Skip to main content

Verified by Psychology Today


From Substance Abuse to Sustained Recovery

It takes more than willpower, insight, and support.

Key points

  • Unconscious vulnerable emotions intensify cravings, activating a network of habits that support substance use.
  • Abuse of substances impairs the ability to maintain emotion regulation in sobriety.
  • The use of substances inhibits the ability to create value and meaning, making the substance seem necessary.

The sad fact about recovery from alcohol and drug abuse is that almost everyone fails in the beginning, even when they have the support of loved ones, friends, and recovery groups. That’s because unconscious emotions intensify the motivation to use substances and activate a network of entrenched habits that lead almost inevitably to relapse.

To maintain a healthy life free of alcohol and drug abuse, it’s necessary to change habits and regulate unconscious impulses that both drive and support abuse. To reverse the devastating effects of alcohol and drug abuse on the meaning of our lives, it’s necessary to develop the innate capacity to create value, meaning, and purpose.

Requirements to maintain sobriety

A program for maintaining sobriety should include the following.

1. A practice regimen to change habits that support abuse. Habits are a sequence of conditioned responses. When “A” occurs, we think a certain kind of thought, feel a certain way and are motivated to behave in a certain way. “A” can be:

  • Obvious (examples: cues from the environment like the smell of beer, the moans of someone high, the sound of laughter in a TV commercial)
  • Subtle (examples: physiological states such as tired, hungry, thirsty, high or low blood sugar, elevated or depressed respiratory rate, etc.)
  • Unnoticeable (examples: reflexive avoidance of vulnerable emotional states, primarily guilt, shame, anxiety, fear, and sadness)

Once any of the above is associated with substance use, the mere occurrence of the internal state or environmental cue activates a series of automatic habits that lead to use.

2. A regimen that reconditions the emotional system to be stronger and more flexible. Abuse of substances impairs the ability to regulate emotions, as the substance takes on the protective, soothing, or exhilarating function of the emotional system. At the same time, the emotional response patterns grow rigid in the dogged pursuit and justification of substance use.

3. Skills to regulate urges automatically. Because the network of conditioned responses that motivate the use of substances is processed in the brain thousands of times faster than conscious will, sobriety requires skills to regulate emotions that can function rapidly, that is, unconsciously.

4. Skills to raise self-value under stress. This reduces the susceptibility to triggers of guilt, shame, anxiety, anger, and resentment, which lead to abuse.

The use of substances is self-reinforcing in that it lowers self-value and the ability to create value and meaning. The erosion of self-value makes the abused substance seem ever more necessary.

Support groups supplemented with the above self-regulation skills have a greater chance of success.

More from Steven Stosny, Ph.D.
More from Psychology Today