Four Key Ingredients to Successful Recovery from Alcoholism
A. Tom Horvath, Ph.D., ABPP, Kaushik Misra, Ph.D., Amy K. Epner, Ph.D., and Galen Morgan Cooper, Ph.D. , edited by C. E. Zupanick, Psy.D.
Each person must ultimately determine his or her own recovery path. It may be helpful to know that every successful recovery effort includes four key ingredients. These are:
1. Humility 2. Motivation 3. Sustained Effort 4. Restoration of life's meaning and purpose
At the most basic level, recovery is about humility. Some people independently solve their addiction problem. This is called natural recovery. Others ask for help. In both cases, it is a humbling experience to face the reality of addiction. This humility extends to treatment professionals as well. To quote the famous French surgeon, Ambroise Pare (c. 1510-1590), "I bandaged him and God healed him." Treatment professionals can point the way. However, each person's recovery is ultimately a personal triumph and victory.
Professional treatment for addiction is really the path of last resort. Think about it for a moment. At its most basic level, treatment involves asking for help. Ordinarily, we don't ask for help until faced with the realization we need some! An analogy might make this easier to understand. Suppose you want to drive your car to an unfamiliar location. Perhaps you never visited this destination before. Do you immediately drive to a gas station and ask for directions? Or, do you first attempt to navigate there on your own?
Until we realize we are lost, we do not consider pulling over and asking for directions. Of course, some people will arrive at this conclusion more quickly than others. Some people are fiercely independent. The notion of asking for help is akin to admitting defeat. Other people are more prone to pull over and ask for directions at the first hint of trouble. The same is true with recovery from addiction. By the time people come in for treatment, they have usually attempted to recover on their own. They've reached their own individual tolerance level for "being lost" and decided they could use some "navigational" help.
Treatment is a type of navigational help. Let's continue with our previous example. When we pull over and ask for directions, we don't expect someone to jump into our car and drive us to our destination! Sure, we've asked for help. Hopefully, we received some helpful directions. Nonetheless, we still must drive ourselves to the desired location. This is true of addictions recovery. Ultimately, everyone must drive themselves down the road to recovery. Therefore, even with "navigational help," recovery still involves natural recovery.
But wait, you say. Does natural recovery mean that people addicted to heroin or alcohol stopped on their own? Are there are more of these "natural recovery" folks than people who successfully complete addictions treatment? Yes and Yes. Heroin use is a classic example. Many Vietnam veterans were addicted to heroin when they returned home. Public health officials were quite concerned about this. What would happen to the government's financial resources if all these heroin-using veterans sought treatment? What if they didn't seek treatment? Would there be a devastating surge in heroin use? None of these outcomes occurred. Most heroin-using veterans simply quit on their own (Robins, 1973). How did they do it? The short answer is natural recovery. Of course, not all veterans fully recovered. Some developed other addictions when they gave up heroin. Others only partially gave up heroin. However, in general, natural recovery occurred for most.
Smoking is a more familiar example. If you have been around since the 1960s or 1970s, your own experience will confirm the following facts. Tens of millions of Americans have quit smoking. Very few of them sought treatment or attended a support group. How many rehabs are you aware of for quitting smoking? If quitting smoking were easy, these results would not surprise us. Most people recognize that quitting smoking is quite difficult. Yet almost everyone who quits smoking does this without specialized help or treatment. It may take a handful of serious attempts in order to finally succeed.
A similar result has been found for alcohol (NIAAA, 2012). Most individuals who stopped or reduced their alcohol use have done so on their own. Unless you are a student of addictions research, you might not know there are so many of these successful quitters and moderators. Indeed, it would be quite unusual to hear someone say, "I used to have a really bad drinking problem. You might have even called me an alcoholic. But you know, I just cleaned up my act on my own. Now I don't think about it much anymore." It's quite sensible that someone wouldn't advertise these facts about themselves. Unfortunately, this silence means most people are unaware of the ways people recover from addiction without help. Researchers became aware of this because of large-scale, federally funded surveys.
A second crucial ingredient to successful recovery is motivation. During interviews with naturally recovering people, a common theme was found. The need to change finally became important enough. In other words, the benefits of change outweighed the costs of remaining addicted. This realization provided sufficient motivation to make needed changes. People who succeeded in natural recovery were able to accurately evaluate the costs and benefits of their addiction. Not all individuals appear to be able to do so. This is where treatment can be very helpful. Treatment can help people take an honest, hard look at their situation. This helps them to evaluate the costs and benefits more accurately. This will then provide the motivation to make needed changes. Motivation is so important that we've devoted an entire section to it in our addictions topic center.
3. SUSTAINED EFFORT
The third key ingredient to successful recovery is sustained effort. Whether you recover on your own or with treatment, recovery requires a sustained effort. Sustained effort is needed to persevere through the initial periods of discomfort. This lesson is clear from smokers who quit. People who successfully quit smoking spend a substantial amount of time preparing to change. They experience varying degrees of discomfort getting through the transitional period from smoker to smoke-free. Many people who do not succeed in their first recovery effort under-estimated how much effort it would involve.
4. RESTORATION OF LIFE'S MEANING AND PURPOSE
Finally, it is necessary to restore meaning and purpose to your life. At some point, it will become evident that your world revolved around your addiction. To succeed in recovery, something else must fill that void. At the onset, build your recovery around things that give your life meaning and purpose. This might mean spending more time with your kids. It might mean enjoying the benefits of healthy recreation such as hiking or going to the gym. Perhaps you'd like to revive your social life. Maybe you would enjoy some meaningful volunteer work. You might like to become more active in your church or to work for a political cause. Maybe it just means feeling more rested and refreshed by getting to bed earlier every night. Whatever it is, begin to recognize and enjoy the benefits of your freedom from addiction.
We know these four ingredients are common ingredients of successful recovery. However, we also know there is no single, correct path to recovery. Expect to find your own road to recovery. Seek information and input. Then consider carefully what makes the most sense for you. Go ahead, try it. If it doesn't work, try something different. A common expression is very fitting. "If at first you don't succeed, try and try again." Realize that very few people are successful with just one attempt. Assume that there are many different roads to recovery just as there are many different people.