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Stages of Addiction & Recovery

Addiction doesn’t happen overnight. Neither does recovery. But the slow journey of recovery is worth every step.

What is Addiction?

It is a question that has been around for as long as there has been alcohol, drugs and other addictive things. It is a question that has as many answers as there have been people asking it. The reason is that addiction is a subjective experience which is deeply emotive for the addict and those affected by it. It is a subject around which objectivity is difficult to achieve.

Nevertheless, there is concensus that addiction is characterised by compulsive and repetitive seeking of pleasure or relief from distress, despite negative consequences.

I’m sure everyone can think of a time when they did something which would fit that description, although most people would not consider themselves to be addicted to anything. It’s important to remember that addiction is not black and white. It’s not something that either you have or you don’t have. It’s more like a sliding scale that fits everyone. Where you are on the scale probably changes from day to day.

Problems tend to arise when you tend towards addictive behaviours more often than not. The move towards problematic addictive behaviours tends to be slow, gradual, subtle and can be approximately characterised in the five stages described in the next section.

Stages of Addiction

In this section, I present an adaptation of stages of addiction first described by Elvin Jellinek in the 1940s. Jellinek described these stages as they apply to alcoholism. In subsequent years, many in the counselling community have come to realise that all types of addiction share common underlying psychological and behaviour components, which I have divided into the stages that follow.

Stage 1 – Pre-Addiction

This is a stage in which the individual’s behaviour is unremarkable and appears not to have any of the hallmarks of addiction. The person can stop or moderate their activities, and engages in life as normal. The only indicator of addiction at this stage lies in the individual’s attitude to the activity that may later become addictive. For example, someone who may go on to develop alcoholism may at this stage have a subtle preoccupation with drinking and drinking-related activities. It may be that they unconsciously plan their weekends around drinking and that they choose to make friends with people who enjoy drinking often. Similarly, people in the pre-addiction stage of any addictive activity will seek out that activity in preference to others. Be it gambling, drug use, work, eating, exercise, sex, relationships (platonic and romantic), etc, the individual will notice that they experience a heightened pleasure associated with a particular activity which is unique to that activity. Needless to say, the pre-addiction stage is very common and most people will never progress past this stage. Nevertheless, those for whom addiction has become a problem can often identify feelings towards the object of their addiction which were present in the pre-addiction stage.

Stage 2 – Early Addiction

By now, the individual will consciously seek out situations in which they can engage in a particular activity, which has begun to become addictive for them. They are aware that the activity feels markedly more enjoyable than other activities and they may have started becoming secretive about their behaviour. Although they can still stop or moderate when they need to, they are becoming aware that their feelings and behaviour in regard of one particular activity are not “normal”. At this point, the individual’s feelings begin to be characterised by remorse, and their behaviour begins to become cyclic: E.g. gambler who regularly spends more than they intended to, feels remorseful afterwards, becomes increasingly secretive about their gambling behaviour and experiences excitement associated with gambling more than with other activities. With the gambler, the excitement often accompanies thoughts such as, “I lost a lot of money last time, but this time I know I can win it all back and more”. Nevertheless, someone in early addiction can usually stop or moderate their addictive behaviour if they can change their attitude towards it. For example, the early-addicted gambler can often break the cycle by accepting that they will never regain their losses and by setting themselves a gambling budget which they can afford and which they know they will stick to. As with pre-addiction, many people never progress beyond the stage of early addiction.

Stage 3 – Middle Addiction

By this stage, addictive activity has likely become a permanent, secretive aspect of the person’s life. For example, in the middle addiction stage, someone who uses drugs will be doing so alone, and in preference to other activities (e.g. spending time with friends and family). The individual’s ability to control or moderate their behaviour is impaired. They can usually stop or moderate for a time, but often return to the addictive activity before very long, and the cycle mentioned in the previous stage is strengthened – a cycle of recovery and relapse has started. The person is aware that they have a problem and often blames those around them for it. E.g. many people with middle-stage alcohol addiction blame their drinking on the stress of family life. This stage is precarious. If the person has enough desire to stop, they may be able to change their approach to their problems and return to a more moderate, controlled enjoyment of the activity. Often they will require ongoing support from friends and family to do so. As with the previous stages, many people never progress past this point while others go further and find themselves in the late stage of addiction.

Stage 4 – Late Addiction

By this time, control has become impossible. The addictive activity rules the person’s life and they have (or are in the process of) sacrificing everything in their life in order to engage in addictive activity. For example, late-stage alcohol addiction is characterised by compulsive drinking which the individual cannot do without. Often the individual is by now estranged from friends and family and the addictive activity is their only source of comfort – and the major cause of their distress. At this point, the person is often acutely aware of their predicament but is entirely unable to see a way out. All of their attempts at control have failed. Once a person has reached this stage, control is impossible. Often, the only solution is abstinence from the behaviours/substances that are fuelling the person’s addiction. For example, the gambler in late-stage addiction can only recover by stopping gambling. The person in late-stage alcoholism can only recover by stopping drinking. The person in late-stage addiction to food can only recover by eliminating those food-groups which trigger the compulsion to binge-eat. This is the most horrible and distressing stage of addiction, and it is often at this stage that people take desperate measures to try to control their addiction. As I have already said, the sad fact is that by this stage control is impossible. The only option that remains is abstinence. When someone has reached late-stage addiction, there is no going back to any of the earlier stages. The only solution is to reach out for help and become willing to completely change your life. While such a prospect may seem daunting, there is plenty of help available and the rewards far outweigh the effort required to achieve them.

Whether you can identify yourself or someone you love at one of the stages described here, there is hope. There is always hope, whether you feel it at the moment or not. If you are feeling hopeless right now, know that your feeling will change when you change; when you do something different. In the next section I describe the process of recovery, how it works and how to get the necessary help and support.

Stages of Recovery

Whatever stage of addiction you find yourself at, it is my firm belief and experience that recovery is always possible. In the following sections I present the stages that constitute long-term, good-quality recovery from addiction.

Stage 1 – Admission

The first step of the recovery process is to admit that you have an addiction problem. Susan Jeffers says it best in her book Feel The Fear And Do It Anyway:

Whether you want it or not, it’s yours.

Nobody asks for addiction. Nobody wakes up one morning and decides to become hopelessly and helplessly addicted, just like nobody wakes up one morning and asks for cancer, or blindness, or motor-neurone disease. Nevertheless, if you fit into one of the stages of addiction, you’ve got it whether or not you want it. How do you feel about that? Angry, sad, hurt, etc? Whatever you feel, that’s yours too. It’s real, it’s valid. You are valid. It’s OK to say, “I think I’m addicted and I’m angry/sad/confused/scared/etc about it”. Emotions are natural and normal and one of the initial challenges you may face is to admit those feelings to yourself and to reach out for help when you feel able and willing to do so. If you feel your family and friends are unsupportive, then think who else can support you. Take a look at my list of other agencies, or contact me. I know it may seem daunting to reach out for help, but remember that I and others are here to help. I will always be happy to help you because I know what it means: that you have the possibility of breaking free from your addiction and turning your life around. Don’t worry if you don’t know what to do about it at the moment, that doesn’t matter. The most important things are firstly, for you to decide whether or not you have a problem and secondly, to ask for help.

Stage 2 – Decision to Accept Help

So you’ve asked for help, but how willing are you to accept the help offered? The answer to this lies in how much you want to stop or moderate your addictive behaviour. You alone can gauge that. Nobody likes to admit that their drinking/drug use/gambling/eating/etc is out of control. It often feels shameful. There comes with it a fear of attack and rejection by others, a fear that others will not understand and will be judgemental. The good news is that I do understand. I want to help. I know that feeling of vulnerability and loneliness. If you can be honest with yourself, the chances are you’ll be in a position to accept help from others. Nevertheless, you are the only person who can make decisions about your own life and I appreciate that it can be difficult to accept help. Whoever you decide to ask for help, I advise you to pick someone who doesn’t tell you whether or not you are addicted. Only you can make that decision, and only you can decide what you want to do about it.

Stage 3 – Making Realistic Life Changes

Depending upon how far down the road of addiction you have gone, you may be able to moderate your addictive behaviour, or you may find that the only option is to stop entirely. A good counsellor will help you make that decision for yourself. I suggest that you take a look back over your addiction and ask yourself the following questions:

When was the last time you tried to stop or moderate?

How successful was your last attempt?

What normally happens when you engage in addictive behaviour?

If you find that stopping or moderating your addiction is difficult or impossible, or if you find that bad things happen each time you engage in addictive behaviour, then abstinence may be your only option. Consider many millions of people worldwide who seemed hopelessly addicted have become abstinent and have become happy and purposeful once again. Nevertheless, I know very well that abstinence may seem like an awful prospect right now. In my opinion, the there are three things that will help you right now:

1.Keep it in the day – you can stay abstinent just for today. Tomorrow isn’t here yet. Just stay abstinent today.

2.Try a meeting of a 12 Step fellowship.

3.Find a support group and/or make contact with a counsellor.

If you have religious affiliations; your local religious organisation may be able to help you. The most important thing is that you decide what is best for you. If you don’t know what’s best yet, explore the options. You need to find a way into recovery that works for you.

I know that becoming abstinent can be a very hard thing to do, so I encourage you to reach out and ask for all the help you can get. There are people out there, including me, who genuinely care about you and want to help you recover.

Stage 4 – Building Meaningful Relationships

Addicted people often share similar traits – the aspects of their personalities that pre-disposed them to addiction in the first place. These aspects show themselves in the following four beliefs that many addicted people have about themselves:

1.I am, in my core, a bad person. This is not true. If you were a bad person, you wouldn’t feel so guilty about your addiction. You feel guilty because you care about yourself and others. You are fundamentally a good person.

2.People would hate me if they knew who I really am. This is not true. Most people, when presented with the truth about another person, are compassionate. Most people are good people (and that includes you). Nevertheless you should carefully decide who you will be honest with. I recommend that in the first instance, you approach a counsellor, a religious minister or a member of a 12 Step fellowship.

3.Nobody will help me, so I have to help myself. This is not true. The truth is that someone who truly understands addiction will be able to help you, if you are willing to accept the help offered.

4.The thing I’m addicted to is what I need most. This is not true. The thing you are addicted to is what you want most, but it’s not what you need.

(Adapted from Carnes, P. (2001), Out of the Shadows (3rd Ed). Hazelden, Minnesota).

Above all, the addicted person feels isolated, alone, apart from others, unable to make personal connection because what they fear most is intimacy with others. The irony is that what most addicted people want is intimacy but, by every mental trick they know, they will convince themselves that they’re best off keeping themselves emotionally distant from others. Does that sound familiar? If so, there is hope for you. There is always hope. Reach out for help and accept what is on offer. If what you get from one place doesn’t feel right for you, try something or someone else.

Stage 5 – Maintenance of Recovery

Whether you’re just starting out on the road to recovery, or you’ve been in recovery a while, there is a word that will be familiar to every addicted person: relapse. Picture the situation – you’ve made the first steps and reached out for help, you’ve found people who can support you, you have made the changes in your life to make recovery possible, and now you’re getting somewhere. You have actually got a handle on your addiction. You are no longer thinking, feeling and behaving in an addictive way. You’ve got it nailed. Then suddenly ... you find yourself back where you started all over again. How frustrating, confusing, disheartening. Perhaps you feel that your worst fear has been confirmed – that you will never escape your addiction. This may be how things seem, but there are two illusions at work here. Firstly, there was the illusion that you had it nailed, and secondly, there is the illusion that you are right back at square one with no means of escape. Neither of these beliefs are true. You need to recognise that if you are to maintain your recovery.

Principally, there are two attitudes which will help you maintain recovery:

1.I need to put action into my recovery on a daily basis. Every day you will need to wake up thinking what you can do today that will help you stay away from addictive behaviour for just one day. Think of it as one of your daily tasks for a good life. You get out of bed every day, you bathe every day, you get dressed every day, so why should recovery be any different? If you slip into thinking that you’ve “cracked it”, then the chances are you will stop doing what you need to do to keep yourself in recovery.

2.If I do relapse, I can learn from it. Some people relapse many hundreds of times before they get recovery. Others never relapse at all. Everyone is different. It doesn’t mean that you’re intrinsically “good” if you stay in recovery, or that you’re “bad” if you relapse. Think of it in terms of how enjoyable you want your life to be. If you chose to dwell on the relapse, give yourself a hard time about it and tell yourself you’ll never get recovery, then the chances are you will relapse again. Life won’t be much fun. On the other hand, you can look back at the relapse and identify what when wrong and what you will do differently in future. If you can accept that the relapse happened, that there’s nothing you can do to change the past, then you give yourself the best chance of changing the present and you give yourself the best opportunity for recovery.

Wherever you are in your journey of addiction or recovery, my ambition in writing this page is that you will take away a sense of hope. Hope that you can recover. Hope that life in recovery will be good. Hope that you can reach out for help. Hope that you can take positive action and find recovery.