12-steps

Relapse Preventions – Final Thoughts

Our exploration related to Relapse Prevention simply touched the surface of a very complex area. I may come back to it as we move along or if there continues to be requests to learn more about this area–I always look forward to your emails (thanks Inny for requesting RP). All we had time for in a week was to cover the basics in addressing any cravings or urges. These tools of Avoid, Confront, Distract and Remind may become your life preservers if you have been attentive to the tasks.

It is imperative to remember that substance disorders are a relapsing reality; it is only the blessed few that will walk this path and never know the hideousness called Relapse. More people will relapse then remain abstinent. The vast majority of those relapses will occur within the first two-years of recovery. The primary reasons for relapse include…
• Complacency
• Attitudes of superiority
• Lack of humility
• Lack of commitment
• Keeping secrets
• Limited or no attendance at appropriate 12-step programs
• Difficulties with the spiritual aspects to recovery
• No access to relapse prevention treatment

If you do relapse, know that this is not the end of the world and it is critical that you stop again ASAP. Some people that relapse begin to think that they might as well “do it right” now that “everything” is ruined. Let me begin by telling you “Everything is not Ruined”!However, it could become that way if you keep going versus stopping soon into the relapse. Another strange message that AA and other 12-step programs send around relapse is that a person has to start over if they relapse. Don’t get me wrong here though, I think the world of the 12-step programs and believe they have contributed to the recovery of more addicts than any other treatment modality; so even if I question a few of the messages I still believe these programs are an addicts best chance at recovery. For some people this discounting of their previous experience or work can be counter-productive as they are more likely to be the ones’ that believe they “might as well do it up right given that it’s all gone”. Let me be the first to tell you, it is not all gone…if you stop soon into a relapse you can do some immediate damage control and you can simply pick up where you left off and learn from the experience.

As I stated before…Recovery is a Gift not a Given! Be grateful for everyday you have substance free and do the work needed to keep your gift…try and remember that people die because they did not get access to the help you have already received. Good luck and Good Recovery.

TODAY HAS STARTED–HAVE A GREAT ONE!

Spirituality in Recovery

This week it has been requested that I write on a topic that I have researched but by no means feel like an expert on; this area is so large that commentary upon a piece does not make one an expert. That topic is spirituality; my research in the area covered Judeo Christian perspectives in recovering alcoholics. I have read plenty in the area and spoken too many about their experiences; and from this I have come to understand that I know only a little. From the concepts and experiences that I have taken away I will share some here over the following week, including spiritual development.

Firstly, let us define the difference between religious and spiritual and explore how these fit into recovery processes.

Religious: A religion is a set of tenets and practices, often centered upon specific supernatural and moral claims about reality, the cosmos, and human nature, and often codified as prayer, ritual, or religious law. Religion also encompasses ancestral or cultural traditions, writings, history, and mythology, as well as personal faith and religious experience. The term “religion” refers to both the personal practices related to communal faith and to group rituals and communication stemming from shared conviction. Religions include Christian, Muslim, Buddhist, Islamic, Jewish, etc.

Spiritual: Spirituality, in a narrow sense, concerns itself with matters of the spirit, a concept often closely tied to religious belief and faith, a transcendent reality, or one or more deities. Spiritual matters are thus those matters regarding humankind’s ultimate nature and purpose, not only as material biological organisms, but also as beings with a unique relationship to that which is perceived to be beyond both time and the material world. Spirituality also implies the mind-body dichotomy, which indicates a separation between the body and soul.

Research in both of these areas is showing that individuals that are religious and/or spiritual are showing better recovery outcomes from a wide variety of physiological and psychological aliments. This is something that the founders of AA either knew or stumbled upon back in 1935. Many 12-Step programs are built around spiritual principles—not religious doctrine.

From a perspective of recovery from substance disorders, the 12-Step programs were all founded upon Judeo Christian concepts and principles couched softly to be inclusive of every possible religion or spiritual focus. Original AA documents included language like “Jesus”, “Lord”, and “Saviour” only to be altered into one term—God. The founders of AA altered what could have been determined to be a “religious” program into one that became “spiritually” focused. Then in the late 90’s there was research showing meaningful splits between “spiritually focused” groups versus “secularly focused” groups and the potentiality of outcome to this pattern. In other words, AA and other 12-Step groups were beginning to split upon meaningful dimensions of a spiritual program versus a non-spiritually focused program. Some meetings were still inclusive of discussing the concepts of God, Spirituality, and the Principles while others began to focus upon more life focused structures like Relationships, Communication, and Balance. It was also the first time ever AA was not in a growth position compared to every decade that preceded it since its inception in 1935. I personally do not see this as a coincidence; many AA groups were now beginning to mirror pop psychology and new age principles that would have drawn many away from the more traditional aspects of recovery to something you could now get without attending AA—just look in the self-help section of any bookstore. The problem becomes that bookstores cannot convey experience, strength, and hope that only comes from two alcoholics talking to each other. In those discussions, couched in those concepts, AA was the most successful recovery modality of any approach at treating addictions. It still is; with one caveat—groups that are spiritually focused produce better, longer-lasting and more meaningful recovery experiences than secularly focused recovery.

I have been privileged to meet thousands of alcoholics over the course of my career and the one thing I can clearly state is that those with a “spiritually” focused recovery have a better chance at long-term success in their recovery. I will provide examples as we go through the week. For today, those in recovery may want to explore those groups that are spiritual versus secular. For those suffering from other ailments, you may want to seek additional spiritual cures in addition to all of your other treatments…you may find additions to your recovery there.

TODAY HAS STARTED—HAVE A GREAT ONE!

12-Steps Programs: Steps 1 – 3

The 12-Step Programs have saved and altered millions of lives across the globe. Today we will begin looking at these steps and the meanings/ interpretations behind them.

Before AA began, the Oxford Groups existed as a program of recovery from alcoholism. The Oxford groups were based upon the principles of absolute honesty, absolute purity, absolute unselfishness, and absolute love. What they discovered were that these four principles were difficult for anyone to maintain, let alone a recovering addict—thus AA was born as a program that was built upon the principle of “progress not perfection”; people were suggested that they made progress in their recovery not attain a perfect recovery. Absolutes were left behind and a “suggested program” was introduced.

Part of this program was the 12 suggested steps towards a life of recovery. The key to that statement is the “suggested” part, individuals could decide to do the steps or not do the steps, —and the only requirement to attending a 12-Step Program is the desire to change.

Today we will look at the first few steps of the AA program—other programs basically mirror the AA program by altering the word alcohol to suit the issue.

1–We admitted we were powerless over alcohol— that our lives had become unmanageable.

This step gets at the heart of accountability. Many have interpreted this as defeat. This is not intended as a statement of defeat, but rather a statement of becoming accountable for one’s actions and bringing a link between alcohol use and unmanageability. It is quite simple—over-use of alcohol causes problems in people’s lives and excessive over-use of alcohol destroys people’s lives. Alcoholics are infamous for seeking every other rationale besides alcohol for why their lives are in chaos; this step puts the accountability where it belongs.

2–Came to believe that a Power greater then ourselves could restore us to sanity.

As stated earlier, AA was built upon Judeo Christian principles and AA incorporated the need for spiritual recovery from alcoholism. Years of research had defined alcoholism as a bio-psycho-social disorder…today that has been extended to include spiritual. There have been vast amounts of research done in the area of spirituality over the past 15 years as it relates to alcoholism with many researchers drawing clear linkages between these two areas. AA was well ahead of its time in the development of this piece. The founders of AA understood the need for individuals to have a program of recovery that extended outside of the individual to something or someone more powerful and thus helpful. The simplistic definition of “insanity” is performing the same activity over and over and expecting different results; restoration of sanity here is the understandings that change were needed for change to occur.

3–Made a decision to turn our will and our lives over to the care of God, as we understood Him.

Having performed research in the area of spiritual belief systems and alcoholism, I am keenly aware of the differences between those that accept and rely upon God as part of their recovery versus those that choose a different path. What this step requests is that a person is willing to rely upon God for good direction in their life (some members of AA even define God as Good Orderly Direction)—most addicts have not done an outstanding job in directing their own lives and thus a spiritual outside support can be essential. It additionally moves one away from ego based direction to understanding and appreciating external direction. How God is defined is reliant upon each individual member of AA—there is no stated religion or spiritual belief system in this step.

These steps build the initial foundations for recovery. When we come back to this, we will begin to explore the action steps within the 12-Steps.

12-Step Programs: Steps 4 – 9

Once a foundation is set within a 12-Step Program, it is time to begin the work. Steps 4-9 are Action Steps within AA and the other 12-Step Programs. These steps are not to be taken lightly, require a significant amount of work, and will be life changing if approached and worked at properly. It is often within these steps that a person will discover if recovery is going to work for someone; those committed to the process will struggle, will experience a range of emotions likely never seen before, and will want to quit over and over but they will not allow themselves to be defeated by a process of internal change and resolution.

Step 4: Made a searching and fearless moral inventory of ourselves.

It is difficult to change what we do not know; this step is designed to explore the inner workings and character of the alcoholic. One is asked to identify resentments, fears, sex problems, and begin the process of knowing where amends will have to be conducted. The founders of AA knew that a life lived with resentments could not be lived by an addict thus it became the critical focus of step-4. Resentments are often driven by anger, ego, hurt, loss, pride, jealousies, etc….all of which are egocentric patterns; a sober alcoholic had to be more than egocentric to realize a world of recovery. Resentments would need to be driven out and replaced with “other-centeredness”, selflessness, and acts of altruism, humility, and honesty. Step-4 begins this process.

Step-5: Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

Knowing what we have done wrong in our lives is one thing—seeking absolution and resolution from God, ourselves, and another is an entirely different activity. Most addicts have difficulty living within their own skin as a result of their behaviors while under the influence of substances. They need to know that what they have done is forgivable. This step provides a clean slate and also a sense of accountability. This step is a working step at reparations between oneself and God; a healing of that relationship and a deeper understanding that actions are accountable for “Recovery without Divinity holds the potential for reduced individual and societal accountability”.

Step-6: Were entirely ready to have God remove all these defects of character.

Step-4 explores a listing of one’s positive and negative traits; in step 6, an addict needs to be prepared to let those things of the past slip away for a new life to begin. Some addicts get comfortable in their patterns and thus experience anxiety in relation to letting these go. This step begins to open one up to new patterns, which lead to new character traits.

Step-7: Humbly asked Him to remove our shortcomings.

This step acknowledges two things; one is that change is needed and the second is that this is not likely to occur simply within one’s own volition. An additional key to this step is the need to become humbled—not humiliated—but humbled, a trait often void in dysfunction.

Step-8: Made a list of all persons we had harmed, and became willing to make amends to them all.

The list of those needing amends is made back in step-4. However, it is at this point in one’s recovery they are asked to become prepared to make those amends. Like the other steps, this step is well placed from a timing perspective as early recovery phases of development would not have a person exist in a position of restitution. However, once a person has been able to fully explore their own clear contributions to their dysfunction they are now better placed to seek forgiveness versus blame for their respective conduct.

Step-9: Made direct amends to such people wherever possible, except when to do so would injure them or others.

This step is simply a follow through to the preparedness sought in step-8. The focus here is not to simply feel better by clearing away the wreckage of one’s past, but truly trying to make what was once wrong… right in another’s life. This step is well placed as so many addicts try to do this in their first week of recovery, which mirrors the many promises they have made in the past. This step is not about promise but about correction. For amends to carry greater meaning there needs to be some recovery time in place so that others are seeing an earnest effort at change. Another key here is not making amends if that amend would harm another human being; this is not about conscience clearing on the part of the addict.

Next time we will cover the steps that provide ongoing maintenance in the recovery process.

12-Step Programs: Steps 10 – 12

The “Maintenance Steps” within the 12-Step Programs consists of steps 10-12. These steps are critical for ongoing development, spiritual development, and other centeredness.

Step 10—Continued to take personal inventory and when we were wrong promptly admitted it.

Albeit that step four explores one’s personal assets and dysfunctions, this step looks to carry on that activity as a means of not stockpiling issues and concerns; the purpose here is to deal and address life immediately versus delayed responses. Daily personal inventories vary for everyone however, most explore where they were wrong in the day, where they may have acted selfishly, and where they may need to take corrective actions. In step four individuals have identified both their positive and negative traits; this step can also allow for a progress gage on areas that a person might be looking to change.

Step 11—Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.

Spiritual development is meaningfully tied to ongoing recovery rates; this step assists in that processes by having one connect regularly with their spiritual resources. Addicts have a tendency to have had years of dysfunctional behavioural patterns and this step seeks to explore spiritual principles as their guiding directives versus self-will.

Step 12—Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

William James and C. S. Lewis have spoken extensively on the areas of spiritual awakenings/ experiences and according to James’s work there are two types of spiritual experiences…those that are of an educational variety and thus developed over time and those that are of a conversion experience which is a result of complete self-surrender. In either of these experiences, individuals have a new or renewed awareness of spiritual principles and the goal is to inject these principles into daily living. The other part to this step is reaching out to others as a means to assisting them in recovery, which in turn assists those who are helping—many addicts have lived a life of selfishness and self-centeredness, this activity moves them away from these negative patterns and allows them to experience the benefits of reaching outside of oneself.