Scott - Aftercare

Understanding addiction is part of my therapy as a survivor of childhood sexual abuse. Most survivors, including myself, have addictive behaviors to shield us from the demons of our trauma. Some of us are addicts. This the last of a four part story about two men fighting to overcome their addictions, fighting for their lives.

The Men

Let’s return to our climbers. They were isolated by their trauma and had been obsessively rock climbing and using recreational drugs to dull their emotional pain. After ninety days of treatment in a closed facility they are ready to rejoin the real world; detoxified, no longer alone, bolstered by a recovery team, and armed with new skills to manage conflict and disappointment.

The younger man returns home to live with his wife and children. With no job and no climbing he doesn’t know what to do with himself. He tries to talk to his wife about treatment and the lessons he is learning but she doesn’t really understand why he is unable to support the family and why he is so emotionally distant. She tries to suppress her feelings but cannot. She is deeply wounded that he abandons her to do whatever he wants, even selfishly meeting his own needs in treatment rather than taking responsibility for his family. He acknowledges his mistakes and leaves the house to call his sponsor.

The younger man’s family fails to attend treatment of their own, or to learn how to support him without enabling his addictive behavior. He really wants to remain sober, but while feeling more in control of his life during treatment, now, at home, he feels powerless again. Everyone expects him to get a job. He tries, but the prospects are few, and he finally settles for a part time job as a stock boy in a local supermarket.

The older man also returns home. He asks his wife and his children for forgiveness for all the harm he has done to them over the years and expresses an earnest desire to start over, to become the man he should already have been. They talk long into the night with many tears of sorrow and of joy. He promises to let his wife know what he is doing all the time, but sets limits. He will answer any of her questions but not give details that might hurt other people. If he thinks that answers to her questions might be hurtful to his wife or family, he will warn her, but tell her anyway if she insists. His feelings are not fully regulated and his trauma not fully processed. He is beginning to learn how to conduct healthy relationships.

The older man decides to attend twelve step meetings, alcoholics anonymous or narcotics anonymous or whatever is available each day for the next ninety days. He knows that he cannot change without help and he resolves that he will also talk to someone on his recovery team daily. He also starts attending church again, with his family. His wife regularly drives him to the VA Hospital in the next town for therapy for post traumatic stress disorder. His new church family pays some of his expenses since he is not working.

The two men meet weekly at a coffee shop. The younger man is bored and unhappy. He’s does not like sobriety and talks continually about the climbs they have made together. The older man invites his friend to come to twelve step meetings with him. There are meetings throughout the day, every day of the week. The younger man jokes that there are no twelve step programs for climbers and anyway he is already anonymous. The older man invites his friend to church meetings, but the younger man is too tired and doesn’t see why his life needs to be regimented. He complains about his sponsor, about his wife who doesn’t understand him, about his family who seems so distant and unsupportive. Over the coming weeks the younger man stops coming to the coffee shop.

The younger man loses his job. He is absent without explanation too many times and is less than diligent in his work. It becomes known that he is climbing again, this time with teenage friends, using little or no equipment. He becomes something of a climbing guru, a celebrity in a shadowy group on the edges of society. He tells stories, some of them true and all of them embellished to increase his stature. When he is unable to prove his claims about his climbing prowess, the teenage climbers begin to drift away from him.

When confronted by his family, the younger man is sullen and angrier than before, but agrees to enter treatment a second time. After treatment he returns to live in an apartment with a girlfriend from years past. He still does not embrace his recovery program.

The older man relapses several times, once spending days in hospital for injuries from a fall from the roof of his house. He calls his sponsor while high on recreational drugs, and breaks down on the phone and cries in deep shame. Confessing his mistakes to his wife and to his recovery team, each time the man immediately restarts his sobriety. He decides that the next time his recovery team and friends at twelve step meetings ask where has been for so long, he will recognize the danger sign of immanent relapse. Gradually he begins to identify the feelings which previously lead to addictive behaviors, before he indulges. He decides to continue attending twelve step programs, at least weekly. The man’s restoration is becoming deeply rooted in his life, and he is reconciled with his wife, his family, his friends, his church, and his God. He is deeply grateful that he still has an increasingly healthy relationship with his wife and children, and especially with his teenage daughter whom he adores. Over time he finds a job, which although low paying provides personal satisfaction. The man begins to think about the future, especially how he might be able to help other hurting men.

The younger man is still rootless, following a recurrent pattern of intervention, treatment, brief sobriety, and extended relapse. He still blames everyone and everything around him for his problems, complaining about all the unhappiness that life throws at him. When he thinks of the future, which he does rarely, it is with fear and resignation.

While it is difficult to be certain from this brief accounting whether the two men were addicts, all indications suggest they were. Confronted with serious negative consequences, with poverty, with estrangement from family, with the real danger of death, they continued their addictive behaviors for many years and even after treatment they relapsed repeatedly. After resolving guilt and shame from past trauma, after working through post traumatic stress it might be possible for the men to climb again without succumbing to obsession. But it would be unwise for them to risk playing with their addictive behaviors and is no different from a sober alcoholic trying to drink just one bottle of beer. The subconscious drive to climb, fueled by memory of a flood of endorphins in their brains, will forever be part of their lives. If the men had addictive behaviors but were not true addicts, it is more likely that they would have been deterred by the danger of their behaviors long before the first intervention.

If both men are both addicts, why was only one successful in recovery?

First, do not assume that the younger man was doomed. His story is unfinished. It takes addicts an average of eight detoxifications and treatments to achieve and maintain lasting sobriety. Second, do not assume that the older man’s greatest battles with addiction were behind him. His story was also not fully written and will not end with his passage from this life. The stories of both men, of addiction, of treatment, of restoration, of relapse, of ultimate success or failure, are inevitably part of a legacy for their children and generations unborn.

Recovery demands that the addict to take responsibility for his life. Those with addictive behaviors, whether addicts or not, typically allow life to pass them by. Addicts and abusers usually react to circumstances rather than initiate. Abraham Maslow wrote,

“I can feel guilty about the past, apprehensive about the future, but only in the present can I act. The ability to be in the present moment is a major component of mental wellness.”

When focused on unresolved past trauma or focused on a fearsome future, we allow our subconscious to control behavior. Our subconscious reacts but cannot consider, cannot make reasoned choices. A traumatized or chemically altered subconscious makes false associations, like between addictive behaviors and survival. Addictive behaviors, which artificially moderate moods, prevent normal and appropriate resolution of conflict and disappointment, and literally retard our emotional development. Even when the addictive fog lifts, lacking the skills for living addicts will naturally fear the future.

How then can we live in the present moment?

We can apply lessons of the past in the present, we can prepare for the future in the present, but we cannot recover alone. Our addictive behaviors isolate us and our lack of skills for living disconnect us from family and friends. We desperately need reconciliation. While trauma, unhealthy relationships, and addictive behaviors have damaged us, it is healthy relationships and joy that will restore us. It is becoming connected to a community and seizing a hope and a future that will offer complete recovery.

It was the deliberate, intentional choices, and the actions of the older climber that set him firmly on the path of restoration and lasting recovery. He practiced new life skills, asking forgiveness, acknowledging thankfulness, establishing boundaries, accepting accountability, being honest and transparent especially with his wife. He acted, making recovery his priority, choosing to regularly attend twelve step meetings, expanding his relationships within church, getting right back to recovery following relapses. As he learned to resolve conflict and disappointment without resorting to addictive behaviors, he began to expect a happier future.

Recovery is not exclusively the responsibility of the addict. The community also bears a burden because healthy relationships do not flow in one direction. Partnership requires give and take. It is sad that the younger man’s family failed to live up to their commitment to treatment, to learning how to support a recovering addict without enabling addictive behaviors. But if an addict returns to an unchanged environment there is enormous pressure on him to also return to addictive behaviors. Perhaps the younger man’s old girlfriend was an enabler who did not assist his sobriety and recovery, but his decision not to return to his family might actually have be wise and necessary.

Society does not treat addicts kindly. There is a stigma attached to addiction, and even more for misdemeanor and felony convictions that may result. The battle over whether addiction is a disease, and beyond the addict’s control, rages within the mental health community. Imagine a similar battle about whether someone can choose not to develop a rash from poison ivy. You can avoid contact with poison ivy, but even with heightened vigilance sooner or later you it will find you. Similarly an addict can avoid opportunities for addictive behaviors, can seek treatment when he stumbles, but he cannot travel the path of sobriety and restoration without companions to pull him back from the brink of relapse.

Even within the recovery community there are fewer twelve step groups for addictive behaviors than for addictive substances, and still fewer support groups for various underlying traumas. Trauma and addiction are as old as mankind but society only recently seems to just emerging from the dark ages, just beginning to understand the nature of addiction and to design appropriate and effective treatments. Twelve step programs have been available less than a hundred years. Post traumatic stress disorder has been explored since the First World War. Serious study of sexual trauma has only been growing for about two decades.

What is a recovering addict to do? Recover sobriety, resolve personal trauma, and shape a healthy future for those that follow. This path is available to every addict irrespective of his faith, but without God I believe that recovery is empty, that reconciliation is incomplete, that the future is joyless. With God we can become fully actualized, and build a future of breath taking freedom and exquisite joy.

Aftercare