What Does Recovery Mean?
Recovery from addiction is the ongoing process of learning, growth, and healing.
Abstinence is instrumental to healing the neurological impacts of addiction.
Recovery goes beyond abstinence and involves learning and practicing conscious awareness and skills.
There are multiple ways in which Western psychotherapy, Buddhist psychology, and 12-step recovery intersect.
Recovery is the ongoing process of learning to live a whole, healthy, and healed life.
“The world breaks everyone. And afterward many are strong in the broken places.” —Ernest Hemingway, A Farewell to Arms
While the term recovery can be applied to getting better or improvement related to a wide range of conditions, it is most often used to describe the process of overcoming addiction to alcohol and other drugs. In this context, recovery is generally thought of as becoming abstinent from these substances, but the reality is that recovery extends far beyond abstinence.
Addiction is a chronic, progressive, and potentially fatal disorder—like other chronic, life-threatening conditions, such as diabetes, asthma, and heart disease. Like these other illnesses, there is no cure for addiction. However, it can be treated and managed successfully through the process of recovery. Recovery allows those with addiction to live long, full, and healthy lives. I should know, having been an addiction treatment professional for over two decades and a person in long-term addiction recovery (16+ years currently).
There is no shortage of personal stories that describe the horrors of addiction, many of which also depict people’s journeys into recovery, and some of these involve people who go on to become addiction counselors. My story is a little different in that I was a behavioral health professional, initially as a therapist and subsequently in high-level management capacities in a variety of settings, including addiction treatment—before I entered recovery. I was highly regarded as a practitioner, supervisor, and administrator until the final devastating 18 months of a 30-year active addiction (exacerbated by a chronic pain condition) when my life as I knew it started to unravel—a process that picked up speed like a snowball gaining momentum and size as it rolls downhill.
The disease of addiction is known for being “cunning, baffling, and powerful.” It is also exquisitely patient, as well as treacherous, in the ways it attempts to convince those who suffer from it that they don’t have it. Ironically, as long as my addiction was active, my education and professional experience obstructed my ability to see it for what it was, admit it, and seek help despite mounting personal and professional consequences.
Usually, it’s only when the pain of staying the same becomes greater than the fear of change that people make significant life changes. Ultimately, the damage to my family of procreation and career “gifted” me with enough desperation to accept that I needed inpatient treatment. There, I was introduced to a holistic, multi-dimensional approach to living with chronic pain and 12-step recovery, both of which I continue to practice. In my second 12-step meeting, someone with nearly 30 years clean stated, “Recovery won’t open the gates of heaven so you can get in, but it will unlock the gates of hell so you can get out.” And that has been my experience.
The Neuroscience of Abstinence
Abstinence is instrumental in healing the neurological impacts of addiction. With the aid of neuroplasticity, the human brain has remarkable abilities to heal. Research using brain scans indicates that with 14 months of abstinence, noticeable healing of the adverse changes caused by active addiction has taken place. This notwithstanding, the brain’s reward center and the mesolimbic dopamine system that feeds it are forever altered.
As neurons that fire together wire together, the brain connects emotion, memory, and sensory stimuli, linking experiences perceived as “positive” with specific associations: images, sounds, smells, people, and places, coding them as omens of comfort and reward. These unconscious learned responses are strong enough to remain operative even after years of abstinence. As a result, their memory tracks tend to pull people back toward the experiences and behaviors with which they are familiar and comfortable, making it more difficult to stop such behaviors and stay stopped. Like petroglyphs etched in rock formations that are clearly visible hundreds of years later, the rhapsodic recollections of drug use are engraved deep within the midbrain—beckoning sweetly and seductively.
Consequently, recovery from addiction involves sustaining abstinence and learning and practicing the awareness and skills necessary to respond intentionally rather than react unconsciously and reflexively. These two elements reinforce one another: Sustained abstinence creates opportunities to build the skills that facilitate growth and healing, which is not possible during the unremitting entropy of active addiction. Conversely, learning and practicing such skills is instrumental to sustaining long-term abstinence.
The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) has defined recovery from both substances use disorders and mental disorders as: “A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential."
Recovery is a process of transformation that necessitates changing how I relate to myself, to others, and to the world. It is an extraordinary undertaking, requiring no small amount of mental, emotional, and spiritual renovation. A foundational underpinning of this metamorphosis is the shifting away from a focus on doing things that make one feel good to doing things one can feel good about. The former is explicitly transitory, and after the mood elevation subsides, it often leaves us feeling even worse than before. Moreover, it frequently takes us further away from our true values, the type of person we want to be, and the kind of life we wish to live. In contrast, the latter is enduring and brings us into greater alignment with our values and closer to the type of person we want to be and the kind of life we wish to live.
In order to get my life back together, I had to be done with tearing myself apart. This is the essence of step one—to accept and admit powerlessness over my addiction and the breadth and depth of the unmanageability it created in my life. In Buddhism, this dynamic is framed in terms of letting go of specific attachments as an essential ingredient in the lessening of suffering—specifically, attachment to the need to deny I was an addict and the beliefs that I could control my using and didn’t need any help, as well as the desire to ease my stress, emotional discomfort, and physical pain through the use of substances.
Once I entered recovery, my professional knowledge and experience became assets that enriched my understanding and awareness of recovery as an ongoing process of learning, growth, and healing. Interestingly, there are multiple ways in which Western psychology and psychotherapy, Buddhist psychology and practice, and 12-step recovery intersect. These include but are not limited to:
Nurturing the ability to observe one’s thoughts and the fictional stories they so often combine to create so their merit can be evaluated and potentially disputed,
Cultivating the capacity to be present with and tolerate the full range of our emotional life—without needing to run away from the painful or cling to the pleasurable,
Learning how to allow space for and accept the ever-shifting sands of our physical status without adversely judging it or ourselves,
Developing enhanced and deeper connections with that beyond oneself to facilitate spiritual centeredness.
Meditation, a 2,600-year-old Buddhist practice, is a formal component of step eleven. Along with other mindfulness practices, mediation has increasingly been incorporated into contemporary psychotherapeutic approaches such as dialectical behavior therapy (DBT) and acceptance and commitment therapy (ACT).
The role of spirituality in 12-step recovery is well known. What is much less well known is that its inclusion in the 12 steps when AA was established in 1935 occurred through Carl Jung, the Swiss psychiatrist and one-time protégé of Sigmund Freud, who founded analytical psychology and pioneered the concepts of archetypes, the shadow self, and the collective unconscious. Jung viewed addiction as a spiritual malady and addicts as frustrated spiritual seekers. He believed that the craving for altered states of consciousness reflected a spiritual thirst for wholeness and that spiritual connection was essential to overcoming addiction.
Life takes its toll on all of us, and everyone, whether or not they struggle with addiction, chronic pain, or any other serious condition, sustains a certain degree of damage along the way. Recovery provides a pathway to heal from that damage and become stronger, just as broken bones can become stronger after they heal than they were before.
Loss of Dopamine Transporters in Methamphetamine Abusers Recovers with Protracted Abstinence, Nora D. Volkow, Linda Chang, Gene-Jack Wang, Joanna S. Fowler, Dinko Franceschi, Mark Sedler, Samuel J. Gatley, Eric Miller, Robert Hitzemann, Yu-Shin Ding, Jean Logan, Journal of Neuroscience 1 December 2001, 21 (23) 9414-9418; DOI: 10.1523/JNEUROSCI.21-23-09414.2001