Last week, a blog cropped up on Facebook and caused quite a stir in the world of social media. The author shared her decision to leave a twelve step program. After a period of self-exploration, she discovered another recovery pathway that worked for her. Once her post started making the rounds, she was subjected to both harsh criticism and ardent support. Her supporters said, “I found something else that works for me, too,” and her critics asked, “why are you criticizing a program helping hundreds of thousands of people?” Some argued that her perspective could save lives, while others claimed her words give suffering people misguided justification to dismiss help. Which perspective is correct?
The right answer is there is no right answer. People tend to develop strong feelings when a recovery pathway saves them from a painful life of substance misuse but, the truth is, there are multiple pathways to recovery. As substance use disorder treatment providers, we have an ethical duty to remain objective and to support people to find their own recovery pathway. We’ve already covered which markers to look for in a holistic recovery program, but we haven’t explored, in depth, the major recovery pathways available in our area. The good news is that we have come a long way since the 1930s, and there are more resources available to accommodate the diverse ideologies in our communities – especially if you live in a large metropolitan area.
The SMART acronym stands for “Self-Management and Recovery Training”. SMART recovery is a “4-Point Program” designed to help people recover from any kind of addictive behavior – not just substance misuse. SMART recovery offers meetings worldwide and online. Its approach is strictly science based. However, the program does not discourage attendees from utilizing the SMART approach in conjunction with other fellowships . The SMART 4-Point Program is outlined below:
- Point 1: Building and Maintaining Motivation
- Point 2: Coping with Urges
- Point 3: Managing Thoughts, Feelings and Behaviors
- Point 4: Living a Balanced Life
The SMART websites describes its program as follows: “To help you reverse your self-destructive behavior, we use a cognitive-behavioral (thinking/doing) psychotherapy called REBT which stands for Rational Emotive Behavior Therapy. Psychologist Albert Ellis devised this system in the’50s. It’s effective and widely accepted. According to REBT, your thinking creates your feelings and leads you to act. By managing the beliefs and emotions that lead you to drink or use, you can empower yourself to quit. Then you can work at problems you have with abstaining”.
Refuge Recovery is a recovery pathway based on Buddhist principles. This non-profit organization believes the power of the Dharma – or the teaching of the Buddha – allows people to “free themselves from the suffering that is caused by addiction”. Not unlike SMART Recovery, Refuge offers meetings in person and online. Refuge Recovery is also similar to twelve step programs in that it utilizes a comprehensive written inventory. The program operates according to “four truths,” which are:
- Addiction creates suffering
- The cause of addiction is repetitive craving
- Recovery is possible
- The path to recovery is available
Refuge Recovery outlines an eightfold path to recovery, which is:
The Refuge Recovery website describes the role meditation plays: “Meditation practice allows us to look at the internal habits and thoughts of our own mind. Developing mindfulness is the most effective way to see this process. We can begin to get a sense of our relationship to pleasant and unpleasant experience, how this affects our habits of craving and in turn leads to grasping, clinging and attachment: This process is the basis of addiction”.
Twelve Step Programs
Alcoholics Anonymous and its sister programs – which include but are not limited to Al-Anon, Narcotics Anonymous, and Overeaters Anonymous – are perhaps the most widely known recovery pathways. The program is characterized by a combination of meeting attendance, sponsorship, and step work.
The Twelve Steps:
- We admitted we were powerless over [behavior] – that our lives had become unmanageable.
- Came to believe that a Power greater than ourselves could restore us to sanity.
- Made a decision to turn our will and our lives over to the care of God as we understood Him.
- Made a searching and fearless moral inventory of ourselves.
- Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
- Were entirely ready to have God remove all these defects of character
- Humbly asked Him to remove our shortcomings
- Made a list of persons we had harmed, and became willing to make amends to them all.
- Made direct amends to such people wherever possible, except when to do so would injure them or others.
- Continued to take personal inventory and when we were wrong promptly admitted it.
- Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
- Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.
While many people have great success working the twelve steps, others understandably struggle to embrace the spiritual aspect of the program. While twelve step programs do not advocate acceptance of God in the Judeo-Christian sense, the wording of the literature can be difficult to digest. A higher power can simply be something that is “not you”, i.e. guidance from a recovery-focused mind or a group of recovery-focused minds. Despite the open invitation to define your own higher power, some find pathways with unambiguous scientific wording to make the most sense.
In a nutshell, the twelve steps help people accept their substance use and/or behavioral disorder, discover a sense of hope, seek mentorship, examine unhelpful thinking patterns, make amends for hurtful actions, sustain connection to a recovery community, and give assistance to others. There is an overall emphasis on a change in thinking, which subsequently leads to a change in behavior. It may come as a surprise, but this is the very spirit of cognitive behavioral therapy.
Three Principles (Health Realization)
As with just about any recovery pathway, the Three Principles focus on thinking. The premise is that your thoughts mold your experience of the world. In other words, the nature of your thinking creates your reality. When you change the way you think and, therefore, the way you react, you change your reality.
The Three Principles:
- Mind – the universal energy that animates all of life, the source of innate health and well-being.
- Consciousness – the ability to be aware of one’s life.
- Thought – the power to think and thereby to create one’s experience of reality.
According to Wikipedia, people “tend to experience their reality as stressful…when they are having insecure or negative thoughts. But [Health Realization] suggests that such thoughts do not have to be taken seriously. When one chooses to take them more lightly, according to HR, the mind quiets down and positive feelings emerge spontaneously. Thus, HR also teaches that people have health and well-being already within them (in HR this is known as “innate health”). …In contrast to psychotherapies that focus on the content of the clients’ dysfunctional thinking, HR focuses on “innate health” and the role of “Mind, Thought, and Consciousness” in creating the clients’ experience of life”.
Other Recovery Meetings
If you have yet to read about a recovery pathway that appeals to you, don’t worry. You may be able to find other fellowships through a Google search or a referral from a counselor. If you are geographically isolated, explore the option of utilizing online meetings as an adjunct to face-to-face support. Local recovery centers are also great resources. These community centers will invariably host a wide array of meetings. For example, Revive Recovery in Nashua, New Hampshire has a Mind Body Spirit Morning Recovery Meeting. This is a “fellowship agnostic” meeting, which means anyone can attend. Recovery community centers also offer support for family members who have loved ones suffering from substance use disorder.
Don’t be afraid to combine programs. Twelve step fellowships have a saying: take what you need and leave the rest. Perhaps you like some parts of N.A., but you prefer to supplement with SMART or Refuge Recovery. Your recovery pathway is your own…be creative! No recovery fellowship is perfect – but you can construct a pathway that is perfect for you. Perhaps your pathway consists of weekly counseling sessions, regular yoga, and gatherings of sober friends. Don’t let the details of someone else’s recovery program be your downfall. Determine your “musts” and “needs” and do what works for you.
It’s unhelpful to debate the superiority of any given recovery pathway. What truly matters is that you choose a pathway and follow it. If your recovery pathway includes an abstinent support network, a commitment to honest self-appraisal and growth, and a sense of purpose, you have set yourself up for success. The only thing left for you to do is walk.
Do you need assistance defining a recovery pathway? Please call (888) 649-1149 or contact us here.
Autumn Khavari is the Process Recovery Center’s in-house writer. She received an education in Substance Use Counseling from Beal College in Bangor, Maine.