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Ending Recoveryism

Aug 8, 2008
Racism, dogmatism, and sexism are the judgments that one race, set of beliefs, or sex are superior. I am introducing the term "recoveryism," defined as the judgment that one approach to recovery is superior. Recoveryism often gets even more extreme: there is only ONE approach to recovery. Any other "approach" is just pseudo-recovery. Individuals who try these pseudo-recoveries will not recover until they finally seek the one true way.

A recent example of recoveryism is found in James Frey's book, A Million Little Pieces. Although aspects of Frey's book have come under intense criticism, I suspect the recoveryism aspect of his writing is accurate. He describes his two month stay in residential treatment, and the intense hours just before and after that experience. Given the information about the age, prestige and location of the facility (see especially page 7) it is reasonable to suppose that he attended Hazelden, in Minnesota. On page 409 he receives his aftercare plan, presented in a file to him. As he glances at it he realized that "it is filled with AA literature and schedules of AA meetings." He has made known to the staff many times that "I don't believe in the Twelve Steps. I don't believe in God or any form of higher power. I refuse to turn my life and my will over to anything or anyone, much less something I don't believe in." Nevertheless the aftercare plan is as it as, according to the counselor giving it to him, "because you won't stay sober without AA...because it is the only thing that works."

See pages 151, 166, 222, 230, 291, 333, 345, and 377 for other poignant examples of how the staff attempts to persuade Mr. Frey into their point of view, and how he holds on to his own view about his behavior and what needs to be done about it. Unfortunately few individuals are likely to have the self-confidence and tenacity of Mr. Frey, who throughout the narrative (including the dramatic final sequence) pursues his own approach to recovery. For many US clients treatment is a mixed experience, and for some it is clearly more detrimental than helpful. In no other arena of healthcare is there anything approaching the lack of client choice, as there is in addiction care.

In all of the attacks on Frey's accuracy (did he really get dental care without painkillers, because he was in recovery?), I have not seen any attacks on his description of the intense persuasion attempts he was subjected to.

It would not be recoveryism to suggest that for specific individuals one recovery approach is better than some or all of the other approaches. Unfortunately we know little about how to find the best (or at least a better) recovery approach for each individual. In practice, we should allow individuals themselves to choose their own path of recovery.

If recoveryism is to end we need to 1) make information about the full diversity of recovery options available to all who need it (I have previously termed this "information parity") and then 2) allow them to choose among them. More precisely, we need to support individuals in crafting their own unique recovery paths. I suggest that there are as many paths to recovery as there are individuals. I think we are just beginning to discover how diverse these paths can be.

What often scares families in crisis is that they have lost confidence in their loved one's capacity to make wise choices given the recent addictive choices. However, there is no eliminating choice in recovery. If we don't allow those in need to choose their own new path, it won't be long before they are annoyed and angry, and choosing their old path.

The majority of recoveries occur outside the treatment system. These recoveries are termed "natural recoveries" because neither treatment nor a support group is attended. It is only from doing studies on large populations of individuals that natural recoveries have come to light. It is not in the treatment industry's interest to emphasize that natural recoveries occur. The industry's ads, at their most enlightened, make statements like "if you don't get help with us at least get it somewhere." What they should be saying is "if it's time to make a change, then do so; if you find you need help, call us."

For now we can support the end of recoveryism by stopping any effort to say what recovery cannot be. We need to focus instead on what recovery might be. If an approach is showing some success, rather than suggest that disaster is just around the corner, let's support what seems to be working. The recovery approach can be modified over time, and indeed is likely to be. This open-minded perspective is more likely than a rigid one to help individuals make changes sooner rather than later. Let's just say Yes to recovery.

Adapted with permission from an article originally published in the SMART Recovery newsletter.
About the Author
A. Tom Horvath, Ph.D., ABPP, is a board certified clinical psychologist and president of Practical Recovery (Alcohol Addiction Treatment Center in San Diego), an addiction treatment facility in La Jolla (San Diego), CA, focusing on collaborative care and self-empowerment.
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