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A Famous Case of Spontaneous Recovery

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Oliver Sacks photo

By Maia Szalavitz

11/27/12

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Much of this recovery did not involve total abstinence: of the 48% of people in this sample who had alcoholism in the past year and recovered, 37% were considered “low-risk” drinkers, 25% didn’t have symptoms of dependence but were considered at high risk for relapse, and just 38% were complete abstainers.

What this means is that the path to recovery that most people think is most common—attending 12-step meetings either with or without some additional treatment, completely abstaining from all psychoactive substances that aren’t prescribed—is actually the unusual one. Between two-thirds and three-quarters of people who recover don’t receive any type of treatment, and only about 40% abstain entirely, at least with the legal drug alcohol.

Moreover, people who take the path of what researchers variously call “natural recovery,” “maturing out” or “spontaneous remission”—like Sacks—tend not to identify as addicts. Although this is the opposite of what people who are helped by AA generally find, for many people, taking on this stigmatized identity can have a crippling effect. Believing that being an addict means being powerless over the problem makes matters worse in these cases: a study by pioneering alcoholism researcher William Miller found that such belief made any relapses that occurred far more dangerous.

Oliver Sacks' ability to take joy in this work replaced the “vapid mania of amphetamines."

Thinking that you can’t stop once you have started, after all, provides little incentive to try. And seeing yourself as an addict, with all the negative qualities our society projects onto us—lying, manipulative, untrustworthy, selfish—can produce despair rather than an attempt to confront the stereotype.

So how do people recover without treatment or support groups? Here Oliver Sacks’ story is also instructive. As a young man, Sacks had many things going for him. His parents were both doctors—so he didn’t exactly come from poverty. He had become a physician himself: he is both extremely intelligent and highly educated. Both having financial resources and being well educated are linked with greater success at any type of recovery.

But probably most importantly, Sacks found in writing an alternative source of pleasure and purpose. His ability to take joy in this work—even when it was not his primary source of income—replaced the “vapid mania of amphetamines”; more critically, writing was more meaningful than taking drugs.

“Natural recovery” is often called “maturing out” in part because as people grow up, they tend to find a place for themselves in society, one that ideally gives them a sense of being useful and engaged. It’s a lot easier to binge-drink in college and miss a few classes than it is to do so if it means possibly losing a job; similarly, being in a committed relationship—especially with kids—entails responsibilities that aren’t easily avoided without conflict but that one has often chosen and wants to fulfill.

Some addicted people are lucky enough to see their alternatives and recognize that they can provide equal or better sources of what they seek in their drugs—options that can channel compulsive drives but don’t have to become destructive addictions. Some are also lucky enough not to be caught in illegal activities and punished in ways that limit their future options and lower the odds of recovery.

Oliver Sacks has given the world great gifts through his writing about neuroscience and his compassionate treatment of patients. He says, in fact, that his drug experiences were important to his ability to empathize: having had hallucinations, for example, made him better able to understand his patients who struggled with them. Imagine what not only he but the rest of us would have lost if he had just been written off as a drug addict, a danger to medicine who should never be allowed to practice.

Maia Szalavitz is a columnist at The Fix. She is also a health reporter at Time magazine online, and co-author, with Bruce Perry, of Born for Love: Why Empathy Is Essential—and Endangered (Morrow, 2010), and author of Help at Any Cost: How the Troubled-Teen Industry Cons Parents and Hurts Kids (Riverhead, 2006). 

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