5 A’s of Good Lovin’

We feel loved when we receive from others and from ourselves:

  • Attention - listening; observing and noticing others’ feelings and our own
  • Acceptance – of others and ourselves just as we are
  • Appreciation - of theirs and our own gifts, limits, longings, and shared human condition
  • Affection - shown through speaking, holding and touching in respectful ways
  • Allowing from others and ourselves the freedom to live in accord with our deepest needs and wishes without attempting to control.

Loving ourselves and othersAdapted with respect and gratitude from the writings of David Richo, including How to Be an Adult in Relationships: The Five Keys to Mindful Loving and When the Past Is Present: Healing the Emotional Wounds that Sabotage our Relationships.

Why Attend Addictions Recovery Support Groups?

If it were possible to run two experiments on a life where a person with addictions became abstinent and spent a year trying to stay that way solo, then was taken back in time and run through that year again but this time attended support group meetings, I’d put my money on more relapses in experiment one vs. experiment two.

Oh, the suffering in experiment one! It feels inhumane to even think of it.

I wish on day one of my abstinence from out-of-control drinking that I had been sent a link to web page like this one. Or even been given the text on a printed handout.

. . . . .

Support Your Recovery by Attending Support Groups

Benefits of attending a recovery support groupIn support of your recovery, we ask you to attend daily support group meetings for a year.

It’s not because support groups are “a good thing.”

Research yields mixed results on the success of support groups in helping people get and stay abstinent from the substance – drugs, alcohol – or the process – over-eating, under-eating, gambling, spending, etc. – that plagues them. Recent research on  one support group reports 1 in 15 stay abstinent.

Nonetheless, we think attending support groups increases the odds of you achieving your recovery goals.

“[Support group] effectiveness may not be due to its specific content or process. Rather, its chief strength may lie in its ability to provide free, long-term, easy access and exposure to recovery-related common therapeutic elements, the dose of which, can be adaptively self-regulated according to perceived need.”
– John Francis Kelly, Molly Magill, and Robert Lauren Stout, How do people recover…?

Yes, but I don’t like it.

Some people challenged with addictions say they attended a few meetings of a support group and didn’t like it.

Sure, support groups may not be for everyone. But try to answer this question: “Can you name some things you do like?”

You probably can’t. You’re not alone. Most people in early recovery don’t like much. They can’t. They have anhedonia, essentially the inability to feel pleasure – to feel good or to feel better – a darkly troubling downside of abstinence. It makes sense you might not like a support group, since you probably don’t like how your hamburger was cooked, how that guy was driving, what you see in the mirror, what you’ve done with your life, etc.

Yes, but I don’t get it.

Some people attend support groups and say they don’t understand what’s going on. Very gently, we want to let you know that your thinking is impaired from abstinence and will be for awhile, although you will improve. You’re going to have trouble understanding much of anything and all you need to understand, for now, is that it’s normal. Easy does it.

Yes, but I want to do this on my own.

Most people have tried the solo route of attempting to abstain on their own. After resolving to quit, or being released from detox or a treatment program, they think, “I’m clean and sober now. I’ve got it this time.” However, hour after hour of alone time begins again. Solo didn’t work before and it’s very unlikely to work again.

The first year of abstinence is the toughest and we want to encourage you to care for yourself and your recovery every day.

And one year is a rough estimate of how long anhedonia can last, although research is mixed. If you don’t “like” support groups after a year, then your cognitive functioning will have improved, your anhedonia might be lifting a bit, and your powers of discernment will be in much better shape. By then, you may be able to know whether or not you truly “like” something. If it’s not your cup of tea after a year, by all means, stop going.

It doesn’t matter whether you attend AA, NA, PP or ZZ. It doesn’t matter what group you attend – it just matters that you do attend.

  • Being with people who want to stay abstinent increases your ability to stay abstinent. (Source)
  • Participating in support groups and building a social network of abstinent people in your life helps you stay abstinent. (Source)
  • Attending support group meetings helps you change “people, places and things.” (Source)
  • People with addiction challenges have trouble believing they can stop. They lack what’s termed “self-efficacy.” Research suggests that those who attend support group meetings grow in self-efficacy. (Source)
  • Research suggests that people who attend support group meetings can stay abstinent longer than those who don’t. (Source)
  • Group attendance offers “close, but not too close,” i.e. being in a group with others begins to heal the isolation of addiction but provides space for the self to heal as well. (Source)

“Despite all our efforts to give, guide, and support, each of us is ultimately alone when it comes to our life, recovery and growth. This is the inevitable plight of the human condition… The primary conflict for us all, the addicted as well as the nonaddicted, is to belong and be connected to something larger than ourselves without losing ourselves… Can I be close and truly intimate without losing myself, or will my need for independence come at a cost of alienation and isolation?”
– David Richo, When the Past is Present

You may find what you hear in support meetings moving and motivating or unusual and confusing. Practice that essential recovery skill of self-calming if you find yourself hearing something you don’t like or don’t agree with. Here are ways to help you make support group meetings helpful to you.

Yes, but I don’t agree with what they say.

That’s okay. You don’t have to. The benefit is from being there.

Remember that it’s not the content of the meeting that’s most important – it’s spending time with people who want to stay abstinent. Discuss any questions and concerns you have with people at the meetings with whom you can relate and with other people in your recovery support network.

Keep looking for ways to make this free and daily source of support for your recovery work for you.

You may hear at meetings, “Take what you like and leave the rest.” By all means. Customize a recovery program that helps you with your recovery goals.

. . . . .

When I realized I had a drinking problem, the only help at the time was a support group meeting and that’s where I went. With the help of a huge team, personal experience, and intensive study, I’ve learned that addictions recovery requires an entire addictions recovery system. Attending support groups is part of that system. I am working on a book manuscript attempting to describe the addictions recovery system I wish had been available to me on day one of my abstinence from alcohol. So, so, so many variables…

I thought my job at a support group was to learn the material, just as if I had been in a class. I fought to understand. And I fought with how to be close enough to people to receive the benefits of connection, but far enough to feel safe. If only I had known I just needed to be there. All I had to do was just rest a minute in the company of people also trying to stay abstinent. Any other benefits that might come my way would be icing on an already fine cake.

Except sugar is a no-no in a recovery support diet. So many variables…

I am grateful to Laurel Sindewald for contributing to the research for this post.

The opinions expressed here are mine and do not necessarily reflect the positions of my associates, employers, clients or relatives.

The content of this post is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Further reading:

How to Make 12-Step Recovery Groups Work for You

How to Make 12-Step Recovery Meetings Work for You

Whether you live in a rural area like mine where 12-step recovery is often the only addictions care in town, or you’re court-mandated to attend 12-step recovery meetings (questionably against your constitutional rights, but it can happen), if you’ve got an addiction problem, you’ll be encouraged (or cajoled) to attend a 12-step recovery meeting.

For addictions recovery, 12-step recovery isn’t enough. This physician estimates only 1 in 15 people who enter one particular program will stay abstinent. Freeing ourselves from addictions requires each of us to custom design our own recovery.

How to benefit from support groups

I offer 2 caveats and 11 suggestions in hopes they may prove of value in helping you receive from 12-step meetings what you personally need for your recovery.

Caveats follow.

Caveat 1: A meeting is not a treatment.

While the focus of 12-step recovery meetings varies tremendously (Wikipedia lists several dozen), 12-step recovery is not a treatment for addiction. In fact, maddeningly, there’s actually no consensus on how to successfully treat addictions. (Middle chapters of this book offer the most current, thoughtful, thorough and informed critical analysis of addictions research I’ve seen.)

Caveat 2: A meeting is a gathering.

Simply put, 12-step recovery meetings are gatherings of people with similar problems who are trying to solve them.

A meeting is a very human event. That means much of what happens there is complex, intangible, and beyond words. Researchers have attempted to quantify what people really get from being together.* For me, sometimes the only eloquence I can muster after a meeting is, “I feel better.”

Suggestions follow.

Accept that you, and you alone, are your own 24/7/365 addictions caregiver.

Addiction is an all-day, every-day condition that requires around-the-clock care. Most of us don’t have the dollars to hire someone to be with us every minute to monitor our abstinence (or harm reduction) or give us a chance to sleep. Attendance at 12-step recovery meetings is free, fills up some of those hours we need care, and lets us join a group vigil so we can take a break from being the only one on watch.

Focus on yourself.

Become aware. Since our addictive behavior tends to occur when we’re unconscious of what’s really going on with us, sitting still for awhile is a chance to become aware of  what we’re feeling, thinking and sensing.

Practice self-management. Becoming aware of what we’re feeling and thinking can be distressing. Many of us are working hard on becoming aware of that distress and managing our feelings and thoughts to ease it. Alone, this can be very difficult. We can use the calm company of others in which to practice self-calming.

Bask in order.

Many of us have lived many of our days in chaos. We were out of control and so were the people around us. Exceptions exist, of course, because people have good days and bad days, but at most 12-step recovery meetings, the same things are done in the same order and everybody does what they’re supposed to do. Stability helps us heal from addictions. Some people do go on and on or say the same things over and over again, day after day. Ah, the blessed, peaceful, healing predictability of it all!

Speak and be heard – without interruption.

If you care to share at a 12-step recovery meeting, that will probably be the only time that day in which you will not be interrupted. Whether with family, a work crew, a committee, or in line waiting at the grocery story, we’re rarely given a chance to complete a thought, much less a sentence. Group norms at most meetings allow people to take turns speaking with silent listening, no interruption, and no correction, criticism or judgment. Freud’s patient coined the phrase “talk therapy,” but she wasn’t the first to understand that we discover understanding through speaking. Enjoy the novelty of uninterrupted self-discovery.

Sing along.

What one hears read aloud at meetings can be difficult to comprehend. If it doesn’t make sense, just let it be like a song on the radio where you can’t quite make out the words. Enjoy the pleasant voice reading, or respect the person who doesn’t read well but is giving it a go. If you find yourself starting to know some of the words, perhaps imagine yourself at a campfire singing Kumbaya or at a football game singing The Star Spangled Banner and join in. Some words may still not make any sense either, or may not be in accord with your beliefs, but there’s something about saying words together – pretty much any old words will do – that makes us feel less alone, that eases, if only a tad, the isolation of addiction.

Talk with, and listen to, people who get it.

As well-meaning as our non-addicted family members, friends and co-workers might be, they just don’t understand what it’s like to not be able to stop. What a relief it is to walk into a room full of people to whom one does not have to explain or justify one’s behavior. They know why you did it. They know why you still might be doing it. They did it, too.

Do what works for you individually.

Notice my suggestions do not include, “Get a sponsor,” “Work The Steps,” “Make conscious contact with your Higher Power,” or “Do service work.” Each of those may be useful and meaningful for specific individuals. For addicts as a group, however, it’s being and talking with people who are intentionally trying to change, rather than us being desperately alone, that has the most impact on our recovery from addictions.*

Accept the paradoxes.

It’s hell to recover alone, often impossible. It can be more possible to recover in the company of others. But we have to individualize our recovery programs. What is said to work for the group as a whole may not work at all for the individual. And the very people whom we depend upon to help us recover will, at times, make us feel crazy enough to drink or use. Sound familiar? Yeah, it’s life.

Be open.

Where else can you go where every single person in the room is single-mindedly wishing you well? You might not like everyone in the room and you might not like everything you hear. But no one, not one person, wants you to drink or use or do what you’re trying not to do again. Listen for practical tips from people who’ve been there and done that. And take in what is inexplicably moving, touching, inspiring and uplifting about being with kind-mindedness for an hour.

Take what you like and leave the rest.

That’s a standard 12-step recovery slogan but it’s the place to begin and end. Consider what you hear at a 12-step meetings to be a buffet meal of possibilities. Some ideas will seem tasty; some will seem distasteful. Serve yourself with what sounds good, maybe try a few spoonfuls of something new on the side, and don’t force down anything you distrust. Let no one tell you what to put on your plate. We’re trying to free ourselves, after all.

. . . . .

*If you’re interested in research on the social network effects of 12-step recovery for addictions, these articles may be of interest. Titles are abbreviated and/or excerpted, and the most recent are listed first. Thanks to Laurel Sindewald for her research assistance.

The opinions expressed here are mine and do not necessarily reflect the positions of my associates, employers, clients or relatives.

The content of this post is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Further reading:

Why Attend Addictions Recovery Support Groups?

You Are Your Own Addictions Treatment Provider

If I could offer one and only one truth discovered from my 25 months of effort to recover from addiction to alcohol, it would be this – and it’s not sexy:

You are your own primary addictions treatment provider and caregiver.

It’s a bitter irony that so much care and help is available (this post begins a series on exactly that) but in the moment when the totality of addiction is upon you, you are the one who has to handle it.

Checkered green fabricYou have the condition, disorder – whatever term one wants to use – all day every day. Who’s going to work that shift, day after day, month after month, to treat you for your condition? No one. It has to be you.

So you’ve now been appointed your 24-7 caretaker. You’re the one-and-only who has to keep you clean and sober, at your appointments, eat, exercise, all of it. You feel sick, deranged, ill, weak. You have physical, emotional, spiritual, psychic flu and you’re supposed to get yourself around, figure out what to do and do it?! A sick person caring for a sick person?! Insanity. Ridiculous.

And as your round-the-clock caregiver, you will experience desolate caregiver burnout – but you can’t quit! There’s no R & R, there’s no break – because you’re your own patient!

Please, truly, get upset about it. I certainly did.

I watched caregivers tend my mother as she was dying. Every moment of the last moments of her life, day after day, week after week, my mother had the company and ministrations of a caregiver. She was no longer an independent entity hunting and gathering food and water on her own, bathing herself, relieving herself privately. She could no longer do life alone.

I was no longer an independent entity when I became addicted to alcohol. Absence of wine had the control. I felt helpless, hopeless. I kept throwing myself off a cliff away from alcohol, falling and falling. I flailed and thrashed, throwing myself here and there, to this person and that person, seeking relief from spinning end-over-end. I don’t remember what, when, or why, but somehow I realized that, to manage my desperate state, I had to gather a part of me to do for myself what the caregivers did for my mother.

My job description as my own personal addictions treatment provider and caregiver is miserably hard but pretty simple:

  1. Handle the acutely distressed moments of addiction as they happen without drinking or using or harming myself or others by word or deed.
  2.  Strengthen myself in between those moments to handle those moments. Because they keep coming.

And the other crazy irony is that once I realized I, alone, had to do this job, I realized I couldn’t do it alone. But I was newly conscious, like a caregiver would be, of what was working and what wasn’t for my patient. I knew better what I needed to ask for help with to do parts 1 and 2 of my job description. And as my mother did, I most needed company.

I have shared that I have begun working on a manuscript for a book I wish I had been able to read on day one of my abstinence from alcohol. For now, its form is a letter to my day-one abstinent self from my two-year sober self. “You are your primary addictions treatment provider and caregiver” isn’t the very first line in the letter. And I don’t say it exactly that way. But it’s near the beginning.

Dear Anne,

Remember when you told your hairdresser that you were asking her for a good hair day for a bad self? You thought it was you, didn’t you? You thought you, yourself, had let this in, that all along you were trying to be such a good girl and follow all the rules to protect yourself from hurt. And you thought you had failed. You were all hurt all the time and you just couldn’t understand. I can see you standing there, such a baffled, woebegone little girl in a green gingham cotton dress. And you’re being so brave, standing there, trying not to cry.

It’s not her, it’s not you, nobody did anything wrong. This is just something that happens to some people. Come here. Let’s hug ourselves. It’s okay. It’s going to be okay. There are some things we can do. You’re not wrong to try. We’re just going to try some different things is all. Things you are so good at – following directions, working hard – they will help us so much. You will be the biggest help. Come here. Let’s hug. We can do this.

Love,
Anne

What It’s Like to Be an Addict

I get that it’s so difficult for those without addictions to relate to those who have them. I, too, have difficulty stopping eating chocolate once I start. But to compare my chocolate-eating to my wine-drinking? I burst into tears even typing that sentence.

Chocoholic?I have found it so difficult to feel heard by those without addictions, both inside and outside of the addictions treatment field, about the magnitude of having an addiction.

Many people with addictions throw up their hands and say those without just can’t get it. They tell me I will frustrate myself trying to explain, to let it go, and to focus on my own recovery from addiction to alcohol.

Why do I keep trying?

Because if your mind can’t in some way think like mine does, if your heart can’t empathize with mine, then I am alone when I am with you.

“Only connect!”
– E. M. Forster, Howard’s End

Difficulty connecting by heart and mind is hard on all relationships. Addiction makes it miserably harder.

And I’m sure it feels dangerous to attempt to access one’s own potential inner addict. If you don’t want to do that, I totally understand. I wouldn’t wish this on anybody.

But if you do want to try to connect, I try again:

Addiction is an unrelentingly powerful condition that requires attending every second of every day, day after day, month after month, year after year. And that condition is a universe unto itself that fills and spills into the universe of the very personhood of the person – body, mind, heart, spirit, feelings, thoughts, beliefs, speech, actions. Wherever you go, there you are, Jon Kabat-Zinn tells us. When one becomes addicted, wherever you go, there you are, but so goes the addiction within.

And not changing what I’m doing doesn’t just result in a moral defeat (Oh, phooey, I ate chocolate again!), or a setback (I know I’m diabetic! Why do I keep eating what I shouldn’t?!), or a chance at a do-over (Okay, enough. Let me stop this and try again.) Not changing as an addict isn’t just about me. Not changing costs and endangers me and you and society. If I don’t change, I could kill you. Or immobilize you under the deadweight of the burden I place on the health care, legal, and social services systems.

And choice has nothing to do with not changing.

For what I have done and been unable to do and am just on the verge of doing, I can loathe myself and I suspect – at some level, consciously or unconsciously – you loathe me.

I will never, ever be free again. Always, always, a part of my concentration – which I would so love to give to the fullness of the presence of you, to the dormant apple trees in the backyard of my new house, to the soft fur of my cute kitten – must be on not.