The Ultimate Guide to Rehab

The Ultimate Guide to Rehab

By Constance Scharff PhD 04/08/14

What you need to know when choosing an addiction treatment center.

(page 5)

Some addicts challenge that the rehab wants people to “extend” (stay longer) simply to make money. This is patently false. Quality treatment facilities very often have wait-lists. There is frequently someone waiting for a bed to be vacated. Furthermore, licensed treatment staff members are trained to evaluate readiness to move to a different level of care. The only reason staff members suggest an individual stay in treatment is because they are unconvinced that the individual has the skills to be successful outside the treatment center. 

Keep in mind too that rehabs will discharge individuals who refuse to do the work of recovery. They want people in the beds who not only need treatment, but want treatment. That is what creates the optimal environment for all the people in the recovery center. 

Special circumstances may warrant a longer or shorter term stay in residential treatment, but expect going in that you will be asked to stay in the range of three to four months. 

How to Get the Most Out of Your Inpatient Stay

1. Do what is suggested of you. You might never have touched a horse, but if equine therapy is suggested for you, try it. If you are asked to keep a journal, do it. If you’re asked to draw a picture of your feelings, what do you have to lose? Remember, you signed up for this! While some of the things you’re asked to do might seem silly, they are designed to work together to help you develop the resilience to live addiction free. Try everything. It just might work.

2. No matter how you feel, stay in treatment. If there is one thing addicts hate, it is feelings. Emotions are not something addicts are equipped to deal with. In speaking with your therapist and uncovering the reasons you needed addiction to cope with your feelings, you will walk through uncomfortable places. Don’t give up. This is part of the process and it will pass.

Sometimes too, good feelings will come up. After detox and a short period in treatment, addicts often feel so much better physically that they think they are “cured” and ready to go home. Just like the negative feelings, the “pink cloud” of health is an experience that is short-lived too. Don’t think that just because you’ve felt good two days in a row that you are prepared for all that life will throw at you outside the treatment setting. Listen to the facility staff. If they say to stay, even though you feel great, believe them that you’re not ready to go, especially if you’ve only been in treatment a few weeks.

3. Use the safety of the treatment center to your advantage. At the treatment center, there are no parents, bosses, spouses, children, or others placing demands on you. You will be provided with all your basic needs and a supportive community. You will not walk through your old playgrounds where you know every dealer or bar on the street. You will be surrounded by people who genuinely care about you and your recovery. Don’t squander this gift. Use this time selfishly – to focus on you and what you need to overcome your addiction. The safety of residential treatment will undoubtedly be one of the greatest gifts you receive from treatment.

4. Expect feelings to arise. Addicts use substances and behaviors to push away feelings. Without those substances and behaviors, feelings are going to come up. They will at times seem overwhelming. You will be uncomfortable and you will not like the experience. But with each experience, you will become stronger and more capable of understanding and moving through your emotions. In a short time, you will begin to experience pleasurable emotions – joy, self-respect, and a sense of well-being. This too is part of the process. 

5. Don’t judge your process. Someone else in rehab with you is going to be richer, smarter, prettier, or get better faster than you are. Alternatively, there are going to be people who are worse off than you and you might be tempted to feel superior. Let the judgment go. You are who you are. They are who they are. You’re on different paths. The truth is you are neither the highest nor the lowest form of life on the planet; you’re just a person doing the best you can under very trying circumstances. If you have to cry, cry. If you want to scream, do it. If you find yourself feeling inferior or superior, tell your therapist about it. Then move on. Judgment only gets in the way of the work and of your recovery.

The Reality of Life after Rehab

Perhaps the greatest disservice done to addicts and their families is that society has the expectation that the addict will go to treatment and somehow emerge “healed” after 30 days. That is not at all how treatment works. Families also very often have the notion that the addict is the “broken” one and if s/he stops using, all will be well. This also is false. All members of the family system must change the way they interact with one another or the addict will return to using. If the family dynamic supported addiction, it must change so that addiction is no longer a viable way of diverting attention away from the family’s problems. 

The truth is that in addition to the addict needing serious help, the entire family system is damaged. The addict goes to treatment to learn ways to bring him/herself into recovery, to build a new life in which s/he has the skills to cope and thrive. Meanwhile, the rest of the family must seek its own treatment and change in ways that provide room for the addict to return to different circumstances. This changed dynamic is critical to the addict’s recovery.

Expect the addict to remain emotionally fragile for the first year of recovery. There will be many firsts to be experienced. The addict will have to learn how to interact, work, be intimate, make future plans – all without relying on substances or behaviors to shield him/her from feelings and insulate him/her from the outside world. There also will likely be tremendous stressors in the addict’s life – from legal or financial problems to mending broken relationships. Dealing with these issues is not easy; far from it. Give your loved one the room to stop, breathe and focus before and during the process of dealing with these issues. The addict must know when to take a break and choose to get support when needed. 

Treatment does not “fix” the addict. Recovery is a process that takes time. Rehab only sets the foundation for recovery. There is much more to be done after leaving the treatment center. Be kind to yourself and the ones you love. One day, the trials before you now will all be a memory.

Staying Sober and Preventing Relapse

Going to rehab is by no means a guarantee that you or the one you love will stay sober. Treatment is just the beginning of the process. Yet relapse is neither imminent nor necessary. You can do things to stay sober and prevent relapse. Most importantly, keep in mind that it is easier to prevent a relapse than to come back from one. Use every tool available to you to remain sober in difficult moments. 

1. Take the option to relapse off the table. There is a saying in 12-step programs – “We don’t drink or use no matter what.” Relapse does not need to be an option for you. If you find yourself wanting to use, seek immediate help. Don’t let embarrassment get the better of you. People who relapse are more prone to relapse in the future. Don’t become a statistic. Use the tools you have to stay sober. The obsession will lift. 

2. Develop a support network. It may be members of your 12-step group, your family, friends, or professionals such as your therapist or psychiatrist. It may be an anonymous help-line or a member of the clergy. Have a list of people you can call and talk to at any hour of the day or night. Yes, you might feel the obsession to drink or use at a less-than-perfect hour. That doesn’t matter. There are people who will be there for you even when it isn’t convenient. Ask for help.

3. This too shall pass. Most relapses happen quickly. The urge to use comes up and the addict puts up little resistance. However, these periods of intense feeling usually do not last long. While you are seeking help, recognize that your feelings are going to change quickly and you will soon feel better.

4. Help someone else. 12-step programs understand this concept very well. If you are helping someone else, you’re not thinking about yourself and your problems. Call a sick friend and ask how they are doing. Go to a 12-step meeting and talk to a newcomer; ask about their day. Volunteer to do work that involves your hands – like building a home with Habitat for Humanity or grooming/walking dogs at the animal shelter. Not only will you build self-esteem by doing esteem-able acts, but you won’t have time to think about yourself or wallow in self-pity. 

5. Pray and/or meditate. There is a lot of power in prayer and meditation. That’s why so many treatment protocols suggest it. Life is tough and we are not usually in control. People get ill. Accidents happen. Circumstances change. There’s nothing anyone can do about any of it but learn to face these challenges with humility and compassion. In such circumstances, prayer or meditation can offer solace, a sense of well-being, right-sized responses to the situation, and sometimes even a feeling of direction and purpose.

Family Involvement in Rehab

Though some addicts have burned all their bridges and enter rehab with no family relationships, most addicts are members of robust – and often troubled – families.