Long-term recovery: lay demons to rest
By David Smallwood
Giving up booze or drugs is only the first step. Recovery in the long term is about learning to live comfortably and contentedly in a manner that’s sober and clean. David Smallwood shares his therapeutic skills and experience
Recovery in the long term is about achieving a healthy state of mind in which we feel at ease with ourselves. We need to let go of trying to manipulate and control everything around us, and instead learn to go with the flow of life in an ordered and sensible way. It involves letting go of our feelings of being ‘less than’ or ‘greater than’ other people. We need to understand that no human being is perfect and we must learn to live with character defects without letting them dominate us.
We might need to constantly re-examine our relationships with others, or ask ourselves if we are contended in our job and our day-to-day activities. If we need to make changes, we should not rush at them head first, but instead take things step by step.
I advise clients to be aware of their dreams and aspirations for the future. Surprisingly few addicts have goals in life, which is stressful in itself. We need to ask what we want out of life and examine what we think will make us truly at ease with ourselves. Our default is to return to the addictive process. The success of our recovery is dependent of changing these settings.
One thing I encourage clients to do is visit a big bookstore and spend an hour wandering round and making a note of anything that catches their eye. This often throws up clues about where their interests lie.
In recovery, you might have to face things about yourself that come as a surprise, or even a shock. The long term requires self-evaluation and honesty. In my case, for example, it was coming to terms relatively late in life about my sexuality. It was a long time before I could be completely honest with myself.
One of the most vital ways of helping to maintain our recovery is to continue to participate in a 12-step programme. I have been clean and sober for 26 years, with that support.
UNLOCKING CHILDHOOD TRAUMA
In many cases, a 12-step programme alone might not be enough to help an addict achieve true contentment. This is particularly the case if they have experienced a high degree of trauma during their childhood. In my experience as a therapist, unresolved childhood trauma is the biggest factor in causing relapses among recovering addicts.
In cases like this, I recommend seeking professional help, such as trauma reduction programmes. This is a way of exploring childhood issues and learning to let go of them through therapy and discussion. In my opinion, most addicts suffer from the codependency that childhood trauma creates, and it can continue to cause emotional distress even though they are no longer involved in addictive processes.
In addition to trauma-reduction programmes, some therapists help addicts overcome problems via EMDR: eye movement desensitisation and reprocessing. EMDR is a way of processing distress that we can feel due to a past trauma, so that it reduces and no longer has the same hold over us. It involves a patient focusing their eyes on a bright light that moves from side to side across a device called a light bar. Experts are divided on exactly how it works, but I can vouch for its success in about 60% of the cases in which I used it.
LIVING WITH SENSITIVITY
We never lose our oversensitivity to emotional distress so must learn to live with it in a positive manner. If we react disproportionately to something, it helps to link it to a similar experience in early life which triggered this emotional response. In later recovery, even if we cannot remember the early-life incident, it helps to know that disproportionate emotional responses can lie in the past not in the present event.
When you have been in recovery for a long time, it is easy to think that you are ‘cured’ – but an addict is never fully cured. The good news is that addiction does not have to be progressive or fatal. We can arrest its progress. This means paying attention to all the basic things that we learn in early recovery, like attention to diet, exercise and rest. If we look after our bodies, the mind will feel the benefits.
THE ROAD TO RELAPSE
One misconception about relapses is that they can occur at any time, out of the blue. This might seem to be the case when viewed by an outsider. But relapse is a process that begins long before someone picks up a drink or drug.
Terence Gorski is a pioneer in researching relapse prevention. He has concluded that there are multiple stages in a relapse which begin with seemingly innocuous events such as a change in an addict’s daily routine. By being mindful of warning signals, we can be on guard. Are our relationships with others starting to struggle? Have we become obsessed by the acquisition of sex, money or certain types of food?
In long-term recovery, we also need to be mindful of building resentments against others. This covers a range of negative mental states, such as when we blame the way we are feeling on others, or when we can’t be bothered putting time and effort into the recovery process by attending self-help meetings or practicing their suggestions. It is important to remember that, even in long-term recovery, addicts have a shame sack; the best way to avoid creating new feelings of shame is to lead an open and honest lifestyle.
VALUES VS ACTIONS
One way of avoiding feelings of guilt and shame is to ensure that our actions in life are in harmony with our personal values. Of course, moral viewpoints can differ from person to person, but most of us have an inherent sense of right and wrong. When our actions conflict with our values, it causes discord that leads us to feel pain and shame, which in turn can lead to relapse. If any part of your life involves actions that offend your values, you need to change one or the other. Usually, this involves changing our behaviour but this is not always the case: we might hold values that we inherited from others that we don’t believe in.
RELAPSE: THE DANGER SIGNALS
The key to a contented recovery is continuing to get the basic things in life right. Below are some practical headings:
• negative moods
• complacency about your recovery
• relationships – seek professional help if in stress
• healthy eating
• stress and anxiety
• anger and irritability.
By this I mean that we are at peace with ourselves and the rest of the world. It does not mean being in a state of euphoria, but about feeling OK in spite of the stresses and strains that we might have to go through.
BE KIND TO YOURSELF
Addicts are notorious for being perfectionists and highly self-critical. Recovery is a voyage of self-discovery. We seek progress rather than perfection. A large part of enjoying a successful recovery is learning to avoid black-and-white thinking, good or bad. Real life is rarely as clear cut as this.
Instead of being consumed by anger and resentment, we need to look for the good in other people and be willing to give them the benefit of the doubt. We need to reconnect with the rest of the human race.
Today I have learned to accept that there are things in the world that I don’t agree with. Acceptance of who we are and acceptance of our limitations can play a very positive role in long-term recovery. It is the key to finding true serenity.
DAVID SMALLWOOD has been working in the recovery field for 16 years, originally training at Promis, returning later as outpatient treatment director. For 10 years, he was addictions treatment manager at Priory Hospital, North London, and is now treatment director at One40. He has had a private practice in London for over 10 years. David has been in recovery for 26 years.