Staying Sober

A Brief Outline Of The 12 Steps — Step 5

This is the sixth in a series of posts in which we hope to acquaint our readers with some of the details surrounding the programs that we recommend. There are a variety of other programs, but because we and most other facilities shape our treatment plans around the 12 Step fellowships, those are the ones on which we will concentrate.

Step 5 reads, “Admitted to God, to ourselves and to another human being the exact nature of our wrongs.”

In recovery, we say that we’re as sick as our secrets. Each of us has things in our past that we believed that we could never tell another person. They are almost always related to shame.

Shame is not the same thing as guilt. Guilt is the knowledge that I have done a bad thing. Shame is the belief that I am a bad person. See the difference? “It was bad,” versus “I am bad.” That’s a huge difference! We can put guilt behind us with relative ease by making up for our actions in some way, but shame becomes a part of us.

If we’re cleaning the kitchen, we can take the garbage out to the dumpster or we can dump it in the closet. If we do that, eventually it will start to seep out under the door, and it will become impossible to enter the kitchen, let alone the closet. To get our kitchen in order, we must first clean out that closet — a job no one wants, but one that is essential. Recovery — the rest of our lives — is like that kitchen, and Step 5 is the primary tool for cleaning all that garbage out of the closet. It is probably safe to say that complete recovery is impossible unless we free ourselves of that burden, and the only way is to tell another person about it.

The power of confession has been known for many centuries. For a couple of millennia it was one of the mainstays of Christianity, and it still is in some parts of the church. Our modern version is therapy, and sometimes we do need to talk to professionals about these things, but it is amazing how much of the burden can be lifted by the simple act of telling our secrets.

By telling them to another addict, we can be sure that we’re not divulging anything that’s likely to be new to them, shock them, or make them think less of us. We all have those closets, and we all had to take out the trash. We all understand that we were good people who did bad things, not the other way around. When we share with others, we rob the secrets of their power over us.

Obviously, in order to do this we need someone we can trust. Some use a sponsor. Some use a person in the fellowship with whom they feel especially comfortable, but have no close ties. Some do use clergy. As far as the “admitted to God” part goes, that’s a matter of personal belief. If we are religious, we might want to offer up the experience to our higher power as a kind of prayer for forgiveness. If our personal philosophy doesn’t run that way, the process will still work.

The principle behind Step 5 is Integrity: honesty with ourselves, with others, and willingness to practice it even when we’d rather not — doing the next right thing, regardless of our fears. It’s scary. Along with Step 4, the Step 5 was a hard mountain to climb for all of us. But once over it — as every recovering person will tell you — the rest of the road is pretty much downhill.

What About People, Places and Things?

Q. How can you stay away from people, places and things when they are family or significant others?

Q. If my boyfriend drinks and does coke occasionally, what should I do about it?

These really translate into the same question: How much do I value my sobriety?

Let's first ask ourselves, why did we get sober? Why did we go to AA, NA, treatment, detox or whatever? Was it because we were having fun while we were using? Was it because our lives were completely under control? Was it because we could pick up a drink or a drug and then stop whenever we wanted to? Could we go into a bar, or to a party, hang with our friends, and choose whether or not we were going to get high?

If any of those answers were yes, then there's no need to worry about it. Why should we? Everything's great!

But if we got  clean because our life was in the toilet; if we were afraid we were going to die, or hurt someone else; if we got clean and sober because we couldn't stand the idea of continuing in the direction we were going, then if we want to remain clean we have to put that idea ahead of everything else in our life.  That doesn't mean we have to live in meetings forever, or that we can't ever have fun again, but it does mean that we may have to change the ways we deal with others, in order to protect our sobriety.

Those people who are able to do so will normally take pains to avoid things that might cause us problems. If they are unable to do that, or won't, the reasons don't matter. We can't change them; we can only make changes in ourselves, and the only sensible thing for us to do is to put our welfare first, and stay away from them.

There are family situations that are so uncomfortable for us, even if alcohol or other drugs are not involved, that we are emotionally unprepared to handle them in early sobriety. If our family drinks or uses drugs, if our friends hang out in bars or hit the restroom five times an evening, if our significant other drinks (and does coke occasionally), it's no business of ours. Our business is taking care of us, and if we believe there's a danger in those people, places and things, then we need to distance ourselves until the conditions change.  We can't take the chance unless we're willing to do the detox and treatment thing all over again — if we survive.

Even if we have children, we may need to stay away for a while. Those kids may need us, but if we can't remain clean they may never have us. Let's face it, we were absent even when we were with them. Isn't it worth a bit more time to help insure that we won't be leaving them again?

Stress is a primary cause of relapse. We need to avoid stressful situations until we are able to handle them.  We also know that just the sight of (or merely thinking about) drugs or alcohol can cause changes in our brain chemistry that cause cravings.  The sight of a guy standing on the corner where we used to cop, a bar where we used to drink — even the recliner where we used to collapse — can do the same thing.

The very fact of wondering about it is a pretty good indication that we aren't ready yet. As much treatment as we can afford, a stay in a halfway house or sober living facility, working at a low-stress job for a while — along with a lot of support from our peers — can better prepare us to go back to the “real world.”

If going home right now worries you — or even if it doesn't — it probably should.

Best Cities For Sober Living

“The Fix” has published a list of the 10 best cities for sober living in the US.  Guess who's number two…

Newly Sober? PAWS Still Has You In Its Claws!

We all know that most relapses occur in the first few months after we get clean and sober.  Many of them are related to Post-acute Withdrawal Syndrome.  We talked about PAWS in a previous post, but I wanted to go into it more specifically here.

Although there are differences in the way they act, all addictive drugs function by either stimulating or imitating the chemicals of the brain's reward system — giving us too much of a good thing.

In an attempt to return our brain chemistry to normal (homeostasis), the brain builds more receptor sites for those particular neurotransmitters.  This allows it to deal with the higher-than-normal levels, leading to tolerance: the need for more drugs to fill up the additional receptors so that we can continue to get high.

When we get clean and sober, those extra receptors clamoring to be filled up are what causes withdrawal: acute withdrawal while the drug is clearing out of our system, and post-acute withdrawal during the period when the brain is deactivating the extra receptor sites and returning to normal.  Some authorities believe that it never normalizes entirely, which may be why any use usually leads back to full-blown addiction.

There is a double-whammy effect, too. When the drug is removed, there is a “rebound.” We begin to experience many feelings and physical symptoms that are the opposite of the way the drugs made us feel.  Removal of the drugs' stimulation causes the production of the reward chemicals to drop to below normal, and they return to their pre-addiction levels slowly. During this period we may be antsy, anxious, depressed, manic, or combinations of those feelings. We may feel as though our recovery is hopeless, and that we might as well use.

That's PAWS.  The duration  varies depending on the drug(s) used and individual physical differences.  It can — but usually does not — last for up to two years.  Ordinarily it will peak and then slowly subside within the first few months.  During that period (and in most cases for the rest of our lives), use of addictive drugs can put us back on the merry-go-round quickly.  It will also prolong the period of PAWS.  It can even set us back completely, because it interferes with the brain's repairs.

So, in early recovery we need to be prepared for a prolonged period of slowly feeling better, with setbacks when our bodies need that additional bit of natural feel-good and don't get enough, usually when we are under stress.  Stress aggravates PAWS symptoms because the natural “drugs” that help us to cope aren't back to full strength yet.

The good news: it always gets better, slowly but surely.

The best medicine for Post-acute Withdrawal Syndrome is time, aided by mild exercise, good nutrition, rest, stress avoidance, and distractions.  We need to have some fun.  We need the support of people who know where we're coming from, and who know how to deal with people in early recovery.

That's why we recommend meetings, fellowship, halfway houses, long-term treatment, and some time away from the old grind and the old stresses.  They help us deal with PAWS, while we're getting into the habits that lead to long-term recovery.

As George Carlin used to say, “Just because the monkey is off your back, it doesn't mean the circus has left town.”

If you've had your own experiences with PAWS, how about sharing in the comments?  Questions?  Feel free!

In Recovery, How Do I Get People To Treat Me Normally?

How do we keep our family and friends from treating us like patients, or walking on eggshells around us, especially around times of celebrations?

First of all, we need to understand that they are doing it because they love us, and are trying to protect us.  It does seem as though they’re attempting to control us in subtle ways, and because we’re feeling something like normal for the first time in years, we want to be treated that way.

However, we need to remember that, to a great degree, we are responsible for those eggshells.  It is probably going to be a while before we can expect to be treated like a normal person.  We need to earn trust and respect by being trustworthy and respectable; we are not entitled to them just because we’ve been sober for a few weeks, or even months.  As the AA saying goes, “Don't expect a medal just because you're finally doing what you should have been doing.”

On their part, our families need to understand that hearing eggshells cracking all the time is irritating, and that the best thing they can do for us in early recovery is to try to treat us as normally as possible — apart from putting temptation in front of us.

That may be hard for them, though.  Remember that for however long we were using, they got used to treating us in certain ways.  Nowadays, our total reality has been turned inside-out, but theirs hasn’t changed much at all.  Change takes time, understanding and trust. Because they do love us and want us to succeed in our recovery, they naturally feel awkward around us because they don’t know what to do.  While that can be really annoying, it’s generally not all that hard to deal with.

We need to sit down with them, discuss our recovery, and honestly let them know how we feel.  If we’re not able to do that yet, we can write them a respectful letter.  If we're seeing a counselor, we can try to arrange a family session.  We need to tell them that while we appreciate their concern, we’d like them to try to relax and be themselves.  They need to know that we’re not going to head for the street or a bar just because someone mentions drinking, or refers to things that might remind us of the past.

We need to let them know that we don’t want to “forget the past, nor wish to shut the door on it,” and that we’ll be bringing it up ourselves from time to time.  They need to know that we don’t expect them to change their lives to accommodate us.

One of the things we can do is ask them to read this article.  Regarding the celebration issue, we can refer them to this article about parties that I publish every year around the Winter Holidays.  Finally, in the case of those who were most affected by our using, we can suggest that they consider a few Al-Anon or NarAnon meetings to learn a little more about living with people in recovery.

Most of all, we need to remember that these people love us.  They want to trust us.  They want us back in their lives.  They want what’s best for us.  They always have.  If we remember these things, and that they’re just doing the best they can — the same as us — it makes getting along a lot easier.

How Do I Deal With Old Relationships In Recovery?

The question of dealing with old friends, drinking buddies and family once we’re in recovery is one of the most vexing (and sometimes complicated) things about getting clean and sober.  How we handle it can be critical to our ability to avoid relapse.

Until we have learned new ways of dealing with pressure and old feelings, we need to keep them minimized.  That’s why professionals recommend treatment and halfway houses that are well away from our home turf.  Too many times they have seen what happens when people in early recovery try to deal with old relationships too soon.  Our continued sobriety is essential to our being able to deal with those issues and get our lives straightened out.  If we relapse, we will only make things worse and we’ll still have to deal with the mess when we get sober again, if we don’t die first.  So it comes down to common sense.

Old buddies who still use or booze — we just stay away from them.  Chances are we no longer have much in common anyway.  Later on — much, much later — maybe we can hang out if they aren’t drinking or using while they’re with us.  Otherwise, it needs to be sayonara.

Family members must understand that recovery comes first.  If they can’t understand that, get a little knowledge about recovery under their belts, and support our program, then we need to stay away until we have the skills to cope with them.

This is especially true of those people we perceive as having the most  power over us: parents, siblings, wives and children.  When it comes to family, we’re with the people who hard-wired our buttons and who can push them without even intending to.  These are the people who can arouse the old feelings, resentments, insecurities and emotions with a word or a look.  Those are powerful triggers, until we’ve learned to handle our own emotions and impulses.

Because we’re addicts, accustomed to short-term solutions to our difficulties (oblivion, after all, was always just a few minutes or drinks away), it’s hard for us to realize that the solution for some of our problems is time.  In the case of relationships, that sometimes includes time away from the problem.

This is not only hard for us to swallow, but often goes against the plans and expectations of the others involved.  Nonetheless, our recovery is paramount.  We have no chance of resolving old issues and improving relationships if we can’t stay clean and sober.  Getting back on the horse too soon, in this case, makes getting bucked off again a pretty sure thing.

I Don’t Need A Program, I Can Recover On My Own

One of the prime goals of treatment is to give us confidence in our ability to overcome our addiction.  We need to be careful, however, to insure that we’re not overconfident.  Confidence in our ability to work a program of recovery successfully is essential, but overconfidence is a free ticket back to where we came from.

Overconfidence is perfectly understandable.  After we get the alcohol and/or other drugs out of our system, get a little

Lonesome road to...what?

exercise, some rest and a few square meals under our belts, we’re probably going to feel better than we’ve felt in years.  We may begin to think, if we’re not careful, that we’re cured and ready to head back out into the “real world.”  At that point, the insistence of therapists and other staff that we need more time is likely to fall on at least partially deaf ears.  After all, don’t we know our own bodies?  Don’t we know how we feel?

Probably not.  We spent a long time interfering with the chemistry of our brains.  We changed our thinking, ethics and lifestyle to accommodate a life of living from one fix, one drink, one line to the next.  In many cases, if not most, we’ve never lived what most people would think of as a “normal” life.  The chances are very good that we don’t even remember what that is any more, if we ever knew.

So how do we know we’re ready to go out and live one?  Where’s the proof that we really do know how we feel and how to take care of our bodies and minds?  What experience have we really had?  It’s an absolute fact that the longer an addict/alcoholic stays in treatment, the greater are their chances of avoiding relapse.  That is not only a matter of learning, it’s a matter of giving ourselves a chance to practice healthy living in a safe environment.

Time in treatment is golden.  If we spend a month longer in house and avoid another few years of using — or death — isn’t that a good trade?  If we spend a few months in a halfway house while we hone our sober living skills with aftercare, meetings and slow movement back into mainstream society, isn’t that better than finding out that we really don’t have the skills and ability we thought we had — the hard way?

If we were going to climb Mt. Everest, we’d get in shape over a period of months.  We’d get a guide, follow his or her directions, buy the right equipment, learn the necessary skills, and finally work our way up to higher and higher altitudes gradually, so that we were sure that we were ready to head for the summit when the weather was right.

Why should we pay less attention to the rest of our lives?