Monday, November 19, 2012

The Third Stage of Alcoholism Treatment ? Transition and Personal ...

This is the third article in a series about the four stages of recovery (as outlined informally by the Spiritual River author!).

The first stage is detox/disruption and the second stage could be called ?early recovery.?

In my experience, the early recovery stage can extend anywhere from a few months to a few years, depending on how quickly a person is developing in their

recovery and personal growth.

This third stage that I am calling ?transition/personal growth? is really about the transition from early recovery to long term sobriety.

Obviously if you talk with a recovering addict who has been clean and sober for over a decade, that person will probably have a different approach to

recovery than someone who has just a few months into their recovery. Somewhere in between these two extremes is a transitional stage that each recovering

addict and alcoholic must go through.

I like to think that this stage of recovery is characterized by personal growth. People who get stuck in recovery and fail to grow any further can have a

couple of different outcomes:

1) Relapse due to lack of growth.
2) Stagnate in recovery and remain sober but essentially remain unhappy, always on the brink of relapse, etc.
3) Shift into a more ?proactive? personal growth mindset, and start trying to actively make positive changes in their life. This is the only option worth

pursuing in my opinion.

You cannot pursue this third option if you choose to practice acceptance in nearly every situation. At some point you have to put your foot down and say

?This is not acceptable to me, and I am going to work hard to change it.? This could be something about yourself or something about your life situation.

Accumulation of positive changes as a means to transition

So we are transitioning to something. What are we transitioning to?

A better life in recovery. And we could argue that life is nothing more than a series of moments.

If your life is full of stressful and negative moments, then you may not be much better off in recovery than what you were in addiction. No one wants that,

and this is not why you get clean and sober to begin with. We enter recovery in the hopes of positive change.

So we can measure our success in recovery by the positive changes that we make.

But it is not enough to make positive changes in our journey. We must accumulate positive change. There is a subtle difference there that can have a huge

impact on your success in recovery.

The idea is one that many are familiar with from their old life in addiction. We are very used to taking a step forward, only to take two steps back. This

happened all the time in our lives when we were still using drugs and alcohol, and we want to avoid this pattern if we can in recovery.

Therefore, instead of just scrambling around trying to make positive changes in recovery, we want to take care and do some thinking here. We want to target

each positive change that we make and then lock in the resulting gains and benefits.

After that we can move on and then make another positive change in our life. But we do not want to be making one change, only to try to take on too much

stuff and then end up losing the gains that we made last month or last week. This is how we lived in addiction, and we want to do better than this in

recovery.

For example, say that you are new in recovery and you want to improve your life and make some positive changes. So you might decide that you want to quit

smoking cigarettes. In order to do so, you ask around for some advice and many ex smokers tell you that regular exercise seems to help them a great deal in

their effort to be a non-smoker.

So what you might do in this case is to slowly, deliberately, and carefully start exercising on a regular basis. Don?t just go nuts and burn yourself out

within in a week or two. Be methodical and be patient with yourself and be in it for the long run. Commit to the change. Know that you are making a long

term, positive lifestyle change, one that will set you up for success with your other goals (especially with the quitting smoking).

In fact, you may even ignore your other goal for now of quitting smoking. Table that for the future, because you want to focus on one positive change at a

time. This is a powerful way to make progress in recovery. It may seem counter-intuitive, because it may seem like you are avoiding other positive changes

that you should be working on. But the key is not to overwhelm yourself, and instead to lock in each positive change?.one thing at a time.

In this example you would establish a solid exercise routine, locking in the change and getting comfortable with the new change in your life over a period of

several months. At some point down the road you might pause, evaulate your progress, and decide that you are very stable in your recovery and in your new

positive habit, and that no matters what happens with your cigarette smoking, you like the ?new you? that exercises on a regular basis, and you intend to

continue with this healthy new habit.

At that point (and only when you reach that point!) should you then move on to your next goal, of quitting smoking. Chances are good that the discipline

that you learned from establishing a regular exercise routine will come in very handy in terms of quitting smoking. The first goal that you mastered will

help you to accomplish your next goal.

This is the concept of accumulation. Most people do not give it significant thought in recovery, but I saw this concept formed very clearly in my own

recovery journey, and it makes a lot of sense to me. I have used the idea and extended it even further to accomplish new goals, without overwhelming myself

and trying to take on too much all at once.

There is also the idea of momentum involved here.

If you make a single positive change (such as getting clean and sober), you do not want to just stop there. If you do, then you run the risk of stagnating

in your growth and possibly relapsing as a result.

Instead, you want to build momentum with your growth. One positive change can lead you to the next, and this is how real self esteem can be built over time.

As I made my journey through recovery and continued to make positive changes, I realized that I was probably setting my sights a bit low. Because I was

building momentum and gaining confidence by making one positive change after another, I started to realize that I could probably accomplish more than I

thought I could. So at one point I set my sights a bit higher, allowing myself to dream a little, and was later shocked when I achieved these dreams without

much trouble at all.

After year one to three years of recovery with stability firmly established

While there are no hard and fast rules about how long it takes before you enter the stage of ?personal growth,? I believe it is usually around the one to

three year mark, and should consist of a shift away from support and towards individual personal growth.

This point is highly controversial because many people believe it is foolish to step away from the support and group therapy style approach that may have

been working so well in their early recovery. After all, if you have been attending AA meetings for a few years and are doing well in recovery, why would

you stop? Why would anyone risk screwing that up? This is what people in traditional recovery typically argue.

My philosophy is that we need to change and evolve and grow in our recovery. I am not necessarily saying that every person needs to step away from group

support and meetings during their journey to long term recovery, but I do think that every individual needs to think carefully about their life before they

just accept a lifetime of meetings as their default path.

Traditional recovery has this fear based message in it that says ?if you ever leave the meetings then you will relapse and die.? I have discovered that this

fear based message is completely false (though of course it does turn out to be true for some). On the other hand, there are plenty of people who STAY in

the meetings and cling to traditional recovery programs to their own detriment?they would actually be better off if they stopped depending on the daily

groups and learned to push themselves to achieve some personal growth in their life.

This all depends on the individual, where you are at in your recovery, how much you depend on the meetings, and how much you push yourself to make personal

growth. There is nothing stating that you HAVE to leave the meetings to be successful. But I think it is a mistake for someone if they get stuck in AA,

rely on the meetings to keep them sober, and basically do nothing to motivate themselves to make any sort of real growth in their lives. The reason this is

even an issue at all? Because I have seen it happen many times in my own personal journey.

Meeting attendance does not insure sobriety, but one of the central fear-based messages that we hear in traditional recovery is that going to lots of

meetings is the solution. What I found in my own journey is that many people who attend lots of meetings end up relapsing anyway. At the same time, I

explored some alternative avenues of recovery and found that there was a sub-group of people who had left the traditional path of daily 12 step meetings and

who were doing just fine.

So what I am suggesting here is that the ?personal growth? stage of recovery should probably come in around the one to three year point of your journey.

These are just ballpark time frames but the key here is not that you stop going to meetings necessarily, but that you shift from the idea that:

?I need group support in order to maintain my sobriety.?

to a mindset of:

?I must pursue personal growth? (and thus reduce the chance of relapse).

What next? How to prioritize your personal growth

I can remember being in this transitionary stage myself and sort of wondering what I should next. I had about two years into my sobriety and I felt like I

was fairly stable in my recovery. I was not craving drugs or alcohol and I was not feeling overwhelmed or anything by my life situation. In fact I was

working and also going to college classes at this point.

At one point during this stage I felt like I was still holding myself back due to my nicotine addiction. I had made a few efforts to try to eliminate my

smoking but I had failed every time.

In some ways I was not too concerned about my smoking addiction because so many other good things were happening in my life. I was clean and sober, working

a steady job, and was also finishing up my degree. But the smoking addiction remained and I knew that it was holding me back (but it was so darn hard to

stop!).

What I realized years later, looking back, was that I had to quit smoking in order to really move forward with my personal growth. It was holding me back in

a way that I could never fully realize or predict, until I had overcome it.

Once I had succesfully quit smoking, it was like this huge light bulb went off. I realized that I could do anything, I had removed all the chains, nothing

more was holding me back. And this taught me something important about personal growth in recovery:

* We should eliminate the negative stuff from our lives FIRST, before pursuing the positive stuff.

This is very counter-intuitive. One would think that something like ?going back to school to pursue a degree? would take precendence over ?eliminating a

negative habit from your life.? But it became very clear to me in recovery that this was

Dependency on meetings vs. personal motivation to grow

One path that I specifically did not want to go down in my recovery was journey was that of meeting dependency. To me, this seemed like a crutch, even

though a dependency on meetings is certainly nowhere near as bad as a dependency on chemicals.

This did not change the fact that I saw negative effects from my peers in recovery who never moved past this particular stage in their recovery. Those who

depended on meetings just to stay clean and sober would never have the same strength of recovery as someone who branched out and enjoyed a stronger recovery

based on their own personal growth.

This may come down to personality type?some people would prefer to sit back and have their life dictated to them (go to meetings, get a sponsor, etc.) and

others would prefer to define their own path in life.

In very early recovery there is a problem when people try to design their own recovery program. They?re not ready to do so yet. They are likely to end up

relapsing because they do not yet have the discipline or the wisdom to know what it takes to remain clean and sober for the long haul.

On the other hand, once you have gained some stability in recovery you gain the ability to design your own path. This is done through self motivation and

taking positive action. There may be several possibilities for growth in your life and the whole key is that you take positive action and do something.

People who go to meetings and work with a sponsor are ?doing something? as well, they are just using a bit more structure in order to do so. You can do the

same thing and achieve the same results by your own design but obviously you have to take action in order to do so and therefore you must be motivated.

For the most part this means that you have to be self motivated. If you abandon support groups and sponsorship then who is going to motivate you other than

yourself? Individual recovery is possible but if you are looking for an easy way to be held accountable then it would be foolish to walk away from AA or

group support programs.

When I decided to stop going to meetings every day I had to face the reality that now everything was up to me. I could no longer count on others to hold me

accountable and I could no longer count on them to listen to all of my problems from day to day. Of course you can still find support out there in the world

without attending meetings every day but if you are used to attending a daily AA meeting then this can be a bit of a lifeline. My choice was to stop using

this as a lifeline and try to depend on my own personal growth for my stability in recovery instead.

As soon as I stopped actually going to daily meetings I was a bit scared. What if everyone was right and I would end up relapsing?

But this did not happen. I was scared enough to take real action, to realize that it was all up to me to recover on my own, and so I pushed myself to engage

in all kinds of personal growth projects. I exercised every day. I pushed myself in education. I reached out to others in recovery via online forums.

I was scared enough of the relapse boogeyman that I made sure that I stayed good and motivated to keep taking positive action.

This was over eight years ago that I made this transition. I forget how long I stayed scared (and guilty) for having left AA meetings, but I know it was

several months or even years. Eventually I realized that I was not going to suddenly relapse because I had quit going to meetings. I realized that I was

taking positive action in my life, even more so than many people who continuously attended the meetings were doing.

No one is 100 percent immune from the threat of relapse, but I had been able to see that daily meeting attendance was only a small part of the equation. If

you could find a way to motivate yourself and take positive action outside of AA, then long term recovery was very possible. Most people I watched who left

AA were not self motivated. Instead, they had simply given up on recovery, and they wanted to go get drunk or high. My situation was different in that I

wanted to go create a new path in recovery, one that was positive and did not rely on daily meetings. I was able to do so but only because I was motivated

enough to make my own personal growth a huge priority.

Will I relapse if I quit going to meetings every day?

You will if you do not have a plan in place. What are you going to do for your recovery instead of going to meetings?

If you are clean and sober in AA or NA and you want to quit going to meetings, that is perfectly fine. But you had better take a proactive approach and make sure you are making darn good use of that hour of time each day.

Recovery is about personal growth, whether you are in AA or doing your own thing. Either way, you have to be making positive progress in your life, or you will eventually be flirting with relapse.

If you are self motivated then you can certainly do your own thing in recovery and be successful with it. If you choose to take this path then I would not bother telling anyone in AA what you are doing?they will simply try to warn you away from your imminent doom that they believe you are headed for.

On the other hand, I would pay very close attention to how your recovery is going if and when you decide to make the leap from ?meeting dependency? to ?personal growth oriented recovery.? If you notice yourself struggling or having cravings, then it might be wise to abandon your plan for now and get back to the structure and regularity of daily meetings. Perhaps it is not the right time to break away and do your own thing. I fully acknowledge that early in my own recovery journey, I needed a lot of structure and support (which is why I lived in rehab for 20 months). By the 36 month point, however, I was completely done with daily meetings.

If the timing is not right for ?individualized recovery,? then stick with the group support for as long as it takes. Maybe group interaction is hugely beneficial to you and to others, and there is no need to leave it at all.

Ultimately it is not about leaving meetings behind or abandoning group support, it is about challenging yourself to grow in recovery. I was ?dependent? on meetings in such a way that I could show up to AA every day and just sort of coast along, stay sober, and not really grow much. This was not doing me any good and I suppose I could have tried to fix this while staying in AA. Instead I chose to challenge myself with another path, and this worked out well for me. What is important for you is not necessarily that you abandon support, but rather that you make sure you are highly motivated to pursue growth in your life.

Finding the right balance of challenge and growth in your life

There is a point at which you can over-do the personal growth thing. I know this is possible because other people have told me about it, but I have yet to reach that point myself. Obviously, you do not want to burn out to the point that you get frustrated with your life and end up relapsing.

On the other hand, what I have seen over and over again in recovery (especially in AA) is that many people get lazy, get complacent, get overly focused on the idea of ?acceptance,? and they do not end up pushing themselves enough to make positive changes.

Why change something about yourself when you can just accept instead, right? This is an attitude in traditional recovery that I have seen far too often. For example, someone might say ?screw it! I am a smoker, I smoke cigarettes, and I just have to accept that. I know it is bad for me but at least I am not killing myself with booze or hard drugs any more,? etc.

Obviously this form of self acceptance is detrimental, and is not what the founding founders of AA had in mind when they talked about how ?acceptance is the answer to all of my problems today.?

Instead we need to take some direction and advice from the good old serenity prayer, and have the wisdom to know when something (like cigarette smoking) is something that we CAN change, and that we should change.

The question you have to ask yourself is: ?Do you need to have AA in your life in order to prompt that kind of positive growth??

If the answer is ?yes? then by all means, stay in AA.

If you find that you can motivate yourself to make positive changes while creating your own path in recovery, then I highly recommend that as well. It has been working well for me for many years.

Recommended Reading

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Source: http://www.spiritualriver.com/the-third-stage-of-alcoholism-treatment-transition-and-personal-growth/

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