It is a great disservice to addicts and their families for society to have the expectation that the addict will go to treatment and somehow emerge “healed” after 30 days. How nice and easy 30 days sounds, but this it not really how it works at all. Families also very often have the notion that the addict is the “broken” one and if s/he stops using, all will be well. This also is false. All members of the family system must change the way they interact with one another or the addict will return to using. If the family dynamic supported addiction, it must change so that addiction is no longer a viable way of diverting attention away from the family’s problems.
The truth is that in addition to the addict needing serious help, the entire family system is damaged. The addict goes to treatment to learn ways to bring him/herself into recovery, to build a new life in which s/he has the skills to cope and thrive. Meanwhile, the rest of the family must seek its own treatment and change in ways that provide room for the addict to return to different circumstances. This changed dynamic is critical to the addict’s recovery.
Expect the addict to remain emotionally fragile for the first year of recovery. There will be many firsts to be experienced. The addict will have to learn how to interact, work, be intimate, make future plans – all without relying on substances or behaviors to shield him/her from feelings and insulate him/her from the outside world. There also will likely be tremendous stressors in the addict’s life – from legal or financial problems to mending broken relationships. Dealing with these issues is not easy; far from it. Give your loved one the room to stop, breathe and focus before and during the process of dealing with these issues. The addict must know when to take a break and choose to get support when needed.
Treatment does not “fix” the addict. Recovery is a process that takes time. Rehab only sets the foundation for recovery. There is much more to be done after leaving the treatment center. Be kind to yourself and the ones you love. One day, the trials before you now will all be a memory.
Staying Sober and Preventing Relapse
Going to rehab is by no means a guarantee that you or the one you love will stay sober. Treatment is just the beginning of the process. Yet relapse is neither imminent nor necessary. You can do things to stay sober and prevent relapse. Most importantly, keep in mind that it is easier to prevent a relapse than to come back from one. Use every tool available to you to remain sober in difficult moments.
1. Take the option to relapse off the table. There is a saying in 12-step programs – “We don’t drink or use no matter what.” Relapse does not need to be an option for you. If you find yourself wanting to use, seek immediate help. Don’t let embarrassment get the better of you. People who relapse are more prone to relapse in the future. Don’t become a statistic. Use the tools you have to stay sober. The obsession will lift.
2. Develop a support network. It may be members of your 12-step group, your family, friends, or professionals such as your therapist or psychiatrist. It may be an anonymous help-line or a member of the clergy. Have a list of people you can call and talk to at any hour of the day or night. Yes, you might feel the obsession to drink or use at a less-than-perfect hour. That doesn’t matter. There are people who will be there for you even when it isn’t convenient. Ask for help.
3. This too shall pass. Most relapses happen quickly. The urge to use comes up and the addict puts up little resistance. However, these periods of intense feeling usually do not last long. While you are seeking help, recognize that your feelings are going to change quickly and you will soon feel better.
4. Help someone else. 12-step programs understand this concept very well. If you are helping someone else, you’re not thinking about yourself and your problems. Call a sick friend and ask how they are doing. Go to a 12-step meeting and talk to a newcomer; ask about their day. Volunteer to do work that involves your hands – like building a home with Habitat for Humanity or grooming/walking dogs at the animal shelter. Not only will you build self-esteem by doing esteem-able acts, but you won’t have time to think about yourself or wallow in self-pity.
5. Pray and/or meditate. There is a lot of power in prayer and meditation. That’s why so many treatment protocols suggest it. Life is tough and we are not usually in control. People get ill. Accidents happen. Circumstances change. There’s nothing anyone can do about any of it but learn to face these challenges with humility and compassion. In such circumstances, prayer or meditation can offer solace, a sense of well-being, right-sized responses to the situation, and sometimes even a feeling of direction and purpose.
Family Involvement in Rehab
Though some addicts have burned all their bridges and enter rehab with no family relationships, most addicts are members of robust – and often troubled – families. Families are systems. Members interact in a fluid dance which can be beneficial or detrimental to the system. The addict’s role is supported by the family system. In general, the addict’s acting out is the system’s way of saying, “Hey, there’s something really wrong here! We need help!” If the addict goes to rehab and returns to the same family system, s/he will relapse. It is almost inevitable. Why? Because the unchanged family system supports and expects addiction. It doesn’t work without the addict using. So the addict will use, because that is his/her role in the system. That’s how families work.
For the addict to recover and the family as a whole to become a more productive and happier system, every member of the family must look at his/her role in the family. Through individual or group therapy and/or attendance at 12-step programs such as Al-Anon, every member of the family can develop skills for living that are healthier, more productive and serve to create positive interactions more frequently than in the past. In particular, family members will need to learn to set healthy boundaries, argue in respectful ways, and maintain realistic expectations of one another. This process allows the entire family, not just the addict, to grow, which benefits everyone in the family unit. How the family is involved in rehab will vary from treatment center to treatment center. Recognize, however, that the bulk of the work for the family is not done in the addict’s residential treatment setting, but can be begun while the addict is in rehab.