Addiction and Recovery

Addiction is a physical, emotional and spiritual disorder that is expressed in obsessive thought and compulsive behavior. Alcoholism, drug addiction and process addictions fall within the addiction parameters. One cannot think one’s way out of compulsive behavior without certain structures in place.

Addiction expresses itself in one of two ways:

• Some addicts and alcoholics report that they used their drug of choice compulsively from the first sip, drug, bite, online chat.
• Others report that they have had a neutral history with their drug of choice until that fateful day that their relationship with the substance or process suddenly accelerated into compulsive using and being unable to stop.

Is there a difference between using a substance “heavily” and using a substance addictively?

Yes, there is. When one uses a substance “heavily” they do not necessarily experience cravings nor does the individual experience the inability to stop using the substance when internal and external cues point to stopping.

There are many similarities to “heavy use” of a substance and addiction. Those include:

• Using to manage emotions of all kinds.
• Using to avoid uncomfortable situations and situations that the individual cannot manage without “a little something to take the edge off.”
• Defining a good time around use of a substance.
• Using the substance as a reward.
• Using the substance with the express intention of getting “wasted,” “high” or “out of it.”

So what is the difference between using a substance and being an addict or an alcoholic?

The definition of addiction and alcoholism includes these three hallmark symptoms:

• Inability to stop using despite consequences in the following areas:
  • Work
  • Interpersonal relationships
  • Legal realm [for example: DUI/DWI, arrests for prostitution/exposure]
• Experiencing physical withdrawal symptoms when not using one’s drug of choice.
• Increased tolerance to one’s drug of choice; needing more of the substance or behavior to reach the same level of experience as previous events. Prescribed medications for the purpose of symptom management, when used according to prescription, do not fall into the “drug of choice” category. Drugs of choice are those that individuals use to alter their moods without benefit of a clinician or medical professional.

Of course there are other symptoms that we look for, however the three listed above are the ones that earn the label.

What is a Process Addiction?

Process addictions are primarily thought and behaviorally directed. The “addiction” is to an internal cocktail of neurotransmitters. Instead of using drugs and alcohol to obtain a specific mood state, process addicts behave in such a manner that neurotransmitters and hormones combine to flood the system. Clinicians will often refer to this behavior as self-medicating or managing a mood state.

Process Addictions include:

• Sex Addiction
• Internet Addiction; Gaming Addiction
• Compulsive Gambling
• Eating Disorders
• Compulsive Shopping
• Compulsive Screen time: computer, television, smart phones

Treatment for Process Addiction often includes abstaining from specific behaviors or limiting them to healthy proportions. Individual therapy is one of the crucial support beams in the recovery structure. There are several 12 step and other supportive groups to facilitate individual therapy in the treatment of these addiction processes.

How do addicts and alcoholics get better? Addiction is viewed as a disease process that affects the body, mind and spirit. Treatment must be managed accordingly.

The Body must heal. Healing is brought about through abstaining from the drugs, alcohol and behaviors that make up the compulsive behavior. With abstinence comes a healthier body that no longer needs to manage effects of drugs, alcohol and other forms of abuse. Many report that as time progresses the body functions much better and the mind becomes clearer.

The Mind heals as the body shakes off the effects of drugs and alcohol. Neurotransmitters come into better alignment and we can see how the brain itself is healing. Faulty thinking can be addressed and new levels of understanding come about. The hard part is managing feelings without using drugs, alcohol and other compulsive behaviors to dull or harness them. Memories, feelings, beliefs and other troublesome thoughts can overwhelm an individual in early recovery. For this reason supportive group experiences, therapy and emotional support from family and friends are crucial.

The Spirit must heal. The spirit is a distinct part of the self that carries our integrity, ethics and sense of greater self. For some the spirit emanates from the larger universe; for others it is a part of the psyche that emanates from one’s sense of self. Regardless of how one views the spirit, we can view addiction as an attempt to gain or outrun existential connectedness to others and oneself. Recovery must focus on healing the existential piece that we humans have.

What can I do to be in recovery?

• Abstain from using drugs, alcohol and compulsive behaviors.
• Be part of a support group. Being with others who have learned how to live life on life’s terms without living in addiction helps manage those life issues that can throw one off.
• Be as honest as you can with yourself and your support group about your impulses and thoughts as well as your doubts.
• 12 Step groups offer experience, strength and hope for addicts and alcoholics in recovery. They offer organic treatment strategies for no money and include 24 hour support.

Do I have to be in a 12 Step Program?Absolutely not. There are many ways to recover and live a productive life that does not include struggling with overuse of a substance. Statistics and research, however, tell us that 12 Step programs have the highest recovery rate and help individuals stay in recovery longer. They facilitate sobriety, healing and reclamation of integrity faster, have a 24 hour support system and deliver help for less money than most other options. For these reasons, many professionals will refer people to 12 Step programs. Understand that there is no right or wrong way to heal from compulsive use of a alcohol or drugs.

Is Alcoholics Anonymous a cult? Are any 12 Step programs cults?

Hallmarks of cults include:

• Strict rules of behavior and, occasionally, dress.
• Usually one individual or a set of individuals lead by making rules and regulations. Cults are usually organized hierarchically and individuals attempt to move through the ranks through behaving in specific ways or are brought up through the ranks due to social or dynamic power within the group.
• One pledges money and/or services to the good of the cult. Once pledged they cannot be retrieved.
• Leaving the cult is difficult.
• Brainwashing techniques such as going a long time without food, sleep and connection with those outside of the group are used to foster a sense of community and bolster an insider experience.

Alcoholics Anonymous & other 12 step programs are not cults because:

• There are no rules in 12 step rooms. A pithy understanding repeated often in 12 step rooms is: “Take what you like and leave the rest.”
• Leadership positions are on a volunteer basis and rotate regularly so that no one individual comes to represent that group or fellowship.
• There are no dues or fees at meetings or in the membership. Service is on a volunteer basis only.
• You are the only person who can decide whether you belong there or not. You are the only person who can decide if you have an addiction. No one else can make that judgment for you.
• You can join at any time. You can leave at any time. You can speak if you choose to do so. You can pass when you choose to do so.
• Meetings tend to last 60 to 90 minutes, depending on the group. You may arrive late and leave early if you choose to do so.
• 12 Step rooms and the people in them pass on crucial information about abstaining from your drug of choice and manage how to live with others while doing that.
• You do not have to sign up for any religion, any God or any belief system.
• You decide how far into recovery you want to go.

12 Steps and Therapy

There are times that working the 12 steps and living the 12 traditions of 12 step programs are not enough to manage other symptoms of depression, anxiety or personality disorders. When this happens, therapy with a clinician who understands addiction is very helpful. Individual therapy, with a focus on a deeper understanding of what drives your behaviors and a more rigorous exploration of behavior changes will supplement the work done in a 12 step program. I always tell my clients that attending a 12 step program while going through therapy cuts the time it takes to heal in half.

The God Stuff in the 12 StepsMany people report feeling turned off or uncomfortable with “the God Stuff” referred to in 12 step meetings and literature. Understand that the reference to God and “Higher Power” is an acknowledgment of the very human need to be attached and connected to something other than oneself. Most addicts and alcoholics who find themselves in 12 step rooms come to understand that they have already been relying on their drug of choice and compulsive behavior to manage all sorts of existential needs. A spiritual leader once said to me “We humans are Made to Worship!” and I believe her. We are made in such a manner that we must connect to a greater experience. This is true figuratively and literally. We are always seeking heroes and finding people, places and things to look up to. It is this need that the A.A. founders referred to when they put the God Stuff in the 12 Steps.

Go slowly with this material. Explore it at your own pace. There is no right way or wrong way to work this out. Again, the best thing about the 12 step groups is that you can, indeed, take what you like and leave the rest. If the God Stuff isn’t for you, put it to the side and focus on the things that make sense to you in this moment. All is well.

Recovery and Change

• Boundaries and Perceptions