Recovery

I’ve noticed something fascinating in the conversations underneath my posts When I question an assumption in addiction treatment, very rarely does the conversation simply stay with the assumption Something else happens Question whether lived experience gives us authority over another person: “So lived experience has no value?” Question whether trauma should be assumed: So trauma doesn’t matter? Question the disease model: So you’re saying addiction isn’t real? Question lifelong recovery: “So you’re telling people to stop doing what keeps them well?” Question whether our assessments actually discover the person: “But we already ask those questions” Question whether a model is organising what we see: “All models have limitations” And one of my favourites: “That’s what we already do” Sometimes the challenge gets exaggerated into something I never said Sometimes it gets absorbed into the existing model Sometimes the original claim quietly changes Sometimes personal experience becomes evidence Sometimes gratitude becomes evidence Sometimes credentials become evidence Sometimes the conversation moves from the question being asked to the person asking it And sometimes we agree with the challenge so completely that we don’t notice ourselves reproducing the very assumption being challenged in the next sentence “This is spot on. And here’s why what I already believed is still the answer” That’s perhaps the most interesting response of all! Because resistance to an idea doesn’t always look like disagreement Sometimes it looks like agreement that changes absolutely nothing I know this process because I’ve done it myself For years I could have told you I was open-minded while interpreting almost everything I encountered through what I already believed about addiction and recovery – I could ask questions – I could listen – I could care deeply And still never notice that my understanding was deciding what their answers meant THAT IS THE BLIND SPOT!! The mind is extraordinarily good at protecting an explanation without experiencing itself as protecting anything And perhaps that’s why genuine inquiry is so difficult It isn’t simply being willing to ask questions It is being willing to remain there when the answer threatens something we have invested years in believing – Our training – Our recovery – Our professional identity – Our model – Our expertise Even the story we’ve used to understand our own life So I’m becoming interested in a different question: What happens inside us when the person, or the evidence, doesn’t fit what we already believe? Do we become more curious? Or do we find a cleverer way of making them fit? Because perhaps the greatest limitation in addiction treatment isn’t that we don’t know enough It’s how difficult it is to see the moment that what we know has stopped us discovering anything new

David is 42 He drinks most evenings, usually beginning around 6pm Over the last three years his drinking has increased from 2- 3 drinks to approximately 8–10 He has tried repeatedly to reduce it and sometimes manages several weeks before returning to the same pattern His marriage is deteriorating. His wife has threatened to leave twice. He has begun missing occasional mornings at work He describes anxiety, difficulty sleeping and periods of feeling “empty” His father drank heavily and was emotionally unpredictable. His parents separated when he was 9 David describes his childhood as “fine” and says he doesn’t believe it has anything to do with his drinking He says “I don’t know why everyone makes this so complicated. I just like drinking” He doesn’t want abstinence. He wants to “get it under control” You’re meeting David for the first time What do you think is happening? What would you want to know next? And what would you recommend? Therapists, psychiatrists, addiction workers, psychologists, recovery professionals, peers – I’m genuinely interested..??

Imagine meeting someone at one of the most frightened, confused and desperate moments of their life They can’t stop drinking They can’t stop using Their family may be falling apart They may have lost their job, their home, their relationships or any sense of who they are They want one thing An answer! And desperate people will often believe answers they would question under different circumstances So what do we tell them? “You are an addict” “You have a lifelong disease” “You are powerless” “You’ll always have this” “It’s waiting for you” “You need to work on your recovery every day” “If you stop doing what keeps you well, you could relapse” “You could die” Then something extraordinary happens (or not) The person gets better They stop using Their life changes Five years pass Ten years. Twenty years Thirty years And we are still be asking them to understand themselves through the explanation they were given during one of the most vulnerable periods of their life I spent 22 years inside that understanding So I’m not mocking it I’m asking whether we appreciate the responsibility involved in giving somebody an identity and an explanation of themselves when they are desperate enough to accept almost anything that offers hope Because some of these statements aren’t neutral facts They are beliefs about what addiction is, what the person is, what their future holds and what they will need for the rest of their life And beliefs have consequences!! Tell someone repeatedly that something dangerous lives inside them and they may spend their life watching for it Tell someone they are powerless and they may interpret struggle as evidence of powerlessness Tell someone recovery must be maintained forever and stopping can become frightening Tell someone relapse proves the disease is still there and relapse becomes confirmation Tell someone continued recovery prevents relapse and every year of abstinence becomes confirmation too Eventually almost anything that happens can prove the original explanation correct That’s the part I think we need to become much more uncomfortable about Because vulnerable people deserve help! They deserve safety! They deserve compassion! They deserve somewhere to belong! They also deserve intellectual humility from the people helping them! Maybe the most ethical thing we can sometimes say is I don’t know exactly what’s happening to you yet But I don’t believe you are broken And I’m not going to tell you who you are or what you will need for the rest of your life before we’ve even discovered what this has meant in yours Help someone through their darkest moment But be very careful about giving them a lifelong identity while they’re there They might still be carrying it 30 years after the crisis has gone!

My last post – “Lived experience can make you worse at helping people” – created quite a reaction! But underneath it was a much bigger point There is no universal human experience called addiction  There are human beings having radically different experiences that we have placed under the same word Two people can use the same drug The same amount For the same number of years Experience the same withdrawal Lose similar things Receive the same diagnosis And what is actually happening for each of them will be entirely different Because nobody experiences drugs, relationships, fear, pleasure, loss, shame, their body, themselves, or the world, directly and identically! Everything is encountered through perception And perception isn’t some neutral camera recording reality It is already organised through everything that has shaped this particular human being learning, memory, relationships, biology, culture, expectation, meaning, previous experience and the state they are in right now Which means the drug itself never has one psychological meaning – For one person it may create silence – For another, belonging – For another, intensity – For another, distance – For another, confidence – For another, simply a way of making the next hour bearable And even those descriptions don’t tell us why that experience became necessary for that person This is why I increasingly struggle with statements like Addiction is caused by trauma Or dopamine Or genetics Or attachment Or childhood Or social deprivation Or an addictive personality These things may be relevant, often they are But the moment we turn any of them into the cause, we have taken something discovered across people and imposed it back onto the individual There is no route from an event to an addiction that bypasses the person experiencing it And this is exactly why neither lived experience nor education gives us the answer My addiction taught me about my addiction A PhD may teach someone an enormous amount about addiction as a field of study Neither tells us what this behaviour means in the life of the human being sitting opposite us We have to discover that Perhaps the greatest mistake in addiction treatment has been assuming that because we gave millions of profoundly different human experiences the same name, we discovered the same thing We didn’t We created a category! The person still has to be understood

Taking Action on Addiction and The Forward Trust are launching a national campaign aiming to start 17,000 conversations about addiction, one for every life lost each year to alcohol or drug-related causes in the UK! On the surface, I support the intention completely. Addiction needs far more public conversation, far less shame, and far more understanding The difficulty is that their own material appears to begin with conclusions that are already settled Taking Action on Addiction describes addiction as a “serious mental health condition” The Forward Trust’s recent material acknowledges that the disease and medical conception of addiction is contested, while still ultimately framing addiction as a well-established mental health condition and describing addictive behaviour as pathological That raises a question I think matters enormously What are the 17,000 conversations actually allowed to question? Can we question whether addiction is best understood as a disease or disorder at all? Can we ask whether behaviours we call pathological may sometimes be highly intelligent adaptations to unbearable internal experience? Can we question treatment systems that still organise people around lifelong identities, maintenance, relapse management and the assumption that the person remains fundamentally vulnerable to addiction? Can we ask why, despite decades of treatment models, services and awareness campaigns, UK drug and alcohol deaths remain so devastatingly high? And perhaps most importantly Can the conversation change the model, or is the model determining the conversation before it begins? I have spent decades around addiction personally and professionally. I spent 22 years inside 12-step recovery, have been drug-free for more than three decades, now work therapeutically with addiction, and have written extensively about a very different way of understanding it My concern with much of the UK addiction field is not that people don’t care My concern is that we keep having conversations from inside the same conceptual assumptions and calling that progress There is also an uncomfortable institutional question does The Forward Trust financially benefit from addiction being understood as disease, disorder or pathology? If an organisation is funded within the system, can it genuinely lead an open inquiry into whether the assumptions underpinning that system are wrong? If we really want a national conversation about addiction, the conversation has to be capable of questioning the foundations of how addiction is understood MIKE TRACE Otherwise it’s not an inquiry It’s an exposure campaign!

For much of the years I spent in fellowships, stopping recovery was unthinkable! Because I knew what could happen, or at least I thought I did Stop doing the things that keep you well and eventually the old you comes back Stop going to meetings Stop working on yourself Stop maintaining your recovery Become complacent Relapse Maybe die So continuing to “do recovery” becomes evidence that you’re taking your recovery seriously But eventually I had to ask myself a question I hadn’t really been willing to ask! What exactly am I afraid would happen if I stopped? And an even more uncomfortable one! If I have to organise my life around preventing addiction, what do I actually mean when I say I am free from it? To be clear – I’m not saying people should stop going to meetings I’m not saying they should abandon something that enriches their life And I’m certainly not saying everyone should follow the path I eventually took I’m questioning the assumption that needing recovery idefinitely must automatically be considered recovery Because there is a difference between I still do this because it adds something beautiful to my life and I have to keep doing this because I’m frightened of who I’ll become without it Those can look identical from the outside Thirty years of meetings Thirty years of fellowship Thirty years of practice But internally they could represent completely different relationships with recovery One chosen freely The other maintained through fear And perhaps we’ve become so accustomed to celebrating the continuation of recovery that we don’t ask the person the most obvious question What do you believe would happen if you stopped? Would you relapse? Lose yourself? Become selfish? Return to the person you used to be? Does something dangerous still live inside you that recovery is keeping under control? And if the answer is yes, I’m not interested in telling you you’re wrong I’m interested in the question that follows: Where did you learn that about yourself? Because perhaps the ultimate purpose of recovery isn’t to become exceptionally good at doing recovery Perhaps it’s to reach a point where your life is no longer organised around addiction I don’t think freedom should require us to forget what helped us But I do think we should be allowed to ask whether we still need it If you stopped “doing recovery” tomorrow, what are you afraid would happen?

And perhaps the deeper question is Who were you before anyone called you anything? Before addict Before alcoholic Before broken Before recovered Before successful Before failure Before even your name became your answer to the question Who are you? You are a seamless flow of thoughts, feelings, sensations and perceptions – Rupert Spira or as Osho put it even more simply You are what you are seeking! This matters enormously in addiction Because a label can begin as a useful description and quietly become an identity I used drugs becomes I am an addict And once “this is what I am” becomes settled, the mind naturally begins looking at life from inside that conclusion A craving appears: There it is – I’m an addict You struggle with food, sex, relationships, money or work: My addiction is manifesting somewhere else You feel anxious or restless: That’s my disease You feel well for twenty years: That’s because I’m successfully managing my disease The identity can become remarkably difficult to disconfirm because almost every experience can be interpreted as evidence for it That’s where confirmation bias becomes more than an intellectual mistake It can become a way of experiencing yourself The story selects the evidence The evidence strengthens the story And eventually the story can feel like the person I’m not saying nobody should call themselves an addict or alcoholic. If those words are meaningful or helpful to you, that’s yours to decide I’m asking something much more fundamental Are you the identity – or are you the one who is aware of the identity? Osho said, “Truth is not something outside to be discovered, it is something inside to be realised” Perhaps recovery can take us to an unexpected place Not a better identity Not addict replaced by recovering addict Not a more acceptable story about ourselves But the discovery that no story we have ever told about ourselves has contained the whole of what we are You existed before the label You are here while the label is being thought And you will still be here if one day you put it down So when you say, “I am an addict” – what exactly do you mean by “I”?

That’s an uncomfortable question, isn’t it? Especially when you believe you owe your life to something A programme, A belief system, A recovery identity, A way of understanding yourself I spent 22 years in 12-Step recovery It helped me stop using drugs. I’m grateful for that, I still recommend it to people But for much of that time, I also believed I was an addict for life. That something was permanently wrong with me. That recovery was something I would always need to maintain… I didn’t question those beliefs Why would I? They were part of the very thing I believed had saved my life And that’s what interests me What happens when gratitude prevents us from questioning something? When does something that once gave us freedom begin defining its limits? When does an explanation that helped us survive become an identity we cannot imagine living without? I’m not suggesting anyone abandon what helps them! I’m really asking whether we can recognise that something was valuable without believing it must remain necessary forever Because what saved your life at one point may not be what allows you to live it fully today And perhaps one of the hardest things to question is the very thing we’re most grateful for How would you know if something that once helped you had become something you no longer needed?

is when the therapist already knows what your problem is!! Not when they get something wrong That can be corrected The dangerous moment is when they stop being available to discover that they might be wrong You mention addiction They already know it’s a disease Or trauma. Or attachment Or dopamine Or childhood neglect Or avoidance Or defects of character Or a nervous system problem Or whatever explanation they were trained to see And then something subtle happens The questions start serving the explanation Your answers are interpreted through it What fits is noticed What doesn’t fit needs explaining away If you agree, the model is confirmed If you disagree, perhaps you lack insight If treatment works, the model worked If it doesn’t, perhaps you weren’t ready Eventually the person can no longer prove the explanation wrong And at that point I’m not sure we’re doing therapy anymore We’re fitting a human being into something we already believe I know this because I’ve done it For years, I believed I understood addiction because I had lived it, recovered from it and spent decades around recovery I had answers A lot of them What I had much less of was the ability to sit with someone and genuinely not know Today I begin somewhere different I may have ideas I may have experience I may notice patterns I may even have a strong orientation towards seeing behaviour as intelligent adaptation rather than defect But none of that gives me the right to decide what another person’s experience means The person still has to be able to prove me wrong Maybe that is one of the simplest tests of any helping relationship: Can the person in front of you still change your mind about them? If not, you may no longer be listening You may just be looking for confirmation

It’s a belief system… Every model begins as a possibility A way of making sense of something – A lens – A framework – A hypothesis “This might help me understand what I’m seeing” But something strange can happen over time The model works It helps people We study it We teach it We build communities around it Maybe it saved our own life And slowly… “This might explain something” becomes… “This is what is happening” Then the model becomes harder to question If someone agrees with it, that confirms the model If they disagree, perhaps they lack insight If the treatment works, the model was right If it doesn’t work, perhaps the person wasn’t ready If they reject the programme, perhaps they’re resistant If they relapse, perhaps they didn’t surrender enough If they question the disease model, perhaps they’re in denial If they don’t identify trauma, perhaps they haven’t recognised it yet If they question the spiritual explanation, perhaps they’re closed-minded Eventually, everything becomes evidence for the model! And at that point the model can no longer lose That is where I think something important changes The problem is not that the model is necessarily wrong It may contain enormous truth It may have helped millions of people It may have saved your life The problem is that the person in front of you is no longer capable of proving it wrong  That is the danger And this applies to all of us – 12 Steps – Disease theory – Trauma – Attachment – Neuroscience – Psychodynamic theory – Spirituality Even my own belief in the intelligence of human adaptation I begin from a deep trust that there is something here that makes sense But if I decide in advance what that intelligence means, or what somebody’s behaviour must be doing for them, then I have done exactly what I criticise others for doing My model has stopped helping me inquire It has started telling me what I am going to find For me, the question is becoming very simple: Can the person still show me that my explanation of them is wrong? If the answer is yes, perhaps I’m still using a model If the answer is no, perhaps the model is using me And maybe that is when a framework stops being a tool for understanding and becomes something much closer to dogma