Rehab is easy, Recovery is hard – Making addiction treatment work

Here’s another article from Sarah Henderson, one of our readers who’s recovered from a long battle with eating disorders and is living with bipolar disorder. She’s very candid about her experiences with addiction treatment, which I like a lot, and her unique view on food addictions (or eating disorders) fills a nice gap  in my own knowledge. In this piece, she discusses issues about addiction treatment setting, independence, and the involvement of others in recovery. We’ve all heard that you can’t make someone overcome their addiction, and Sarah’s story shows that sometimes what does the trick is making them confront their own problems. As I’ve talked about in the past, I had a similar experience when I decided to own up  to my problems and asked my father to let me take care of finding treatment myself. It was the first time I’d really internalized that I was the final piece in this puzzle.

Rehab is Easy. Recovery is Hard.

At least, that’s been my experience. Throughout the the years I struggled with anorexia, bulimia, self-harm, drug abuse, and bipolar I had a very distinct pattern: get sick, make people worry, get very sick, go to therapy, get extremely sick, go to residential treatment. Once there, I’d battle the people who were trying to help, then slowly acquiesce, then start to be semi-okay, get my weight up, get my symptoms down, and get discharged. Then, I’d get sick.

And around and around we go.

I did this for about ten years. I went to hospital after hospital, RTC after RTC, therapist after therapist. I was kicked out of treatment in several places for various reasons: not cooperating, hindering other patients’ recovery efforts, refusing therapies or medications. At one point, I was even kicked out of my small private high school because I was so sick I was “disturbing” the other students.

There is a time in my illness when I would have been proud of these things. I would have seen them as showing how tough I was, how strong in my cause, how determined to go down fighting. Now, however, remembering these things only brings a sense of sadness, and heart-wrenching compassion for the pain that this girl was in, how much she had to have been hurting to continue to put herself in that situation.

At a certain point though, the cycle stopped. I had been to this one treatment center twice in one year- and been asked to leave both times. Finally, the person who had been funding my psychiatric revolving door decided that was the last time he was paying for inpatient care. The next time I decided to get super sick, I was on my own.

After getting out of inpatient that very last time, I continued to relapse. However, knowing that no one was going to swoop in and save me, toss me in treatment, and keep up my game, created a shift in my thinking. I didn’t really have the option of continuing to get sick; at least, if I wanted to live. Wanting to live was something I went back and forth on often. I went through two very uncomfortable, joyful, horrible, painful, gratifying, terrifying, and ultimately life-saving years in outpatient therapy stumbling my way towards recovery. That time was like a dance, getting sicker then better, back and forth, until little by little the better days outnumber the sicker ones. I don’t have a “clean date” like many people; I couldn’t tell you the last day I skipped a meal or purged or cut myself. All I know is that I’m recovered.

It took a long time and a lot of work to get here. And all those years that I spent in addiction treatment did NOT go to waste, despite how it may sound. I think for me- for many people- inpatient treatment lays foundation for recovery, plants the seeds of new behaviors, thoughts, and coping strategies. But it’s not until you leave that safe, rarefied environment that those seeds will sprout, and recovery can begin to flower. I always had this idea that RTC was supposed to cure me; that I should be able to walk out all whole and healed, no problems at all. And I was always pissed when it didn’t happen that way. Finally I figured out that’s not how it works. Treatment just gives you the tools and materials for recovery. YOU are responsible for building it.

I wish someone had told me that the very first time I went to inpatient. It’s an important thing to remember throughout the treatment process; the more you understand that you alone are accountable and responsible for your own health and recovery, the more likely you are to achieve it.

Final thoughts from Adi

Like I said in the beginning, I appreciate Sarah’s truthfulness about her experience. Additionally, I share some of her story, especially as it pertains to having to own up to her condition and lose some of the guidance, or maybe crutch, that had been there for so long. However, I think that this story is a great example of why it is true that while addiction stories can offer great inspiration and hope, addiction research looks at patterns in data that can offer insight no given story can give us.

For instance, Sarah says she that outpatient treatment let her truly put the tools that she learned about in residential treatment to use. In fact, she suggests that this is the role of outpatient treatment. In actuality though, addiction research shows that people do better if they’ve been to residential treatment, especially among more difficult cases, and that a structured transition, like moving from a residential treatment facility to sober-living or to outpatient, increases the chances of long-term sobriety.However, I don’t know of any research that shows that past experience at residential treatment predicts greater success at outpatient treatment. Everything I’ve seen shows that past failure at rehab predicts future failure, not success. That’s not to say that Sarah’s story doesn’t repeat, but as a rule, more difficult cases do better in residential, not outpatient.

These sort of research findings can help guide us towards the most probable path to success, after which point individual variability sort of takes over and works its magic. The hope is that as we get better and better at it, our addiction research will guide us towards more customized initial treatment selection. It’s how we make things work in our A3 Rehab-Finder.

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