Articles

Recovering from Addictions

By Peter S. Silin, MSW, RSW

There is no “right way” to recover from addictions or compulsive behaviour. There are various approaches that have been successful for people based on a wide variety of factors. These include the length of time that someone has been involved in addictive behaviour, their motivation, their situation, the type of addiction. Recovery also depends on the resources that people have available to them; these include financial, emotional, supportive, and other environmental resources. Generally, however, there are some truisms about recovering from addictions. There are also some general frameworks that are used to look at recovery.

One overarching framework for looking at recovery is the understanding of addictions from the viewpoint of what is called a biopsychosocial model. In brief, the biopsychosocial model understands addictions as having a biological, a psychological, and a social component. Each of these “spheres” contributes to someone’s becoming addicted and remaining addicted. This suggests that they should be considered when approaching recovery.

The biological refers to the physical and chemical changes that occur in the body and brain as the result of addictive behaviours and/or ingestion of drugs, alcohol, etc. The psychological refers to the psychological factors in a person’s history and experiences that may make them vulnerable to addictions. It also refers to the factors which influence their remaining addicted. The social refers to a person’s environment that influences the development and maintenance of the addiction. The environment can consist of a physical environment, a social network (or lack thereof), or family networks.

There is also what is called the medical model of addiction, which is sometimes seen as one component of the biopsychosocial model. In its most pure form, this model sees addiction as an illness, generally a chronic illness. In speaking of this model, diabetes is often used as an example—it is an illness that can moderated and handled, but it is not one that “goes away.”  It also relieves addicts of the shame that comes from addiction because it says, “You are not responsible for developing the addiction, but you are responsible for managing it.”

The medical model developed out a Christian approach to the problem of addiction, and as an advance from the thinking about addictions that saw them as social or ethical failures — judgments about the person who is addicted.

Just as there is controversy about the nature of addictions, so there is controversy about the idea of changing or ceasing addictive behaviour. As pointed out there is the medical model, which says that addictions are a chronic illness. There is also a harm reduction model, which says that people who engage in addictive behaviour can be trained to limit their actions to moderated amounts at which they will be able to function within whatever spheres they need too—work or family for instance. There are models which say that people can deal with their addictions, stop the behaviour, and then get on with their lives—they can be cured/ cure themselves and one that says a person is always an addict, but recovering. Each of these approaches has backing. Each of them works and is “true” for different people. Proponents of one often disagree vehemently with proponents of the other.

The trick is to use an approach which is right for you. Choosing what is right is difficult, for many reasons. One of these is that an approach about which you are feeling some resistance may in fact be what will be helpful to you. It is often hard to think clearly about what you need when you are in the middle of a problem, especially when part of the problem has to do with the way you are thinking about something. One way to think about this is that you do not have to choose one approach or treatment method.  You can use several, for instance a therapist, and a twelve step group.

For all addicts, there is a withdrawal process. That is true of process and substance addictions. This means that if you are addicted to pornography, set, gambling, spending, etc, you will go through withdrawal.  The withdrawal process has a physical and a psychological component, and they do not “end, (if they do at all) at the same time. Withdrawal from even a process addiction at a physical level can take at least thirty days or more.  For some drug addictions the withdrawal and repair period can take up to a couple of years, if the brain ever really does “repair itself.”

Withdrawal usually has physical symptoms, even from process addictions. These can manifest as physical concerns such as sleep disturbance, sweating, shaking or more. There are often mood disturbances—people feel anxious, angry, depressed, or disconnected. For some drug addictions, it is advisable to have the help of a physician.

It is often the case that after a certain period of withdrawal and being free of the behaviour and/or substance, people think that they can handle whatever was their addictive behaviour. They think they can “just do it once,” or “it wasn’t so bad.” These thoughts are what lead to relapse. This is why relapse prevention and planning need to be part of the recovery process. What generally happens with addictions is that if someone relapses, or slips, they easily return to the level at which they were at before the stopped, and continue from there. It is as if they had not stopped at all.

Generally, research shows that recovery is best accomplished with a combination of therapy and a recovery programme, either outpatient, community, or residential. One reason for that is addiction is about the addictive behaviour and the actual addiction, but it is also about emotions and personal history. This multi-pronged approach helps people work on both. It also provides the one to one attention that they need. But, as pointed out, there is no one right way. Sometimes people need to try several ways and times before they accept and understand what is best for them.

How do people recover?

  1. Find a therapist.
  2. Find a programme. This could be one of the 12 Step programmes, such as A.A. SAA (Sex Addicts Anonymous), GA (Gamblers Anonymous, Debtors Anonymous. There is also Rational Recovery and SMART (Self Management and Recovery Training. There are also night programmes, day programmes and residential treatment programmes, usually lasting about 28 days. Sometimes these are paid for by the province.
  3. Addiction is a family process also. If you have a spouse or children, they may need to have some support and counselling. You may want to have couple counselling as well as an individual counsellor.
  4. Recovery is about replacement of activities, as well as withdrawal. It is essential that you develop a new lifestyle and choose activities that will meet some of the needs that you had that led to becoming addicted in the first place. For instance developing friends, develop fun activities, take hot baths
  5. Identify your triggers—what sets off the addictive thoughts in your head and leads you to do what you do. These may be emotions such as anger, loneliness, fear, helplessness, etc. They may also be people, places, dates, or things or certain thoughts. Then figure out ways to avoid the triggers, and handle them when they occur.
  6. Identify the skills you may have been lacking which contributed to your becoming addicted.
  7. Educate yourself as to what the addiction has done to your brain and body chemistry and who at is will take to repair it.
  8. Exercise.
  9. Have good nutrition. You may need vitamins to replace what has been lost.
  10. Learn to meditate.
  11. Consider appropriate pharmacotherapy, such as anti-depressants. Discuss this with a therapist or physician.
  12. Develop a concept of sobriety. What does it mean to be sexually sober? To recover from food or debt compulsive behaviour?
  13. Learn to reward yourself appropriately.
  14. Know that there may be tough times. Plan for those and how you will handle them. Do not handle them alone.
  15. Know that there will be ways your mind will try to trick you—“just once” or “only one,” for example.
  16. Make sure you have some social support from family or friends as well as a counsellor. The bigger the network of support you can find the better. It may be helpful to have support from people “who have been there” and are recovering, and people who have not, but are part of the healthy lifestyle you wish to attain.  The two groups may overlap.
  17. Use technology—pagers, cell phones, internet blocking sites.
  18. Commit to self honesty and be willing to hear feedback. For most addicts there are ways that they try to lie to themselves or others, or that they try to hide things from themselves or others. Addicts become good at hiding, lying, etc.
  19. Commit to transparency.
  20. Remember that you can do it. Some people do it the first time around. Some people take several tries.  But “if they can, you can.”

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Peter S. Silin, MSW, RSW

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