In our final blogs on the invaluable insights into the Recovery process given by the research and experience of William White we finish by looking at the rise of recovery communities in the US in particular and discuss whether this “New Recovery Advocacy Movement” is the future of recovery (treatment) which is much more long term recovery orientated rather than simply treating this chronic condition of addiction as an acute disorder which is generally what treatment centres do.
We may have to move away from a narrow neurobiology of addiction (disease model) to a wider neurobiology of recovery (recovery model). We may have to make it more plain to the world that recovery happens all the time and that millions upon millions around the world are in long term recovery, and have a very high chance of remaining so.
That is not to say we should not continue to look within the brains of addicts to learn which neural and affective mechanisms propel this disorder forward but that research into addiction needs to be much less lopsided and negative. It needs to look at vulnerability and the progression of this condition but it also needs to more fully address the recovery stage too. It is like reading a page turning novel only to find the riveting denouncement has pretty much been omitted. Research needs to move from diagnosis of the problem to prognosis of the solution, i.e. recovery.
The shares of a 12 step meeting are some of the greatest stories of redemption you are likely to hear. The outside world needs to know how these stories are created, yes, but also how they are resolved via recovery. The outside world needs to hear the story does not end with recovery, in some ways this is where the story really gets interesting. The spiritual voyage of recovery is a story those suffering from addictive behaviour need to hear. Otherwise, research demoralises, rather than encourages. It perpetuates a unnecessarily negative view and a false picture about the reality of long term recovery for many millions of people, their families and communities.
Clinical neuroscience, in particular, needs to show the images to go with these stories otherwise it is falling down on it’s obligations to society and the greater world.
Science has not sufficiently shown us how the brain is altered in a positive, adaptive, healthy manner by behavioural changes associated with long term recovery. The major role of science is to predict behaviour. It needs to start demonstrating and confirming that if an addict starts doing certain behaviours, certain positive outcomes will follow. It needs to illustrate the neuroplasticity so that suffering people can clearly chart, in a rational manner, the course of wellness ahead.
I remember seeing the Jellinek Curve in treatment and was re-assured that this was a disease that one could clearly recover from and within a defined trajectory. It showed me rationally how others had done this recovery thing and how I could and would if I wanted to achieve what they had achieved.
Rather than the constant search for a “magic pill” should we not be celebrating in research this wonderful success story called long term recovery. Isn’t this one of the greatest stories out there?
Anyway, back to William White and his powerful advocacy of recovery communities which as he suggests may make students of us all when some of use thought we were teachers.
The story moves on, becoming more enriching and inspiring.
There is a movement towards the management of long term recovery from an acute treatment model. There have been new developments like recovery coaches which show an increasing focus on long term recovery.
There is also an emergence of a recovery movement that has not historically existed before. “Recovery is everywhere” campaigns organised not by treatment centres but by local, grass-root, recovery community organisations. They are not mutual aid or treatment based. They have never had a category to put them in until now.
We are seeing the mobilisation of people in recovery. We are seeing a number of New Recovery Support Institutions such as Recovery Community Centres, offering non clinical recovery support services for individuals and families in long term recovery, Recovery Homes, Recovery Schools movement, Collegiate recovery programs, recovery industries who realise that people in recovery make the best and most hard working employees, recovery ministries, religious base recovery communities like including Celebrate Recovery which is attached to over 10,000 churches throughout the US, Recovery Cafes, and an ever increasingly elaborate interconnection of recovery resources.
William White ends with an intriguing suggestion that we may, via these increase recovery support organisation and via our own long term recovery be able to break the chain of dependence in our own children.
This way seem somewhat far fetched to some but equally it may be possible to identify the ways genes are expressed by certain behaviours in certain environments and for these to be altered by a change in these behaviours as the result of recovery and for environments to be changed too.
If, as we have suggested, addiction is at heart an emotion processing and regulation disorder, we could intervene to shore up these skills in those vulnerable to alter addiction by teaching sharing emotions, identifying and labeling of emotions, verbalisng of emotions etc, because we are attacking the pathomechanism of addiction, the mechanism by which addiction is propelled.
In doing so we may have a fighting chance of altering the course of possible addiction. So what has always been seen as inevitable (drunks beget drunkards) may for the first time in history not be so straight forward, so inevitable. This pathomechanism may be malleable and be susceptible to us changing the course of a likely disorder. In doing so, it will affect the chain of genetic inheritance from one generation to the next?
Fanciful or possible?
We discuss our ideas and William White’s ideas on this in another blog.