REFLECTIONS ON LONG-TERM RECOVERY (GALEN TINDER AND BILL WHITE)-April 12, 2019-Bill White

Addiction recovery is far more than the removal of drugs from an otherwise unchanged life. Recent definitions of recovery transcend radical changes in the person-drug relationship and encompass enhanced global health and social functioning. The authors have carried on a decades-long interest in what has been christened full recovery or amplified recovery—a state of enhanced quality of life and personal character in long-term recovery. We each know individuals we believe have achieved such status and have asked ourselves what unique characteristics distinguish such persons. Here are some of our initial reflections on this question, offered here as an expression of gratitude to such people who have enriched our own lives.

They have been freed from the daily physical cravings (that insatiable itch) and distorted thinking that are at the heart of the addiction experience and that in the past rendered them uncomfortable within their own skin. The necessity to live life drug free has shifted from a perceived curse to a gift that one wears comfortably and humbly. Their recovery is no longer a struggle, but a set of favorite old clothes worn comfortably like a second skin.

They are not in the grip of non-substance cross-addictions such as gambling, sex, food, money, and control. (They also embrace smoking cessation and other acts of self-care within their personal understanding of recovery.) They may have tangled with one or more of these addictions earlier in their recovery career but typically somewhere between 10 and 15 years they were able to shake them. Some experience periodic temptation but they move through these periods, not through an assertion of will but by talking to other people about managing these shadow dimensions of personal character.

They are capable of achieving stable and emotionally rich relationships with partners, family members, friends, and colleagues. Their history of past relationships may be harrowing but they have now tamed the disruptive and self-destructive patterns of behavior that previously complicated their relations with others. Rifts in family relationships have been healed to the extent possible.

Regardless of whether they have pursued a secular, spiritual, or religious pathway of recovery, they continue to work an active program of recovery that includes self-inventory, honest acknowledgement of misdeeds, personal amends, and acts of service to others. In addition, they address with equal determination issues of resentment and the forgiveness of others who have harmed them.

Most reflect in their lives four qualities that are fundamental to a life of spiritual substance- humility, compassion, honesty, and gratitude.

They laugh regularly and deeply with rather than at people. They find joy and humor in the simple incongruities and absurdities encountered in daily life. The can offer healing laughter and a twinkle in the eyes as a balm to those in early recovery whose daily emotional dramas seem unceasing. Theirs is a healing laughter.

They are open-minded and inquisitive. They acknowledge that their own views and convictions may be mistaken or limited. They are thus eager to learn about the experiences and opinions of others and to expand their knowledge of the world. They have fully relinquished the distorted belief that the universe revolves around them. They listen more than they speak.

They give service to the community outside of their immediate recovery support network, usually on a volunteer basis. In addition, they are aware of the value to the larger society of maintaining a personal posture of openness, civility, and compassion. They view this posture as an act of needed service that, through its infectiousness, counter the poisonous tone of current social and political discourse.

They have worked through childhood traumas, one of the most tenacious causes of addiction recurrence. Working through does not mean putting it behind them (negating the suffering) but rather integrating the trauma experience in a manner that transmutes their suffering into compassion for themselves and others. It remains fresh, but not disabling, so that they can draw from it in helping others. In our observations, most of this trauma work occurs after five years of stable recovery.

For those achieving amplified recovery within a 12-Step program, most maintain meeting attendance of at least once a week. They usually have a sponsor and sponsor others. They periodically brush up on the steps, sometimes by facilitating step studies. At the same time, however, they are non-dogmatic about the program and take ample advantage of other aids to recovery such as psychodynamic therapy, CBT, yoga, meditation, the Buddhist grounded program of Refuge Recovery, and energy healing.

They recovered through living narratively—what some call living out loud. In the beginning, they told the story of their past, affirming that they did not want to return to their former way of life. Next, they began to contrast the present and past as they sought to construct a new identity centered in a new set of values. They became at ease talking about their experiences and their feelings—literally talking their way into a new more transparent existence, leaving behind their former duplicitous, self-absorbed, self-contained personage.

In the process of constructing a new identity, they faced the challenge of shame that is typically rooted in the past and revitalized by present events and relationships. Shame is the most potent impediment to recovery—the whisper that we are not worthy of recovery and the fruits it can bring. In tackling their shame, they discovered what Brene Brown found through her grounded theory research – shame is defeated by vulnerability, by developing exactly the wide-open stance toward the world that shame warns us against.

They have developed the capacity to listen closely and effectively to other people, and particularly to their pain. They are “wounded healers” who use their own survival to help others facing similar threats and opportunities. From a deep plunge into their own depths of agony, they emerged with new capacities for hope and love.

They have found meaning and purpose in their lives beyond themselves, one that evolves through an epiphany at the intersection of transcendence and communion. The nature of this transcendence varies greatly from formal religious faith to the sense that the universe vibrates with either love or hate, depending on what we humans project into it through our thoughts and deeds. They have committed themselves to healing themselves, their families, their communities, and, to the extent possible, the world, knowing that they will pursue this effort imperfectly but relentlessly and that profound meaning lies within that pursuit.

We have met some wonderful people through our recovery journeys—people who have lived full meaningful lives in recovery and exhibited exemplary qualities of character and styles of daily living. In closing, we should also note that we have met others not in recovery who shared these traits and lifestyles but who had survived their own “dark night of the soul” and had emerged as different and quite remarkable people. Surviving life-threatening events or conditions have the potential to be life-transforming—taking people beyond survival and healing to the status of healers in their own right. We hope your life has been similarly blessed by your encounters with such people.

Post Date April 12, 2019 by Bill White

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RADICAL HOPE AND RECOVERY INITIATION-April 5, 2019 -Bill White

Radical hope—a radiant vision of new possibilities in the face of personal or collective devastation—is the catalytic ingredient at the heart of personal transformations and successful social movements. Such hope has been spread contagiously by charismatic figures like Handsome Lake, Frederick Douglass, Susan B. Anthony, Mahatma Gandhi, Rosa Parks, Martin Luther King, Jr., Malcolm X, and Cesar Chavez, to name a few. Radical hope, at a personal level, allows one to rise from the ashes of addiction-related collapse and step into an unknown recovery future.

Psychoanalyst and philosopher Jonathan Lear, in his 2008 book Radical Hope: Ethics in the Face of Cultural Devastation recounts the story of the great Crow Chief, Plenty Coups, who guided the Crow nation through an era of utter cultural devastation. In the wake of cataclysmic loss—mass slaughter of the buffalo, epidemic disease, and White intrusion into Crow hunting grounds, all amidst the larger physical and cultural assault on Native tribes, Plenty Coups faced the question of how the Crow people could go on without the values and traditions that had made life meaningful throughout their tribal history. Plenty Coups drew upon an apocalyptic dream to lead the Crow nation into a completely unknown and questionable future. His dream suggested that the Crow would have a future only by emulating the Chickadee figure of Crow mythology whose distinguishing trait was the ability to listen and learn from others. According to Lear, it was this focused capacity to observe, listen, and learn that allowed construction of a new and meaningful life for the Crow people.

Addiction tests our capacity for suffering and our fear that life has no meaning beyond pain and insatiable desire. For many at the brink of extinction—the exhaustion of our personal history and the near-complete destruction of all that we had been and hoped to be, a life without drugs and a life in recovery seemed completely inconceivable. Only a radical form of hope—a hope powerful enough to challenge the formidable objective evidence of a hopeless future—could propel us through the early days and weeks of recovery. That transition often required death of the old self to form the ashes from which a new self can rise. Radical hope, as opposed to false optimism or outright delusion, provided the courage to let go of the past, the momentum to step forward, and the endurance to fully commit to this turbulent journey of personal resurrection. What made this hope radical was its leap into a future beyond one’s capacity to see and understand.

Recovery tests our capacity for healing and forces us to face the fear that a life without our elixir will be filled only with nothingness. Facing that fear requires radical hope bolstered only by the knowledge that others have made this journey before us. Like the Chickadee figure in Crow mythology, what will guide us is the ability to observe, listen, and learn as we move forward into this unknown world of recovery. Through others who have made this journey, we can learn the words, ideas, rituals, and relationships that guide the reconstruction of personal character, personal identity, and daily lifestyle. Some will draw on hidden resources within the self while others draw on powers beyond the self, but rarely is the journey of recovery made in isolation.

The Chickadee figure suggests a “middle ground” between two worlds where one can, through the acts of listening and learning, forge a new way of thinking and being. Various cultures of recovery may provide such a middle ground. Within such a milieu we can construct a new story of our lives—one describing what life was like before one’s metamorphosis, and what life is like now (who and what we are becoming). Central to that new way of life is commitment to a lifelong process of character reconstruction based on a new set of ideals (e.g., honesty, humility, gratitude, forgiveness, tolerance, harmony, and service). Recovery moves beyond removing intoxicants from one’s life to changing one’s identity at a most fundamental level. Embracing the need to do both may be possible only in the presence of radical hope.

Lear suggests that when the Crow people were at their lowest point of impotent grief and rage as a nation, what they most needed was a new poet who could reinterpret Crow beliefs of the past to forge “vibrant new ways for the Crow to live and to be.” Plenty Coups served this role and in doing so opened a path of radical hope for the future. The lowest points of addiction provide similar opportunities, and the collective stories forged across secular, spiritual, and religious pathways of recovery provide both the radical hope and the building blocks through which new ways to live and be become possible.

So what advise does this offer the person at the doorway to recovery? Welcome and embrace radical hope no matter how imperfect its messenger and emulate the Chickadee virtues of observing, listening, and learning from the successes and failures of those around you. As experienced by so many who have gone before you, radical hope can enable your survival and open new ways of living and being.

Post Date April 5, 2019 by Bill White

Bill White-THE ROLE OF RECOVERY COMMUNITIES IN CULTURAL HEALING-November 9, 2018


Ironically, it is at the margins of society that one discovers the moral center. –Van Jones

In a bleeding world, where are the sources of communal healing? When our connecting fabric is shredding under the assault of hateful rhetoric, where do we find common ground—settings where people speak with each other and not at and over each other? How can we escape the spell of political pimps of all persuasions creating and exploiting divisions for personal aggrandizement and ideological gain?

These are questions being asked by people of conscience from diverse political, economic, religious, and cultural backgrounds. As Van Jones suggests, the sources that could help us get re-centered could come from unexpected quarters. Is it possible that people in addiction recovery and diverse communities of recovery could serve as a force for cultural and cross-cultural healing?

A reasonable response might well be, “What could people whose past lives have been ravaged by addiction have to offer on issues of such great import?” It is not the lessons from addiction that might offer a balm for our cultural wounds, though addiction can be an astute if unforgiving teacher; it is rather what has been collectively learned within the recovery from addiction that holds solutions of potentially larger value to our country and beyond.

Individuals, communities, and whole cultures are always in a process of self-correction from extremes that threaten their existence. Addiction recovery is itself such a correction process. What is needed culturally when ideologically extremes prevail is a vanguard of people who purposefully infuse into the culture critically needed and missing ingredients. People in recovery and communities of recovery may be uniquely poised to provide such missing ingredients.

Narcissism, with all its ornaments of self-righteousness, arrogance, and self-aggrandizement, has become the new religion—a selfie culture gone mad. We now have leaders who champion these defects of character as a source of pride and purported strength. This worship of self when elevated to a cultural level fuels fervent nationalist movements that claim superiority, build walls of isolation, and deny the interconnectedness and interdependence of all people and nations. People who have been addicted know something of this religion, its sources, and its solutions. The addicted person’s world progressively shrinks in anguish to the person-drug relationship—a radical disordering of personal priorities and a progressive disconnection from others.

Many valuable lessons can be found in the process of escaping such self-entrapment. It takes a village to heal the wounded—and we have all been wounded; healing and wholeness require resources and relationships beyond the self and beyond closed social silos. Personal survival hinges on a greater social unity and common purpose; what we share in common is far more important than our superficial differences. We can achieve together what we have been unable to achieve alone. Distortions of reality, projection of blame, and scapegoating can be diminished by acceptance of our brokenness—our Not-Godness, acceptance of our common humanity, and the assertion of personal responsibility. Amends can be made for past sins of omission and commission. Personal and collective excesses can give way to greater balance and harmony—from competition and conflict to compassion and care. Self-absorption can be diminished through open acknowledgement of one’s imperfection. The masks of grandiosity can be shed and replaced by genuine humility. Bitterness and resentment can give way to forgiveness and gratitude. Preoccupations with power and control (and the resulting close-mindedness and aggression) can give way to tolerance, mutual identification, and service to others. Anguished self-absorption can give way to connection to community, shared joy, and laughter. Settings can be created where people actually listen to one another without interruption or condemnation. Those are among the lessons of recovery.

Excesses within our current cultural life suggest deep wounds—wounds crying for a collective and sustained healing process. As our culture seeks self-correction, communities of recovery can offer healing ingredients as we as a people seek a new moral center. For those in recovery who have concealed these gifts within the rooms, perhaps it is time to reach out and touch someone.

Post Date November 9, 2018 by Bill White

Bill White-YOUR RECOVERY QUOTIENT? TOWARD RECOVERY FLUENCY-October 19, 2018

In 2012, I experimented with the creation of a recovery knowledge exam (See What is Your Recovery Quotient? Toward Recovery-focused Education of Addiction Professionals and Recovery Support Specialists). The 100-item test was intended to illustrate the training emphasis on drug trends, psychopharmacology, and addiction-related pathologies in marked contrast to the scant attention paid to the prevalence, pathways, styles, and stages of long-term addiction recovery. (For details on such limited attention, click HERE)
We live in a world where people experiencing significant alcohol and other drug (AOD) problems call upon diverse iconic historical and contemporary figures, catalytic ideas, words, slogans, metaphors, and quite varied identity and story styles to resolve these problems. The challenge for addiction treatment and recovery community organizations and their service providers is to create environments and service menus within which all of these organizing motifs and languages are available. Achieving such broad recovery fluency among addiction treatment and recovery support specialists requires mastery of the history of addiction recovery and a basic understanding of what is being learned about recovery through rigorous scientific studies.

For addiction professionals and recovery support specialists, this calls for basic fluency in the language of secular, spiritual, and religious pathways of recovery and their related mutual aid societies; knowledgeable about assisted and unassisted styles of problem resolution; and knowledge of a broad spectrum of prevention, harm reduction, treatment, and recovery support technologies. Embracing such a menu is predicated on the belief that people use diverse ways to avoid and escape AOD problems and that such success is enhanced through informed choice and respectful guidance.

So exactly what would such fluency mean at its most practical level? Which of the following statements would you support?

*Educational media within addiction treatment and recovery support programs should be available in multiple languages, particularly the most prominent languages within a program’s geographical catchment area.

*Organizations providing addiction treatment and non-clinical recovery support services, regardless of their primary orientation (secular, spiritual, or religious; abstinence-based or pharmacotherapy-focused; etc.), should provide everyone screened and served with information on alternative approaches.

*Organizations providing addiction treatment and non-clinical recovery support services should shift from stand-alone, single-modality/philosophy service organizations to multimodality service centers offering a broad menu of evidence-based, experience-informed services.

*Any person being served by an addiction treatment or recovery support organization who fails to respond via measurable positive effects or who experiences clinical deterioration during the course of service should be informed of alternative approaches and assertively linked to such services.

*People in recovery working in professional or peer service roles and people who are academically credentialed without experiential knowledge of recovery should be provided orientation and training on and exposure to alternative pathways of recovery and how to present treatment and recovery support options in an objective manner.

*Addiction treatment and recovery support specialists should have a working knowledge of the history, organization, primary mechanisms of change, core literature, meeting and communication rituals, and assertive referral procedures for the major recovery mutual aid organizations and other indigenous recovery support institutions.

*Addiction professionals and recovery support specialists should be knowledgeable about local ethnic/cultural communities and indigenous healing roles and healing practices that may be engaged as sources of recovery support.

If you would like to assess your recovery quotient and fluency, click HERE. I look forward to updating this test in the future to incorporate recent historical developments and recovery research published since 2012.

We have learned so much about addiction-related pathologies and the mechanics of biopsychosocial stabilization (acute treatment); it is past time we learned about the prevalence, pathways, and processes through which individuals and families resolve such problems and the diverse communities in which such healing occurs.

Post Date October 19, 2018 by Bill White

Bill White-EXPERIENCING RELEASE IN RECOVERY-October 12, 2018

In their classic 1992 text, The Spirituality of Imperfection, Ernie Kurtz and Katherine Ketcham described six dimensions of spirituality at the core of the recovery experience: release, gratitude, humility, tolerance, forgiveness, and being-at-home. In my prolonged mentorship by and collaborations with Ernie, we often returned to those central themes.

The essence of the addiction experience is being confined and bound by something once highly prized that subsequently mutated into a monster over which one had minimal if any control. It is then not surprising that within numerous varieties of recovery experience, there is a shared thread of letting go, of breaking free. This experience of release goes by many names and descriptors—escape (from physical craving and mental obsession), deliverance, liberation, pardon, regeneration, serenity, tranquility, harmony, and balance. This release is both breaking free from an enslaved past—a freedom from the insatiable demands of the drug and the guilt, shame, fear of insanity, and self-pity that are so integral to the addiction experience—and a freedom to move forward to a life of higher meaning and purpose. This sense of being liberated, when fully realized, elicits an emotional intensity impossible to comprehend by those suggesting that addiction is a choice.

Kurtz and Ketcham describe a paradox embedded within this release opportunity.

“Letting go” involves a breaking down of the resistance to reality, a surrender to the demand for certitude; it can be pictured as a letting fall of fetters, a shucking of bonds of fear and possessiveness now experienced as no longer binding. We ‘wake up” to discover that the locks and chains have been removed, and realizing this, we lift our arms and let the chains drop away. But—the chains cannot drop if we have become so attached to them that we fear being without them. While the chains may no longer be attached to us, we may still be attached to them. The deeper release, then, is of our attachment to the chains that bind us (Kurtz and Ketcham, 1992, p. 170).

In our discussions, Ernie often suggested that self-centeredness and self-deception were the major obstacles to this act of letting go so central to the initiation of recovery, but he left open the question of whether such self-entrapment was a cause or consequence of addiction. In contrast to traditional psychotherapies, Ernie thought that recovery for many involved a process of getting out of themselves rather than deeper into themselves.

Release in recovery is a complex experience. It has physical dimensions, particularly the diminishment or complete loss of the insatiable cravings (i.e. the cellular hunger for the drug). It is marked by cognitive and perceptual changes—escape from the mental preoccupations that crowded out all else and the loss of attentional bias toward drug cues that leaves one the sense of truly seeing the world for the first time. There are, of course, psychological and emotional dimensions to release—the expiation of long-suppressed emotions and what is sometimes experienced as a simultaneous and paradoxical escape from self and acceptance of self—the essence of Kurtz and Ketcham’s spirituality of imperfection. Spiritual dimensions of release include awakening to the reality that one has been gifted (graced) with a new sense of freedom and hope—a rebirth—midwifed by some greater force in the universe or the fruit of an ultimate life decision. Release can also have relational aspects in the severing of toxic, drug-linked relationships and the expansion of one’s social world.

To those who are yet seeking such a release, know that it is an immeasurable gift buried within the heart of the recovery experience. Know that you will not likely be in control of when and how it arrives. For some, this sense of being set free arrives early in recovery while for others it arrives unannounced months or years into recovery at a time its expectation has been forsaken. For some, release will come in a lighting strike—the legacy of a transformational change experience that is unplanned, positive, and permanent; for others, it slowly seeps into one’s experience until the day arrives when one suddenly realizes that destructive desires and obsessions are gone.

For many, the release experience remains a mystery, but a mystery worth embracing with deep humility and gratitude.

Post Date October 12, 2018 by Bill White

Bill White-TOWARD A TECHNOLOGY OF HOPE-September 21, 2018


Andy: Remember Red, hope is a good thing, maybe the best of things, and no good thing ever dies.

Red: Hope is a dangerous thing my friend, it can kill a man.

–The Shawshank Redemption

In earlier blogs, we explored the curse of low recovery expectations expressed in policy, professional, and public contexts and how those who work in addiction treatment and other recovery support roles can counter addiction-related stigma in their public and professional interactions. The present blog addresses how those working in such roles can ignite hope among addicted people and their families who may themselves have internalized the socially and professionally pervasive pessimism about the prospects of long-term addiction recovery.

Recovery from severe addictions has long been framed as a pain quotient: Recovery becomes possible when the pain of addiction gets greater than its experienced rewards (e.g., when people “hit bottom”). Belief in this equation has two unfortunate consequences. First, it provides the historical rationale for heaping untold pain (shame, social shunning, arrest, incarceration, and invasive and humiliating “treatments”) on those addicted with little awareness that such interventions may actually thrust the individual deeper into addiction. Second, it ignores the critical role hope plays in recovery initiation. Escalating pain in the absence of hope is an invitation to, at best, accelerated drug use, or, at worst, suicide.

The pain of addiction-related consequences serves as a catalyst of recovery only in the presence of hope. The natural history of addiction will provide sufficient quantities of pain to incite recovery readiness, but what and where are the sources of hope essential for recovery initiation? And what roles can addiction professionals and peer recovery support specialists play in nurturing such hope? Below are some prescriptive actions that addiction professionals and those providing recovery support services can use to elicit hope in the face of addiction-fueled despair.

    Practice a Ministry of Presence
    Addiction is a disorder of disconnection with hope for recovery most often rising in the context of relationships—relationships marked by empathy, compassion, respect, and encouragement. The first gift we give those in need of recovery is our time and attention. Practicing this ministry of peaceful presence requires quieting the roar of our own pressing needs to be fully present, to listen, and to experience another’s story. It is helpful to recall people in our own lives who gifted us with such hopeful presence. The first acts of help and hope? Listen, Listen, Listen.

    Capitalize on Crisis Most people seeking our help will arrive in crisis, and the crises will keep unfolding well into recovery–the legacy baggage of addiction. Some of those we serve will be as addicted to such crises as they were to the drugs in their lives. Each crisis is a window of potential opportunity—a turning point, a teachable moment, a developmental window of opportunity, a crossroads—to help those we serve see the larger picture of their lives, understand how such crises are created, learn how they can be shed, and, most importantly, how they can be prevented. Rather than simply rescuing, crises are opportunities to teach critical thinking and problem-solving skills. Hope rises exponentially with the expansion and application of such competencies.

    Normalize Ambivalence Addiction and early recovery are each marked by extreme ambivalence. What the individual wants to do more than anything is to maintain the drug relationship—the very definition of addiction. What the individual wants to do more than anything is to sever the drug relationship—the essential requirement for recovery initiation. It is helpful to acknowledge this ambivalence. The scales of such ambivalence can often be tipped towards recovery by periodically conducting a pro-con analysis of drug use and the rewards each person hopes to gain from recovery. This first involves reviewing what drugs did for (+) the person and what drugs did to (-) the person. The second involves envisioning the promised of recovery.

    Express Confidence in Their Capacity to Recover Let those you are helping know that recovery is the norm rather than the exception and that, with concerted effort, they can join millions of people who have achieved long-term recovery and its gifts. That confidence can best be expressed by hanging in with them in the face of setbacks after which they have been historically abandoned by others in anger and disgust. Let those we serve know that those seeking recovery can achieve together what each was unable to achieve alone. Let them know that previously hidden powers within and beyond themselves can be mobilized to speed this journey. Conduct a formal inventory of each person’s assets (recovery capital) and acknowledge incremental changes as a way to stoke confidence and sustain the momentum for change.

    Offer Living Proof of Recovery Share your own story of recovery and/or your witness of the recovery of others over the course of your career and expose the newcomer in recovery to as many people in long-term recovery as possible, particularly people with whom they may experience strong mutual identification. Make sure such exposure includes recovery carriers—people in recovery who make recovery contagious based on their infectious personalities, character traits, and their service activities. Offer living proof that people whose lives were diminished by destructive addictions now experience purpose-driven lives day after day, year after year, without the need for chemical anesthesia. Expose them to the laughter of recovery—that raucous, joyous expression of relief, release, and gratitude.

    Acknowledge the Varieties of Recovery Experience Convey to those seeking recovery that there are many pathways and styles of recovery and share descriptions of such variations, e.g., with and without treatment, through varied treatment methods, with and without medication, with and without recovery mutual aid participation, through a variety of mutual aid choices, etc. Choice of recovery goals and methods incentivizes recovery initiation and enriches quality of life in recovery.

    Share Iconic Stories Expose those you are helping to the stories of earlier recovery pioneers with whom they can identify. Good storytellers are among the most effective professional helpers. Collect stories that inspire and elevate those you serve. Use stories to convey catalytic words, phrases, and metaphors that are personally and culturally meaningful. For members of marginalized groups, link the personal story to the larger story of recovery of a people, e.g., drugs as a tool of oppression and recovery as an act of personal/cultural/political resistance.

    Facilitate Story Reconstruction and Storytelling Help the person seeking recovery make sense of the chaos they are experiencing via their own story: 1) Who was I before I began using? 2) Who and what did I become as a result of my use? 3) Why me? How do I explain what happened? 4) What led to my decision to change? 5) Who and what am I now? 6) Where am I going and what do I need to do to get there? Exploring these questions activates the push and pull forces of recovery and opens the further question, “Recovery to do what?”—a self-questioning that in some cases involves the retrieval of childhood dreams and aspirations.

    Provide Exposure to the Culture of Recovery Guide those seeking recovery into relationships with people, places, and things that support recovery. Help them discover recovery-friendly people and places within their local community. Provide exposure to the language, symbols, rituals, literature, music, film, theatre, and art of recovery. Articulate recovery values. Note the growing number of recovery support institutions. Introduce those you serve to others in recovery with shared backgrounds, vocations, avocations, and aspirations. Social support is the glue that binds elements of a recovery lifestyle.

    Provide Systems Navigation Those with the most severe and greatest number of problems who you serve may need resources across multiple systems to initiate and sustain their recovery. Navigating the ever-complex helping systems can be extremely frustrating and lead to pessimism about one’s prospects for change. Providing a map and tour guide through these systems can minimize such frustration and allow clearer visualization of a later life in recovery.

    Convey The Promises of Recovery Let those you are helping know that recovery is more than the deletion of problems from an otherwise unchanged life. Let them know that recovery brings with it an unlimited range of possibilities to not just get well, but to get better than well. Let them know that recovery comes with the potential for a new life of meaning and purpose.

    Recovery opens a doorway to a new life. In this rebirthing process, hope is a glowing new skin. The above are among the actions I have found that stimulate hope in the recovery process. What actions would you add to this list?

    Before closing, a final note of warning from Red is warranted. Hope has restored and transformed untold number of lives, but there is also a risky side of hope. Elevating hope without the necessary resources to fulfill that hope risks fueling endless despair and self-destruction. When we offer hope, we must have the capacity to deliver on the promises of recovery. Achieving “recovery by any means necessary under any circumstances” doesn’t require perfect resources, but it does require that we fulfill our commitment of continued recovery support over time—again, that ministry of presence.

    Post Date September 21, 2018 by Bill White

Bill White-VARIATIONS IN RECOVERY IDENTITY ADOPTION-September 14, 2018

A significant portion of people who resolve alcohol and other drug (AOD) problems do not embrace a recovery identity—do not see themselves as recovered, recovering, or in recovery. I first suggested this in Pathways from the Culture of Addiction to the Culture Recovery (1990) and later in a co-authored essay on the varieties of recovery experience (White & Kurtz, 2006), but had nothing but years of observation and anecdotal stories to support it. When I was asked about the prevalence of adoption or non-adoption of a recovery identity among people who had resolved AOD problems, no data were available to inform that question. Thanks to a just-published study by Dr. John Kelly and colleagues of the Recovery Research Institute, there is now data that addresses that and related questions.

The Kelly-led research team surveyed a representative U.S. population sample of people who had resolved a significant AOD problem during their lifetime and determined the extent to which such individuals adopted a recovery identity and whether such identification had changed over time. Here are some of their major findings.

*Of the 45.1% of people who had resolved an AOD self-identified as “in recovery”, 39.5% had never seen themselves as being “in recovery”, and 15.4% once identified as being “in recovery” but no longer embraced a recovery identity. Of all people with recovery identification at some point in their lives, 25% no longer embrace a recovery identity.

*People who had resolved an AOD problem and who also currently embraced a recovery identity were more likely to have been diagnosed with a substance use disorder (SUD), diagnosed with a mental health disorder, treated for a SUD, and more likely to have been involved with a recovery mutual aid group—all potential proxies for greater problem severity and complexity.

*People who had resolved an AOD problem who never saw or presently do not see themselves “in recovery” offered several reasons for not embracing a recovery identity: 1) self-perceived lower problem severity, 2) self-perceived ability to function in spite of AOD problems, 3) ability to stop AOD use without peer or professional help or, for some, success in decelerating use to escape AOD-related problems, 4) seeing AOD problem resolution as a past chapter of their life—a past decision—and not a present struggle, and 5) a desire to avoid the “sickness” label.

*Quality of life indicators did not differ across the three groups (current recovery identity, rejection of recovery identity, once embraced but now reject recovery identity).

The Kelly group study confirms the variations in recovery identity among people who have resolved a significant AOD problem. It appears that people with lower problem severity may resolve AOD problems without embracing a recovery identity, while people with greater problem severity may find it helpful to embrace such an identity as a mechanism of stable recovery maintenance. Also of note is the portion of people who evolve out of a recovery identity over time. These include people who may have once been involved with a recovery mutual aid group but who have sustained problem remission after cessation of such active participation. I have discussed these populations in earlier blogs HERE and HERE.

What is becoming apparent and confirmed in multiple studies is that AOD problems exist of a broad spectrum of problem severity with quite different lifetime trajectories—from risky use, binge use, sustained heavy use, and compulsive use. Problem resolution strategies and personal styles vary greatly across this spectrum. The question facing addiction treatment as a social institution and recovery community organizations is this: Do we seek cultural ownership of all AOD problems or only the most severe and complex of such problems?

If the treatment field embraces responsibility for all AOD problems, then our knowledge base, our change and support technologies, and our public messaging must be dramatically broadened and become far more nuanced. If the field restricts itself to the most sever and complex AOD problems, then we need to clearly define the boundaries of our expertise, practice only within those boundaries, and make it clear that other social institutions are responsible for AOD problems marked by lower severity, complexity, and chronicity. Unintended harm can come from indiscriminately applying models of care and support designed for high problem severity and low recovery capital typical of late state SUDs to people with low problem severity and high levels of recovery capital—and vice versa!

The Kelly recovery identity study also has important implications for how we communicate to the public and policymakers about AOD problems. As the Kelly research team suggests, “AOD public health communication efforts may need to consider additional concepts and terminology beyond recovery (e.g., “problem resolution”) to meet a broader range of preferences, perspectives, and experiences.”

Are the addiction treatment and recovery support fields capable of reaching people within this broader spectrum of AOD problems? Are they ready to embrace broader pathways and styles of AOD problem resolution? The fact that less than half of people who have resolved a significant AOD problem see themselves as “in recovery” is a striking finding. Are we ready to introduce ourselves to the other half and face the challenges such contact will inevitably bring to prevailing ideas and service practices? What do you think?

References

Kelly, J. F., Abry, A. W., Milligan, C. M., Bergman, B. G., & Hoeppner, B. B. (2018). On being “in recovery”: A national study of prevalence and correlates of adopting or not adopting a recovery identity among individuals resolving drug and alcohol problems. Psychology of Addictive Behaviors, August. doi: 10.1037/adb0000386

Kelly, J. F., Bergman, B., Hoeppner, B., Vilsaint, C., & White, W. L. (2017). Prevalence, pathways, and predictors of recovery from drug and alcohol problems in the United States Population: Implications for practice, research, and policy. Drug and Alcohol Dependence, 181, 162-169.

Post Date September 14, 2018 by Bill White