Once rehab is over and it’s time to continue life with sobriety, it’s crucial to know that support is out there to help you to stay on track. There is no reason to feel that you are alone on this journey.
Addiction is still not fully understood and different organizations have their theories of what addiction is and what causes it. There are many different types of addiction treatment programs. After all, everyone is different.
For example, at The District, we can help offer evidence-based treatment methods through our partnerships with rehabs around Orange County as well as access and admission to our sober living homes in the area.
We typically associate treatment for getting sober with Alcoholics Anonymous. AA is a huge organization that was established in 1935 and has an estimated 2 million members worldwide.
Alcoholics Anonymous is a 12-step program which means it is underpinned by spiritual principles. But, many people find that the religious aspect of 12-step programs is contrived and cult-like.
However, twelve-step programs do help many people to stay sober and substance-free. Even atheists find that programs like Alcoholics Anonymous and Narcotics Anonymous provide the support needed to stay on track.
While programs like Alcoholics Anonymous and Narcotics Anonymous do have success in helping people to stay substance or alcohol-free, its religious aspect turns many people off.
The religious aspect of AA gave rise to more secular addiction treatment programs such as Women In Sobriety and SMART Recovery.
What Is A Twelve Step Program?
A twelve-step program is a support group to help its members achieve sobriety from drugs, drink, or addictive behaviors. This approach to addiction treatment started in the 1930s when Bill W, the founder of Alcoholics Anonymous had a religious epiphany during treatment for an alcohol use disorder.
Bill W struggled with an alcohol use disorder and entered rehab at Towns Hospital in Central Park, New York four times between 1934 and 1935.
During this time he met up with an old drinking buddy called Ebby Thacher. Ebby had stopped drinking and attributed it to a spiritual awakening he had whilst attending an evangelical Christian group called The Oxford Group.
Whilst Bill W was experiencing alcohol withdrawals during his fourth treatment at Town’s hospital he claimed to “see a brilliant white light.” He never touched another alcoholic drink after.
Twelve Step Meetings
The Serenity Prayer is typically read aloud after the AA preamble at the opening of AA and other twelve step meetings:
“God, grant me the serenity
To accept the things I cannot change;
Courage to change the things I can;
and wisdom to know the difference.”
The prayer is also referred to as the ‘acceptance’ prayer. Acceptance is a vital part of recovery as a person must accept that life has struggles, especially when withdrawing from drugs and alcohol. A person cannot change the fact that they will experience cravings from drugs, drink, or a certain behavior, and they have to accept that.
Once the preamble and Serenity Prayer has been read, then the session moves onto the study of the twelve steps. Each week or session focuses on a particular step. People who have been attending AA regularly over the years will have worked through the steps several times. Studying the steps involves reading the AA literature and applying the steps to their own lives. This can be quite daunting and challenging for many people.
One step, for instance, requires a person to approach people they have harmed in the past and apologize, even if the person doesn’t know. The idea is that by asking for forgiveness and acknowledging one’s shortcomings they will create happiness in the longer term.
What Are The Twelve Steps?
When a person attends AA they work with others on the program to ‘work through the steps.’ The steps are a series of lessons in life that help a person to become a better version of themselves. By improving one’s integrity and moral code, a person raises their self-esteem and is better able to manage the desire to drink or take drugs.
The twelve steps are:
- We admitted we were powerless over alcohol, that our lives had become unmanageable
- Came to believe that a power greater than ourselves could restore us to sanity.
- Made a decision to turn our will and our lives over to the care of God as we understood him.
- Made a searching and fearless moral inventory of ourselves.
- Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
- Were entirely ready to have God remove all of these defects of character.
- Humbly asked him to remove our shortcomings
- Made a list of all persons we had harmed, and became willing to make amends to them all.
- Made direct amends wherever possible, except when to do so would injure them or others.
- Continued to take personal inventory and when we were wrong admitted it promptly.
- Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
- Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.
Spirituality and Recovery
Bill W, like many others, believes that to become sober, one must have a spiritual awakening. The psychedelic movement supports this theory.
Many people turn to psychedelic substances combined with psychotherapy to acquire the necessary shift in brain chemistry to achieve long-term sobriety.
The idea of spirituality and recovery is that a person becomes able to accept the struggle of being in recovery without relapsing. Being spiritual means accepting life as it is with its hardships and difficulties and believing that a higher power or ‘God’ will take care of things.
Many people who attend Alcoholics Anonymous and twelve-step programs are atheists but they still find great support in the meetings. Some atheists interpret their higher power to be other members of the fellowship, and this seems to work for them. It’s important to remember that while AA has roots in Christianity, it’s not completely faith-based and works mainly on the support and connectedness between people.
Other agnostic or atheist people who stick with the program sometimes find that they gradually experience a spiritual epiphany. This is a highly personal and subjective process. Cynical onlookers may see this as brainwashing, others may see it as a spiritual awakening.
Ultimately, it’s vital to find out what works for the individual.
The problem with healing addiction is understanding it. Addiction is a psychological, physical, and physiological problem. It’s unlike cancer or heart disease which you can identify under the microscope.
Is Addiction a Disease?
This is a controversial subject. Twelve-step programs believe that addiction is a disease. The National Institute of Drug Abuse defines addiction as a “chronic relapsing brain disorder.”
The American Society of Addiction Medicine defines addiction as a chronic treatable medical disease that involves the brain circuitry, genetics, and life experiences.
In medical circles, addiction is typically considered a mental illness or mental disorder.
In modern medicine, mental health disorders are treated with medication and cognitive-behavioral therapies that help a person to transform their thought processes.
What Is SMART Recovery?
SMART stands for Self-Management and Recovery Training and refers to a secular alternative to AA. This program aims to support people who struggle with addictions and co-occurring disorders.
While there are other secular alternatives to AA, SMART recovery is the most well-known. It is incorporated into many organizations in the US such as:
- Psychiatric hospitals
- Used to help military veterans with substance use disorders and PTSD
- College campus
SMART recovery does not recognize addiction as a brain disease. Instead SMART views addiction as a maladaptive behavior or bad habit that can be changed.
The main difference between SMART and AA is that SMART is not religion-based. Spirituality does not feature at all in SMART recovery. Instead, it focuses on using science-based behavioral therapy methods to help a person overcome their addictions.
This secular program incorporates:
- Motivational interviewing
- Cognitive behavioral therapy
- Rational emotive behavioral therapy
The National Institute of Drug Abuse (NIDA) and the American Association of Family Physicians (AAFP), and the National Institute of Alcoholism and Alcohol Abuse (NIAAA) endorse SMART recovery as an effective and legitimate means of addiction support.
How SMART Works
SMART is a four-point program that doesn’t have chronological steps. With this program, members work with volunteer facilitators to work through the various exercises that are based on cognitive-behavioral therapy.
Motivational interviewing is a way of getting a person to open up about themselves and get them talking. A person is more likely to change a behavior if they verbalize it beforehand.
This type of interviewing encourages the person to freely express their thoughts and feelings so that they eventually resolve any inner conflicts and arrive at conclusions themselves.
There are four main vital skills with motivational interviewing:
- Open-ended questions
- Summary Statements
- Reflective Listening
The Difference Between SMART and AA
Where AA sees the addicted person as powerless and needs to surrender to God, SMART aims to empower the individual and become self-reliant to be abstinent.
The spiritual aspect found in AA is completely absent in SMART recovery. There is no mention of a higher power, spirit, or god, with SMART. This is completely science-based and relies on evidence-based methods of overcoming addiction.
With AA, members receive a chip for every sober milestone they reach. Each chip measures approximately 3.5cm. This tradition is said to have started in Indianapolis in 1942.
The idea of the sobriety coin is that it helps to strengthen a person’s resolve to stay abstinent. When a person looks at the chip, it reminds them of how far they have come in their sobriety. When AA presents a member with their first coin, they usually tell the person that, “this coin represents AA’s commitment to you, not us.”
In contrast, SMART doesn’t use a chip system, nor does it expect complete abstinence. A criticism of the chip system is that if a person relapses, they have to start at the beginning of the chip system again, even if they’ve been sober for years. This may lead to some people avoiding meetings after a relapse.
SMART is said to have a more permissive atmosphere so that people feel they are able to discuss their problems while they are relapsing. AA on the other hand requires complete abstinence and encourages a person to reach out in meetings before they relapse.
A significant and major difference between SMART and AA is the conclusion of recovery. With AA you can never be considered ‘recovered.’ As you must ‘take each day at a time’ there is no denouement, no end to the struggle. It’s as if you will be in a cycle of addiction and recovery until the day you die. This can be somewhat disheartening, which can weaken a person’s resolve.
AA has graduation as one of the steps of change. In contrast, SMART recovery doesn’t. SMART doesn’t regard recovery as a long-term process, instead it allows a person to put their addiction and their associated thoughts and behaviors behind them in the past. Allowing a person to put their addiction behind them and pursue a new life is empowering for the individual.
Powerlessness vs Empowerment
Many people don’t find that AA’s idea that the addicted person is powerless is unhelpful. This is where SMART becomes more attractive for many as it encourages people with addictions to empower themselves with choice.
For many, the idea of surrendering oneself to a ‘higher power’ fails to resonate with them. This is what can be so problematic for many people who first come to AA. Over time, many people develop an understanding of the idea of surrendering to a higher power.
For people who have no religious leanings, the idea of a higher power can seem a little far-fetched. They often ask, what is a higher power? What does it look like? How does it work? Those who believe in the higher power report that they sense that extra forces
Some people who attend AA but who are agnostic interpret the higher power to be other members of the fellowship. This can make sense as AA is about connectedness between members. AA meetings focus on being there for each other and creating a non-judgmental environment where people are free to express themselves.
Which Is More Successful?
Research points out that twelve step programs are slightly more successful than mutual support groups such as SMART recovery. But, due to its religious nature, many people don’t attend twelve steps groups in the long term.
Other studies suggest that it’s not so much the program that matters, but more the consistency of attendance and the development of healthy relationships with people on the program and people who facilitate the program.
Ultimately, there is no right or wrong way to become free from addiction.
Some people find they prefer AA some prefer SMART recovery. And others prefer to work with a combination of both.
It’s important for a person to find what works for them. SMART Recovery has lots of practical science-based activities that can help a person enormously.
AA helps greatly because it seems to improve social cohesion between members. It is difficult for some however, to see the value in this program due to the religious aspect.
But, it seems that those who can put their judgements aside about spirituality and approach the twelve steps with an open mind do glean considerable benefits.
Every person is different. They’ve had different childhood experiences, have different mental health problems, and experience addiction in slightly different ways.
It appears to be that consistency is key, along with staying connected with others.
If you need help with any aspect of recovery today, call the friendly District Recovery team at 866.330.9449 and we’ll help you get back on track.