Each new year rings in a brief and frenzied season of resolution. Dictionary.com defines a resolution as “a firm decision to do or not to do something”. Process CEO, Justin Etling, has long resolved to offer innovative solutions, along with the best addiction treatment center practices available. Unlike most resolutions, his decision has never wavered. Justin has always been interested in the science behind failed decision-making. After all, the first stage of addiction treatment is based on the decision to ask for help. Why, then, over the course of addiction recovery, does one’s drive to sustain healthy decision-making falter? Justin has dedicated an entire curriculum to solving this problem and improving recovery statistics. This new curriculum is based on the daily completion of eight tasks for sixty four days.
“We’re trying to constantly offer innovative solutions,” Justin explained. “We’ve spent – I don’t know how many man hours – on a unique curriculum that focuses on not just telling people what to do, but explaining why they need to do it. Statistics are against people suffering with substance use disorder. Ultimately, it’s about trying to find a more innovative approach to motivate people. Different addiction treatment centers can be more effective just based on a clinician or someone who affects you. But I think, overall, most addiction treatment centers have used similar modalities for years. The modalities are effective – and the information is sound – but a lot of people don’t understand why they need to take action. Since they don’t understand, they resist and, in turn, fail at addiction recovery. When they come back from a relapse, they’ll hear the same information again. We have people come back and say, ‘I know what I need to do,’ but then they don’t do it. So, how do you combat that?
One of the strategies we’ve worked on is trying to explain the science behind why these action steps work. For example, group therapy: When you go to a meeting and you’re with a group of people, it creates positive energy. If everybody in that meeting is thinking about staying sober and bettering their lives, it creates power in that thought, and the likelihood that your thinking will change to staying sober and bettering your life increases drastically. If you don’t go to a meeting, how are you creating positive energy? What are you doing to change your thinking? Einstein said ‘we can’t solve problems by using the same kind of thinking we used when we created them’. In other words, we can’t fix our own thinking.
I would argue that people suffering from substance use disorder are negative thinkers. They create negative energy for themselves on a regular basis. The symptoms prove that. They suffer from anxiety and depression. But all of those are symptoms of negative thinking. It’s very easy to say, ‘think positively,’ but it’s not possible. If we could just fix our thinking, we would. It’s not that simple. Addiction treatment is about trying to change the way that people think.
People come to addiction treatment but they’re not mindfully thinking about the things they’re doing to treat their disease. So, they’re in groups all day – they’re receiving group therapy. They meet with their therapist – they’re receiving one on one. They check-in with how they’re feeling. They form a community with the people. A lot of the building blocks end up being provided for them. You can tell them while they’re in addiction treatment, ‘you need to go to a meeting,’ which is just another form of group therapy, or ‘you need to get a mentor or sponsor,’ which is another form of one on one. But then they go home and their initial thought is, ‘I don’t like meetings. I don’t want to go to meetings’. It’s like someone who suffers from cancer saying, ‘I don’t like chemo’. Well, nobody likes chemo. Nobody wants to take chemo. But you’re going to die if you don’t. Your doctor tells you, “if you don’t do this, your disease will progress”. For some reason, when it comes to behavioral change, it’s very easy for us to rationalize and justify why doing some healthy activities aren’t as necessary. This goes back to the question, ‘Is it a disease or is it a choice?’ It’s very easy for people to say it’s a choice or a moral dilemma. But if it were as easy as just choosing not to ever do it again, most people with substance use disorder would choose to never do it again. They don’t come here on vacation. They come here because their lives are a disaster. Yet, they’re compelled to make that decision. And they’re compelled because their thinking is broken. If they don’t do certain things to change the way they think daily, they will inevitably fail again.
It’s just like physical activity: The push-ups you did yesterday don’t make you stronger today. Every day you don’t do push-ups, you get weaker. If you go to treatment for weight loss, run on the treadmill every day for thirty days, make great progress, and then go home and sit, you’re gaining weight. You’re going backward. It’s inevitable.
So, we’ve come up with a curriculum where people take action steps while they’re in addiction treatment, but we help them be mindful of the action steps they’re taking. It’s very easy for people to go through the motions, get results, and then leave without an awareness of all the things they were doing. They don’t relate the group therapy they were getting in addiction treatment to a meeting. A lot of clients will say, ‘I like group therapy better in treatment than in the meetings,’ which I understand. They get comfortable. But they don’t give themselves time to get comfortable outside of here – which they have to do. It’s part of sustaining long-term recovery. They became comfortable in treatment because they stick with it. When they leave addiction treatment, they have to go through the uncomfortable phase again.
I would say that the biggest mistake people make when they leave addiction treatment is that they leave it up to choice whether they’re going to do these tasks are not. When someone dedicates themselves, they don’t really leave it up to choice. They decide, ‘I’m doing this. I’m going to the gym every single day’. They don’t leave it up to Monday and then decide. In my opinion, if you leave it up to question – am I going to do something or am I not? – the likelihood that you will choose not to do it increases. If you’ve already come up with a plan: ‘Tomorrow I’m going to the gym,’ the next day, you’re going to the gym. The decision is made.
When you decide that you’re going to do something, you’ve presented your subconscious with a goal that you’re asking it to help accomplish. Most of our brain power lives in our subconscious. Choice lives in our conscious mind. On a daily basis, our conscious mind has to make choices, but a lot of of our actions are taken subconsciously. We don’t have to think, we do them automatically. You don’t have to think about walking. Your subconscious stops the mental fight. It’s just like work; you don’t question whether or not you’re going to work every day. You just do it. Your subconscious has taken over so it aids you. It doesn’t mean you always want to go to work, but there’s a piece of you that knows you have to go to work. When you decide something, you’re utilizing your subconscious. But if you say, ‘I’m going to try to go to a meeting tomorrow,’ you don’t really present your subconscious with a problem. You don’t give it a goal or a direction. You’ve said: ‘Maybe I will, maybe I won’t’. Most people suffering from substance use disorder have a hard time choosing to make healthy decisions for themselves.
In response to this dilemma, we formulated a 64 Day Plan. Sixty-four days is a minuscule part of your life. It’s less than a quarter of one percent. The premise is: ‘I’m asking you to make a decision right now – a commitment – to work on eight tasks diligently every day for sixty-four days, whether you want to or not’. After sixty-four days, your subconscious will take over. Continuing to utilize the tasks will be easier because you’ve created habits. You’re not questioning on a daily basis: ‘Do I want to? Do I not want to?’ You’ve already decided.
We’re talking about life and death. Staying sober should be the most important thing. Because if you stay sober, everything else is going to prosper. People are willing to drive an hour to go to work. But if you ask them to drive twenty minutes to go to a meeting, it’s too much of an inconvenience. Why is that? What are your priorities? If you can get people to understand and set their priorities appropriately, they’ll be able to remove the barriers. The only barriers that stop people from staying sober are in their minds. In my opinion, everybody is on equal footing in terms of the ability to stay sober. Some people have used more, some people have had worse trauma than others – but if you look at the people who stay sober and the people who don’t, it’s not the people who experience less trauma, it’s the people who were willing to take action compared to the people who weren’t. The people who don’t take action fail. The people who take action succeed. It’s literally that simple.
Writing plays a central role in the 64 Day Plan. The clients write down all the action steps that they’re taking. If they stop taking action steps, they can look back and it gives them some accountability. ‘I’m not feeling too good this week. Let me compare what I did this week with what I did the week before’. You can have some record of why you’re feeling the way you’re feeling. I think, fundamentally, recovery comes down to creating positive energy for yourself on a regular basis. Many of the steps you have to take to accomplish that are outside of yourself: ask for help, go to meetings, read books, pray, meditate. The more action you take, the more skilled you become. It’s like anything else. I would argue that when people leave addiction treatment, they are not skilled enough. They have not developed the skills to properly stay sober long-term.
Part our curriculum is community connection. We don’t just help them build habits, but we start plugging them into different places in the community so they have an arena to continue honing their skills. We plug them into that beforehand so they’re comfortable in the ‘real world’. We try to have them join a recovery organization, whether it be a twelve step fellowship, Celebrate Recovery, Refuge Recovery, or SMART Recovery. There’s a plethora of recovery organizations you can join… but it is essential you join one. If you’re a biker, you don’t join a hiking club. You join a biking club. As a result of biking with other people, you stay motivated and continue to do it. If you’re just doing something by yourself, the likelihood that you’re going to continue doing it forever diminishes. The problem with recovery is that if you get into it and then you stop, you relapse. You die. So, you can’t stop. Being involved with an organization and a group of people becomes a way of living. It helps you to continuously focus on asking, ‘How am I bettering myself? What am I working on?’ The longer you stay sober, the better you can identify, ‘I’m not feeling good because I’m not doing x, y, and z’.
You are going to get off-track. Just because your life is going great doesn’t mean that you’re not susceptible to a relapse. Life going great is not a barometer of addiction recovery. A barometer for addiction recovery is action steps taken for recovery. That’s an issue people wrestle with a lot; they start doing things they think make their life better and equate it to recovery. This is an issue for families, too. They see their loved one and think, ‘oh, they look great now’. But, at the end of the day, if someone wakes up in the morning, goes to work, comes home, eats dinner, watches television, and goes to bed, what did he do for his recovery? The answer is ‘nothing’. Now, a normal person might look at this scenario and say, ‘they’re doing great!’ They might look great on the outside, but on the inside – mentally – they are deteriorating. In my opinion, without some type of addiction recovery task in your life, the disease of addiction is slowly but surely chipping away at you.
It’s easy for people – and not just people who suffer from substance use disorder – to put on the facade that everything is great. Look at Facebook! Most people want to create the perception that everything is good on the outside. It’s our human nature. It’s our ego. We don’t want anybody to judge us. But someone suffering from substance use disorder always has a mental problem. You can’t fix a problem unless you know you have it. Once somebody identifies they have a problem, they can find the solution. There’s no shame. I don’t know anybody in this world who would shame someone for trying to better themselves as a person.
One of the tasks that we have on our 64 Day Plan is ‘spend time on a weekly basis with someone who inspires you’. Someone who inspires you doesn’t necessarily have to be your mentor or sponsor. If it is – great! But someone who inspires you could just be some random guy you heard at a meeting who shared a fantastic message. I don’t know how many times I’ve heard somebody say, ‘the meeting was awesome last night. The speaker was great!’ In my opinion, if the speaker was awesome and the meeting was great, it would be in your best interest to find out where that speaker is from and where he goes to meetings on a regular basis. He probably goes to a meeting every week. Most people in long-term addiction recovery go to meetings on a regular basis; at least a couple times a week. They’ve done a ton of work on themselves, but they still go because it still helps them. So, if you find one of those people, it’s in your best interest to spend time around him or her. I’m not even talking intimate time; sit in their presence. How many people go to seminars just to be in someone’s presence? There’s Tony Robbins, Jack Canfield – people pay thousands of dollars. Well, the truth is that all those teachings – Tony Robbins’, Jack Canfield’s – are about self improvement. Whether people realize it or not, addiction recovery is about self-improvement. They’re teaching the same things – the same principles. In addiction recovery, there are people who are masters in the craft, but you have to make the effort to be around them. Again, it’s a very mindful task. It’s easy to let opportunities pass you by. That’s why we encourage clients to be mindful about people who make them feel good and motivate them. I do believe that one person can make all the difference in the world between staying sober and not. But you have to find that person or people. That’s your responsibility. Any people who have accomplished great things in life will attribute their success to mentors along the way. Addiction recovery is the same. It’s not a different way of thinking about things. In the ‘real world’ people are doing x, y, and z to be successful, so why not use the same formulas to be successful in recovery?
I think that people sit around waiting for motivation… and motivation is not built from a standstill. Motivation, to me, is a lot like momentum. You don’t gain momentum standing still. As you take action steps, you will gain motivation. But if you think that you’re just going to sit there and it’s just going to hit you – you’re just going to be super motivated one day – you are incorrect. You have wrongly assessed motivation.
In my opinion, if people do exactly what they’re supposed to for their recovery, it’s guaranteed they’ll stay sober. The problem is that people resist doing these things. As a result, they fail, but they don’t understand why they fail. They weren’t doing what the needed to – or they weren’t doing what they needed for long enough. We’re confronting that resistance head on – acknowledging it, talking about. We’re helping people understand why they resist and then helping them follow through. As a result, I think we have great results and great feedback, and our addiction treatment is effective for everybody. We don’t force people to do any one form of addiction treatment. We ask, ‘what form of treatment do you want to do?’ A lot of places have one modality, like the twelve steps. The twelve steps work…but so do other forms of recovery. It’s very easy to get egotistical about why one form of addiction recovery is better than another. The truth is all forms of recovery share some similarities. They have some really important common denominators that people need to incorporate into their lives. If you incorporate those common denominators – if you know the numbers to the combination lock – the lock has to open. But you need to know the numbers. You can’t just figure them out yourself. You also need to spin the lock. You can sit there and say, ‘I know the numbers,’ but if you’re not spinning, the lock isn’t going to open.
We’ve identified those numbers, and each number can have a range of different actions in it. We’re not saying one number is just A.A. or just N.A. We’re saying one number incorporates all of those modalities, which I think is a little different than other approaches. There are many great addiction treatment centers out there. I think ours is unique in that we try to be creative in delivering information to people. I also think being your own best self-critic is the way to go. As an addiction recovery organization, we need to be consistently asking, ‘what more can we be doing? What can we be doing that’s more effective?’ For example, we’re about to introduce Nuerofeedback – which has proven scientific results. It’s just one more thing to add to our repertoire and to help people have the best odds”.