Finding a Skeptical Starting Point

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You’re ready for change. Maybe still a little ambivalent about it, maybe still unsure what it might actually involve, maybe still hoping you can find a way out without quitting altogether forever. But right now, at any rate, it’s clear that you can’t go on like this. What are the options?

Four widely-used approaches

Approach	Does it work?	Upsides	Downsides
Go “cold turkey” and get sober on your own. Maybe read a few books, get some ideas, but basically gut it out on willpower alone.	Let’s just say it has a low initial success rate and an even lower long-term success rate. That’s not to say it’s never been done- there are folks who have managed it that way. But they’re rare- almost the exceptions that prove the rule.	Well, it’s cheap in both time, and money. And you get serious bragging rights (which others might not appreciate, but that’s their problem, right?)	Primarily that very low success rate. Also, some people manage to achieve long-term sobriety this way, but don’t seem to make much progress in feeling as though they are “living well,” or “enjoying life.”
Join a support group and use the group philosophy and help from other members to stay sober.	AA’s Bill Wilson is reported to have said that although AA is a great way to stay sober, it’s not always the best way to get sober. That’s true, but some people do sober up with no more help than a support group.	It’s cheap- most support groups accept donations to defray group costs (meeting space, coffee, literature,) but they don’t charge admission. And if you can get sober, the long-term chances to stay sober are good with group support.	Non-AA type groups like SOS, Rational Recovery, LifeRing, etc., are still not very common, and a once-weekly meeting in the next town might not be enough. AA is much more available, but it can be hard for non-believers to feel comfortable.
Enroll in a formal addiction treatment program, either residential or outpatient.	Many people achieve long-term sobriety after participating in one or more treatment programs. We say “or more,” deliberately- relapse is still common. But treatment is effective. Works best in combination with further involvement in a long-term support group.	Treatment programs can provide help with the physical problems of early recovery, education and information, and structured support for changes in behavior and lifestyle that promote long term sobriety. It’s an effective “jump start” for the recovery process for many.	There are many types of programs and finding the one that will work best for you isn’t always easy. It’s a substantial investment of time and money (although insurance may cover some costs,) and it may not be cheap, or even accessible.
Therapy and/or coaching, working on an individualized, one-to-one basis with a professional.	It can be effective, with the right match of professional to client. But just as with treatment programs, change is difficult, and relapse is common.	Individual therapy or coaching can be tailored for your schedule, your particular needs, etc.	Finding a really effective professional can be difficult. And individual therapy, like other forms of treatment, works best in combination with support.

 

For the vast majority of people who achieve long-term sobriety, non-believers and believers alike, the journey starts with one of the middle two approaches: A support group, a treatment program, or both. And, because relapse is a common occurrence in the course of addictive disease, successful individuals may try these approaches more than once- several times, in fact. But of course, “not giving up” is part of the definition of “successful” in this case.

Earlier articles in this series (see below) have discussed some of the issues non-believers encounter with support groups, and tools for adapting the group models to a non-believer’s approach. We’ll come back to that in more detail in future articles, too.

But what about treatment? There’s nothing easy about treatment even when the curriculum is solid and the staff are respectful of non-believers. Finding yourself in a program steeped in spirituality language, with devout staff and an overt (or nearly so) faith bias may not be an insurmountable obstacle if you’re really determined, but for most people, there’s still plenty of ambivalence. One more reference to the “healing power of (insert deity reference here)” could tip the balance for an early check-out.

Most faith-based treatment programs clearly identify their orientation, and while many will welcome non-believers, they may reasonably expect anyone enrolling in their program to be tolerant of the faith-based orientation.

Programs that don’t consider themselves “faith-based” may still rely on 12-Step models and spirituality tools rooted in religious belief, however. And many non-believers have adapted such tools to work well for their own recovery. After all, “spirituality” isn’t the exclusive territory of religious believers, and “faith” doesn’t need to refer to a deity.

The best way to address this issue when looking for a treatment program that will suit a non-believer is to simply ask: “I (or the person on whose behalf I’m asking) am an atheist. How will your program curriculum and staff work for someone who doesn’t believe in a god?” Their response will help you decide whether it’s likely to pose problems if you enroll.

Here are eight things to look for in a treatment program that’s likely to work well for non-believers:

• The program treats addiction as a biogenic disease. Meaning, a disease related to physiological vulnerability and adaptation, as opposed to a problem “caused” by psychological problems, the need to “self-medicate” underlying emotional problems, or “coping with” unresolved childhood issues. Those all may be factors, but treatment models based on a psychogenic approach can be less effective for skeptics.
• Treatment is aimed at achieving specific goals. The program should be able to tell you clearly what the goals are, and why they are goals. Look for: Understanding the disease and the treatment directions, achieving self-diagnosis, and learning methods for maintaining sobriety, among others.
• The program emphasizes education. Knowledge is power, and there’s a lot to know about alcoholism and drug dependence. Programs and therapists who tell a newly-recovering individual to “trust their gut” are doing you no favors- your gut has no special ability to help you stop drinking. Learn everything you can about your illness.
• The program uses group therapy. Groups are important; they can help in ways individual therapy can’t. They reinforce the common struggle and provide experience and practical advice from peers. And when a confrontation is needed to penetrate denial or prevent relapse, a well-run group is much more effective than an individual therapist. “If one person says you’re a horse, laugh. If five people say it, buy a saddle.”
• Program staff are experts in addiction treatment. Not all clinical credentials imply expertise with addiction. Ask specifically about training and experience with addiction treatment.
• The program offers good transitional or aftercare services. It takes about a year for most people to stabilize sobriety. Will this program help you follow through and find resources and support to keep you on track? Will you be able to ask them for help, and will they be able to connect you to additional services?
• The program is oriented toward preventing relapse. Good addiction treatment programs address relapse because it’s a common occurrence with this disease. They should be able to discuss how the program and staff will help clients understand relapse triggers, prepare to meet them, and (hopefully) avoid relapse..
• The program provides family education and counseling. If for no other reason than an untreated family often provokes relapse. Ask about family sessions or programs and what is taught in them.

You can also download our article “Finding the Best Addiction Treatment for YOUR Needs,” which has more detailed discussion and resources.

Coming soon: Re-engineering Recovery Tools