Recovery Process

What is recovery?

The dictionary definition of recovery is that it is a return to a normal state of health, mind or strength. Inherent in the word is the idea that you are getting something back. However, many people in recovery have never had a normal state of health or mind. Further, what is considered normal is not necessarily healthy.

These days recovery has come to mean something much more than recovering from an illness or addiction. Indeed, it is used to describe the process of reaching an optimal state of health, mind and spirit. For me the recovery process is the enlightenment processes. When I am in recovery, I am acting from my connection with source and I am reaching for greater balance, greater wholeness, and ultimate peace.

There are many important principles that form the recovery process for both substance use and other mental health disorders. Five critical principles are: 1) recovery is self-directed, 2) recovery is individualized and person-centered, 3) recovery is non-linear, 4) recovery is holistic, 5) recovery involves peers and allies.

Recovery is Self-Directed

Recovery is about achieving a personally fulfilling life. To this end, each person’s recovery must be directed by them. Any other approach would be nonsensical and doomed for failure. Each person’s must decide what they want out of life or a particular situation. Here are some steps that are useful.

  • Make a list of what you value. Include everything that is important to you.
  • Prioritize the list. What items are the most important to you?
  • Group together things that seem similar.
  • Make a list of things you want to achieve in your life.
  • What would your ideal day look like? Where would you be, who would you be with, what would you be doing?

 

Recovery is Individualized

Once you have a list of goals, you need to create a plan. Recovery isn’t a one size fits all type of program. What works for one person, may not work for another. Each person’s recovery plan is unique and personal. Everybody has their own way.

For reflection: “What is my way?”

The process of recovery involves learning who you are and what works for you. To assist self discovery and progress to the goal of abstinence, try listing situations from your past (even childhood) where you felt successful and fulfilled. Describe them in detail and then explore common themes.

  • What types of things were I involved in?
  • Who or what was I working with?
  • What was the end result?
  • How did I work? Did I use my hands, mind, etc.

This process of exploration will help you learn more about what truly and naturally fulfills you. Then turn back to your goals and consider the following:

  • What would you need to do to reach your goals?
  • Break this down into doable steps.
  • Determine if you could use outside help to do each step.
  • Identify helpers and recruit them.

 

Recovery is Non-linear

Understanding that recovery is non-linear is important to avoiding a good/bad attitude towards progress.  Judging our actions as good or bad is not useful.  It is more useful to discern actions that bring us towards recovery and our goals and those that bring us away from recovery and out goals. One way to grasp this is to do a “relapse plan”.  This means to focus on one behavior you are changing and write out the step that would lead you back into that behavior.  For instance, if you have decided to not drink alcohol anymore and theoretical individual relapse plan may look like:

  1. Feeling great with absolutely no desire to drink.
  2. Deciding to skip recovery meetings or recovery activities because busy at work and/or with family activities.
  3. No getting enough sleep due to extra activities.
  4. Deciding to not exercise because feeling tired.
  5. Go to a family activity and get in an argument with a family member.
  6. Leave the activity and want to just relax
  7. Decide to have a glass of alcohol just to chill out.

 

Prolapse is the process of moving away from relapse.  At any one time someone could take the relapse plan and make a different choice at any of the steps.  For instance, at step four one might decide that they need to cut down on extra activities in order to get more sleep so they can exercise.  They then might have time again to go to recovery meetings.  The key to this is learning about how to be aware of what we are doing, why we are doing it and the consequences of those actions.

We may also have to practice surrender.  In this case it may mean surrendering the extra work or activities and dealing with the loss that is associated with that letting go at the same time as being cognizant of the greater good we are achieving.  Awareness of one’s goals is paramount, as is a greater understanding of the steps that take one away from recovery and the steps that take one towards recovery.

Recovery is Holistic

This brings us to the important principle that recovery is holistic and all encompassing. Once we enter into a recovery process to change one thing often means changing things in many aspects of our lives.  Often we may find that some of our goals may conflict with other things.  For instance, having that specific great job that provides stable income may not allow us three months off a year to do a silent retreat.  We may have to choose between the two or recreate our life so that we have both.

The best way to see that our recovery impacts our entire being is to consider what triggers the behavior you are in the process of changing and what you would need to complete the transformation.  For instance, many people list HALT (hunger, anger, loneliness, and tiredness) as triggers for using. To effectively reduce such high risk situations as HALT you would ideally change lifestyle things such as when and what you eat and how much sleep you are getting.  You would also need to learn new cognitive processes to deal with anger and/or improve relationships. In addition, increasing support networks and learning how to really connect with people and/or a spiritual source is critical for coping with loneliness.

Exploring such a scenario puts recovery into perspective as a life-long project.  Indeed, you may start with a small change in eating regularly and then realize that the coffee or soda habit is creating additional tiredness and sugar cravings.  When you eliminate these you feel worse during withdrawal and then better after.  Then you notice that other aspects of your diet are not optimal and you can focus on these.

Recovery Involves Peers and Allies

Finally, recovery cannot be done in isolation. It requires the support and assistance of peers and allies. This becomes clear once the extent of change that is needed for a person to reach a fulfilling life is realized. In addition, the recovery process is a more enjoyable journey when walked with peers.

  • Review you list of goals
  • Determine ideal level of help you need to reach each one.
  • Identify helpers.
  • Who or what serves as an impediment to reaching the goals?
  • Plan to recruit the aid you need.

 

Recovery is a life-long self-directed process that is unique to each individual. The process tends to be non-linear and involves all aspects of a person’s life. As such, the process of recovery and reaching ones highest potential and self-fulfillment involves multiple people that serves as support and guides.

Alternate Reality

Yesterday, I was talking about the placebo effect of antidepressants.  I had started to write about my reaction to the denial surrounding the use of anti-depressants and went down a different thought train than I intended.  So, today I want to get back on track and talk about a new perspective I have been contemplating surrounding anti-depressant use.

It use to be that I lived in a world where I thought there was some truth I could find and adhere to.  For instance, I believed that anti-depressants did not work.  I even had scientific research to back it up. Now, I have an understanding that the world I live in is deceptive.  For instance, I once read research that claimed liquid extracts of feverfew were ineffective in treating migraines.  So, I stopped taking my feverfew tincture and my migraines came back.  So much for scientific research.

But it is not that the research is wrong…

Buddhism, Ho’oponopono, and new age perspectives all concur that the world we see around us is created (fully or in-part) by ourselves.  This means that just because antidepressants don’t work in my world, doesn’t mean they are not effective in other people’s worlds.

This means that I’ve “created” a world were anti-depressants do not work.  I see research that supports that, all my friends that use anti-depressants do not feel better, and I disregard claims that anti-depressants work as “placebo effect.”  And since the world I create is 100% real this is a valid reality.

On the other hand, other people live in a world where anti-depressants work.  Not just placebo work, but actually work.  They get mad at people like me that say their drugs do not work because they have evidence.  They have tried diet, exercise and herbs only to have those treatments fail.  These people go to doctors that know anti-depressants work and they feel better when they take them.  They really do have a brain chemistry imbalance that is corrected with pharmaceutical.  Their world is also 100% valid reality.

My reality is valid and all the alternative realities are also valid.

I have noticed that I spend a great deal of time arguing in support of my perceptions in my head.  I justify what I do by thoughts that support the rightness of it.  I also see others telling each other what to do and what works.  “All of us know what is right.”

I can imagine a true path to non-violence includes accepting that other people’s worlds are different from ours.  Not just their perspectives and experiences, but the actual makings of the world they live in are different.  They are not just apparently different.  They are functionally different as well.

I was once at a scientific conference with some of the big names in physics there.  One of the discussions centered on the problem of being able to replicate research.  For instance, someone (perhaps hypothetical) had developed a process of doing fission to create unlimited energy, but no one else could reproduce the process.  The creator had what it took to manifest this incredible creation, but others didn’t.  His world included fission, while for the rest of us it does not exist (yet).

The crux of the problem was what I just described.  Each person creates their world and if they do not have the karma or beliefs that include certain realities or if they have the beliefs that excludes certain realities then they will not experience them. As far as I know we have the technology to cure all disease, to feed all people, to clean up all pollution.  What stands between us and the Garden of Eden is simply misbeliefs held by the majority.  (That is why I like ThetaHealing so much.  It is a way to remove dysfunctional misbeliefs.)

 

Placebo

I’ve been so busy with work and school, it is so good to finally have some time to write.

This week we studied co-occurring disorders.  I was especially interested in the perspective presented on depression.  Mainstream medicine appears to be in denial around the use of anti-depressants.  Research consistently shows that antidepressants do not work any better than placebo.  So why do we still use them?  They get approved as drugs because they do have a statistically significant effect on depression.  However, that effect is not clinically significant.

The difference between clinical significance and statistical significance can be described like this:  Le’ts say that people start the study with depression reported as a 7.0 on a ten point scale with the most severe depression being 10.  And at the end of the study they have improved to a 4.0.  That’s great!  They are feeling better.  However, the placebo controls have also improved and they come in at a 4.1.  For our example the 4.0 is statistically different than the 4.1.  However the difference between placebo and anti-depressant is not clinically different.  People just don’t say, “my depression is down to 4.0 from 4.1 and I feel the difference.”

Different ailments appear to have respond differently to placebo.  Depression is highly responsive to placebo.  Research from 1999 found the effects of placebo on depression to be 75%.  However, these placebo effects on depression have been continuing to grow over the past couple decades, so that now we are finding certain antidepressants no better than placebo.  Menopausal hot flashes also have a nice placebo response.  And at least one third of the results of pain relief can be attributed to placebo effect alone.

Placebo, or context effect as I like to call it, has been extensively studied.  We know some of the things that will increase the likelihood of a treatment being effective.  These range from the color of the pill to patients perception’s of the health care practitioner.   Placebo effect is really not much different than marketing.

The mental health practitioner doesn’t realize that when they listen attentively to their client, label them with a disorder name (e.g. “You have bipolar depression.”) and tell the client that there is a pill that will “stabilize their brain chemistry” they are actually marketing the treatment.  They may also tell the client that the drug’s effects could “kick in” immediately, or they might occur slowly over a period of a couple months.  This gives the client options on how to respond to their “placebo/antidepressant”.  If the client then runs into someone that is on “their” antidepressant and they say it “saved their life”, they have additional context to boost the effectiveness of the treatment.

The word “placebo” has gotten a bad wrap, in the sense that only a fool would respond to placebo effect.  That is one of the reasons I prefer “context effects” over “placebo”.  Context matters and optimizing context to support healing seems like a good strategy, not a unethical strategy.  Certain settings, particular colors, and personal biases make a difference in treatment effectiveness.  Does optimizing context fall under the adage of “first do no harm” or does it harm someone to play into their natural tendencies to put faith in certain people, places and things?

REFERENCES
Kirsch, I., (2008). Challenging Received Wisdom: Antidepressants and the Placebo Effect.  McGill Journal of Medicine, 11(2): 219-222.

Di Blasi, Z. & Kleijnen, J., (2003).  CONTEXT EFFECTS:  Powerful Therapies or Methodological Bias?  Evaluation & The Health Professions, 26(2), 166-179 DOI: 10.1177/0163278703252254.