Recovering from addiction is hard, just ask anyone who’s doing it, and they will tell you it is just about the hardest thing they have ever done. Simultaneously, these same people will tell you that recovering from addiction is one of the most enlightening, empowering, and fulfilling things they have ever done. Addiction has the strange characteristic of being one of the more difficult diseases to treat. Conversely, long-term addiction treatment results in a better quality of life for the Patient, than they ever experienced, prior to contracting the disease.
There are numerous studies conducted by various government agencies, universities, and a few private agencies: all point to the effectiveness of addiction treatment. With addiction treatment effectiveness ranging anywhere from 10% to 80%, it is safe to assume that there is more going on in addiction treatment than just the treatment program. Obviously, the individual patient in treatment must be a willing participant, and his/her relationship with healthcare professionals, peers, and family members must be supportive. Naturally, the patient must be capable of receiving treatment and hopeful for recovery, and the treatment team must be knowledgeable about the individual patient’s needs. Nevertheless, there is more than that; the environment in which the recovering person must live needs to be conducive to recovery as well.
When speaking of the environment, many facets come to mind. There is the physical environment, the emotional environment, the ethereal environment to contend with, and all must be treated with importance. In order to provide the greatest likelihood of a successful recovery effort from addiction, ‘all the starts must be in alignment.’
Addiction treatment addresses the physiological, psychological, sociological, and spiritual realms of the patient. Therefore, it is of primary importance that the patient’s environment be therapeutic. Healing must be encouraged and allowed to take place, and while this may sound obvious, it is often one of the most difficult and challenging goals to achieve.
The Therapeutic Environment
The patient undergoing treatment for addiction is complex and confusing for his/her caretakers. Sometimes the patient needs privacy to process through intense thoughts and emotions, and other times the patient needs the support of an individual or a group of individuals. Moreover, it is the individual patient that dictates these needs, and at what time these needs present themselves. Arguably, the best approach to provide a therapeutic environment is to attempt to create a safe haven for the patient wherein they can express themselves openly and without fear of reprisal: hopefully the result being that the patient is communicating their needs to the caretakers.
Characteristics of the therapeutic environment will vary from location to location and from culture to culture: however, there are a series of environmental factors that should be accounted for despite the environment.
• Contemplative space to allow the patient to engage in the proper mindset for looking inward and for connecting to a higher power;
• Accountability systems to allow the patient to achieve daily goal standards and prove achievement of those standards in order to build self-confidence;
• Routine process and stability of systems to allow the patient to rely on something that serves them, and will not abandon them;
• Appropriate distraction to allow play, stimulation and interest without promoting excessive drama, obsession and unhealthy focus;
• Caring, loving and forgiving interaction with others to allow the patient to process through guilt and shame based thinking without external judgment.
• Peer interaction and mentor guidance to provide the patient with new ways of coping with their life.
With an appropriate environment, the patient is able to take advantage of his/her growth and change efforts. Hopefully, he/she will identify those areas of life that are in need of alignment with long-term life philosophies that will provide for sobriety and a quality fulfilling lifestyle.
I have developed a philosophy of seven guiding principles called Balanced Center Living. Certainly, these principles are nothing new, however they do provide an excellent base point from which an individual in recovery can contribute in the journey of life and hopefully avoid the unmanageable stresses that may lead to addiction relapse.
Balanced Center Living
The physical body requires rest to recover from strain and to grow. The cognitive mind must rest, or enter into an anabolic state where simple substances are synthesized into complex living tissues, in order to maintain normal function. The average adult requires 7-8 hours of sleep each day, although some require as few as 5 hours and some as much as 10 hours each day.
The best way to give your body the balanced nutrition it needs to function properly is by eating a variety of nutrient-packed foods every day that stay within your daily calorie needs. Just be sure to stay within your daily calorie needs. A healthy eating plan is one that:
• Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products.
• Includes lean meats, poultry, fish, beans, eggs, and nuts.
• Is low in saturated fats, trans-fats, cholesterol, salt (sodium), and added sugars.
Moderate cardiovascular exercise for 20-30 minutes each day will significantly improve the body’s health. Moderate exercise is the equivalent of walking or jogging at a 4 – 5 mile per hour pace. Strength training is also beneficial because muscle tissue tends to break down without use.
Play energizes us. It makes us happier, renews a natural sense of optimism and allows our imaginations to thrive. Play allows us to practice, elaborate on, and perfect skills before they become necessary (Rubin, 1982).
Activities for the purpose of recreation or excitement, whether potentially dangerous or not, creates psychological and physiological arousal that is interpreted in our mind as positive or negative. Adventurous experiences push our limits and provide opportunities for internal growth.
Mental processes (e.g. art, music, abstract thought, writing, etc.), involving the generation of new ideas or concepts, or new association between ideas or concepts. Creativity stimulates the brain and causes intellectual growth and elevates mood. Creative insight can evoke feelings of elation, personal awareness and spiritual enhancement.
One’s ability to confront shame, scandal, intimidation, fear, pain or uncertainty and push beyond these physical and moral barriers empowers the individual to realize confidence in his/her abilities as well as boundaries for their behavior.
One’s desired states of affairs which are specific, measurable and attainable are one’s goals. Goals give structure to desires and cause thought around the surrounding circumstances as they are now, how circumstances can change, and what it will take to change the circumstances. Goal setting is a practice that produces improvements in circumstances without fail.
Firmness of purpose when encountering life choices, desires and circumstances yield forward motion rather than stagnation.
At times it is necessary to act regardless of the possibility that an event may occur that will have a negative impact on the results, because it is also a possibility that the same event will have a positive impact on the results. With some risk, there is the possibility of greater rewards.
3.1. Higher power
A power greater than one’s self which one can turn to for connection, whether a formal religious figure or not, is essential in developing and maintaining a spiritual system. By turning to a higher power for help, guidance, strength, and opportunity one is relieved of the burden of solving all life’s difficulties alone.
Being charitable or acting charitably toward others creates a sense of fulfillment for social animals such as human beings. Kindness bonds us together with emotions such as compassion, empathy and generosity.
The peacefulness resulting from the absence of agitation is known as serenity. It is in the mental state of serenity that one can be fully present.
Understanding that one is not more important, better than, or more valuable than another is a belief system that is virtuous because it contributes to one’s ability to comprehend that they are not in control of most circumstances.
The spiritual process of relinquishing feelings of resentment, offense or anger against another person or one’s self, and liberating one’s self from the expectation of punishment or restitution. Forgiveness is central to one’s ability to let go of the past and move into the present.
Consistency in adhering to a framework of principle beliefs creates integrity to the extent that behaviors match those beliefs. Integrity bestows emotional security in decision making.
One’s ability to communicate and act in harmony with one’s views as one truly believes them to be. Honesty relieves one of internal conflict.
One’s ability to communicate and act in harmony with one’s understanding of facts as one truly believes them to be. Truthfulness relieves one of contradiction.
Any method of transferring a message from one to another is communication. Effective communication includes a method of feedback to confirm that the intended message was received by the recipient.
5. Accurate Thought
Being in the current moment of time and space delivers true clarity and the personal ability to think and act in a healthy way. Some consider being present a spiritual connection revealed, or a direct link to one’s soul. Being present can also be interpreted as having mind, body and spirit connected together all at once.
A state of non-judgmental awareness of one’s thoughts and behaviors in the present moment is the basis for one’s independent existence.
The belief that a circumstance does not require one’s efforts to change the circumstance creates agreement between the reality of the circumstance and one’s self-will.
One’s ability to form an opinion, after careful consideration, of what is true, right or lasting will result in healthy attitudes, beliefs and courses of action.
Understanding that one exists as an individual with private thoughts, personal traits, particular emotions and unique behaviors distinguishes one from other people and causes a willingness to accept one’s self as well as others.
Family, friends and intimate partners with whom one forms social associations and a particular type of connection that provides mutual support and affinity creates a sense of confidence, fulfillment and well-being which enables one to take healthy risks.
Friendly relationships associated with people of similar tastes, interests or experiences sustain a sense of community and involvement.
6.3. Joyful focus
Attention given to people, places and things that give one happiness, delight and elation positively guides one’s attitude and outlook on life.
One’s belief that good ultimately predominates over evil and that people and events are inherently virtuous will bring about an understanding that most situations will work themselves out for the best.
Taking part, or sharing, in something nurtures one’s need to belong and contribute.
The state of being ready to show thankfulness increases one’s ability to be happy and tends to make one more helpful, forgiving and less depressed.
Laughter is an expression of merriment that also clarifies one’s intentions in a social exchange such as a positive contribution in conversation or acceptance of being part of a group interaction.
One’s ability to exercise control over one’s behavior and emotions empowers one to improve upon a skill, train for particular conditions, or refrain from unhealthy behaviors.
Being answerable to one’s self for one’s conduct when social forces bind one to a specific course of action qualifies one to be a part of a society which includes a basis of rules and acceptable behaviors.
7.3. Fulfilling work
Work that satisfies one’s healthy desires, expectations, needs and demands in order to deliver a feeling of contentment is beneficial in supporting a positive self-image and attitude.
Exercising one’s normal mental and bodily powers causes energy to flow and invigorates mind, body and spirit.
By Andrew Martin, MBA, LAADC, SAP, CA-CCS