In Praise of the Geographical Cure

By Tessa Torgeson 10/22/18

For me, leaving was about survival and going back to supportive friends and family who had known me my whole life and who would give me a temporary place to stay.

Woman in driver's seat, resting arm on steering wheel, looks sad or stressed.
As I drove east, I felt as flattened and empty as the prairies of my home state.

When I moved to the city of my dreams, I drove my Navy Subaru Impreza stuffed so full that I couldn’t see out of the rearview mirror the entire 1300-mile trek. My backseat was packed with my white cat Toby, my maple-bass guitar Helga, a vintage amp, a typewriter, a case of angsty journals, and a ridiculous amount of polka-dot and striped clothes. All things that I deemed too valuable for the moving truck. A month later, my serious boyfriend finished welding school back home and joined me. After finally leaving our sleepy home state of North Dakota, we were excited to start our new life together.

Fast forward a few chaotic years to a plot that is achingly familiar for those of us who struggle with addiction; a plot almost sad and pathetic enough to make me a country song — if only I drove a pick-up truck and was a dog person rather than a cat lady. When the city of my dreams became the city of my nightmares, I decided to leave. My addiction counselor warned me that running away from my problems wouldn’t fix me, but I didn’t care. My drug hook-ups practically lived outside the Whole Foods across the street from my apartment, the same store that I had been kicked out of for stealing. My rent check bounced so I was on the verge of eviction. I needed to get the hell out.

When I left the nightmare city, my cat Toby had died, my car had died, my identity had been stolen, and worst of all, I had broken up with that boyfriend who was supposed to be my forever mate. Then I fell in love again and that passionate, drug-fueled love also didn’t work out. Since I had sold or given away most of my possessions, pawned my bass and amp, there was no need for a moving truck this time around. I left, feeling broken.

I sobbed as I said goodbye to the stunning Pacific Northwest wonderland with its gleaming snow-topped mountains and volcanoes, waterfalls, rainforest. As I drove east, I felt as flattened and empty as the prairies of my home state.

I knew that just because I was moving home, it didn’t mean that I’d be magically fixed. I tried not to fall under the spell of what folks in the program call the “geographical cure.” Kerry Neville recently wrote a beautiful, lyrical, and illuminating piece on the geographical cure in which she says: “a change in external position on the map doesn’t reset the compass and point us to true north, because we always meet up with the self we are, no matter where we are.”

I agree with some of Neville’s points, namely that taking vacations to topical locales will not get rid of our problems and provide us with a healthy, extended recovery. Yes, I knew that changing my zip code wouldn’t necessarily change my soul. I knew that I’d have to really dig down and do the hard, gritty work of recovery. But for me, leaving wasn’t about a vacation. I couldn’t afford vacation, I couldn’t even afford my rent. For me, leaving was about survival and going back to supportive friends and family who had known me my whole life and who would give me a temporary place to stay.

Now that I mention it, the geographical cure warning is ironic because it contradicts other 12-step platitudes. These platitudes are like currency in the rooms, exchanged as freely as the collection basket for money and meeting lists: If you go to the barbershop enough times, eventually you’re going to get a cut, and: The only thing you have to change is everything. Change people, places, and things.

Why are those of us who do decide to change our location criticized? Why do certain meetings and rehabs keep using their one-size-fits-all mottos rather than listen and embrace the many winding paths that lead us to recovery? In the few meetings I attended and the online recovery groups I participated in, people reacted negatively when I told them what I was doing. The consensus was that I was making a mistake. Even my counselor was quick to remind me that I wasn’t “special and unique,” and if this plan didn’t work for others, then why should it work for me? But I chose to do the thing that I knew would help me and my recovery. It wasn’t a mistake; it saved my life.

Surely I wasn't the only one who felt that perhaps the geographical cure may have been successful, so I decided to research the power of environmental cues, aka triggers, for addiction, relapse, and recovery. It’s likely you’re familiar with Pavlov’s classic dog study and the mechanics of classical conditioning, but I want to review it because it's the foundation of every study that I read on this topic. Russian physiologist Ivan Pavlov was studying salivation in dogs when he noticed that the dogs salivated every time a door was opened, even when researchers didn’t have food. This was because the dogs began associating a neutral stimulus like opening a door (or, later, ringing a bell or flashing a light), with food. Researchers later used this model to study people with addictions.

Studies found that people who develop alcoholism and addictions develop strong associations with drug-associated cues and environmental stimuli like Pavlov’s dogs. In other words, after repeated experiences, drug users relate the rewarding effects of a drug (like euphoria and relaxation) with the people, places, and things that are present when we are using. For example, one study found that smokers who received IV nicotine still reported cravings, whereas smokers who received IV nicotine and nicotine-free cigarettes didn’t. Why? Because of the power of environmental cues, including the feeling of holding a cigarette in one’s hand, the smell of smoke, and even packaging of a cigarette box.

I mention these study results not just because they confirm what I already knew in my heart to be true and I love being right, but because they are vital for understanding recovery and relapse prevention. We must acknowledge the power of our environment and triggers. Although most of us won’t take the extreme step of moving across the country, we all can minimize our exposure to triggers until we feel strong enough to deal with them. We can also bring a friend or family member to face triggers and create new associations, as the studies I read suggested.

Above all, we should all learn to embrace our own unique path to find what works best for us, even if it goes against the current of AA axioms. I will always be grateful that I listened to the fluttering in my chest. Wisdom means knowing when to keep your feet firmly planted in place or when to take flight. Sometimes leaving is the thing that saves you after all.

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Tessa Torgeson is a collector of bad habits aka addictions, polka-dot stuff, and general awkwardness in Minnesota. Embracing alternative recovery, she is currently writing a memoir about addiction and recovery from a non-traditional, harm reduction perspective. If you want to hop on the feelings train, follow her on twitter @tessa_tito and read more of her writing at