The period of early recovery from substance use disorders is a difficult time because so many changes are being attempted at the same time. It can be overwhelming for a healthy person to take on too many sweeping changes at once, let alone someone who is in post-acute withdrawal from substance use.
Post-acute withdrawal symptoms include difficulty interacting with others, an inability to derive enjoyment from activities and others, depressed mood, agitation, shame and guilt, obsessive thinking, a focus on the negative, lack of concentration, challenges in problem solving, memory loss, emotional overreactions, sleep disturbance, clumsiness, increased sensitivity to stressors, anxiety, and other symptoms that generally impair one’s ability to function at full capacity.
Because the recovering person has made a genuine commitment to living life without mood altering addictive substances, they have also made a decision to change the way they interact with the world around them. A new set of coping skills must be developed in order to allow the recovering person to effectively deal with life circumstances without turning to the substances for escape or enhancement.
The path of lifestyle improvement that the recovering person has chosen is a difficult one, and it can take a very long time to progress. Because so much change is happening throughout the journey, especially at the beginning of the journey, the recovering person is also experiencing a great deal of pain in the form of uncertainty, anxiety, failure, and frustration in combination with success, accomplishment and self-awareness.
The emotional turmoil of early recovery is so significant that individuals want to get through it as quickly as possible in order to minimize the pain and overwhelm. Unfortunately, attempts to speed up the recovery process, and eradicate old addict behaviors once and for all, are not usually met with success. Substance use disorders take a long time to develop and are usually supported by behaviors that were developed in childhood conditioning. It only makes sense that it will take a long time to change these behaviors to something healthier.
It can be disappointing and demoralizing when a recovering person is trying very hard to change their behaviors and experiences results that are less than what they had expected. That is why managing realistic and reasonable expectations is so important in early recovery. Even with reasonable expectations there will still be times of setback which will require a change in plan.
When plans do have to change because of setbacks or circumstantial changes in life, the recovering person can once again experience disappointment and demoralization if not in a healthy mindset. This is where acceptance and patience begin to take a large and imminently important role in early recovery.
The frustration associated with struggling to change behaviors can be minimized if the recovering person can accept the simple truth that they must change in order to live a better lifestyle. This sounds simple, but it is quite difficult to thoroughly embed this idea into the mind of someone who is in post-acute withdrawal, especially when disappointments and setbacks occur. Quite often the individual will give up the effort, and justify giving up through self-pity and aggrandizing the previous lifestyle of substance use and acting out inappropriately.
During these times of distress, interventions designed to redirect the recovering person’s thoughts and energies into their original desire to life a healthy lifestyle of recovery are effective in bringing people back on track. Once again, acceptance and patience are key concepts for the recovering individual to embrace.
Acceptance comes in many forms, and the most fundamental requirements for lifestyle change include:
• Accepting the need for change
• Accepting there is no cure for addiction
• Accepting the need for long-term work investment
• Accepting the need for support
• Accepting a lifetime journey of change efforts
• Accepting a lack of control
• Accepting self-importance and humility simultaneously
The recovering person meets this need through the support and encouragement of those around them. Loved ones, clinicians, self-help fellowship, and community all play a part in supporting the recovery effort.
Regular recognition of the hard work the recovering person is producing can help to encourage staying on the difficult path of improvement. Even when setbacks and failures occur, encouragement needs to be focused on the successes and accomplishments to date. There is a phrase used in the rooms of 12 Step programs that exemplifies this type of support, “progress, not perfection.”
It can be especially difficult for loved ones because the recovering person may seek support from others. This is normal, and should be encouraged as well. There is a safety in receiving support through fellowship and community that is not present in close family relationships. Eventually the close family relationships will strengthen, and patience on the part of family members is required.
It is through patience and acceptance that the recovering person and the family can remain engaged in the recovery process and create a long-term healthy lifestyle of recovery.
By Andrew Martin, MBA, LAADC, SAP, CA-CCS