The Evolution of Recovery From Addiction

The recovery process from Substance Use Disorders (SUDs) has evolved over time. So often, the recovery process is referred to as a “pathway” or “journey,” which may seem like appropriate terms. However, when examining the idea of a pathway more closely, it implies that there is a singular chosen “path” or “road” that one will follow and adhere to. Historically, the expectation for recovery has been on choosing a particular therapeutic or self-help path and committing to it.

In the past, there were fewer self-help and treatment program options and less access to resources. The landscape has changed post-pandemic, and innovations in the self-help and treatment space, as well as many virtual options, have increased access to care. More recently, there has been a movement towards a fluid and adaptive approach to recovery that resembles a patchwork of non-linear layers and choices.

There are five stages to the recovery process identified by the Connecticut Community for Addiction Recovery training for recovery coaches.

1. Stabilization: This tends to occur in the initial year of early recovery. Milestones in this stage may include understanding the disease of addiction, coping with post-acute withdrawal symptoms, not using substances when faced with stressors, learning to socialize without substances, avoiding situations (places and things) that may increase chances of relapse, and learning to ask for support.
2. Deepening: This tends to occur in the second year and refers to the increase in focus and understanding of the recovery process. Some of the milestones include recognizing and correcting behaviors that no longer feel appropriate, focusing on emotional sobriety, increasing the quality of physical health, increasing the ability to tolerate distress, learning to identify feeling states, increasing commitment to recovery, and increasing the ability to address underlying mental health and medical issues. This can also be a difficult time because the novelty of the first year has worn off.
3. Connectedness: This may occur in the third and fourth years of recovery. Milestones may include feeling a greater level of both joy and pain, appreciating the need to revisit earlier recovery work, establishing clear boundaries, avoiding emotional entanglements, developing consistency between inner and outer life, being open to a broader circle of friends in and out of recovery, and addressing deeper layers of relationship or mental health issues.
4. Integration: This typically occurs in years six through ten of recovery. Milestones in this stage include having relationships based on love versus need, using recovery tools automatically, having the ability to act on self-knowledge and insight, practicing self-forgiveness, and enjoying life and finding peace.
5. Fulfillment: Refers to the characteristics of those who have been in recovery for ten years or longer. This stage is characterized by discovering and following through on life purpose, living with and knowing how to return to a sense of peace/serenity, aligning morals and actions, developing confidence in recovery rhythm, and having gratitude and pride in recovery

So, what has shifted? If individuals are in the stabilization or deepening stages—a pathway is necessary to feel a sense of containment and stability. Or they may need consistency or struggle with change. The connectedness or integration stages of recovery may increase the desire to explore different healing modalities. While new spiritual, therapeutic, or self-care practices have been added into their recovery plan, there may be resistance from self-help group members. Those in the integration and fulfillment stages of recovery often experience acclimation to their current pathway and may be seeking something to reinvigorate their program. Everyone’s recovery patchwork is unique, and while some may share similarities, it is okay to think outside of the box and add or shift the process. It is advisable to include your therapist, coach, or mentor around these adjustments in order to be sure they are comprehensive enough to support your specific recovery needs.

What are possible patchwork options? They may include shifting, adding, or changing self-help groups and clinical resources to adapt to your evolving recovery lifestyle needs. This can involve re-evaluating your recovery wellness domains: physical, psychological, vocational/academic, interpersonal, spiritual, and home environment. It is also possible to be involved in a self-help program while adding in meetings from other groups—especially in this age of virtual meeting options.

Patchwork options can also include the pursuit of deeper layers in the mental health healing process, such as therapy, healing arts, meditation, recovery yoga/yoga, breathwork, medication management, dietary changes, entertainment, hobbies, etc. Spiritual pursuits can be another patch on the quilt and based on an individual's current religion, family of origin’s religion, more general spiritual pursuits, exploring new ways to connect with a “source,” "High Powerer,” “Universe,” etc. For some, connecting with nature allows them to sense something greater than themselves. Others have found different pursuits that allow for feelings of awe and recharge.

What is most important in the process of growth is to find individuals in the therapeutic and self-help worlds that value individualized care. While there are certain frameworks and levels of care that may apply to most people in recovery, there are also variations that should be respected. Exposure to the concept of a patchwork can encourage longer-term recovery by making it more stimulating. This concept can also be a relief for those who have already been creating their own patchwork but had either received negative feedback or were concerned about others' opinions. If someone is struggling to maintain sobriety or safety, it is crucial that they are encouraged to return to a more structured pathway in order to stabilize and then reassess their needs.

Where can you go? In exploring this evolution, it is important to have open discussions with potential treaters, treatment programs, recovery coaches, life coaches, loved ones, and self-help group members and ask questions. Find out where they stand in terms of the rigidity of the program over time. Structure and consistency are crucial in early sobriety, but as you begin to feel a sense of stability, you may want to be supported by others who are understanding.

Recovery is also about individuals regaining a compass and learning to trust themselves enough to make changes and explore options. While it can take a great deal of courage to pursue adding to a personal patchwork, it is imperative to have appropriate clinical, self-help, loved one, or coaching support when making these shifts.

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