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A World I Saw

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“Disruptive innovation, a term coined by Clayton Christensen, describes a process by which a product or service takes root initially in simple applications at the bottom of a market and then relentlessly moves up market, eventually displacing established competitors.”

The worlds of addiction treatment and recovery mutual aid are on the brink of being radically disrupted and transformed. New recovery support institutions and bold innovations in how, when, and where recovery supports are delivered will pose unprecedented threats and opportunities for established players within the treatment and mutual aid arenas.

SMART Recovery's new executive director, Susan Licate, brings the proven skills in strategic leadership, communications, fundraising and business administration needed to sustain and accelerate the organization's growth. Her award-winning talents in marketing and media outreach should broaden awareness and acceptance of SMART as a mainstream provider of recovery support. Susan will officially join SMART Recovery on April 2nd.

“Disruptive innovation, a term coined by Clayton Christensen, describes a process by which a product or service takes root initially in simple applications at the bottom of a market and then relentlessly moves up market, eventually displacing established competitors.”

The worlds of addiction treatment and recovery mutual aid are on the brink of being radically disrupted and transformed. New recovery support institutions and bold innovations in how, when, and where recovery supports are delivered will pose unprecedented threats and opportunities for established players within the treatment and mutual aid arenas.

If you have spent any significant time in the worlds of addiction treatment and recovery, you have witnessed couples who survived everything addiction inflicted on their relationship only to have that relationship disintegrate during the recovery process. What is going on here?

Recovery from addiction can answer long-proffered prayers, but, without transitional support, recovery can also threaten the stability and future of intimate and family relationships. That provocative conclusion, drawn from the original research of Drs. Stephanie Brown and Virginia Lewis, has profound implications for the design and delivery of addiction treatment and recovery support services. A long-term perspective on intimate relationships is critical to the provision of family-focused addiction recovery support services, as is awareness that missteps in the provision of such support can undermine relationship viability.

One of the existential turning points within the recovery experience is marked by the diminishment of backward sense making (What happened to me?) and the increased urgency regarding one’s post-sobriety future (Okay, what do I do now?). All manner of emotions feed this transition: release, relief, gratitude, unworthiness (survival guilt), remorse (guilt over past transgressions), a gnawing sense of emptiness, and, not uncommonly, a passion to help others similarly afflicted. Many forces coalesce to push people out of addiction, but finding a higher purpose in one’s life is a potentially powerful pull force within the process of long-term recovery. For many, that purpose is found in service to others.

The understanding of addiction as a brain disease has been a central organizing principle within the research agendas of the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism. Promotion of the brain disease paradigm stirred controversies over its scientific legitimacy and contentions and counter-contentions over its effects on addiction-related stigma, but it exerted unquestioned influence on public and professional conceptions of addiction and approaches to the treatment of addiction in the United States. Interesting variations in the conceptualization of addiction as a brain disease occurred contemporaneously in other countries. The challenge across cultural contexts has been to integrate recent research on the neurobiology of addiction to create more dynamic biopsychosocial models of treatment and recovery support.

One of the most innovative examples of such integration can be found within the Islamic Republic of Iran’s Congress 60 recovery community. Encompassing more than 57,000 active members across 58 branches in Iran, Congress 60 combines a medication-assisted transition into recovery with an extensive menu of psychosocial supports. The rationale for medication support and the unique scheme of such support (the DST method) has been outlined by Congress 60 Founder Hossein Dezhakam in what he christened the X Theory.

A.A. is so decentralized that in a very real sense, there really is no such single entity as “Alcoholics Anonymous”—only A.A. members and local A.A. groups that reflect a broad and ever increasing variety of A.A. experience. To suggest that Alcoholics Anonymous represents a “one size fits all approach” to alcoholism recovery, as some critics are prone to do, ignores the actual rich diversity of A.A. experience in local A.A. groups and the diverse cultural, religious, and political contexts in which A.A. is flourishing internationally. (Kurtz & White, 2015)

Addiction recovery is far more complex than a “happily ever after” story. Recovery contains the full spectrum of emotions, including great sadness, because life itself is filled with a rainbow of emotions. The experience of loss in recovery can come in many forms: job loss, financial calamity, fractured relationships, the death of loved ones, and injury or disability, to name a few.

Loss is an inevitable part of life. Fully embracing the experience of loss in recovery joins us to the rest of humanity. We share with the rest of the world losses that cannot be anticipated, losses that seem brutally unfair, and losses so profound as to seem ungrievable. Having survived addiction does not exempt us from such suffering. We will each experience loss and eventually take our turn leaving. That is the way of life. What matters is what we do in the midst of such losses before our own leaving. Recovery does not relieve us of that responsibility. It actually adds weight to it because of lost time and the need to balance transgressions from “the life.” If we use our allotted time wisely, we can accept loss as part of life’s way and approach our own departure without guilt, regret, or fear.

The devastating effects of addiction on physical/emotional health and social functioning have been meticulously catalogued, but far less attention has been given to its toll on character and the role character reconstruction plays in the recovery process. A recent rereading of David Brook’s The Road to Character has spurred this reflection on character and addiction recovery.


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