You are Enough, We are Enough!

“The wounded healer” refers to us, who suffer greatly from shame, helping others via love, tolerance and understanding who also suffer greatly from shame.

We can help others and be helped because we all know what it is like to feel the chronic, toxic shame the drives addictive behaviours.

Our understanding of shame is not out of a book it is real, lived experience. We know how it can drive one into chronic addiction and we know how to recovery from the persistent effects of this shame.

The main thing that struck me when I first went to AA was a lack of judgement which was amazing considering I was very jaundiced at the time.

I was accepted in the group without  reservation. This greatly helped my damaged sense of belonging, my not feeling part of.

It made me feel that this is the place I need to be. Have always needed to be?

The “shares” or testimonies of other recovering people made we realise they suffered the same shame as me and had worked to overcome it via the steps, via having fellowships, people in their lives who understood and who helped them. They told me of their triumphs over their emotional difficulties, over their chronic lack of self esteem, over not feeling good enough, of feeling less than.

A failure –  they talked about me and how I felt about me. How I had always felt about me!?

I had never been in a group of people who had talked so openly about their intimate feelings which was amazing. In doing so they were talking about my intimate feelings too. This gave me a sense of not being alone anymore. They seemed to be shining a light of hope into the dark recesses of of my shameful psyche.

It addressed my sense of isolation right away.

I had spent my life feeling not good enough, bad, l had that knawing feeling of less than, that hole in the sole.

I was like these people. They were like me.

I felt and continue to feel more like these people than I do my own family.

They became my surrogate family, my newly learnt attachment.

They were like me. They had not learnt this stuff out of a book, by professional observation but by having been through this stuff themselves. This was real not learnt.

They had been there. They were here now for me.

They knew what they were talking about.

This was the beginning of my psychic change. A person who was to become by therapist at the local treatment  was at my first meeting and he later said that he felt I had a psychic change at that my first meeting.

I had come in utterly beaten, at  death’s door and had left with hope.

The journey started with hope.

I had found a portal in the universe – it was Alcoholics Anonymous but from the shares it might have been called Shame sufferers Anonymous.

Shame ran through every share. They say fear is the corrosive thread which ran through our lives but it is equally the case that shame does too and causes just as much distress and damage.

It is difficult to live life when you do not have your own back, believe in yourself as  worthy of the good, healthy, things  in life. That you are not worthy them. That these things happen to others. Not you as you do not deserve them.

Why recover at all when you are not worth it?

This is how many of us feel? We are not worth it, this recovery.

The truth is the opposite, we are worth it. We do deserve it.

We are heroes who suffered so much and come through so much. We deserve happiness more than most! As a result we have  so have so much to offer others. We are all wounded healers.

We are here to help others like ourselves, in a way that only we can!

It was via others, like parents that we have this shame and these negative self schemas.

It is through human relationships that these start to heal. Shame is a social emotion which needs a social treatment.

We need to reconnect to overcome the isolating force of shame.

You are enough! We are enough!

How Stories Transform Lives

When I first came to AA, I wondered how the hell sitting around in a circle listening to one person talking, and the next person talking and …. could have anything to do with my stopping drinking?

It didn’t seem very medical or scientific? Did not seem like any sort of treatment?  How could I get sober this way, listening to other people talking?

It didn’t make any sense. Any time I tried to ask a question I was told that we do not ask questions, we simply listen to other recovering alcoholics share what they called their “experience, strength and hope”?

How does this help you recover from one of the most profound disorders known, from chronic alcoholism?

I did not realise  that this “experience, strength and hope” in AA parlance, is fundamental in shifting an alcoholic’s self schema from a schema that did not accept one’s own alcoholism, to a self schema that did, a schema that shifts via the content of these shared stories from a addicted self schema to recovering person self schema.

Over the weeks, months and years I have grown to marvel at the transformative power of this story format and watched people change in front of my very eyes over a short period of time via this process of sharing one’s story of alcoholic damage to recovery from alcoholism.

I have seen people transformed from dark despair to the  lustre of hope and health.

One of the greatest stories you are ever likely to hear and one I never ever tire of hearing.

Through another person sharing their story they seem to be telling your story at the same time. The power of identification is amplified via this sharing.

If one views A.A. as a spiritually-based community, one quickly observe s that A.A. is brimming with stories.

The majority of A.A.’s primary text (putatively entitled Alcoholics Anonymous but referred to almost universally as “The Big Book,” A.A., 1976) is made up of the stories of its members.

During meetings, successful affiliates tell the story of their recovery. In the course of helping new members through difficult times, sponsors frequently tell parts of their own or others’ stories to make the points they feel a neophyte A.A. member needs to hear. Stories are also circulated in A.A. through the organization’s magazine, Grapevine.

But the most important story form in Alcoholics Anonymous describes  personal accounts of descent into alcoholism and recovery through A.A. In the words of A.A. members, explains “what we used to be like, what happened, and what we are like now.”

Members typically begin telling their story by describing their initial involvement with alcohol, sometimes including a comment about alcoholic parents.

Members often describe early experiences with alcohol positively, and frequently mention that they got a special charge out of drinking that others do not experience. As the story progresses, more mention is made of initial problems with alcohol, such as job loss, marital conflict, or friends expressing concern over the speaker’s drinking.

Members will typically describe having seen such problems as insignificant and may label themselves as having been grandiose or in denial about the alcohol problem. As problems continue to mount, the story often details attempts to control the drinking problem, such as by avoid-ing drinking buddies, moving, drinking only wine or beer, and attempting to stay abstinent for set periods of time.

sharing 82a62c4e060569b3dedb0dc7e4c6c438

 

The climax of the story occurs when the problems become too severe to deny any longer. A.A. members call this experience “hitting bottom.”

Some examples of hitting bottom that have been related to me include having a psychotic breakdown, being arrested and incarcerated, getting divorced, having convulsions or delirium tremens, attempting suicide, being publicly humiliated due to drinking, having a drinking buddy die, going bankrupt, and being hospitalized for substance abuse or depression.

After members relate this traumatic experience, they will then describe how they came into contact with A.A. or an A.A.-oriented treatment facility…storytellers incorporate aspects of the A.A. world view into their own identity and approach to living.

Composing and sharing one’s story is a form of self-teaching—a way of incorporating the A.A. world view (Cain, 1991). This incorporation is gradual for some members and dramatic for others, but it is almost always experienced as a personal transformation.

So before we do the 12 steps we start by accepting step one  – We admitted we were powerless over alcohol——that out lives had become unmanageable –  and by listening to and sharing stories which give many expamples of this loss of control or powerlessness over drinking. .

Sharing our stories also allows us to stat comprehending the insanity or out of contolness (unmanageability)  of our drinking and steps us up for considering step 2 –  Came to believe that a Power greater than ourselves could restore us to sanity – through  to step three, so the storeies not only help us change self schema they set us on the way to treating our alcoholism via the 12 steps.

In these stories we accept our alcoholsimm and the need for persoanl, emotional and spirtual transformation. The need to be born anew, as a person in recovery.

Reference

1. Humphreys, K. (2000). Community narratives and personal stories in Alcoholics Anonymous. Journal of community psychology, 28(5), 495-506.

 

 

Forgiving Others is the Number One Healer!?

“Resentment is the “number one” offender. It destroys more alcoholics than anything else… In dealing with resentments, we set them on paper. We listed people, institutions or principles with whom we were angry… The first thing apparent was that this world and its people were often quite wrong. To conclude that others were wrong was as far as most of us ever got. The usual outcome was that people continued to wrong us and we stayed sore. Sometimes it was remorse and then we were sore at ourselves. But the more we fought and tried to have our own way, the worse matters got…It is plain that a life which includes deep resentment leads only to futility and unhappiness…If we were to live, we had to be free of anger. The grouch and the brainstorm were not for us. They may be the dubious luxury of normal men, but for alcoholics these things are poison…We saw that these resentments must be mastered, but how?… (1)”

Later, p.77, it suggests  “a helpful and forgiving spirit.”

In the 12 Steps and 12  Traditions, p.78, in reference to step 8 it suggests “why shouldn’t we start out by forgiving them, one and all?

These truncated passages from the Big Book (1)  and the 12 and 12 (3) illustrates how resentments cause relapse and that they need to by treated with the antidote of forgiveness.

We suggest also that the myriad of resentments which swirl around our minds in early recovery are also negative emotions unprocessed and thus unregulated from the past. They continually haunt us because we have not put them “to bed” in long term memory.

We have not dealt with them, by clearly identifying, labelling, sharing via verbalising them with others and then by letting go of them via forgiveness. “Letting go” is another emotional regulatory strategy that healthy people use.

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Instead of constantly holding on to memories and incidents from the past, endlessly ruminating on them we maturely face up to them and consign them to the past.

We were thus interested in a study which was not using 12 step recovery but which came to the same conclusion but via another route (2).

“Anger and related emotions have been identified as triggers in substance use. Forgiveness therapy (FT) targets anger, anxiety, and depression as foci of treatment. Fourteen patients with substance dependence from a local residential treatment facility were randomly assigned to and completed either 12 approximately twice-weekly sessions of individual FT or 12 approximately twice-weekly sessions of an alternative individual treatment based. Participants who completed FT had significantly more improvement in total and trait anger, depression, total and trait anxiety, self-esteem, forgiveness, and vulnerability to drug use than did the alternative treatment group. Most benefits of FT remained significant at 4-month follow-up.

The levels of anger and violence observed among alcohol and other substance abusers are far higher than the levels found in the general population.

Alcohol and other substance abusers administered the State-Trait Anger Expression Inventory typically have been shown to have higher state and trait anger, to be more likely to express anger to others, and to have less control of their anger.

Reducing levels of anger and its related emotions is now seen as an important feature of recovery programs. For example, according to the Project Match 12-step facilitation therapy manual, “Anger and resentment are pivotal emotions for most recovering alcoholics. Anger that evokes anxiety drives the alcoholic to drink in order to anesthetize it. Resentment, which comes from unexpressed (denied) anger, represents a constant threat to sobriety for the same reason” (Nowinski, Baker, & Carroll, 1999, p. 83).

Marlatt (1985) emphasized the importance of anger and frustration as triggers for relapse in both the intrapersonal and interpersonal domains. He noted that 29% of relapses are related to intrapersonal frustration and anger and that 16% are related to interpersonal conflict and associated anger and frustration.

Litt, Cooney, and Morse (2000) reported that those alcoholics who had urges to use after treatment had higher degrees of alcohol dependence, anxiety, and trait anger than those without such urges.

Forgiveness is an important way to resolve anger and restore hope (Enright & Fitzgibbons, 2000). In helping clients move toward forgiveness, it is essential to differentiate forgiving from condoning, pardoning, reconciling, or forgetting.

Forgiveness is a personal decision to give up resentment and to respond with beneficence toward the person responsible for a severe injustice that caused deep, lasting hurt. FT helps the wronged person examine the injustice, consider forgiveness as an option, make a decision to forgive or not, and learn the skills to forgive.

Findings – Our clients came to the program with trait anxiety and trait anger scores substantially above the published norms for adults; after treatment, however, FT participants exhibited scores comparable to the average.  In other words, the treatment did not lead simply to a change in anxiety and anger (particularly the reportedly more stable trait anxiety) but to a change toward normal profiles. In contrast, patients in the alternative treatment condition had anxiety scores well above average, especially in terms of trait anxiety, which showed little change at post test and only minimal improvement at follow-up.

FT did not focus on drug vulnerabilities, whereas the alternative treatment did. Urges to use substances are not necessary for relapse, they are important indicators.

FT  treatment is centered more on clients’ thoughts, feelings, and behaviors about someone other than themselves: an offender who hurt them deeply and unfairly. In FT, a potential reason for substance use is examined, that of avoiding painful memories of betrayal, violence, or abuse. When patients are allowed to heal, their motivation to abuse substances may be substantially reduced…(it) is worth considering as a way to address core issues of emotional pain.

resentment

 

This can lead to a reduction in negative emotions and increases in self-esteem and forgiveness… it moves to the heart of the matter for some clients. Deep hurts borne out of unfair treatment seem to play a part in substance use and abuse. Even when clients have many people to forgive…we find that they seem to know which person is most crucial to forgive first before moving to other offenders. Substance use, from this perspective, is a symptom of underlying resentments and related emotional disruptions.

If we fail to realize this, we may end up treating only symptoms rather than underlying causes. ”

 

This process seems practically the same as the inventory of Step 4 and the forgiveness implicit to steps 8 and 9. This study also highlights that we through forgiveness we actually tackle the underlying condition of emotional dysregulation. It is this emotion dysregulation (or spiritual disease) which appears to drive addiction so needs to be fundamentally addressed. By addressing these issues via the steps especially step 4 we begin to see how it works!

It was interesting that forgiveness led to higher self esteem, as if being tied to the past was akin to being tied to a former negative self schema, that people from our pained past did actually have the power to control us! Especially how we feel about ourselves. We change how we feel about ourselves and our past by simply forgiving, it is such a powerful tool in recovery.

Importantly by viewing studies like this (2)  we get beyond negative views of 12 step recovery to show that the recovery program’s effectiveness is clearly highlighted by the success of other psychological treatments getting the same positive results by using exactly the same strategies.

12 step groups provide a battery of the most profoundly effective psychological therapies for addiction ever contained within one treatment philosophy.

Don’t we all need to re-appraise how we see 12 step recovery?

Can’t we all benefit from stepping to one side and looking via a different angle to see why 12 step recovery is effective?

 

Reference

1. Alcoholics Anonymous. (2001). Alcoholics Anonymous, 4th Edition. New York: A.A. World Services.

2. Lin, W. F., Mack, D., Enright, R. D., Krahn, D., & Baskin, T. W. (2004). Effects of forgiveness therapy on anger, mood, and vulnerability to substance use among inpatient substance-dependent clients. Journal of consulting and clinical psychology, 72(6), 1114.

3.   Twelve steps and twelve traditions. (1989). New York, NY: Alcoholics Anonymous World Services

Filling the Empty Self

In the first part of this two part blog – we looked at how addicts in recovery move from a more negative (perhaps chronically negative) self schema to a more positive recovering self schema and how this now sense of self and the new interrelatedness with others which develops in recovery drives recovery and an increased self empowerment.

The self, via schema, is increasingly positive in outlook, attitude and action. In other words recovery does for the self schema, sense of self, what we could not do for our own selves, our own self schemas. The self and the self schema becomes a vehicle for increasing well being and not further disease and disorder.

It is a vehicle by which we recover.  For me it helped recover the person who I was meant to be, the person who had become so lost to alcoholism for so long. It in some ways introduced me to a person I did not really know and in many ways am still getting to know.

The fascinating thing also is that negative self perception, as we know from previous blogs, generates a brain frequency very similar to thinking about drinking and not similar to drinking itself. We presume a positive self perception does not and this not only does not lead one back to drinking but very much in the opposite direction.

We again cite from the same article as before (1) to demonstrate perhaps how self schema, especially, the recovering self schema, is so vital to recovery for alcoholism.

“….From this perspective, specific disturbances in the underlying structure of the self-concept are considered intermediary factors that serve as important mechanisms that link more distal factors (e.g., genetic factors, family history of alcohol problems) to alcohol
use. A person with a self-concept composed of few positive and many negative and highly interrelated self-schemas would not have the internal motivation necessary to facilitate adaptive behavior. The negative affect stemming from such a self-concept configuration
would be likely to motivate maladaptive
behavior in an attempt to escape the negative self views
(Baumeister, 1990) and “fill up” the empty self (Cushman, 1990).

Persons with a family history of alcohol problems or other risk factors for alcohol problems would be likely to turn to alcohol (versus other types of maladaptive behavior) as a means to escape the negative emotions. A core belief about the self in relation
to alcohol (drinker self-schema) would be likely to form as drinking experience accumulates and similarities across drinking-related incidents are abstracted. Such a drinking-related self-schema
would serve to motivate schema-consistent (drinking)
behavior.
According to the hypothesized model, a person in sustained recovery (long-term abstinence) would have a more well-developed self-concept—one that consists of newly developed positive self-schemas and a recoveryrelated
self-schema. The recovery self-schema is conceptualized
as central to the recovery process as it would serve to motivate schema-consistent (recovery) behaviors.

During the process of recovery, new positive self-schemas are likely to form as a result of new relationships, activities, and involvements. The development of new positive self-schemas would diminish the proportion of negative self-schemas and the overall level of interrelatedness among the self-schemas.

 

How-To-Fill-The-Inner-Emptiness-Of-Addiction-PhysicianHealthProgram

 

TESTING THE THEORETICAL MODEL

… findings provide empirical evidence that (a) young adults with early-onset alcohol dependence have impaired self-concepts that are characterized by many negative self-schemas, a tendency toward few positive self-schemas, and an elaborated self-schema related to alcohol; and (b) young adults in recovery have healthier self-concepts characterized by few negative self-schemas, a tendency toward many positive self-schemas, and an elaborated recovery related self-schema.

If further longitudinal research studies demonstrate that the self-concept configuration that we found in persons with early-onset alcohol dependence contributes to the development of the disorder,
then prevention strategies aimed at children and adolescents
could be beneficial, particularly for those children who are at risk for alcohol problems based on the presence of other risk factors (e.g., familial alcohol problems, conduct problems). More specifically, interventions designed to build a healthy self-concept (by
fostering the development of a diverse collection of positive self-schemas, thereby decreasing the relative proportion of negative self-schemas) may serve as a protective factor that buffers the effects of the more distal risk factors.

 

At the other end of the spectrum, the data from our study suggest that interventions may also profitably focus on fostering the development of a recovery self schema in persons with alcohol dependence. 

…the nature of any recovery related intervention would depend on how ready the person is to change. For a person who does not yet recognize that alcohol is a problem, the goal would not be
to foster the development of a recovery schema but to help him or her identify that drinking is a problem.

One possible way to do this is to assist the person to make associative links across the multitude of negative alcohol-related outcomes so that rather than a series of unrelated incidents, the individual begins to see a pattern of repeated, enduring, and pervasive alcohol-related problems.

when the individual is able to pull unpleasant alcohol related episodic memories together to identify that he or she indeed has a problem with alcohol. So whereas
assisting the person to increase his or her awareness
of problems with alcohol is consistent with the basic
tenets of motivational interviewing (Miller & Rollnick,
2002), fostering the development of a recovery self schema
is not.

For people who recognize that they have a problem with alcohol or people who are seeking treatment for alcohol problems, one strategy may be to foster the idea that they can be recovering persons— that is, that recovery is possible for them. Fostering communication with other recovering persons and encouraging involvement in recovery-related activities may help to form a recovery-related “possible self”—a future-oriented conception of the self one “hopes to be,” that is, a recovering person.

Imagining the self in the future by developing detailed images of what one would be like in recovery is an important part of this process. Participation in 12-step recovery programs such as Alcoholics Anonymous that explicitly foster the development of a recovery related identity may also be helpful…

In fact, one plausible explanation…for an emerging recovery related self-schema is that the alcohol dependent participants were in a treatment  facility based on such a 12-step recovery program.

 

 

Reference

1. Corte, C. (2007). Schema model of the self-concept to examine the role of the self-concept in alcohol dependence and recovery.Journal of the American Psychiatric Nurses Association, 13(1), 31-41.

Reconstructing the Hole in the Soul – part 1

In this two part blog I will look at how positive (as opposed to negative) views of self (self schema) lie at the heart of successful recovery and how negative self schema keep addicts in active addiction.

I cite this study for much of these blogs (1)…

“Psycho-social and environmental factors may also influence the expression of genetic and other biologic factors, serve as important mediators of genetic and other biologic risk, and increase risk load in an additive way (Heath & Nelson, 2003). Because they may also be more amenable to change than genetic and other biologic
factors, it is important to identify modifiable psychosocial and environmental factors that motivate maladaptive alcohol use to develop more effective prevention and treatment strategies.

One potentially modifiable psychosocial factor that has been implicated as a determinant of alcohol dependence as well as a factor in recovery from alcohol dependence is the self-concept. For decades, theorists and clinicians have suggested that vulnerabilities in the knowledge about the self may contribute to the development and progression of alcohol problems. The self-concept is also viewed by some theorists as a key determinant in recovery  and  n the incidence of relapse.

For several decades, theorists and researchers have argued that alcohol dependence results in part from inadequate development of the self. Support for this view was noted in an early empirical
study that showed that the number of self-descriptive adjectives endorsed was negatively associated with the severity of alcohol dependence in persons in inpatient treatment for alcohol dependence, providing suggestive evidence that the degree of elaboration or richness of thoughts about the self is associated with the severity of the disorder.

More recently, two qualitative studies of persons in recovery from alcohol dependence also provide some suggestion that drinking may be motivated by an empty self. Klingemann (1992) interviewed spontaneous remitters who reported that they used alcohol to fill a
hole of inner emptiness.

Based on observations of more than 2,000 Alcoholics Anonymous meetings, Denzin (1993) concluded that alcohol was used to
escape an inner emptiness of self. As such, he argues that an empty self is at the core of alcohol dependence.

There is also some suggestion in the literature that with recovery, the self-concept is more well-developed and includes a more extensive and diverse collection of beliefs about the self. Theorists suggest that with continued abstinence, a new self is “built,” that is, new identities and domains of self-definition are formed . Connor (1962) found that among groups of alcoholics who had stopped drinking, the total number of self-descriptive adjectives endorsed
was positively associated with the length of sobriety.”

Although the Big Book of AA suggests that self centredness is the root of our troubles, paradoxically it may seem, that  the process of recovery, may be a process of “reinvesting” in the self, a process of renewing oneself. Although this may be realignment of self may obviously be aided via support of AA members and a higher power.

Ultimately we may become more ourselves in a sense, or real selves, the self we were born to be. Not the self lost in a fog of active addiction.

Egomaniacs with low self esteem?

“Studies have found that persons with alcohol dependence have lower global self-esteem than controls , and furthermore, that low global self-esteem prospectively predicts the development of alcohol use disorders. The findings are consistent with having either few positive and/or many negative beliefs about the self. A second group of studies focused on the number of positive and negative self descriptive adjective endorsements and found that persons with alcohol dependence endorsed fewer positive and more negative adjectives as self-descriptive compared to controls.

The literature also suggests that self-evaluation may improve with recovery. Bennett (1988) found that among alcoholics in recovery, the length of sobriety was positively associated with self-esteem. Earlier work using adjective endorsements also showed that as the length of sobriety increases, the relative proportion of positive self-descriptive adjective endorsements increases (Connor, 1962). The most compelling evidence comes from the Tarquinio et al. (2001) study noted earlier. They found that persons with alcohol dependence described themselves more positively and
less negatively 4 months after treatment, but no such change was noted in controls after 4 months.

The pattern of findings suggests that the lack of positivity and the high proportion of negativity in the self-concept may normalize with recovery.

Those at risk for alcohol dependence may have unstable or
uncertain self-concepts.

Connor (1962) found that persons with alcohol dependence used more contradictory terms to describe themselves compared to controls.

Drozd and Dalenberg (1994) found that adult female children of alcoholics were less consistent in their self-descriptive adjective endorsements during a 1- week time span than controls and were more uncertain about their self-descriptions compared to controls.
Drozd and Dalenberg also found that the level of uncertainty predicted scores on an alcoholism screening test. Based on a qualitative study noted earlier, Denzin (1993) concluded that persons with alcohol dependence who are actively drinking have a “divided” self-concept with two simultaneous modes of existence:
sober and intoxicated. He argues that these opposing modes of existence leave the individual emotionally divided with two separate and distinct senses of self.

Very recently, Knauth, Skowron, and Escobar (2006) found that adolescents who had an unclear sense of self were more likely to have difficulty with problem solving, which in turn influenced alcohol and other drug use.

An unclear sense of self, two distinctly different senses of self, and inconsistency, lack of certainty, and use of opposing terms to describe the self suggest that the self-definitions may be transient and poorly formed rather than stable, internal knowledge structures.

The “alcoholic self”

Taking on an “alcoholic” identity is a strategy used to cope with the lack of a clear and focused self (Blume, 1967; Denzin, 1993).

Denzin (1993) argues that an alcohol-related self-concept becomes a “master identity that overrides all other [self] conceptions the
alcoholic has” (p. 97).

An alternative model of the self in alcohol dependence is that the “alcoholic” identity must be adopted for recovery to occur. According to this view, recovery is a reconstruction project involving the self.”

I know which view I support!

Specifically, it involves building a new self, one that is rooted in an identity as an alcoholic.   From this
perspective, radical transformations of the self occur
once the alcoholic identity is adopted.

. An example of a model based on this premise is Alcoholics Anonymous (AA). AA is explicit about fostering an identity as an alcoholic (Alcoholics Anonymous World Services, Inc., 2001).

In fact, it is customary for members to identify themselves at group meetings by their first name and the label “alcoholic” and to share stories about “what it used to be like,” “what happened,” and “what it is like now.”

Participating in a recovery program that focuses exclusively on living with and recovering from alcoholism contributes to the development of a “recovering alcoholic” identity.

However it should be noted, in terms of treatment,  that alternative
treatment approaches to alcohol dependence, such as motivational interviewing and cognitive behavioral skills training , focus on drinking as a problematic behavior pattern, not as a central
part of “who one is.” As such, these different treatment perspectives would have different implications in terms of a recovery self-schema. More specifically, whereas a recovery-related identity is viewed as a critical component of recovery from the AA perspective, it is inconsistent with the motivational interviewing and cognitive behavioral skills training perspectives.”

How these therapy regimes deal with persons  with alcohol dependence who have an underdeveloped, negative, and unstable self-concept and a conception of the self is unclear and I am not in a position to comment as I have not used either in my own recovery.

What we can conclude perhaps that people with alcohol dependence have an underdeveloped, negative, and unstable self-concept and a conception of the self in terms of drinking that motivates alcohol use, and persons in recovery often have a more well-developed, positive self-concept and a conception of the self in terms of recovery.

to be continued…

References

Corte, C. (2007). Schema model of the self-concept to examine the role of the self-concept in alcohol dependence and recovery. Journal of the American Psychiatric Nurses Association, 13(1), 31-41.