Addiction Alcoholism Treatment

Why Treatment? Why Meetings? Isn’t Family Enough Support?

This is the thirteenth 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 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.

People in early recovery sometimes face resistance from family and significant others. It often takes the form of questions like, “You have us for support; why do you need those meetings? Aren’t we enough?” Another approach (that addicts often ask themselves) is “You’ve spent all that time away from us, and before that you neglected us. Isn’t it time you suited up and made up for all the time you missed and the ways we needed you?”

The reality is that we can’t “make up for” anything. All we can do is try to keep it from happening again, and live the rest of our lives looking forward, not backward. But those are perfectly reasonable questions from loved ones who don’t understand the dynamics of addiction and recovery. They’ve been neglected, emotionally deprived and abused. They’ve spent uncounted hours worrying about someone vitally important to them, their addict has cost them much pain, and they’ve paid a huge price in a variety of other ways.

Now their loved one tells them that they’ll be going to treatment, living in a halfway house, going to meetings, and perhaps staying in another part of the country for months. They feel disappointed, angry, rejected, taken advantage of once again — but mostly rejected. The person they thought was going to be returning to them has other ideas. Why does the addict need other people? They know her best, what better support could she need?

The answer is completely summed up in the previous sentence: “They know her best….” The people who know us best are almost never the best supports — at least in the beginning. Why? Too much emotional static. Too many recent hurts. Too many old resentments. Too many habitual ways of reacting to each other. In short, too much history.

We talk about folks “pushing each other’s buttons.” Our families and friends are the people who hard-wired our buttons, and we wired theirs. We can play symphonies on one another’s buttons, and we do — through habit, through anger, through frustration, through simple thoughtlessness. We know how to get under each other’s skin, and the closer we are, the easier it is.

These are dangerous waters for people in early recovery, because the buttons that urge us to take a drink or have some other drug are hard-wired as well. Research has shown that a picture of a guy standing on a street corner can trigger the urge to use in a crack addict. Just a photo of a guy who may have some drugs to sell! Other research has shown the same responses to liquor stores, places where the addict drank or used, pictures of drug paraphernalia, and so forth. Addicts in early recovery have not learned the skills that allow them to deflect these urges and bypass these temptations.

It’s been just short of 20 years since I used tobacco. A couple of months ago, during a routine but stressful, situation, I found myself patting my shirt pocket where the pack of cigarettes used to reside. I had to laugh at myself. It’s been a long time, I have healthy habits that kick in in those sorts of situations, and I understand the psychological and physical responses that lead to reactions like that, but would I have lit up if there had been a pack there? I don’t think so, but I’m not going to start carrying one around to find out.

Stress, in its various forms, is a major cause of relapse. Addicts who have relapsed and survived tell us that those are the sorts of situations that triggered their use. Not great tragedies, but the little things: the everyday tensions, marital spats, seeing friends drink or use other drugs, driving through the old neighborhood. These things trigger our addictions because they are familiar solutions, and we don’t yet have other habits to replace the old stuff. It takes years to get rid of those unexpected urges (or to learn to laugh at our addict thinking and ignore them). While we’re learning, stress is not our friend. And who/what are the best things to trigger stress in a newly-recovering person? Old “people, places and things.”

Treatment, halfway houses and meetings are places where we are accepted unconditionally, without regard to what we have done in the past, but with support for what we are trying to accomplish in the present. There we are surrounded by people who have slogged many long miles in our shoes. We are safe there, free of the old triggers, while we slowly learn the new habits of sobriety that will replace the deeply-ingrained habits of addiction. Families can help by understanding this, and by the willingness to delay their wants a little bit longer. That will help improve the chances that their addict will return to them for for the long run, not just until the next run.

Geographic Cures and Denial

Q. I've heard people at meetings refer to “geographicals,” or “geographical cures.” What's that about?

Hand-drawn map of North America, 1811 -- Library of Congress, Geography and Map Division

A geographical cure is an attempt to avoid the reality of our addiction by changing location.  They are a form of denial, a defense mechanism in which we are faced with a fact that is too uncomfortable to accept and so we convince ourselves that it is not true despite what may be overwhelming evidence.

Excuses are a major form of denial. We learn their usefulness as small children: “She hit me first!” We usually grow out of that phase, but for addicts the need to make excuses and convince ourselves and others that we're really okay is our way of protecting the addiction. We say things like, “If you were married to that bitch,” or “If you'd seen the things I've seen…,” all of which, we have convinced ourselves, justify our drinking, drugging or whatever we may prefer not to look at too closely. (If we did, we might have to do something about it.)

So, when things get rough, we sometimes convince ourselves that all we need is a fresh start in a new place, and we'll be able to get our lives back under control. However, unless our geographical cure has also involved detox, treatment and a program of recovery, we discover that it doesn't take long for the things that we thought we'd left behind to hop out of the trees and right onto our backs again.

We failed to consider one of life's major truths: No Matter Where You Go, There You Are!  We need to change our way of living, not where we live.

Hitting the road doesn't solve our problems, it just means that we have to face them in a strange place, among strangers.  If, however, we decide to get out of the old neighborhood and get some help, that's not necessarily such a bad idea.