July 25, 2011
Rehab: It Worked for Me 13
Alcoholics Anonymous doesn’t work for everyone. Sometimes, people need rehab. I should know, because initially, AA didn’t get me sober. It took rehab to accomplish this.
I suppose this issue is on my mind because I hear some people scoffing at how rehab failed Amy Winehouse—and fails all these other celebrities who are in and out of them as if the places have a swinging door. And then yesterday I was reading a post on another recovery blog in which the writer, an AA old-timer, was criticizing people who’d used rehab as a way to get sober. She claimed that people who go to rehab spend $40,000 to get temporarily sober because they inevitably go back out. They don’t adhere, she said, to the steps and traditions of AA. She concluded that people who go to rehab miss the boat: you can be successful in AA for free!
(Another problem she had with rehab is that they tend to treat all addictions as the same: whether you’re an alcoholic, or a drug addict, or a sex addict, or whatever, her assertion is that Alcoholism is different. I disagree with this, but that’s a post for another day.)
So, since she ruffled my alcoholic feathers, and criticized the thing that had actually saved my life, I started wondering why AA hadn’t worked for me initially. I tried AA, and some alternatives, three times before I finally tried rehab. My first try was over twelve years ago when I lived in OhiO; I managed to stay sober for 7 months before I went back out. What was the problem that first try? Well, I couldn’t relate. AA meetings were chock-full of old guys chain-smoking and drinking coffee as if all coffee plantations on the planet had been suddenly hit with a deadly pox; I didn’t fit in. Nobody ever said, “Hello” to me, and I was too afraid to go up and introduce myself. After six meetings or so of sitting there alone and terrified, I finally chucked it and tried to get sober on my own. After seven months, I forgot what it was that had made me want to stop drinking in the first place. It couldn’t have been that bad if I’d forgotten what the big deal was. So, back out I went.
Time number two was about five years later, here in California. This time I found a non-smoking women’s meeting, and I even mustered the guts to reach out and ask somebody to sponsor me. She started me on the Steps. One night we met over dinner, and she started telling me all about her own past drunk life, including that she’d been forced to admit she had a problem when she was arrested driving drunk down the 101 the wrong way. And her friends were sick of her stealing from them all the time. I looked at her, then looked at myself, and I thought, “Dude, I’ve never even gotten a DUI. I’ve never stolen. I have a job; I have two freaking master’s degrees. The most I ever do is get drunk and pass out sometimes.”
So, that First Step was a problem for me. I just couldn’t bring myself to admit alcohol had me in its grips and that I couldn’t control my binges. My sponsor didn’t have the tools to help me look deeper, to help me look at myself more honestly. Instead, I persuaded myself that I could switch to beer only, and that wouldn’t get me in trouble. Besides, I was just getting ready to go on vacation to Puerto Vallarta, and who wants to go on vacation and not be able to drink and enjoy themselves? Mexico: land of margaritas and Corona (with a wedge of lime, please). And if it turned out I had a problem keeping it under control in Mexico, then I’d try quitting again when I got back.
I was determined; I had to white-knuckle it in Mexico at times, but I did okay. When I got back from vacation, I tossed AA into the trash again and recommenced my experiment in “moderate drinking.”
A few years later found me in the Emergency Room with an IV in my arm, having passed out and fallen off my bar stool in a bar and puking up my guts all over the place. That was scary enough to keep me sober for three months. But by then, I’d developed a real attitude about AA. The AA people I’d met were religious freaks. AA was a cult of simple-minded people with self-esteem problems who’d replaced one addiction with a new addiction to a recovery program. How could anyone admit to things like character defects or powerlessness? The feminist in me bristled. I am not inherently flawed. We can overcome weaknesses and lack of control by trying harder. I don’t need God to “fix” me. That’s irrational. And don’t even call alcoholism a disease. Cancer is a disease. THAT, you can’t control. I choose whether or not to drink; I clearly just hadn’t really tried. So, I tried some AA alternatives: Moderation Management, Rational Recovery, SMART Recovery.
All of these things worked only temporarily. I’d control my drinking for awhile, but inevitably I’d tumble back down the well again.
This is what happens when a person is running on ego.
A couple years later, I was in one of those periods of successful controlled drinking when I met someone I fell hard for. The third time I tried AA was right after I broke up with her. She flat out told me I was an alcoholic. (It’s not the reason we broke up.) But I think a part of me wanted to prove her wrong; maybe some part of me believed that if I got sober, she’d be impressed and want to stop seeing other people and get back together with me. It’s a dumb reason to get sober, to do it for someone else. The moment I accepted she truly was in another committed relationship (and heaven help me I couldn’t stand the new woman she was with!), this little dance with AA didn’t last. I think I went to all of three meetings that time. AA just wasn’t connecting with me.
Fast forward five years later, after I’d graduated from occasional nightly binges to three-day weekend benders and then drinking every other night during the week. I was making all kinds of mistakes and on the verge of trying a geographical cure. I was out of ideas. Rehab seemed to be the only option. (And it didn’t cost $40K. It cost $9K, out of pocket. My insurance didn’t cover it). And it worked. Or I should say, so far it’s working. I’ve been sober now for almost two years.
What worked for me is that I was in a controlled environment for 28 days, surrounded by other people 24/7 who were fighting the same fight. I got to see firsthand the horrible effects of addiction (you see this somewhat in AA in meetings, but you really haven’t experienced the full impact until you’ve witnessed, or roomed with, somebody who is detoxing.) There was my own detox. It hadn’t even occurred to me that my morning sweats weren’t hormonal. Neither was the racing heartbeat. And since the nurses monitored my blood pressure for the first week, I saw for myself how it went down and returned to normal as my body adjusted to functioning without booze. My detox was an easy one, probably because I hadn’t been a daily drinker. Not so for other patients. There was one guy who shook so badly he had to use both hands to bring his fork to his mouth at dinner. He used to drink a quart of vodka a day, when heroin wasn’t available. There was my Christian roommate, as sweet a person as could be, who had been in AA for years but just couldn’t kick her addiction to booze. She had liver damage and had already had surgery for esophageal varices. She left rehab and within 7 days had gone on a bender that landed her back in the hospital. There was another guy–a brilliant man, an MD, a cardiac surgeon, who had lost everything to crack cocaine.
And seeing all this, and suddenly feeling lucky I wasn’t worse than I was, and then going through a checklist with my counselor that asked me to examine how alcohol operated in my life, I had to admit that I had about as much control over booze as I have over a politician saying something comprehensible. It was a moment of clarity and surrender. My ego finally had to admit it wasn’t all-powerful. No amount of self-control would keep me sober. Damn, it was a relief to finally see that. I finally understood the First Step. And what I’d always thought would make me feel embarrassed, stupid, or humiliated actually made me feel grateful.
I’m grateful that my bottom didn’t have to go any lower than it did. And, it took rehab to humble me that way, not 90 meetings in 90 days. Actually, rehab is kind of like 90 meetings in 28 days. It is daily meetings from 8am to 8pm, group work, counseling, and work on Steps 1-3. It isn’t a spa. We had AA or NA meetings every night. Days were highly structured. Even if you didn’t eat, you had to show up for meals. We had only one hour a day of free time. Even on Sundays, Family Day, we were still expected to attend group workshops and an AA meeting while family members went to an Al-Anon meeting. This idea that going to rehab is like going on a vacation is a total falsehood. Neither is it “forced sobriety”—you can walk off the property at any time. Like anything on earth, you will get out of it exactly what you put into it.
So, you know, the Old-Timers can make fun of rehab. People who aren’t in recovery at all can parody the stereotypical drunk at AA meetings who stand up and say, “Hi, I’m Joe, and I’m an alcoholic.” We can poke fun of the self-help movement and how everybody is working the Twelve Steps nowadays. We can laugh at Al Franken doing his Stuart Smiley impression. We can watch 28 Days and laugh at the chanting and all the New Age stuff. But I’m all for rehab. For some of us, it is a good solution. For some of us, it got us somewhere that meetings alone couldn’t take us. And it got me into AA. Who is anybody to judge someone else’s program if it can indeed work?
Jul 26, 2011 @ 00:08:48
For me, taking the step to drive myself up to the rehab center and checking myself in was the step I needed to get off the beer. It was finally admitting I had a huge problem that required a huge commitment and a block of dedicated time with professionals. I needed help. Rehab provided just the help I needed and I don’t want to ever have to go back. Whatever it takes to turn your life around and get off your substance is good in my book!
Jul 26, 2011 @ 01:44:06
Hear, hear! Thanks, Anne.
Jul 26, 2011 @ 11:51:45
I understand your point, and it is certainly the point made by a lot of members of the AA faith, and promoted by the recovery industry.
Some of us have a very different point of view, as we see rehab, which in the US over 90% of the time, is forced, mandated, and coerced participation and conversion to the AA faith. It certainly was in my case.
Yes followers of AA promote the organization- as they are told they should. Many of the steppers become professional drug and alcohol counselors. Most of the two hatter pros I have dealt with over the years were utterly unemployable as anything else.
The problem with the AA faith, and its profitable business arm, the recovery industry cartel is not their successes but rather their failures.
There is no one to speak for the dead, and the recovery industry kills a lot of them and accepts no responsibility regarding the mortality, nor the innocent people that are killed in drunk driving incidents by people wrongly convinced they have a concocted brain disease.
There are many of us lobbying in different ways to have insurance stop ALL payments for ‘rehab’ It has actually gotten so bad that the word ‘rehab’ is used as a punchline for late night comedians, while informercials for the industry such as A&E Intervention and Dr Drew continue to kill people on national television.
The AA faith and the recovery industry cartel really should be less deceptive with the public and be more forward with their actual efficacy rates, as well as be honest about the fact that they use heavy duty fundamentalist religion to cure an alleged medical ‘disease’.
Jul 26, 2011 @ 15:50:02
You do make a good point: as I said, people really only get out of things what they put into them. I went into rehab because I CHOSE to go. So I was ready to listen, ready to work. I can’t say that was really the case before those failed attempts at AA (and most rehabs are built around the AA model).
It’s true that one fellow in the rehab I was in was actually asked to leave because (1) he didn’t want to be there and (2) he kept being disruptive–disruptive to the point of making fun of people in meetings, talking in the back so loudly about other things that people in the front couldn’t even hear the speaker, etc etc. He clearly got nothing out of the experience.
Just like AA, the failure rate for rehab is high. If the same standards were applied to, say, a method of cancer treatment, we’d call AA and rehabs failures and look for other methods of treatment. You’ll get no argument from me about that.
But unlike a physical disease, genuine DESIRE to be well seems to be at the crux of getting better (Not so for a cancer patient; no amount of desire will make them well.) But desire and will boil down to the same thing, and so we have a paradox: your desire will help you, but your desire won’t help you.
I guess, for me, I separated it all out this way: I don’t have control over getting or not getting cravings. But I do have some measure of control over why I developed those cravings to begin with. All of that had to do with not learning to deal with feelings well, how to cope with things as an adult, how to embrace fear without falling apart, how to be more self-aware so I wasn’t constantly reacting and acting out without forethought, etc etc. I’m still not sure I buy into the idea of addiction as a disease per se–if anything, it is a malady of ineffective coping skills.
The Steps are worthwhile because (for me anyway) I found they taught me the hows and the whys behind my destructive behaviors, and once I started fixing those things, the desire to drink went away. I was just saying to a friend yesterday that the Steps could stand to be rewritten using more modern phraseology (sacrilege! ha)–the idea of all of us being born with innate character defects is hard to swallow. Sounds like we’ve all got borderline personality disorder or something. I’d probably rephrase it as “we took action to begin aligning our values with our words and actions” or something like that.
But the bottom line is this: so far we know of NO OTHER TREATMENT that has had better success than the AA model. The good thing about AA is that there is enough wiggle room that a person can find their own way to some kind of faith, for example. It doesn’t have to be fundamentalism by any means. I’m certainly not. My sponsor is a practicing Buddhist. But for sure if the rehab I’d chosen been Christian-based and started shoving religion down my throat, we would not have seen the good result.
As you can see, I have no answers, just some thoughts.
Jul 28, 2011 @ 22:09:58
Again I must disagree, with this statement being perhaps one of the most destructive and dangerous statements commonly overused in the AA faith and the recovery industry complex
‘But the bottom line is this: so far we know of NO OTHER TREATMENT that has had better success than the AA model’
In reality AA and 12 step facilitation came in respectively 37 and 38 in rank of efficacy.
http://www.behaviortherapy.com/whatworks.htm
In addition, this survey does not include the Sinclair Method in conjunction with the drug Naltrexone, which has a verifiable 78% efficacy rate. The AA faith and the recovery industry wrongly tries to downplay and discourage this method (Many times with dirty tactics such as accidently confusing Naltrexone with Antabuse that has not been used in almost 25 years) because the Sinclair Method is simply not as profitable as the 12 step model nor does it promote AA theology.
Unfortunately people continue to die because of the misinformation and disinformation promoted by the recovery industry and AA as medical fact that is neither medical nor fact.
Any in depth search of the faulty ‘disease’ model of addiction results in realization that it carries no credibility and really little support in the medical, scientific, or academic community by persons that are not AA members.
If the recovery industry expects to continue to bilk health insurance carriers for their failed industry, they should be held accountable for the deaths they continue to cause.
Jul 29, 2011 @ 01:23:13
At this point I’m not sure how to respond to you, because really you’re not taking issue at all with me and my own post, because I was talking about rehab and that it worked for *me* (see title of article, read my article). I ended that entire article with the statement: “Who is anybody to judge someone else’s program if it can indeed work?”
Really it seems (to me) that you just want to say that AA and the recovery industry don’t work–and I think you’re also saying “they fail more than they help.” All I can say is that *I* was helped.
I’m a single individual: I don’t work for the recovery industry, I don’t hold any positions within the AA organization, I don’t work for any insurance companies; I teach English at a local community college, lol In other words, you’re taking issue with me because… I honestly have no idea. I’m in no position to make the kinds of sweeping changes to what doctors and health care providers and the insurance industry, etc, approve or don’t approve. Perhaps you might get the kinds of actions you’d like to see if you contacted your Congressman and asked for some sort of inquiry into the recovery movement. Perhaps write a book. Perhaps start your own movement.
But thanks for the info about the other forms of treatment. I’d never heard of them, and it may have been helpful to have been offered any of those as options back when I was using and needed help. The point is now moot, however. I’m sober and I’m happy and since I did it with the help of rehab and then some occasional support in an AA group in my own town, I’m good. I’m afraid you’re not going to persuade me that rehab didn’t help me, though, because it definitely did.
Jul 29, 2011 @ 01:36:56
I do have a question about the info at the link you provided: it has a column titled “Excellence” and 12-step facilitation gets an 83% which is higher than any of the others (though some of the others have practices that exist within most types of rehab or AA programs, like brief interventions or stress counseling and that sort of thing). Am I not understanding the chart, because that seems to me to be saying that 12-step facilitation is effective?
Jul 29, 2011 @ 01:46:41
Well, another look seems to be telling me that that number has something to do with the quality, perhaps, of the studies done on that method. But really, to be persuasive, you’d have to have something about the criteria by which the ranking was done and so forth, and I’m not seeing any of that. Looks like the source is some kind of behavior management site. I did say in my original post that I did try Rational Recovery and SMART recovery, both CBT types of programs, and I read a lot of Ellis. Didn’t work for me. But in all fairness, as I also said above in one of the comments, I’m not sure I really wanted to quit for real until I checked myself into rehab.
Jul 29, 2011 @ 23:41:18
i am so glad to be alive today. I never wanted to quit drinking just stop hurting. Daily, and more, I ask my Higher Power for His will for me and the power to carry it out (it wasn’t natural for me but all I had to do was wait and listen. Every day I find PEACE when I ask His will for me in prayer. He is in my daily life trying to repair my ills. AA has been my life for 31 years….all thanks to this prayer and the 12 steps moving toward Him. God bless and keep coming back so u too can see His miracle. My sponsor is very ill now but still a major factor in my life……..Easy Does It.
Jul 30, 2011 @ 00:20:50
Yes, Steve, thank you so much for that reminder. I have found serenity, a healthy “live and let live” attitude, and a feeling of blessedness in building a relationship with my Higher Power. I’m not really a Christian (I sort of take bits I like from different religions), but The St. Francis Prayer never ceases to make me feel better because it reminds me to DO better.
Jul 30, 2011 @ 14:12:28
Good point about old-timers scoffing about current treatment ideas. I have been sober and clean and around the rooms for decades without getting any new perspective on treatment. My know-how was almost as old as that damn book. I saw Addiction – an HBO special and it opened my eyes to what science has done for us over the years.
An AA Trustee and Harvard Doctor estimates that 40% of sober alcoholics were helped by AA. That means lots of things work if the alcoholic is committed to changing their life. I have often been such a cheerleader for AA – it’s the best, your team sucks type of attitude. Bill W was happy for drunks who got sober no matter how they got sober. It wasn’t about selling his book it was about his compassion for the suffering alkie. We’re all on the same team. Nice article.
Jul 30, 2011 @ 16:33:10
Thanks, Tom. You know, the more I think about it, the more I think the Steps are a fine set of tools (that can be used in any number of ways, depending on the person) that can lead a person to sobriety and maintaining their sobriety. I think where we all run into trouble is when they become a dogma. There is no ONE way. It’s like that saying, “Take what you need and leave the rest.” If the goal is sobriety and one way doesn’t work, try another; then try another; then try another–as long as there is willingness, a way will come.
Aug 17, 2011 @ 10:59:50
Rehab worked for me, (22) weeks worth, going to AA was great but did not teach me how to live without drugs and alcohol as my entire life revolved around it, it was my entire life. I learned to live all over again without all my crutches, AA Big Book Study, Step Study, Group, One on One Counseling, Meetings daily, living with 136 other drunks and addicts. AA can work great for some right off the streets, not for this drunk. The foundation layed out for me in rehab was priceless and I highly recommend it to anyone who can go, problem is today there are somany that are so expensive , based on money not recovery and many others push pills as a part of recovery. They talk a great game but their results are dismal to say the least.