Creating a more approachable and desirable picture of recovery

By Dennis Kutzen

Like most of us on this forum, I started my journey in traditional AA and then came to secular for the absence of a higher power and stuck around for the openness.  I appreciated the ability to embrace change in approaches to recovery.  Five years ago, just before Covid, I helped found the West Bloomfield Secular Group.  We were a group of people, some agnostic/atheist, some believers, who just wanted to dispense with the rituals and repetition of meetings.  We wanted to talk about how to move on with our lives.  There were no rules, except no AA bashing and no god bashing.  Almost no AA bashing. Over the last five years we as a group have tried new ideas and new practices in our recovery.

Two years ago, with 14 years of sobriety, 10 years as a speaker at a treatment center, and 40 years of a now former career behind me, I was urged to pursue my masters in Social Work, and become a therapist with certifications in SUD treatment and trauma.  Through my schooling, and with clients (my internship was for 6 months at the facility) I began to formulate some ideas for making recovery more approachable and desirable.  These are all techniques backed up by peer-reviewed studies.  I am applying these to clients now in an attempt to chip away at the miserable success rate of people fighting addiction.

So full disclaimer:  yes, I’m just starting out as a licensed professional.  This is a lot of opinion, but it’s backed up by psychology. I offer them up as ideas for improving the odds of success.

Building an idealized future

For any change to happen, there needs to be a desirable and achievable goal.  It can’t just be the same life without the addiction. Sure, there will be less relationship problems, less health problems, less familiarity with the criminal justice system.  But what is the goal that makes quitting worth it?

Therapists will ask clients what is called the magic question. It’s a year from now, addiction is no longer part of your life.  What’s your life like?  What are you doing now that you weren’t before?  Not anything related to recovery.  Responses will inevitably be about pleasurable activities that had been given up, and things they’ve always wanted to do but never did.  This is the idealized future.  This is what makes it worth it.  One day at a time is great for getting through those rough first months, but if recovery is nothing but 90 in 90, reading literature, and doing a program, recovery becomes drudgery, and sobriety offers a second-best life. Without goals, there is no way to judge progress.

Understanding why we use

We don’t use because we are alcoholics/addicts.  We progress to the point of addiction because we use.  We use because we want to numb or escape from thoughts and feelings we don’t like.  Anxiety, fear, anger, depression. This goes for substance and behavioral use like gambling and food.  And it works, usually really well. But over time, the negative baggage that comes along with using becomes unsustainable.  But just quitting alone still leaves us with the feelings. Essential to overcoming addictive behaviors is identifying the feelings that make us want to use and finding healthier coping skills to deal with those feelings. Identifying your personal shortcomings is not going to do this.  If someone has significant trauma, it would be best to treat that directly.  For most people, the problem that causes the feelings doesn’t need to be solved, it just needs a different coping skill than using.

Stop, or limit talk about “the disease”

Yes, the AMA declared alcoholism a disease in 1956, and the APA made addiction a mental health disorder in 1980.  My issue with this is not that it’s a disease/disorder, it’s how “the disease” is misunderstood and talked about.  “I was born an alcoholic, and I’ll die as one”.  Sorry, the biology doesn’t support that.  Yes, there are genetics involved, but genetics alone cannot make someone use or keep someone using.  You still have to have a reason to start and keep using while the negative consequences add up.  And that is environment. Poverty, violence, parents who use or have mental health issues, bullying…all these factors and dozens more create feelings that beg to be self-medicated.  And then the genetics can make moderating difficult. Genetic pre-disposition without an environmental influence will not cause addiction, but severe environmental issues alone can.

The reason to at least de-emphasize the disease is the emotional damage it does.  In very early sobriety, adopting the idea of having a disease can help alleviate guilt and shame.  But as one begins to move on, studies show that people in recovery reject the idea of a life-long disease as something that makes them different or ‘less than’.  The “disease” is diagnosed by the presence of symptoms, so if someone is no longer satisfying the criteria for diagnosis, how are they diseased?  Are they in remission? What exactly is it that is in remission.  The loss of brain tissue and the restructuring of the dopamine reward pathway (the actual disease) will return to normal within 12 months for most people.  So why would we carry this burden of the label?

In our secular group, we made identifying ourselves as addicts/alcoholics optional.  This is something that I do with clients as well.  We want people to know that this is not how they will define themselves in the future.  Again, part of the idealized future.  This is incredibly empowering. We’ve had people say that if we don’t say it, we’ll forget.  Anyone think that will happen?

De-stigmatize relapse.

Completely.  Totally.  It’s going to happen.  For any personal change, losing weight, quitting smoking, changing careers, there are stages of change. Bottom line, people are ready when they are ready, and no amount of berating, encouragement, or going to meetings is going to make someone change if they aren’t ready.  Our job as supportive people in recovery is to empower people, help them visualize a future worth working toward, and give them the skills they need so when they are ready, they can succeed.  This is why we need to normalize relapse.  Working at a rehab, I see clients back for the fifth and sixth time frequently.  They bring enough guilt and hopelessness on their own.  They don’t need it from anyone else.  They just aren’t ready yet. If they understand that we are simply trying to get them closer to change, they are more encouraged to keep trying.  Therapist working with SUD clients try to move them to the next stage of change, even if that is short of abstinence. If this isn’t the time, we want their next bout of using to be shorter and less severe.

Every group says that they welcome people back with open arms.  But we all know how that feels.  Not wanting to face your group or start counting days from 1 is an easy reason to not come back.  When it’s seen as just part of their process, people feel that they are still participating in their progress and not failing.  It is vital to emphasize that a relapse or slip is not starting over.  You have all the knowledge and skills you learned up to that point.  Now just address the weak points.

Empower.  Empower.  Empower.

In order for people to change, and sustain that change, they must know that they have the ability and power to create that change.  Asking for help is essential, but it’s the individual themselves that does the work.  This seems obvious.  However, repeated messaging like surrender, no control, the futility of will power, daily reprieve, and over-dependance on others (like sponsors) for decision making is the adult equivalent of a parent telling a child that they will never amount to anything.  Eventually, the person begins to incorporate that as truth.  Sure, none of those concepts are completely untrue, but being repeated without context beats down peoples’ self-image.  Many, if not most people with addictive behaviors have issues with self-esteem.  There is no chance of a person sustaining a difficult change in behavior if they don’t think they deserve it.  “We’ll love you until you love yourself” means nothing to a newcomer.

Empowering means reinforcing that addiction is not a lifelong struggle.  The person just currently lacks the skills they need to cope in a healthy manner.  The disease is not out in the parking lot doing pushups. Promote the idea that having an addiction is just one facet of a person who has many, many other strengths.  When we come to recovery, we think we are nothing but an addict.  We can still be intelligent, caring, creative, loving, loyal, etc.  I show clients a list of 30 personal strengths and ask them how many they feel they have.  Most people will pick out at least 20.  I then point out that addiction doesn’t erase their other strengths, and those strengths are what is going to help them succeed.  They are not defined by addiction. That’s empowerment. That rebuilds self-esteem.

Early sobriety sucks.  There’s no way around it.  But people need to know that the things they need to do to get through their first 90 days, 6 months or a year have nothing to do with what the rest of their lives will be like.  The point of recovery is to get this behind you and move on with your life.  The brain heals, the person changes. Life becomes whatever you want it to be.

The big finish

Without a doubt, there’s nothing I’ve written here that couldn’t eventually be learned in most rooms given enough time.  Most people drop out of recovery early, or don’t try at all, because they can’t see themselves in a future that they would want. Why not promote these concepts right from the beginning, in plain language? SMART is way ahead of the game.  Addiction recovery rates are so dismal because we don’t appreciate that in order to move people to the stage of readiness, they have to see a sober life as desirable, not just necessary.  If we can start to build that idealized future, remove stigma of relapse and change our language to empower the newcomer, maybe more will stay with it.

Dennis Kutzen is a newly minted LLMSW, CAADC-DP therapist working at an in-patient SUD treatment facility. He continues to manage the West Bloomfield Secular Recovery Group on zoom twice a week.  He has 15 years of sobriety.

For a PDF of today’s article, click here: Creating a more approachable and desirable picture of recovery.