Constance Scharff Ph.D.

Ending Addiction for Good

What Do Addicts Feel in Rehab?

Feelings will come up in rehab. Here's what to expect.

Posted Jul 27, 2018

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Most people wonder what addiction treatment will be like. In addition to a medical detox (separation from the substances of abuse), rehab is a lot about feeling the emotions that come up. Substance abuse allows us to run from our feelings. If alcohol or drugs were the problem, simply getting off those substances would resolve the issue. The problem with addiction or substance abuse is that when drugs and alcohol are removed, the real issues a person has been running from begin to surface.

The following are some of the emotions individuals begin to feel in treatment. These are not mutually exclusive states of being. Many people will feel several of these emotions at once or over the course of a day or week.

Hopelessness: Addicts and alcoholics have often destroyed their lives to the point that they do not see a way to dig themselves out of the hole they are in. They may have legal, financial or relationship issues that are at a crisis level. Restoring a sense of hope for the future is a main goal of addiction treatment.

Shame: Shame is a feeling of humiliation or distress caused by one’s actions. Many substance abusers have done things that trouble them. They may have hurt people, lied, stolen, or been involved in criminal activity. Feeling shame might be an appropriate response to some of these actions. However, an inability to work through that shame will keep a person from moving forward in their life. Looking at the past with a realistic lens and beginning to set wrongs right is the beginning of healing.

Guilt: Guilt is different from shame. Guilt is the feeling of having done wrong or failed to meet an obligation. The person may not have done wrong or may have only partially failed an obligation. Addicts and alcoholics who suffer from guilt, like those who feel shame, are helped in treatment to look at their past in a realistic way and formulate a plan to set right any wrongdoing.

Frustration: Frustration is feeling upset or annoyed, often because we are unable to change something. Addicts and alcoholics are constantly frustrated in the early days of recovery. Not only are they forced to follow life’s and the treatment center’s rules, but they also frequently can’t get a good handle on their emotional state. Feelings explode seemingly out of nowhere. Life’s problems cannot be put on hold. All this leads to frustration and very often, a desire to leave treatment.

Anger: One of the emotions that comes out of frustration is anger. Occasionally, individuals in treatment who are experiencing extreme frustration will become violent. Most often, though, anger is a cover for grief, sadness or fear. Anger feels powerful and proactive. Grief, sadness, or fear can be overwhelming and lead a person to feel powerless over their lives. Working through anger with a therapist can be a productive way to uncover underlying issues.

Trauma: Trauma is the shock of living through a greatly disturbing, often life-threatening experience. A large number of people who have a substance abuse disorder have experienced trauma that has not been resolved. Specialized therapy and coping tools are available for those with trauma in their life history. Those with severe trauma may be diagnosed with post-traumatic stress disorder (PTSD) and receive additional, specialized treatment.

Lack of Self-Esteem: No one would expect an addict to feel good about themselves when they enter treatment. In the months or years preceding rehab, addicts often don’t accomplish much. They may have lost their jobs or their relationships. Their finances are often a mess. Their families are fed up. There isn’t a lot to feel good about. Recovery from substance abuse helps addicts and alcoholics to identify their best features and work to put those features in the foreground of their lives. Those is recovery also work to engage in “estimable acts,” actions about which they can feel good.

Terminal Uniqueness: This idea comes from 12-step programs and is well-applied in addiction treatment settings. Those with substance abuse problems very often feel that they are “different” or “the worst” in some way. They have taken horrible actions or been engaged in shameful activities and don’t want anyone else to know. The truth is, lots of people feel the exact same thing about the same actions. Once addicts and alcoholics begin to learn that they are not unique in their histories or their feelings and they are not alone, they can begin to overcome their shame.

Inability to Express or Identify Feelings: For most people with substance use disorders who have been pushing aside feelings for a long time, feelings will come up that they cannot identify. Or feelings will get for a short period “stuck” and cannot be expressed on demand. Having a tumult of unexplainable or unidentifiable emotions can be frustrating for those in treatment. This, however, is a common occurrence. The therapists in the treatment setting will help identify and work through these emotions.

Resignation to Death: Some addicts in treatment, especially those with suicidal ideation, who have had friends die or those who have overdosed a number of times, will feel resigned to death. They might wonder why they are even bothering with treatment as overdose and death are perceived to be inevitable. This simply is wrong-thinking. Where there is breath and even the smallest willingness to attempt recovery, there is reason to hope. Death is not the inevitable outcome of substance abuse if treatment is sought. Every day on this side of the grass is a gift, and despite how one might feel in the first few weeks of treatment, one that is deserved.

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