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Roads to #Addiction #Recovery – Here we go again!

Nooo… spare me from these incessant arguments…enough already!

signpostsMostly by necessity of continued professional development but also, due to a personal interest in the topic, I follow many forums on addiction within social-media. I also read science and opinion based articles and view numerous presentations and talks on the subject. For anyone with even a passing interest in our society, psychology and why people do what they do in general, it is fascinating. That said, I also find it so bloody frustrating sometimes.

I can soak up and even understand most of the science, I can accept any logical argument, even if I don’t particularly agree with it however; what I get almost incandescent about is the associated levels of pedantic authoritarian dogma that surround the subject, especially if/when it displays or promotes any form of ‘tribal’ or spiritual superiority.

Add to this overt commercialism in addictions rehabilitation treatment, particularly in the USA, and I’m about fit to blow a fuse. From an ethical viewpoint alone, helping and supporting others should never ever be about how much money you can make from that process. That said, I can fully understand where most of that thought process and current working practices have evolved from. But this is by no means a new phenomenon.

Addiction has long been deeply misunderstood in both our culture and clinical practice. Rather than being a reflection of impulsivity or self-destructiveness, or a result of genetic or physical factors, addiction can be shown to be a psychological mechanism that is a subset of psychological compulsions in general. (Dr. Lance M. Dodes)

In a 2015 interview with the Tom Woods show in America, Dr. Lance Dodes, a retired professor of psychiatry at Harvard Medical School, accurately and academically dissected the “bad science” behind the [American] “rehab” industry and 12-step programs, which have in his words “miserable success rates” (see below).

With so much cash floating around in the ‘recovery business’ it stands to reason that skewed beliefs can and do develop, particularly in America. As my brother often points out, when you want to understand why something is what it is, “follow the money trail” to discover the answer… simplistic but sadly often correct.

Also, with an increasingly secular and diverse society of spiritual belief, there are also connected and raised passions around the non-financial ‘value’ of differing pathways, if only to promote and protect personal beliefs as well as the monetary incomes. But when you add career aspirations and income generation to personal beliefs, recovery pathways will continue to get ever more muddied, emotive, in addition to being littered with ‘new’ and ‘exciting’ methods. People will always try to defend that which they hold dear, be it right or wrong. This is a fundamental reason why people must be afforded the option of individual and informed choice.

What It’s Like to Go to SMART Recovery After Eight Years in AA (August 2015): I never wanted to go to AA, even when I needed it. After doing a bit of research when a private doc suggested it eight years ago, I decided it wasn’t for me. The steps upset me, the prayers upset me, and the group itself was a bit too smothering at first. But I had no idea that other recovery programs existed. Not one medical professional or therapist knew of any other means to get sober outside of AA. (Tracy Chabala)

OK, that’s several years ago now, but it’s still a far too prevalent view  in the industry. Claudia Christian,  a successful actress who saw her personal life and career tested by addiction, explained her journey of recovery from alcoholism, whilst offering “fresh perspectives” on so-called alcohol use disorder treatments… I say ‘so-called’ because I don’t actually personally subscribe to the disease model often associated with addictions and recovery. To my mind, it’s simply another means of labelling individuals, again mostly due to financial and/or medically statistical reasoning.

In addictions recovery, as the above tends to show, there is always something new coming along and rightly so. The difficulty is identifying the ‘Snake Oil’ salesmen and women. But as we better understand something, surely it follows that we should try different methods for dealing with it? Reliance upon solely historical reasoning, although sometimes relevant, is often fraught with perverse outcomes.

“We can’t solve problems by using the same kind of thinking we used when we created them.” – Albert Einstein

Indeed, new thinking based upon scientifically evidenced results was how SMART Recovery originally came into being, mostly to the dismay and angst of many of those following more traditional and historically accepted pathways. To my mind, the word ‘different’ doesn’t always mean ‘better’ however; when it at least appears to be, surely burying your head in the sand and denying that fact must be counterproductive at best, and a Luddite mentality at worst?

There is rightly a common factor across addiction recovery, especially amongst those who have achieved their goal; people reaching that point in their life are often passionate about both the results and the pathway that got them there. That in itself isn’t a bad thing but it can also promote and fuel the mistaken belief; “my recovery is better than yours” sadly. This is another major part of why we witness the constant bickering from some quarters… irrespective of all the monetary considerations. These are all factors that also tend to galvanise that inherent ‘cult status’ view associated with so many aspects of mutual-aid, not least the 12-step fellowships approach.

That is sad but also worrying, because it can and does aids the possibility of impropriety or even worse. That predominant secretive ethos involved in some forms of mutual-aid can be a pressure cooker for the proliferation of seedy and dangerous individuals, the type of individuals that vulnerable people actually need protection from. This unsavoury aspect of mutual-aid has been succinctly identified and evidenced by Monica Richardson in her widely acclaimed film The 13th Step (see below), as part of her Leaving AA campaign.

But even with these worrying and shocking observations outlined and ‘evidenced’ in the film, many people were also quick to dismiss the production almost out of hand. Many followers of the 12-Steps were expectedly and vociferously critical of Monica’s work…when under siege, often the best forms of defence is attack.

But even those who tried to present a balanced and informed approach to critique – Debunking The 13th Step Movie (Danielle Stewart) – tended to fall into the trap of dismissing Monica as a disgruntled ‘non-believer’ who had “failed the programme” because she was no longer abstinent. Obviously that would make anyone ‘anti-12-steps’ wouldn’t it?

More evidence to support the ‘cult’ status belief that many hold – anything other than total lifelong commitment to the fellowship and sobriety delivered by adherence to the 12-steps is failure. That is wrong for more than one reason. Firstly, it is wrong to form that stereotype but also, it is wrong to say that failure to adhere and comply is in some way a personal failure… that is wholly dependant upon the ultimate goal of the individual.

Arguably, recovery from substance addiction may ultimately result in total abstinence for many but also, moderation and temperance can also be a choice for some. When that choice doesn’t result in problematic outcomes for the individual concerned, their family or our wider society, who has the right to try to control or influence that personal choice? I would argue, nobody.

The Fix – Reworking the 13th Step: What do you get when you sober up a drunk horse thief? A sober horse thief. AA is slowly making me less of an asshole but everybody is not so lucky. I’ve met some wonderful people in AA and I’ve also met some sociopathic predators. This film is a chilling reminder that just because somebody is “sober” doesn’t mean they are a “good person.” (Amy Dresner)

As can be seen above, there were also some who whilst being critical of AA, still found benefit from their engagement with that form of mutual-aid. This has to be the way forward; speak as you find, don’t ever accept the stereotypical assumptions made by others and most importantly, after make your own informed choice, take all possible measure to insure you remain safe.

There are also numerous professionals, along with individuals who have realised their own recovery who truly believe and display the fact… it is possible to actually recover and graduate from the recovery journey… and rightly so.

Over time I have realised that many people move away from formal recovery groups and if they have dealt with the problems in their life that drove their addictions, they can do well. I have discovered many other types of support including Smart Recovery which uses similar CBT techniques to the ones I was taught by my therapist, which really helped me once I had a bit of sober time. (Recovering from Recovery)

Many involved with recovery, not least those who have it (unhealthily) ingrained in their personal and professional life, often to the total exclusion of any other social or commercial interaction, will understandably feel uncomfortable when they try to distance themselves from their membership of the recovery social-club. It is after all, mostly an exciting and pleasant aspect of newfound social inclusion for so many. People who may well have not experienced any form of inclusion in their past.

With the condemnation of the film, or indeed 12-steps fellowships featured within it, if you view the film or the arguments without greater understanding of all the factors involved here; there is also a great danger that all forms of mutual-aid will get tarred with the same brush of opinionated stereotypical viewpoints.

Like those first days on the road to recovery, once you’ve found your prefered route at that crossroads in your life, there are actually still more junctions to negotiate… not least the turn at the end of your road… if you choose to take it? There is life after your journey and graduation from the recovery treadmill if you want it. Yes, some may be a little anxious about the option, even find it far too daunting to even contemplate but, as with that original choice, you never know what will happen unless you try.

Unfortunately, whilst our society (particularly in America) holds this unhealthy love affair with cash within a commercial business model of addictions treatment and recovery, coupled with the bigoted views about other people’s spirituality (or lack of it), there will continue to be many negative impacts upon effective and ethical delivery of ‘recovery’ programmes. If you are one of those individuals in need of that type of support, try to ensure you’re afforded the opportunity to make real and informed choice. And importantly, whilst staying safe, never be afraid to move on from the process once you have achieved your goal.

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