individuals, but not for everybody, and I believe, not for most. Either point would be hard to prove because the overwhelming number of people who are addicted to a substance, in our culture, never seek any kind of treatment for the addiction. People are motivated differently. Some need to be promised into heaven and others scared out of hell, as it were. One way of addressing addiction that is promoted is to intervene, then tear the addict down. Then the plan is to build them back up. How many folks get built back up as contrasted with those who don't? I don't know. What I do know is that the relapse rates are not much better, if any, than 40 years ago. Relapse rates are not so much an indication of the inadequacies of treatment as it is evidence of the power of addiction.
It appears the majority of people in a recovery program right now are not there because they chose to address the addiction via a structured program. They are in a program because criminal justice has said to go to treatment or go to jail. Another large group of folks who are in treatment, are there to get someone (the spouse, the employer, their friends, etc.) off their back. You can divide the stages of recovery for the above described motivations into three categories:
Those who are defiant to recovery are pretty clear that they don't believe there is a problem. They "No" on the outside and "No" on the inside. Those who have entered the next stage of recovery are complying with the program and the education they are receiving. They tend to say "Yes" on the outside, but "No" on the inside. In other words, they have figured out what the counselor wants to hear, and they say it. Sometimes, they say it rather convincingly. If the process goes as we would like, folks get to the third stage: Surrender or Acceptance. Here, the person really does buy into the belief that they have an addiction, that addiction is not good for them, and they can truly recover. They say "Yes" to the concepts of addiction and recovery on the outside and they are saying "Yes" on the inside.
So, are there any people with addictions who don't suffer from denial? Are there any people with addictions who don't have to be forced into treatment? Yes. I believe there are many. They get caught up in the statistical jungle created by those who do surveys and outcome studies for various programs. They just don't get counted.
Dr. Candace McDaniel
8021 East Thornton FWY, Suite A
Dallas, Texas 75228
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