I have heard feedback about what works for recovery and what gets in the way of recovery from patients who have anywhere from a few months to thirty years or more of sobriety. The stories that most impress me are how often the helping professionals were one of the obstacles for patients on the way to sobriety.

In the early eighties I did a study of one-hundred alcoholics (some also used other drugs) through UC Berkeley Extension. All had completed three to five weeks of inpatient treatment and were offered intensive follow-up care. Out of one-hundred about fifty percent didn’t drink or use for the full year. Twenty-five percent used one time up to a maximum of forty eight hours. The other twenty-five percent returned to their usual alcohol use or could not be monitored close enough to count in anything but the using column.

Some of the results didn’t fit with what I believed at the time about relapse.

The first thing I didn’t expect was what most of those who relapsed said.  All relayed about the same thing: “I don’t know why I drank, things were never better.”

The ones who went regularly to twelve step meetings seemed to fit into two groups: those who went to a lot of meetings and those who did step work which included a fifth step. Those who just went to meetings stayed sober at a rate of fifty percent; those who did significant step work stayed sober at a rate of ninety-five percent.

As I carefully looked over other studies, which were much more detailed and organized I found similar results.Some Thoughts About Surviving Early Recovery

Old beliefs die hard and in addiction treatment and the mental health system some have a belief system that is more like a religion than a science.

Myth One: It is popular to believe alcoholics drink because they feel inadequate, have suffered a traumatic event and/or are emotionally fragile.

If you believe that, then what follows is to treat the trauma or lower the emotional distress and their drinking will cease or return to normal. That sounds good but the only problem is it doesn’t work in real life.

When A.A. first started they were concerned that maybe recovering alcoholics couldn’t stand the emotional pressure others faced. When World War II started there was some fear the sober alcoholics wouldn’t be able to stand-up under the pressure the other solders encountered. What really happened altered their belief; those who served on the war front had a better record of staying sober than those who didn’t serve. They conducted themselves at least as good as any other solders.

Myth Two: Some years later numerous studies were completed in an attempt to prove alcoholics had more mental illness and/or personality disorders than the general population.

Prior to the onset of the alcoholism, stubbornly, it kept showing-up, the rate of mental illness was the same as the general population. Another troublesome fact to take away from this myth and also adding to the puzzle, was after a few years of sobriety the rate of mental illness in alcoholics was again, the same as the general population. One fact became clear to all but the most stubborn was the mental illness that showed-up in advanced alcoholics was the result of the alcoholism and not the cause.

The Natural History of Alcoholism, by George E. Vaillant, was awarded the Biennial Jellinek Memorial Fund Prize for the Best Research on Alcohol Abuse in the World. Sidney Cohen, M.D. was a powerful force in a new understanding of addictive disease by the many books he authored on addictive disease. There were also many others who were equally helpful.

However helpful the above mentioned information was on studies and research on alcoholism, the information was read by only a few professionals in the field, often medical doctors.

Myth Three:  There is a profile for addicted and potentially addictive personalities.

When Sidney Cohen, M.D. was asked about “the addictive personality” he said there is none. This was reinforced by other respected sources.

What really changed the understanding for most people was Under the Influence: A Guide to the Myths and Realities of Alcoholism by James Robert Milam and Katherine Ketcham.  The information is based on realistic studies and research; plus, presented in a style that is easy for anyone to read or look-up a question. This started a change in much of treatment and it started many alcoholics on the road to recovery.

We kept a stock of these books at the hospital chemical dependency program. We gave patients a copy and at times I would give a copy to a person who came for an interview but didn’t get admitted to the program. I started hearing back from people who said it helped them get a new understanding of addiction and was a primary reason why they began recovery.

One case was particularly significant. It was a department head in the same hospital where I worked. She wouldn’t even discuss her problem until she was satisfied it would be absolutely confidential. She said if it got out, she would lose her job. All the solutions to her alcohol problem were rejected by her except a “maybe” on A.A. I gave her a copy of  Under the Influence before she left.  For several months I only saw her in the hallway or cafeteria but she looked okay.

One day, several months later, she stopped in my office. She said she had been sober since shortly after our first session. She was going to A.A. and felt great. She said the key was reading Under the Influence because it made sense about alcoholism and for the first time, it significantly reduced her shame.

Myth Four: She had talked to therapists before and it had only increased her shame and reduced her self confidence. She kept getting this picture presented to her that she was this emotionally fragile, pathetically neurotic female, and the stresses of ordinary life were just too much for her–and that is why she drank.

She said, “I now realize what a bunch of bullshit I was getting, while I made their car payments.”

Although she had insurance coverage for her therapy sessions she paid for them in cash, she didn’t want word to get back through the HR department.

Shame is one of the great barriers to treatment and recovery from alcoholism. At times it can be obvious and other times it is very subtle. When going to treatment for alcoholism, whether it is inpatient or outpatient, it frequently is one of the worst times in the person’s life and any talking down to the patient or discounting what they say can put a real damper on their treatment.

Myth Five: Another question I have been asked is, “Doesn’t the idea of powerlessness leave the person without any responsibility for their behavior?”

Answer: No. The person quits trying to do what isn’t working. At this point, all the time, money and energy that were wasted before can now be applied to realistic tasks. Another way of looking at it is by watching those in recovery. You will soon see they do very clearly take responsibility for their behavior.

Myth Six: I have heard endless complaints about A.A. Most of the time it had nothing to do with what A.A. has to offer, it usually is someone who is speaking for A.A. and has little or no knowledge of the program. I have heard psychologists complain about how A.A. is too religious and a cult, plus other negative comments.

I asked one of them, “Have you ever been to a meeting?”

He said, “No.”

“Have you ever read the Big Book?”

He said, “No.”

“Have you ever read the twelve steps?”

Again his response was, “No.”

Yet, this person felt qualified to make lengthy negative judgments.

Many people don’t realize there is no shortage of atheists and agnostics in A.A. who are doing just fine.

Myth Seven:  Go to ninety A.A. meetings in 90 days. Why does Alcoholics Anonymous say you have to go to 90 meetings in 90 days?

To the best of my knowledge this didn’t originate from A.A. Sometimes members say it did, but the recommendation started in treatment centers. I have no problem with anyone who wants to attend A.A. every day. But, there can be some problems with substituting quantity for quality. If a person believes the recovery comes from attending a lot of meetings instead of doing the step-work, they have missed the whole point and benefit of the twelve step programs.

Myths Eight, Nine and Ten: Sponsors at times can cause problems. I have had patients tell me their sponsors told them to divorce their wives, quit taking their medication, and ignore their physician’s advice. The above advice can be devastating to a newly recovering person. Sometimes, even deadly.

An important point here is that it can easily be avoided by going to the Big Book or Twelve by Twelve and reading the truth. So if you are skeptical of anyone’s advice about A.A. go to the source material. Don’t believe anyone unless it can be backed up in A.A. approved literature.

When you are getting recovery advice you may be betting your life on that information, so, just like any other potentially terminal illness make sure it is the best information available.

How do you do that? Information is available on counselor certification and/or licensure through NAADAC, a national organization, and they can direct you to your state organization. ASAM has both physician information and referral and medical information regarding addiction treatment. Feel free to question any health-care professional about their background in addiction treatment and if it doesn’t completely satisfy you, go elsewhere

If the situation is urgent and you have little time, go to my website, Alcoholism Answers, and you will find a link to a government treatment facility locator where you can find treatment help in your local area. Another source is to see your primary care physician or a local physician; most have some knowledge of addiction and can help with referral.

Ernie Hooker, CADC II, NCAC II 

If you have friends who are interested in addiction treatment and recovery please forward this article to them. If you have suggestions for a topic, contact me and, if possible, I will include the information in a newsletter, Ernie Hooker, CADC II, NCAC II.