The notion of recovery goes back to roughly 1830, at which time John Perceval, son of an English prime minister, penned his personal story of recovering from a two-year-long psychotic episode. He notes that his recovery was independent of medical assistance of any kind.Perceval’s personal narrative of recovery is chronicled in the 1972 book, Perceval’s Narrative: A Patient’s Account of His Psychosis, 1830-1832. Researchers at Massachusetts’ Worcester Asylum, in 1881, discovered recovery when they examined the cases of some 1,157 who had been discharged from their facility. Their search went back to 1840.
They were surprised to find that roughly 58% of those leaving their care were free of relapse for the rest of their lives. The concept of recovery picked up steam with the advent of Alcoholics Anonymous and other 12-step sober support groups.
Whether mental health or substance use issues, the focus was not on a medical model and based upon community support of some kind. In 12-step programs, the individual “leans” on the support of regular groups and also, typically, a sponsor who guides him or her through the recovery process.
In mental health recovery, often referred to as wellness programs, individuals who have successfully recovered aid those who are early in recovery. These people, often professionals are referred to as peer bridgers or simply peer support specialists. Both groups tend to see human distress as a normal part of life, rather than as a disease or something to be moralized or pathologies in any way.
Forms of distress are simply seen as an organic part of living. The goal of recovery support is to partner with the client and develop an individualized recovery plan. This plan may involve medications, therapy, or several other typical modalities, but not necessarily so. Nothing is forced upon an individual or even suggested.
The idea is to join with the client in his or her process and to utilize his or her strengths to aid in the steps to recovery. Often, if the client desires it, family and other community supports are utilized. There is no cookie-cutter process in recovery; from their perspective, each recovery is unique and intensely personal to the individual and his or her life context.
Recovery, seen as an organic process, experienced some setbacks during the 1940s and 1950s in the US, as the predominant way of contending with psychological distress was institutionalization. Even during the deinstitutionalization, beginning in the 1970s, it was assumed that recovery was not possible from so-called psychiatric diseases.
Unfortunately, we still see this today. Nonetheless, the recovery movement persevered, refusing to adopt the limiting and errant beliefs of the psychiatric establishment. Laing and his colleagues made substantial headway in establishing a therapeutic household that still remains today, such as the Philadelphia Association in the UK.
Following Laing, Mosher, as already mentioned, was successful in his work at Soteria House. To this day, Soteria houses still exist in various locations. In a similar vein, the consumer and psychiatric survivor movements began taking hold in the 1980s and 1990s and are still quite active to this day.
By 2002, the President’s New Freedom Commission on Mental Health solidified a way for a system-wide paradigm shift. As of this writing, Washington State legislators are revising its codes to reflect “recovery” language to include a component of “meeting one where he or she is at” and not placing stringent requirements (ie substance abstinence or being symptom-free) (Potter, 2015).
The Substance Abuse and Mental Health Service Administration (SAMHSA) has adopted recovery-oriented language in its guiding philosophy. (This is, again, as opposed to abstinence-based or symptom-free or disease model perspectives). SAMSA (2020) states that it is dedicated to, “Recovery-oriented care and recovery support systems help people with mental and substance use disorders manage their conditions successfully.”
Recovery is a process of change through which people improve their health and wellness, live self-directed lives, and strive to reach their full potential. Four major dimensions support recovery:
Health: overcoming or managing one’s disease(s) or symptoms and making informed, healthy choices that support physical and emotional well-being.
Home: having a stable and safe place to live.
Purpose: conducting meaningful daily activities and having the independence, income, and resources to participate in society.
Community: having relationships and social networks that provide support, friendship, love, and hope.
Hope, the belief that these challenges and conditions can be overcome, is the foundation of recovery. The process of recovery is highly personal and occurs via many pathways. Recovery is characterized by continual growth and improvement in one’s health and wellness that may involve setbacks. Because setbacks are a natural part of life, resilience becomes a key component of recovery.
The process of recovery is supported through relationships and social networks. This often involves family members who become the champions of their loved one’s recovery. Families of people in recovery may experience adversities that lead to increased family stress, guilt, shame, anger, fear, anxiety, loss, grief, and isolation.
The concept of resilience in recovery is also vital for family members who need access to intentional supports that promote their health and well-being. The support of peers and friends is also crucial in engaging and supporting individuals in recovery (SAMSHA, 2020).
Perhaps the most well known in the recovery world is the 12 Step movement. The 12 Steps of Alcoholics Anonymous have been utilized by millions for over 70 years. While the largest and arguably the world’s best known, its efficacy and methods are hotly debated. It is not the purpose of this writing to enter into this controversy but to delineate (broadly) what is in the field presently.
Unlike the aforementioned perspectives in the recovery movement, the aim of the 12 Steps is abstinence from all mind and mood-altering substances. This all began with the Four Absolutes adopted by the Oxford Groups in the 1930s and was expanded by Bill Wilson and Dr. Bob Smith to the current 12 Steps.
Their chance meeting resulted in a sharing of experiences and ideas. They founded Alcoholics Anonymous on June 10, 1935, the day of one of its pivotal founders, Dr. Bob’s, first day of permanent sobriety.
The Original Twelve Steps to Recovery
1. WE ADMITTED WE WERE POWERLESS OVER ALCOHOL – THAT OUR LIVES HAD BECOME UNMANAGEABLE.
The first step is admitting and accepting one has no control over his or her addiction. Addiction is deceptive and individuals suffering from this affliction typically struggle with various forms of cognitive dissonance and defensiveness, usually in the forms of denial.
When individuals believe that they are able to control their addictions they perpetuate the condition which led to addiction in the first place. For people to make a lasting recovery, from this perspective, addicts must acknowledge the futility of their struggle. which is very difficult.
2. WE CAME TO BELIEVE THAT A POWER GREATER THAN OURSELVES COULD RESTORE US TO SANITY.
The deceptive nature of addiction means that no individual can effectively manage their own recovery. Fortunately, no one is ever alone in any struggle because there is always a higher spiritual power that exists to guide us in the right direction. In this world, there are positives and negatives, there are darkness and light. If there exists a force as destructive as addiction, then there must also exist a healing force with equal vigor.
3. WE MADE A DECISION TO TURN OUR WILL AND OUR LIVES OVER TO THE CARE OF GOD AS WE UNDERSTOOD HIM.
After acknowledging that there is a higher power that exists in complete contrast to the darkness and negativity of addiction, the next step is to accept the authority of this power. This spiritual force is a guide that helps decipher and protect against the deceptive nature of addiction. In this model, addicts strive to create an environment where this spiritual energy can both serve and protect individuals as they progress.
4. WE MADE A SEARCHING AND FEARLESS MORAL INVENTORY OF OURSELVES.
This is often one of the most difficult steps to recovery. As the veil of deception is lifted and individuals can see their actions in a new light, reconciliation can become difficult. Sometimes, it can seem like accepting the responsibilities and consequences of the actions of a completely different human being. Connecting with others that share the same affliction can alleviate some of the duress associated with this stage of recovery.
5. ADMITTED TO GOD, TO OURSELVES, AND TO ANOTHER HUMAN BEING THE EXACT NATURE OF OUR WRONGS.
This step is about accountability. The dark and destructive nature of addiction means that individuals in recovery will have to face difficult truths about their past. Feelings of sadness, embarrassment, self-loathing, and depression may cause some to feel that it is best to hide these realizations, but this is the worst course of action.
It is important to keep in mind that for all of the negative energy created by addiction there is stronger positive energy that exists to help individuals heal. Admitting the mistakes of the past to oneself and to the higher power that governs this positive energy creates accountability. For both support and to further the strength of this newfound accountability individuals must seek the counsel of their peers over their self-assessment.
6. WE WERE ENTIRELY READY TO HAVE GOD REMOVE ALL THESE DEFECTS OF CHARACTER.
When individuals are in the grips of addiction, they commit acts which they believe will make them feel better. This false sense of security comes from satisfying the destructive cycle of addiction. Individuals who become focused on this cycle are unable to see the harm they bring to themselves and others in their life.
During recovery, the true nature of the past becomes clear and individuals are often confronted by feelings of doubt and remorse. These feelings are indicators of the spirit showing individuals the total consequences of their actions for everyone in their life without the blinders of substance abuse. In revealing the true nature of these actions and helping individuals assign the correct values to them, the spirit simultaneously grants individuals a way to address the flaws of their character.
7. WE HUMBLY ASKED HIM TO REMOVE OUR SHORTCOMINGS.
Like an addiction, shortcomings have a deceptive nature. Often, if we could see our own shortcomings and the consequences they cause, we would avoid those actions and behaviors. It is precisely because we consistently miscalculate certain decisions and actions that they become known as shortcomings.
Just as the spirit of the higher power can reveal the true nature of addiction, it can also deliver us from our other shortcomings. Being humble means being receptive to messages from the spirit when it is trying to guide us towards opportunities for improvement.
8. WE MADE A LIST OF ALL PERSONS WE HAD HARMED AND BECAME WILLING TO MAKE AMENDS WITH THEM ALL.
Recovery can’t erase the past or even stop the consequences that are the result of past actions. However, recovery does offer an honest chance to make amends because it allows individuals to see the world as it is, without the shroud of addiction. It is only in this way individuals can assume full responsibility for the consequences of their actions which is necessary for a true and full reparation.
9. WE MADE DIRECT AMENDS WITH SUCH PEOPLE WHEREVER POSSIBLE, EXCEPT WHEN TO DO SO WOULD INJURE THEM OR OTHERS.
While recovery presents the opportunity to make amends, it can’t guarantee it. Addiction can drive people to make some very poor decisions and these decisions can lead to circumstances that cause great duress to those hurt by addicts or even to recovering addicts themselves.
It is possible that confronting the issues caused by addiction can result in more problems than it may solve. In this way, individuals need to be able to consult professionals like their sponsors to properly assess the gravity of a particular situation. Sometimes, making amends is not possible and individuals must learn to reconcile their past actions through the higher power of the spirit.
10. WE CONTINUED TO TAKE PERSONAL INVENTORY AND WHEN WE WERE WRONG PROMPTLY ADMITTED IT.
It is often difficult to admit mistakes and addiction recovery doesn’t offer an exception to the rule. However, having trustworthy advisors and sponsors that can relate to the difficulties of recovery can sometimes ease the process. This helps create a place where recovering individuals are both responsible for themselves and open to constructive criticism from their peers, which facilitates a more complete recovery.
11. WE SOUGHT THROUGH PRAYER AND MEDITATION TO IMPROVE OUR CONSCIOUS CONTACT WITH GOD, AS WE UNDERSTOOD HIM, PRAYING ONLY FOR KNOWLEDGE OF HIS WILL FOR US AND THE POWER TO CARRY THAT OUT.
Even under the best circumstances, recovery is a difficult lifelong process. It is impossible without a healthy and lasting relationship with a higher spiritual purpose. This relationship is renewed and strengthened through concentration, meditation, and prayer.
Asking only for a purpose and the resources to fulfill that purpose is a humble act that avoids the dangers of presumption. Without humility, it is possible to mistake the strengthening trials of purpose for abandonment.
It is important to accept that the higher power to confront addiction is available to all of those who seek it and this trial is unique for everyone. Having a strong spiritual relationship and a humble nature circumvents presumption and the dangers of comparing oneself to others.
12. HAVING HAD A SPIRITUAL AWAKENING AS THE RESULT OF THESE STEPS, WE TRIED TO CARRY THIS MESSAGE TO ALCOHOLICS, AND TO PRACTICE THESE PRINCIPLES IN ALL OUR AFFAIRS.
Acknowledging the great achievement in confronting addiction is important. Celebrating this great achievement and the spiritual development that comes with it can be done through service. By having firsthand experience in these trials, recovering individuals have a unique position in assisting others who are suffering from the same affliction.
While this step has obvious benefits for those entering into the program for the first time, what are often overlooked are the therapeutic benefits for those further along in the process. Assisting others is not only spiritually fulfilling, but it is also a healthy reminder of the long difficult path that has already been traveled.
Alcoholics Anonymous World Services (AAWS). (2001). Alcoholics Anonymous (4th Ed). New York: AAWS
Potter, B. (2015). Elements of reparation. London: Karnac Books
Substance and Mental Health Service Administration (SAMSHA). (2020). Recovery and recovery support. Available: https://www.samhsa.gov/find-help/recovery
Renaissance Recovery Center. (2020). The 12 Step Program. Available: https://www.renaissancerecoverycenter.com/about-us/the-12-step-program/
“Don’t Give Up”, Courtesy of Dan Meyers, Unsplash.com, CC0 License; “Blurred Vision”, Courtesy of Jesus Rocha, Unsplash.com, CC0 License; “Motion”, Courtesy of Joonas Sild, Unsplash.com, CC0 License; “Reach for the Sun,” courtesy of Aaron Blanco Tejedor, unsplash.com, CC0 License