Canada Drug Rehab

Modern war and major disasters such as 9/11 and Hurricane Katrina have highlighted the horrendous effects of psychological trauma. Here are some rates of post-traumatic stress disorder (PTSD): 23 percent in regions in Israel that have been shelled, 40-70 percent in Gaza, 17 percent of US military personnel, 44 percent in high school seniors in Kosovo five years after hostilities ended, and 30 percent in New Orleans after the hurricane.

Many of these poor souls have turned to alcohol and other drugs to deal with the impact. New research is helping us develop new ways to treat these clients with co-occurring disorders.

The Impact of Trauma on the Brain

Trauma imprints itself in the brain’s memory system. Stress hormones that accompany the emotional intensity of trauma activate the amygdala, which in turn activates other subcortical structures in the limbic system, the primitive, ‘non-thinking’, part of the brain. In other words, emotion mediates how memories are consolidated. The precise mechanisms involved are still debated, but neuroscientist James McGaugh says everyone agrees that “Stronger emotional experiences make for stronger, more reliable memories” (2003, p. 327). Memories of a wartime fire-fight or a collapsed building may intrude repeatedly in a survivor’s daily life or lead to nightmares. Survivors appear to be sensitized that even a door slamming or an image on television can trigger the intense experience. As psychologist David Myers says, “It is as if they [the memories] were burned in” (2010, p. 342). Even months or years later, traumatic memories are so clear that victims recall the event with remarkable detail.

To understand the power of trauma on the memory, think back to 9/11. Chances are that you remember what you were doing on September 11, 2001. But do you remember what you were doing September 11, 1999? Myers reports a study in which victims of car accidents, rape, and other traumatic incidents were given either a placebo or propranolol, a drug that blunts memories. Three months later, half the placebo group and none of the propranolol group experienced stress disorder. “Weaker emotion means weaker memories” (Myers, 2010, p. 342).

Trauma and Drug Use

Statistically, there is an association between addiction and trauma, though much more work is needed to discover what the precise link is. Some say that those suffering from trauma are more vulnerable to addiction; the earlier the trauma, the stronger the association. This may be due to the impact of early trauma on the brain’s development. Others say that the addicted brain makes people more vulnerable to PTSD. Some suggest that traumatized people are more vulnerable to addiction because they want to medicate their condition. Still others say that those with trauma who are addicted to substances are not medicating their pain, but using substances as any addict does—to relieve boredom, despair, guilt, loneliness, and a lack of a sense of belonging. And so on.

Treatment

Traditionally, scientific treatment for trauma and addiction has relied on cognitive-behavioral therapy (CBT). Among the most the most famous for co-occurring additions and trauma is Lisa Najavits’ Seeking Safety (2002) program. But many are questioning whether CBT and traditional psychotherapy are enough. One of the more controversial figures advocating a new clinical approach is Bessel van der Kolk (2005). He has suggested that because trauma affects structures in the brain’s limbic system and inhibits key functioning in the ‘thinking’ brain, that body-oriented and self-regulation therapies may be more effective than traditional talk therapies alone.

Based on brain-imaging techniques that show traumatic memories appear to be mediated or moderated by the limbic system, some trauma experts are using techniques that integrate the mind and the body. James Gordon (2010), head of the college of mind-body medicine at Saybrook University, works with US soldiers and local residents in Gaza, Bosnia, Afghanistan, and elsewhere. Gordon’s mind-body approach focuses on client strengths, builds resiliency, and balances the sympathetic nervous system’s fight or flight response with the parasympathetic nervous system’s relaxation response. Initially, after creating a safe environment, he follows a three-step process: shake, breathe, and move to music. Strange as the idea may first appear, this body-work frees participants sufficiently to deal with the trauma. They often break down sobbing during this somatic process, able to talk about what happened to them. Othre clinicians use EMDR and OEI, various types of body-work, forms of psychodrama, and other cutting-edge techniques.

Today, little of this trauma work is applied in the addiction field. But there is great hope that as addictions clinicians become more familiar with trauma, that their traumatized clients will fare better.

References

Gordon, J. S. (2010, Jan 19). Trauma and transformation: Healing the wounds of war and other disasters. [Workshop]. College of Mind-Body Medicine, Saybrook University, San Franciso, CA.

McGaugh, J. I. (2003). Memory and emotion: The making of lasting memories. New York, NY: Columbia University Press.

Myers, D. G.. (2010). Psychology. New York, NY: Worth Publishers.

Najavits, L. M. (2002). Seeking safety: A treatment manual for PTSD and substance abuse. New York, NY: The Guilford Press.

van der Kolk, B. A., Roth, S., Pelcovitz, D., Sunday, S., & Spinazzola, J. (2005). Disorders of extreme stress: The empirical foundation of a complex adaptation to trauma. Journal of Traumatic Stress, 18(5), 389-399.

By Daniel Jordan
General Manager
Sunshine Coast Health Center

In one of my web surfing sessions I happened to come across a YouTube video showing an interview with Carl Gustav Jung, the famous Swiss psychiatrist. Not only is this a rare glimpse into the world of a master therapist it is, to me, an account of the ‘inner void’ that seems to lie at the core of addiction. 

For those that prefer not to watch the entire video, the key section of the video (2:22 - 7:54) has been transcribed as follows:

Background

Jung: A case where there was an intelligent, young woman, she was a student of philosophy, very good mind; where one would expect easily that she would see that I am not the parental authority but she was utterly unable to get out of this delusion. And, in such a case, one always has recourse to dreams: it was just as if one would ask the unconscious “now what do you say to such a condition?” You see, she says in her conscious “of course I know you are not my father but I just feel like that; it is like that: I depend on you …”

The Therapy Session

Jung: Now let’s see what the unconscious says. Now the unconscious produced dreams in which I really assume the very curious role … she was the little infant, she was sitting on my knees; I held her in my arms. I was really tender father to the little girl. And, more and more, the dreams became empathic in that respect; namely that I was a sort of giant; and she a very little, very human, thing you know like a little girl in the hands of an enormous being; and the last dream of that series was … I cannot tell you all the dreams; was I was out in nature, I stood in a field of wheat that was ripe for harvest and I was a giant and I held her in my arms like a baby and the wind was blowing that field of wheat. Now you know when the wind is blowing over a wheat field there is waves; and with these waves I swayed as if putting her to sleep and she felt as if being in the arms of a god; of the godhead.

“Now the harvest is ripe, and I must tell her. And I told her, “what you want and what you project into me - because you are not conscious of it - that is, you have the idea of a deity you don’t possess. Therefore you see it in me. That clicked.”

“She suddenly became aware of an entirely heathenish image that comes fresh from the archetype. She had no idea of a Christian God or an Old Testament Yahweh. It was a heathenish God, a God of nature, of vegetation, he was the wheat himself, the spirit of the wind; and was in the arms of that numen.” *

(*) Numen - a god or spirit believed to inhabit a place or being.

Jung’s Interpretation

Jung: That is the living experience of an archetype. That made a tremendous impression upon that girl and instantly clicked. She saw what she really was missing; that missing value, which was in the form of a projection in myself and made myself indispensible to her. She saw he’s [Jung] not indispensible; because it as the dream says, it is in the arms of that archetype … idea. That is a numinous experience. And that is the thing people are looking for: an archetypal experience, that gives them an incorruptible value. They depend upon other conditions, they depend upon their desires; their ambitions; they depend upon other people because they have no value in themselves. They have nothing in themselves. They are only rational, they are not in possession of a treasure that would make them independent.

“But when that girl can hold that experience then she doesn’t depend any more; she cannot depend any more; because that value is in herself, and that is a sort of liberation.”

“And that, of course, makes her complete. Inasmuch she can realize such a luminous experience, she is able to continue her path, her way, her individuation.”

WHY THE FASCINATION WITH THIS VIDEO

Despite it’s title, neither transference * nor archetypes is central to my interest in this video. Furthermore, dream analysis is typically not a technique we utilize at Sunshine Coast Health Center. ** So why, you may ask, the fascination with this video? For me, it’s the “numinous experience” described by Dr. Jung as the moment when his client, the philosophy student, was able to free herself from her unhealthy fixation on Dr. Jung.

Obviously, Dr. Jung is not some sort of drug but, according to Dr. Jung himself, his client was “dependent” on him as a father figure. From my personal experience with our chemically dependent clients, there seems to be an inner void (clients often call it their ‘donut hole’) that finds them grasping for anything external: drugs, alcohol, cigarettes, sex, gambling, anarchy, etc. Those clients that complete addiction treatment and go on to live happy lives seem to discover an inner “treasure” that, as Dr. Jung points out, makes them independent, complete, liberated.

(*) Transference: the emotional bond that develops on the client towards his analyst/therapist.

(**) Note: Sunshine Coast Health Center does, however, use depth psychology, which is related to archetypal psychology in that they both employ the model of the unconscious mind as the source of healing and development in the individual.

BILL WILSON’S ‘WHITE LIGHT EXPERIENCE’

For Bill Wilson, a similar moment of transformation was the beginning of long-term recovery for the famous founder of Alcoholics Anonymous. During Wilson’s fourth admittance to Towns Hospital in 1934, Bill Wilson recalls his ‘white light’ experience: “Suddenly the room lit up with a great white light. I was caught up into an ecstasy which there are no words to describe. It seemed to me, in the mind’s eye, that I was on a mountain and that a wind not of air but of spirit was blowing. And then it burst upon me that I was a free man.” *

Source: Kurtz, Ernest (1979) Not-God: A History of Alcoholics Anonymous, pgs. 19-20.

CONCLUSION

I will be the first to admit that these peak experiences are rare and that holds true for the clients at our alcohol and drug rehab program. For them, addiction recovery is more gradual, with repeated advances and retreats. Regardless of how long it takes, however, the objective of personal transformation remains valid.

Oftentimes, it’s a difference in language. For example, what Dr. Jung calls a “luminous” or “archetypal” experience, we at Sunshine Coast Health Center call “personal transformation.” The end result of such an experience, what Dr. Jung calls “incorruptible value,” we call “meaning and purpose.” However, this video, if anything, further reinforces my sense that our current approach to treatment is heading in the right direction.

Cathy Patterson-Sterling, MA, RCC

Cathy Patterson-Sterling, Director of Family Services for Sunshine Coast Health Centre, shares ways to discuss having alcohol in your home or at family gatherings when a loved one is in recovery, without singling them out or making them feel “abnormal.”

By Daniel Jordan
General Manager
Sunshine Coast Health Center

For the families we are privileged to serve at Sunshine Coast Health Center, starting residential drug rehabilitation can be a roller coaster of emotions. Starting treatment is really about wholesale change since, by the time we get involved, addiction has progressed to the point where everything our clients hold dear - family, friends, health, and home - is in jeopardy. For clients and their families alike, addiction treatment can be symbolized as the light at the end of a very dark tunnel.

Starting Treatment Can Be Overwhelming

Unfortunately, however, clients may be hopeful but can also be awash with conflicting emotions, particularly fear. Regardless of how dysfunctional their addict lifestyle has become, at least it’s familiar. Judging by the questions we get, nothing about treatment is familiar. Where am I going? Who will I be sharing a room with? How long am I going for? Can I use the telephone? These are basic questions but most clients at this point in their recovery are in no shape to go to our website and research our program beforehand.  

In 2008, Sunshine Coast Health Center managed a retention rate of 89.41 percent for clients who were admitted to treatment. So our internal research gives families pretty good odds that their loved one will complete treatment.

Another piece of good news is that the majority of the 1 in 10 that did not complete treatment * left in the first week. Therefore, if your loved one makes it through the first week the actual likelihood of completing treatment at Sunshine Coast Health Center is closer to 93 percent.

The third piece of good news is that there are steps that family members can take to make the odds even better. By following some basic recommendations, family members can actually help keep their loved ones in treatment.

(*) Note: includes clients who left due to either leaving against staff advice (ASA), at staff request due to a dischargeable offense (ASR), leaving without notice (AWOL), or due to medical complications (MD).

Why Some Clients Want to Leave Treatment Early

First off, it’s important to understand why some clients want to leave treatment early. It is easy to dismiss a client’s decision to leave treatment early as nothing more than ‘not being ready’ or an overwhelming desire to get drunk or high. However, as is often the case with addiction, it’s not that simple. Most clients in early recovery struggle with ambivalence. Early recovery offers the promise of better days, the expectations of significant others, the uncertainty of a life in recovery, and the daunting task of cleaning up the huge mess that awaits them back home. Usually, when confronted by reality, the automatic response for addicts is to escape with drugs, alcohol, gambling, or sex. In treatment, however, that is not an option.

Clients Often Call Home Before They Leave Treatment

There is really no prevailing behaviour for clients who decide to leave treatment early. Some don’t hesitate to make their intentions clear the minute they arrive, while some clients keep it such a secret that staff don’t know until they find a note on a pillow the next morning. Somewhere in between these two extremes is the client who calls home first before leaving treatment. If you are one of those unfortunate family members who gets that call in the middle of the night, it is important to remember that you may be the first person who is aware of your loved one’s decision. Staff may be busy performing their duties, unaware that a client in their midst is moments away from ‘making a run for it’.

Why Clients Call Home Before Leaving Treatment

If we take a moment to reflect, it’s actually a huge opportunity for positive change when clients call home before they leave. After all, if someone was really intent on leaving, they wouldn’t complicate matters by calling home first. That phone call can represent one of two things: (1) they don’t have the resources to leave or (2) they are seeking approval before they leave treatment. Either way, you as a family member are far from being a helpless victim to your loved one’s intentions.

Three Possible Outcomes for The Same Scenario

To learn how to effectively deal with a loved one who calls home and is intent on leaving treatment early, one scenario is presented with four different scenarios based on how you, the family member, respond to your loved one.

Scenario: A client calls home late one night wants to leave treatment. You, the family member, have a telephone conversation with Cathy Patterson-Sterling, Director of Family Services, the following day:

Family Member: “Hi there. Keith called me last night and told me that his stay there wasn’t how he thought it was going to be. He complained that he just can’t relate to the other clients there and he just can’t imagine having to stay there for 6 more weeks.”

Cathy: “Oh, that’s unfortunate. Now, remember what we talked about while Keith was on his way to the treatment center? I pointed out that individuals in their first week of treatment have to contend with unfamiliar surroundings and strangers. To complicate matters, they are also going through withdrawal and don’t have their drug of choice to fall back on, so they will often try to think of a reason to leave treatment. Do you remember our conversation?”

Family Member: “Yes, I remember that.”

Cathy: “Right. That is why we reviewed all of the excuses that you could expect were going to come up and one of them was that about the “wrong peer group”. So, when Keith told you he wanted to leave, how did you respond?”

Response A

Family Member: “Well, I thought about what you said but then I thought what’s the point of Keith staying in treatment if he’s just going to be hiding out in his room the whole time he’s there? So I booked a flight for him.”

Conclusion to Response A: The client packs his bags and leaves treatment. The family member pays for his flight. Keith flies home.

Response B

Family Member: “Well, I thought about what you said and I told him that I wasn’t going to pay for his cab or his airfare to come home. Besides, I told him, if he does come back he won’t be staying here and I won’t be paying his car insurance either. Then I hung up.”

Conclusion to Response C: The client, realizing that he’s got nowhere else to go, decides to stay, at least for as long as he can figure out another option. Treatment center staff remain unaware of the situation.

Response C

Family Member: “Well, I thought about what you said, so I immediately hung up the phone, then called the treatment center and talked to one of the night staff there.”

Conclusion to Response B: A counsellor was called in to talk to Keith. It turns out that Keith was homesick for his daughter. Keith feels he has not been much of a father due to his preoccupation with his addiction and was overwhelmed with guilt. The counsellor was able to talk Keith through his overwhelming emotional state. Keith decided to stay in treatment for at least a week and try to work through his feelings of guilt with his assigned counsellor and peer group.

Response D

Family Member: “Well I thought about what you said and reassured him that he was probably just going through an adjustment period. I also told him that there was no way he could come home until after he completes treatment. Then I hung up and called the treatment center.”

Conclusion to Response D: Client feels he has no other option but to stay in treatment. Staff are aware of the situation with a conclusion similar to Response C. However, this time the client, realizing that he is not welcome at home until he completes treatment, commits to staying for the duration of treatment.

Conclusion

Obviously, conversations of this nature are not always as cut and dry as what was presented here. Remember, if a loved one calls home and tells you that he wants to leave treatment, it’s because he needs  your money, your approval, or assurance that life can return back to the way it used to be before treatment.

Regardless of the rationale, you are not powerless in the face of apparently dire circumstances.

Furthermore, taking a firm line with your loved one and partnering with the staff in crisis situations is critical. So, the minute you hang up the phone with your loved one call the treatment center for support. Don’t assume that staff know about your family member’s intentions. Finally, don’t worry about being a nuisance. Typically, these types of calls happen late at night when clients are not busy engaged in the program or have the support of their peers. Don’t worry about it being too late at night to call. Staff are here, 24/7 and are prepared for these little emergencies.

For more information read the Sunshine Coast Health Center pamphlet, Contact Guidelines for Family Members.

By Daniel Jordan
General Manager
Sunshine Coast Health Center

In Part 1 of this article I highlighted the importance of designing a clinical brochure that is current, user-friendly, and comprehensive. Originally, I had planned to jump right in and explain our “integrated approach” to addiction treatment. However, as I was preparing for Part 2 I realized that exploring the complexity of residential addiction treatment is a necessary first step before attempting to explain our unique method of treatment.

Complexity #1: The Living Vs. Non-Living Universe

This may seem obvious but living entities are much more complex than inorganic objects. Neuroscientists point out that there are more synapses in the brain than stars in the galaxy and that the brain is the most complex device in the known universe. * The interesting part, however, is how we approach problems associated with living vs. non-living objects. In his book, Guide for the Perplexed, economist E.F. Schumacher argues that there are two types of problems in the world: (1) convergent and (2) divergent. 

Convergent problems are ones in which attempted solutions gradually focus on one solution or answer. Of primary importance is that convergent problems are those where that all tend to point to the non-living universe. Take, for example, the problem of manned flight. In the early days of aviation, there were many different contraptions that inventors hoped would become the first successful flying machine. Perhaps you have seen the old movie footage of planes with 4 sets of wings, or wings that would flap up and down, etc. Finally, after a lot of trial and error, Orville and Wilbur Wright made the world’s first flight in a powered, heavier-than-air machine on December 17, 1903 near Kitty Hawk, North Carolina. 100 years later, aeronautical engineers continue to improve on the Wright Brother’s original design, however, all manufacturers such as Boeing, Bombardier, or Airbus, build planes that follow remarkably similar design principles. The same is true for automobiles, cell phones, and portable computers.

Divergent problems are ones which we must find multiple solutions to a single problem and are typically found when we are dealing with living organisms, particularly human beings. For example, if you are trying to solve the problem of HIV/AIDS, handing out condoms or clean needles may be a start but it’s not going to completely solve the problem. Another agency may start a 24 hour help line and this may help as well. But these are just 2 of many possible solutions. The ongoing search for a cure to cancer, which is basically a living organism within a larger living organism (us), is another good example.  

(*) Source: Nuts, bolts of who we are, Princeton Weekly Bulletin, May 1, 2000.

Complexity #2: Chronic Conditions Vs. Acute Conditions

While many people may consider addiction a chronic condition *, the truth is that addiction has a lot more in common with diabetes, high blood pressure, and arthritis than it does with acute medical conditions such as a broken leg or appendicitis. This misconception is clearly evident whenever scientists claim to have found the gene responsible for alcoholism or pharmaceutical companies promote a new drug as the cure for addiction.

Even residential alcohol and drug treatment centers that should know better typically operate like hospital emergency wards, throwing everything they have at the client during primary treatment and leaving precious few resources for follow-up or relapse.

(*) Note: for more information on the chronic nature of addiction refer to William White’s articles on bhrm.org .

Complexity #3: Addiction Impacts All Life Domains

Unlike many medical conditions, addiction cannot be treated by localising the problem to a particular part of the body and then treating it. Addiction is a Biopsychosocial condition that impacts all life domains - biological, psychological, social and spiritual. For example, all may be well with a client while he is in the safe confines of residential treatment, however, what happens when he gets home where the same job, family, and old haunts await his return? Furthermore, most addictions impact negatively on the body (liver damaged by alcohol, tooth enamel destroyed by crystal meth or crack cocaine, etc.). Psychotherapy can be particularly challenging if a client is also suffering from cognitive impairment, or mental illness.

Not only does addiction require a diverse team of professionals to be involved in treatment, it means that often treatment often has to be applied concurrently, and that the discharge plan must include community resources that also embrace the Biopsychosocial nature of addiction.

Complexity #4: Addiction Defies Simple Definitions

The origins of addiction have been a source of lively debate for hundreds of years. Is it a learned behaviour or is it a disease? Is addiction a choice or is it a genetic predisposition? Is addiction caused by developmental factors or do some people have addictive personalities? Are addicts created by eating a diet deficient in certain nutrients? Or is addiction a response to feeling disconnected from the world?

As Ken Wilber in his book Integral Psychology states, “The great problem with psychology as it has historically unfolded is that, for the most part, different schools of psychology have often taken one of those aspects of the extraordinarily rich and multifaceted phenomenon of consciousness and announced that it is the only aspect worth studying (or even that it is the only aspect that actually exists).” Dr. David Burns, author of Feeling Good: The New Mood Therapy, calls it the “schools over tools” approach. This tendency towards over-simplification, commonly referred to as reductionism, is alive and well in the treatment of addiction. This is most unfortunate since addiction is a complex condition that impacts all aspects of health and lifestyle.  

Now combine debate among competing schools in psychology with the medical community and you begin to see why the matter of deciding on effective treatment for addiction is far from settled.

Complexity #5: Addiction Requires More Than Mere Abstinence

Even the goal of addiction treatment is a topic of lively debate. Some will reason that if only the addict will stop using his/her drug or process of choice (gambling, online porn, etc.) then the problems associated with addiction will go away. Unfortunately, just as health is more than the absence of disease, recovery requires a fundamental shift that impacts all life domains mentioned in Complexity #3.

At Sunshine Coast Health Center, we believe that abstinence is a by-product, not a goal of alcohol and drug rehabilitation. When an individual discovers his true calling and begins the process of living a life of purpose, we believe that ’external’ solutions and unhealthy attachments will be discarded in favour of being true to one’s self.

Complexity #6: Not Everyone With an Addiction is Motivated to Quit

Another point to ponder is that people with addictions actually need a reason to stop. Having something to lose (health, marriage, career) may work for a brief period of time but, long term, a fundamental shift or transformation is often required for abstinence to become permanent. Unlike most disorders or medical conditions, addiction produces a positive benefit for the individual such as dissociation (numbing out) or escaping from, what Narcotics Anonymous calls, the ”meaningless, monotonous, and boring” life of an addict.

Complexity #7: Primary Residential Treatment Vs. Outpatient Treatment

The last point to make on complexity is that residential addiction treatment, is more than just counselling with room and board thrown in for good measure. Social skills associated with the give and take of living 24/7 with a peer group is an issue for residential treatment while the same can’t be said for outpatient.

Furthermore, group therapy, commonplace in residential treatment, is rarely provided in most outpatient settings. Group therapy is, by nature, a dynamic process that can have remarkable therapeutic effect in the hands of a skilled psychotherapist.

Complexity #8: Addiction is More Than Just Drugs and Alcohol

Cross-addiction (having more than one addiction) is a common occurence for individuals who struggle with drugs or alcohol. Sunshine Coast recognizes this tendency and is redesigning its program to expand the definition of addiction to include process addictions such as gambling, gaming, sex, even eating disorders.

Conclusion

Addiction is a complex condition that requires an equally complex approach to treatment. Sunshine Coast Health Center recognizes these challenges and has been continually finding new ways to enhance program effectiveness. in Part 3 of The Challenge of Writing a Clinical Brochure, I will examine how other individuals and groups are integrating their approach to address complex problems.

Geoff Thompson - MA, CCC

Geoff Thompson, Program Director for Sunshine Coast Health Centre, discusses what reputable sources have to say about addiction.

By Geoff Thompson, Program Director

Sunshine Coast Health Center

A requirement for living a fulfilling life is feeling a sense of belonging in the world. One of the key problems with those suffering from addictions is that they feel they are different. They feel they don’t fit in. They feel they don’t belong. Clients at Sunshine Coast are often asked to think back to their life in active addiction: did they feel they just didn’t fit in, that they didn’t feel that they were the same as others, that something was wrong with them? Perhaps they became something of chameleons just to fit in with different groups of people. In fact if you listen to the stories of addicts, this is one of the most common themes. If you are in recovery, listen for this at the next 12-step meeting you go to, or read any of the stories in the Big Book, or watch a drug movie such as Barfly with Mickey Rourke or Panic in Needle Park with Al Pacino. You will hear what it’s like to be an outcast in the world.

So a great deal of life in recovery is often spent finding a sense of belonging in the world. So often, clinical staff at Sunshine Coast Health Center hears from those clients who have slipped or relapsed that they didn’t feel this belonging. Here’s a typical example: ‘I cleaned up, did everything suggested to me, I’m living this middle class existence…and I’ve never been so bored in my life!’. Other clients report that they don’t find a sense of belonging at 12 step meetings. Or even at home. In short, they still don’t feel comfortable in the world.

So how do we pull off this trick of feeling completely comfortable, whether at an AA dance or at work or at home? This article looks at some of the strategies people in recovery can use.This is an important point: To find a sense of belonging in the world requires action. Clients are often reminded that they are the authors of their lives. Waiting for someone else to help may mean waiting an eternity. 

Tip # One: Start asking yourself, “What does Life demand of me?”

Addicts are notorious for demanding that people (and situations) change to suit their own needs and expectations. What this looks like in daily life is that they usually go about their lives making demands on the world. Some examples: I demand that I be able to use drugs, even though they are illegal. I demand that I be allowed to drink and drive, because I’ve run out of booze and I really need more. I demand that I be allowed to leave the family for three days to get loaded and then be forgiven. I demand that I be the centre of attention. I demand….I demand…I demand. For Sunshine Coast clients, this may remind them of the story King Baby.

Alumni at Sunshine Coast are often asked: “What are you prepared to do for your recovery?” One of the reasons we ask this is because so many clients come into treatment making demands on recovery: ‘I will stay in recovery if and only if…’ and then come the demands. ‘I came into recovery to learn how not to use my drug of choice….but I demand that I be allowed to have a beer or smoke pot because they were not problems for me’. Or how about this one: ‘I will take risks…but I demand that I only have to take risks that I’m comfortable with’. Or this one: ‘I demand that my recovery progress only if my family is fully supportive’.

Some clients get upset when they call a government office and then get put on hold for 30 minutes. They are demanding that someone answer their call immediately. Some clients get frustrated when they have to wait 90 minutes at the hospital to get their blood tests done. Some clients get upset when there is no space in the van to go to the recreation complex. Some get upset when their family members do not visit.

In all these examples, the person is making demands on others and on situations. The reason that this is dangerous for recovery is that anyone who makes demands on Life is still an outcast, still on the outside of life looking in.

A much better approach is to stop demanding that people act a certain way or think a certain way. The strategy to accomplish this is to ask yourself, ‘What does Life (this situation) demand of me?’ The genius of this approach is that people in recovery then join in with life. When they join in with life, they’re no longer on the outside looking in, no longer an outcast.

Tip # Two: Start connecting with others in the community

Another approach to feeling a sense of belonging is to get involved in the world. 

It probably isn’t a surprise to you to learn that researchers have found a very strong link between recovery and volunteering. And, as we remind our clients, at every 12-step meeting there are really three meetings: the get-together before the meeting, the meeting, and the get-together after the meeting. The reason for this is that you need to feel ‘part-of’ the group.

Here are some examples of things that Sunshine Coast alumni are doing: volunteering to be the contact person for Sunshine Coast clients when their program is over, volunteering to sit on a Board of Directors, volunteering to be the Group Service Representative of their AA group, helping out serving Christmas supper in a poor neighbourhood, coaching a minor hockey team, giving talks to high school kids on the dangers of drugs, raising money for a charity, helping out at the local amateur theatre group, helping promote environmental awareness, joining a political party, etc. It’s quite remarkable that those alumni who do these things also say they are doing well in recovery.

It’s a strange thing, but most of us don’t even know our neighbours. It’s hard to feel a sense of belonging when we don’t even know who’s living next to us. Lots of people in recovery go out of their way to be good neighbours. Some typical examples are helping out shoveling snow after a snow storm, holding a neighbourhood barbeque, joining a neighbourhood-watch program or an ‘adopt-a-street’ program to pick up litter, sending Christmas cards to each neighbour, inviting a neighbour over for coffee.

Tip # Three: Start taking action to make different parts of your life more appealing

It’s interesting that people who are fulfilled in recovery do things that are very meaningful to them.

Some alumni have worked jobs that they find no longer a challenge. In recovery, they have returned to school or are pursuing other careers.

Some are near retirement or have other obligations, so they cannot realistically give up their jobs. But they have done things to make the job more interesting such as relocating to another company office, shifting to a new location, asking their manager if they could work toward a higher position, giving up working overtime, sitting down with someone they have a conflict with and working it out, sitting down with their manager and expressing what is troubling them, etc. All of these strategies have the same purpose: to make the job more comfortable to go to.

As well as making work more interesting, many alumni have made their home life more exciting. Here are some of the strategies alumni have used: Wednesday night is family movie night, doing something special for each member of the family once a week, having coffee in bed with their partner on Saturday morning to talk about their relationship.

Tip # Four: Start looking at the positive

We all know that life is filled with misery. In fact, psychology researchers have discovered, as have artists, that our greatest fear is the knowledge that we will die. This is what the so-called ‘midlife crisis’ is all about: we’ve lived half of our lives, we’re not as physically resilient as we used to be, and we have gained the wisdom to begin reflecting on what we’ve accomplished.. And we also know that we will likely get sick or have an accident or have to deal with the goofy things our teenagers do.

We all suffer. People in recovery may find It’s easy enough to complain about the jerk at work or the AA member who smokes pot and yet takes a cake. It’s easy to dwell on our own weaknesses and the weaknesses of others.

But it is also true that we have many gifts: freedom of choice, freedom to change the way we look at ourselves and at the world, freedom to find something meaningful even in the worst possible situation. We’re not like a rat in a cage, who is trapped. We have the blessing of changing our situation and our attitudes. Remember that passage in the Big Book that says, “nothing happens by mistake”? We have the wonderful ability to learn and grow even from our worst failures.

We’ve known for thousands of years that we react to things according to how we make sense of them. It’s not the things in life that are important, but how we interpret them.

Geoff Thompson - MA, CCC

Geoff Thompson, Program Director for Sunshine Coast Health Centre, discusses Wayne Dyer’s movie “Ambition to Meaning” as it relates to depth psychology and the realization that you are an important, worthwhile, living, breathing human being.

Cathy Patterson-Sterling, MA, RCC

Cathy Patterson-Sterling, Director of Family Services for Sunshine Coast Health Centre discusses why any mood altering substance should be avoided, especially in early addiction recovery, to avoid relying on these as a crutch.

Cathy Patterson-Sterling, MA, RCC

Cathy Patterson-Sterling, Director of Family Services at Sunshine Coast Health Centre, discusses signs to look for in early addiction recovery that show whether someone is on track with their recovery or not.