Help the patient tap into resource of courage

Courage is not the absence of fear, but the willingness to push forward and make changes in the face of fear. For those with addictions to drugs and alcohol, the thought of giving up mood-altering chemicals is a scary proposition that requires significant courage. However, with the help of addiction professionals, individuals can overcome their fear and negative self-image, accept the limitations of their condition and be encouraged toward positive steps in their recovery.

Overcoming fear and negative self-image can be a struggle for most alcoholics and addicts. Initially, the effects of mood-altering chemicals provided a “solution” that worked quite well in assisting them to nullify their fears—fear of being found out, fear of social situations, fear of being judged by others, fear of failure, fear of responsibility, and fear of the unknown. The thought of giving up this solution can frighten the individual. During my three decades of working with thousands of addicts and their families, I have come to learn that most suffer from many of these fears to some degree, even if they are not recognized.

As these individuals' addiction progresses, the most fearful unknown concerns what their life will be like without their single most valued “solution.” This fear is so powerful that addicts will continue to pursue their solution despite the myriad problems it is causing in their life—problems with relationships, their livelihood, their health, the legal system and more. Their level of fear can directly correlate to their level of denial about these problems. The thought of accepting the fact that their solution has now become a problem is simply too frightening.

Addiction professionals can help the addict overcome fear through therapy. Along with the 12-Step philosophy, a variety of therapeutic approaches can help guide the addict on the path to recovery. A group therapy setting can help addicts realize that they are not alone, nor are they the only ones struggling with addiction. Group therapy provides a support system with other individuals who understand and can relate to the struggles.

Family therapy can help the addict’s family members cope with and understand the addict’s actions, as well as their own responses to the addictive behavior. Once family members have a better understanding of the family system and dynamics, each family member can pursue the goal of embracing the recovery process.

Addressing limitations

Accepting the limitations of the human condition, limitations that others freely accept as a part of being human, proves difficult for many addicts. I have observed over the years that this stems partly from their irrational belief that such limitations should not exist. Rather than embrace their strengths and accept such limitations, they tend to place greater strain on themselves and exacerbate their fears. Because they tend to envy others' strengths, dwell on their own shortcomings, and experience guilt and shame over the conflict between their behavior and their values, they suffer from a poor self-image.

To face and accept this reality constitutes no easy task. To admit powerlessness over drugs or alcohol and that “my life has become unmanageable” means becoming willing to believe that the once highly valued solution has now become an ugly problem, and that the impacted life is in shambles. To push forward despite ongoing fears about owning up to past transgressions, shortcomings, judgment by others, life without mood-altering chemicals, etc., requires an immeasurable level of courage.

Addiction professionals can help addicts realize and celebrate their strengths instead of focusing on the negatives. Professionals also can help them create a positive support system that can assist in their recovery. Another way in which professionals can help is by providing them with volunteer opportunities. Volunteering offers an excellent way to get out of one’s head, putting one's own troubles on the back burner in order to help another. It provides the addict with a new purpose, so that he/she no longer has to focus on drugs or alcohol.

In a review article published in Alcoholism Treatment Quarterly, Maria Pagano says “research indicates that getting active in service helps alcoholics and other addicts become sober and stay sober, and suggests this approach is applicable to all treatment-seeking individuals with a desire to not drink or use drugs.”

Personalizing the plan

Encouraging positive steps toward recovery is the responsibility of professionals in the addiction field. For an addict to take the initial steps forward in the recovery process, even in the face of lingering fears, requires an impressive display of courage. It is crucial that addiction professionals acknowledge this courage and view it as a strength.

Addiction professionals have to come up with a personalized plan for each addict. First, make no assumptions. We should consider the “whole person” in order to determine a course of action. Is the addict in need of immediate hospitalization or detox, or would an inpatient or outpatient rehabilitation center be more appropriate? In some instances, a less restrictive option might be considered, such as a flexible plan that includes a combination of regular Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) meetings and check-ins with a qualified addiction professional. Each case is personal, so an addiction specialist must consider all aspects of the situation and individual before coming up with a plan.

What other obstacles might the patient experience? Together, the professional and the addict should come up with several plans for the future. If there are any legal issues that the addict has to face, plan for that. Legal issues might seem overwhelming and daunting to the addict, so creating a plan can make the problem seem more manageable.

Help the patient predict what his/her triggers are and how to react if experiencing one. Decide in advance what should be done if such a trigger presents itself. How should the person remove himself from the situation? Who should he contact? Where should he go?

Creating a list of AA or NA meetings that the patient might consider attending is also beneficial. Again, take into account the person with whom you are working. AA and NA meetings have evolved over the years, so there are now groups specific to young people, midnight meetings, meditation meetings, dual diagnosis meetings … the list is extensive. Consider all aspects and help the patient make a detailed, positive plan for the future.

Finding the “courage to change the things I can” and continuing to participate in the recovery process eventually rewards the addict with a peace and serenity far greater than previously imagined, and certainly far greater than any chemical “solution” ever provided. Addiction professionals can support addicts every step of the way. Through therapy, positivity, a strong support system such as AA or NA, and volunteering, patients can begin to tap into their courage and overcome their fears.

Johnny Patout, LCSW, is CEO of New Beginnings Adolescent Recovery Center in Opelousas, La., and is a licensed clinical social worker with nearly 30 years of experience in the addiction treatment field. Patout is a recovering alcoholic and drug addict with more than 30 years of sobriety.