What Does Mature Recovery Look Like 1: Early Stages
We have a friend we shall call Bob. Bob is a community leader, well educated, successful in business, an avid community volunteer, generous with his treasure for local non-profits. Bob became active with us in the area of substance use disorder and recovery for the first time after his 65th birthday. We met every week for a while as he helped several recovery-related, community organizations find the resources to continue their work. One day he said, “Suddenly it seems that recovering people and their family members are everywhere. I encounter them at church, in social situations, at work, and in community organizations. Is there something changing?” “Oh, Bob”, we replied. After a few seconds of puzzled look Bob said, “Oh, they have been there all along?”. Yes, Bob, they were there all along.
As we build to describe mature stages of recovery and why we do not know about our friends and colleagues, let us first discuss why we are aware of people in early recovery. There are probably three million people in recovery within AA and NA today. There may be many more following a program of self-guided recovery or in focused programs such as Impaired Physicians that guard identity for obvious reasons. It is likely that Bob’s experience is not unique.
To a certain extent people in recovery are less conspicuous because of the traditions of anonymity. When AA was formed the moralistic views of alcoholism were still prevalent (certainly those views persist today in some measure). Prohibition was not that far back in memory and temperance societies still flourished. The founders were both Christians and had been part of the Oxford Group that was affiliated with the Lutheran Church.
Early AAers believed that only those who had “hit rock bottom” would be open to the rigors that this new program would require. As such, the first members of AA were, indeed, people who had experienced and done some pretty heinous stuff. The shame levels were everywhere, and they were reinforced everywhere. The early members shared the moralistic view of themselves.
As a result of all this shroud the early members practiced anonymity from the public and oftentimes with themselves. First names only were used, meetings were often held after dark, and they occurred in church kitchens accessed by entering through the back door of the church. Anonymity was strictly followed. Many AAers also observed the 11th Tradition, “We shall maintain anonymity at the level of press, radio and film.” This principle was as much about humility as anything else, but it also protected this newformed society against judgment in case a member relapsed as was the case with a very visible and well known member. In any event, all of this focus on anonymity, both externally and internally generated, resulted in people in recovery being rather closeted. Yet, for many these admonitions and practices remain and result in our friend Bob not knowing about them in his work, church, and community settings.
Today it is much more common to see people in recovery talk about that on television and radio. There are many, many autobiographic books written about personal recovery. People in recovery “blog” about their recovery on the internet. There are people who make a living on the speaking circuit talking about their experience. Yet, for most people in recovery their experience remains a personal matter. They do not “wear recovery on their sleeve” as a practice. To some this is protective as those biases remain in society. Some fear retribution. Some fear losing jobs or healthcare coverage. Yet others are still dealing with behaviors from their past that were at best antisocial and at worst criminal. For yet others this disease is like other diseases, and our society frowns on those who go on about one’s cancer treatment or any other diseases. These are private matters.
As more people become increasingly public about their recovery the general society is becoming more aware of the early stages of recovery and the experience of early treatment. We have all known someone who has gone through the early stages of treatment. Likely they have had some public issue (i.e. DUI) that we knew about and then were “away” for 28 days. There are now many marketing efforts on behalf of for-profit and non-profit treatment organizations, and they usually talk about people in early treatment. As a result, we are increasingly aware of those early days in treatment.
A 2019 study by the NIH discusses the transition from early recovery to longer term, stable recovery. Early treatment success is more uniform and structured with most participants describing this core transition of surrendering to new authority. This early stage may include residential, ongoing outpatient treatment or aftercare, and twelve step programs. In this early phase individualism seems sacrificed in return for the safety provided by these authorities. In AA they say, “Some of us have tried to hold on to our old ideas but the result was nil until we let go absolutely”. Demands of abstinence, submission to this new structure, and rigorous honesty are likely to contribute to many people not sustaining recovery. Those who do “let go absolutely” usually have an easier road.
This intense focus of people in early recovery is something many of us have witnessed. It is too much of our loved one’s life for it not to be obvious. Those who are successful in this phase are often “converts” to this structure. Too, people in early stages of recovery tend to talk about it by confiding in close friends. They have new friends in their twelve step programs, make meetings every day, sometimes multiple meetings every day, they practice the twelve steps, they are ebullient. It is sometimes difficult to watch and, frankly, tolerate all this. Why so energized by living the life you should have in the first place? Yet, most of us tolerate this stage as we recognize that our loved ones are on the right track, they have a disease not a moral failing, it is a part of the process, and (hopefully) this too shall pass. The point for this article is that unlike people in long-term recovery this phase is a bit more public and recognizable.
Later the newness wears off, cravings abate, the physical and emotional withdrawal symptoms lessen. This is a dangerous point in early recovery. Some feel that they are out of the woods now and no longer require these new rigors. For others these same new authorities that got them this far often come to be experienced as limiting, de-humanizing, or irrelevant. Perhaps they begin to think they can drink or use after all. This is rather common in the case of alcohol or cannabis. This is where relapse lives. As we have noted previously, relapse is common, ranging from 40-90% depending on the substance of choice. Again, for our purposes here, the point is that many of us have witnessed this stage of recovery. While we may be disappointed, even frightened, this is not the end of recovery but a part of the process. Oftentimes relapse serves as a reinforcing reminder that addiction likely requires early attention and abstinence. But it is another way in which the general public experiences early stages of recovery and knows about people in this stage of things.
Our point in all of this is to note that while we often do not know the person in the next cubicle is in long term recovery, we are much more aware of the person in the company or our church or our family who is early in recovery. They experienced a public, drug or alcohol induced crisis. They were “away” for a month. They are zealous about their new found freedom and tend to talk openly about that recovery. As a result many of us do know someone in early recovery and we have a pattern of behavior we might recognize in others.
We have not yet explained why Bob was unaware of those people around him in long term recovery. After all, those people were once in early recovery. Why is it that we subsequently do not know about these folks and their recovery? Next, what does that long term recovery look like. What of people in long term recovery? What is their experience? Why does Bob not know they are nearby.
Gene Gilchrist
Louisville, Kentucky
