The “trauma of recovery”

unexpected-road1Bill White with Stephanie Brown on the unexpected  “trauma of recovery”:

Bill White: Yes, you used the phrase “trauma of recovery” that just stunned me when I first read it.

Stephanie Brown: By 1994/95, we were well into analyzing family data and clearly saw that the experience of trauma, so starkly evident during active addiction, continues in the beginnings of recovery. Most people expect that when the drinking stops, everything is going to be fine, and it isn’t. It isn’t for the individual, and it definitely isn’t for the family. New kinds of problems actually emerge with recovery, totally unexpected because no one knows what to expect with abstinence, and the family members do not know how to operate without the drinking. The family system in active addiction achieves homeostasis by adapting to the pathology of addiction. The family system works during active addiction to maintain the status quo, but when you enter active recovery, those mechanisms no longer work. And, there are no family system mechanisms yet developed to support healthy living or healthy relationships. That leaves the family in the beginnings of recovery without structure to nurture and support the health of family members or the family as a whole. There’s a vacuum in the system, which often creates more trauma—new trauma—which we labeled the “trauma of recovery.” Clearly, this vacuum is a time when the family needs much greater external support to help “hold” them in their new recovery process. The transition from exiting formal treatment to achieving stable family functioning is still a huge vacuum for many families.

Stephanie Brown Interview on Addictions and Psychotherapy

l4c6db7e6bdd48Stephanie Brown on object attachment in addiction and recovery:

RW: Is this what people refer to as hitting bottom, or surrendering somehow?

SB: That’s the first experience – to hit bottom, to surrender, and to reach outside the self. So people seek help, they go to 12-steps. They then shift their object attachment from alcohol to a 12-step group, or to a treatment or mission- based center. They shift to whatever substitute will take the place so that they are still taking in, they still have an attachment. They begin to go to meetings; they’ll get a sponsor. They begin to take in the new object replacement for the substance.

VY: Why do you think this shift is so crucial to recovery?

SB: It is important so that you are not asked to give up your substance for nothing. The recognition is that you need a substitute attachment, so you get it. When you reach out for help, you’re going to reach out for a new object that represents recovery. It represents abstinence in the 12-step model and so the process of transformational change is under way with the shifted object attachment and the substitute new behaviors. What are the new behaviors? Going to the meetings, reaching for the phone, being in action to substitute something that represents recovery.

She very clearly describes a challenge we see frequently when a psychiatric diagnosis has been made. We see clients attaching to that diagnosis or their medication more strongly than to their recovery. It’s a fine line. We must be and we are responsive to their emotional/psychological suffering, but we also need to be cautious and conscious of the iatrogenic harm that can result from an inappropriate diagnosis and treatment.

RW: How much does it matter what that attachment is?

SB: I now see a lot of people going into treatment for addiction who are taking so many legal medications. They’re making their object attachment to the medication, instead of, “I have hit bottom. I am attaching to recovery.” These people are struggling in AA and NA. They’re sitting at meetings thinking about, “How’s my level of medications, should I up my antidepressants?” They’re talking all about the new object attachment to their medications.

via Stephanie Brown Interview on Addictions and Psychotherapy.