Inside the Head of the Addict or Alcoholic

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How could men who loved their wives and children be so unthinking, so callous, so cruel? There could be no love in such persons, we thought. And just as we were being convinced of their heartlessness, they would surprise us with fresh resolves and new attentions. For a while they would be their old sweet selves, only to dash the new structure of affection to pieces once more. Asked why they commenced to drink again, they would reply with some silly excuse, or none. It was so baffling, so heartbreaking.  (Alcoholics Anonymous pg 107)

This passage is written specifically to wives of alcoholics (the chapter is named “To Wives”) but it really is a message to all who have a loved one or friend who has serious alcoholism or addiction issues. 

People around us that don’t suffer from the same addictions as us often have these or similar questions bouncing around in their minds.  “How could we be so unthinking or uncaring?”  The actual answer is that in most cases, we don’t know.  This is not (or at least not always) an attempt to excuse some bad behavior; this is often the actual answer.  As a matter of fact, in many cases we were asking ourselves the same questions.

My point here is not to excuse any behaviors or actions, but to help those who have a loved one or a friend who is suffering to understand that much of this is not personal, it is just part of what addicts and alcoholics do.  That by no means implies that you have to just sit back and let it happen, it just means that often it is not that we don’t care or want to hurt anyone, it is often just a crazy that seems compulsive to us.

In this post I hope to help those around an addict or alcoholic see what we do more clearly and for the addict or alcoholic to get an idea of how crazy our behavior seems to others. 

Let’s look at a few of these common things we do that confuse or hurt those close to us.  We will start with the progression that Bill W. (Bill W. one of the founding members) went through as his using got to be worse and worse.  You may see close similarities to your friend, loved one or to yourself if you suffer from addiction or alcohol problems.

1.  We ignore discussions and signs that we might be getting worse or “going overboard”

Though my drinking was not yet continuous, it disturbed my wife. We had long talks when I would still her forebodings by telling her that men of genius conceived their best projects when drunk; that the most majestic constructions of philosophic thought were so derived.  (Alcoholics Anonymous pg 2)

In this case he was starting to show signs of that his using might be developing into a serious problem.  His wife, who would know, was disturbed and would try to have discussion about it with him.  He not only wouldn’t consider what she was concerned about, he tried to convince her that it is better for people to be drunk because they somehow work better. 

This is a part of being a serious alcoholic or addict.  One of the first signs that we are losing our grip is that someone outside of you begins to be bothered or concerned.  According to this, she didn’t go nuts; she even had reasonable discussion about it.  Someone close to him was showing loving concern and it was as if they were speaking different languages. 

Old Bill also made sure he explained how geniuses and great philosophers were not on users of alcohol, but did their best thinking and working while drink.  I suspect that he was convincing his wife and himself at the same time.  Oh what a cloud of nonsense that we can disappear behind when confronted.  This is also a normal part of what it is to be an addict or alcoholic.  Not only do we not listen, we blurt out almost reasonable sounding excuses for our using.

2.  Everything seems like it is just better when using.  In Bill’s Story, Bill simply put it this way

Drink was taking an important and exhilarating part in my life. (Alcoholics Anonymous pg 3)

Using takes an important role in the life of the person.  I starts to become the source of excitement no matter what the person is doing.  If the person is doing something exciting, he or she feels like it would be a little more exciting if he or she were using and it is missing something if he or she doesn’t use. 

If we are in an environment where it is not socially acceptable to use we slip off to use or we just don’t enjoy ourselves.  It is a feeling like something is missing even in the most exciting of activities.

3.  Using moves from important to dominant.  It begins to take over as most important in the person’s life.

My drinking assumed more serious proportions, continuing all day and almost every night. The remonstrances of my friends terminated in a row and I became a lone wolf. There were many unhappy scenes in our sumptuous apartment. (Alcoholics Anonymous pg 3)

So now, Bill is almost always drunk.  What that means is where it used to be that drunk was added to whatever he was doing, now, whatever he is doing is being added to the fact that he is drunk.  It no longer is just there to make other things better, the other things have to be reduced to things that make being drunk better (or they are not to be done). 

What all of that means is that the world becomes measured by how it interacts with my high or attempts to get high.  Getting high or drunk now dominates my thoughts and desires and everything else is in servitude to my new master; intoxication.  The way I like to see this is that it is not that person necessarily loves you or whatever he or she loved before less, he or she has just started loving being high or drunk more.

Then there is this remonstrances of his friends terminating in a row stuff.  What is all that?  Lets define two of the terms used using the Merriam-Webster Dictionary:

  • Remonstrances = an earnest presentation of reasons for opposition or grievance
  • Row = have a quarrel

So that translates to:  “The presentation of reasons opposing the amount of drinking Bill W. was doing let to quarrels or fights and he ended up being a loner.”  Every time people tried to bring to his attention how bad his using was getting, he would get into a fight with them to the point of chasing them off.  The fights would be so bad and his level of using so bad that the people who cared enough about him to say something to him decided to stay away from him all together.

That’s when our crazy really starts to come out.  There are these people who really care about us, enough to try and talk to us about our obviously growing problem, and we push them away.  We scream, holler, say stupid things, insult them, whatever it takes, just so they do not interfere with or try to interfere with our using.  Because remember, we usually haven’t started caring for the person who confronts us less, we just care about being high or drunk more.  So if that person is interfering, high or drunk must be protected at all costs.

One more thing from this passage, notice the change of tone in his relationship with his wife.  Before, they were having “long talks,” now they are having “unhappy scenes.”   Those of us who get to this level of using start pushing anyone who cares about us away, but some people are more tied to us than others.  So even though he had become a loner, his wife was there whenever he decided to be home.  It’s probably not about loving her less; it’s probably about loving being high or drunk more.  She may be second on the list, but if she is in any way going to interfere with his high or with his comfort, she is immediately a problem.  She probably stays in second place, but a very distant second place.

The pushing away of people is a normal part of the alcoholic’s or addict’s life.  There may seem to be many different reasons (such as to not think about how much we hate ourselves, to avoid facing the problem, to avoid the stress, etc.) but, the real problem is that sick as it may sound, in our heads, the high becomes the most important thing to be protected in our lives. 

None of that excuses it, but it is a fact at this level of using.

4.   There starts to be small physical changes

I began to be jittery in the morning.  (Alcoholics Anonymous pg 3)

This will vary between alcohol and other drugs of choice and will even vary between different people.  Different things happen.  It may be the shakes, bags under the eyes, breaking out or rashes, extreme weight loss or gain, lots of minor illnesses (colds, flu’s, etc.), and many other physical symptoms. 

These are some of the signs that the person’s body is having some troubles with the chemicals the person is ingesting.  The odd part is we rarely even notice these signs of problems and if we do we tell ourselves they are somehow normal.  As a rule if our bodies are trying to reject something or are have a negative response to something, it is a bad idea to continue taking in whatever it is.  Yet we always find some reason to go on anyway. 

When these signs start to appear, we are on the verge of serious problems (beyond whatever other serious problems we are causing ourselves).  This is the point that those around us should feel an urgency and a desperation for us, the problem is that by this time they are pushed away from previous attempts to talk to or deal with us.  We on the other hand, are at this point thinking in such a distorted way that we would be willing to have some physical problems as long as we can be drunk or high.

5.  It eventually progresses from being the most important thing in our lives to the totality of our life.  We have been pretty bad by this point and it is clear to those around us that we are an alcoholic or addict, but at some point it gets even worse

Liquor ceased to be a luxury; it became a necessity. (Alcoholics Anonymous pg 5)

The way Bill W. observed this is that his addiction became as important as breathing, his heart beating and eating in his mind.   It was no longer something that he did, it became a must.  He was not able to function if not using.  This is another area that will look different depending upon the addiction and the person, but this is another sign that the problem has progressed to incredibly desperate levels.

At this point it is incredibly hard to stop, to want to stop, to see any way to stop or even to take a break.  IN previous levels in this progression, if a person wanted to stop there would be struggle and some confusion etc. but at this level, it is a much bigger challenge.  When a person tries to stop there is so much confusion and inner resistance to stopping that the person will have a terrible time mustering any desire to stop. 

If the person was one of those people who could quit for a year here or there or six months here and there, that becomes increasingly difficult from here on.  It’s like asking them to quit breathing or to want to quit breathing. 

The thought life of the person also becomes monopolized by the desire to use.  It is as if the person only lives to use.  Work becomes only a way to get more (if work is even an option at this point).  Interactions with loved ones become ways to keep their world together so as not to hinder their ability to continue to get high.  For example one of the main reasons someone like this might not want a divorce is because he or she may end up paying child support etc. and have a harder time finding money to use with. 

It may have started at an earlier place in this progression, but it is common by this stage to lie about the using or to sneak using if there are still people around that would be seen as somehow interfering with the using.

6.  Serious physical dependence

I began to waken very early in the morning shaking violently. A tumbler full of gin followed by half a dozen bottles of beer would be required if I were to eat any breakfast. Nevertheless, I still thought I could control the situation, and there were periods of sobriety which renewed my wife’s hope. (Alcoholics Anonymous pg 5)

At this point not only his mind acts as if using is as important as breathing or the heart beating, his body now reacts as if something important has stopped working properly whenever he is not using.  Think about what he has just stated.  When he did get to sleep (whatever time that happened at) the amount of time he spent sleeping (not using) created such a stress for his whole system that he awakened early to get more.  When he awakened his body would be shaking violently desperate to use even a little bit.  After that he even had to use if he wanted to eat his breakfast without throwing up.  His body would not even allow him to eat if he wasn’t using.

At this point it is hard to even imagine quitting as an option.  Think of it this way:  “If I can’t be sober long enough to sleep, how am I gonna be sober longer?” 

Now lets do a little reading to look at some occurrences in Bill W’s life at this point in the hope of getting some more understanding:

Then I got a promising business opportunity. Stocks were at the low point of 1932, and I had somehow formed a group to buy. I was to share generously in the profits. Then I went on a prodigious bender, and that chance vanished.
    I woke up. This had to be stopped. I saw I could not take so much as one drink. I was through forever. Before then, I had written lots of sweet promises, but my wife happily observed that this time I meant business. And so I did.
    Shortly afterward I came home drunk. There had been no fight. Where had been my high resolve? I simply didn’t know. It hadn’t even come to mind. Someone had pushed a drink my way, and I had taken it. Was I crazy? I began to wonder, for such an appalling lack of perspective seemed near being just that.
    Renewing my resolve, I tried again. Some time passed, and confidence began to be replaced by cock-sureness. I could laugh at the gin mills. Now I had what it takes! One day I walked into a cafe to telephone. In no time I was beating on the bar asking myself how it happened. As the whisky rose to my head I told myself I would manage better next time, but I might as well get good and drunk then. And I did.  (Alcoholics Anonymous pgs 5-6)

So Bill had promising work that could put him back on his feet, but couldn’t stay sober long enough to go through with it.  He finally “gets it” and knows how bad he has gotten and that he no longer has control and focuses himself on quitting.  He meant business and could only hold on a short time before coming home drunk again. 

Did you notice that the same questions that we would have for him, he had for himself.  Where was all that “resolve?”  What was going on in his mind when he relapsed?  Is he crazy?  Did you notice he could provide himself with no answer?  That is why he or she doesn’t give a reasonable answer or any answer to those strong enough to still care after all of this:  the person doesn’t have an answer!

Then there was a period where it looked like he had figured it out.  He had done it all on his own and gave great hope to those that still cared about him.  Then without warning, another relapse.

This may seem pretty bad but it gets worse. 

7.  Complete hopelessness (and possibly suicide attempts)

The remorse, horror and hopelessness of the next morning are unforgettable. The courage to do battle was not there. My brain raced uncontrollably and there was a terrible sense of impending calamity. I hardly dared cross the street, lest I collapse and be run down by an early morning truck, for it was scarcely daylight. An all night place supplied me with a dozen glasses of ale. My writhing nerves were stilled at last.  (Alcoholics Anonymous pg 6)

He had given up on the idea of sobriety and was scared while using too.  The only escape he had prior to this was no longer an escape.  Even using would not bring the desired escape any more yet sobriety even more unbearable.  There was no place to escape from the results of using so he went and used. 

For those who have never used or have never been this far along in their using, welcome to the insanity that is bouncing around the head of a person living at this level.  After this reality, sometimes a person reaches what seems to be the only logical conclusion (this may have been a problem previously and may have even preceded using, but it does seem to be supported by this twisted logic now).

Should I kill myself? No – not now.  Then a mental fog settled down. Gin would fix that.  (Alcoholics Anonymous pg 6)

This is pretty serious hopelessness.  Once you completely give up on yourself, there is really no place to hide from that fact.  You cannot truly hide from yourself.  The closest you can get to hiding from yourself is the mental fog spoken of here.  That’s not just being tipsy or a little high; that is being completely blitzed.

In the case of Bill W. he reached this point and stuck it out for years he describes hi mind and body as having to endure “this agony” for two more years and described it as “physical and mental torture.” 

Eventually his alcohol was not enough to get enough of a mental fog and watch what happens:

A doctor came with a heavy sedative. Next day found me drinking both gin and sedative. This combination soon landed me on the rocks. People feared for my sanity. So did I. I could eat little or nothing when drinking, and I was forty pounds under weight.  (Alcoholics Anonymous pgs 6-7)

Bill W. who seems to have been content with only using alcohol, and never showed an interest in doing any other drugs, suddenly is mixing drugs with his alcohol use.  In other words, just when it looks like it couldn’t get any worse, those of us who use at this terrible level as if by magic find a way to make it worse. 

In brief, Bill goes through recovery at a hospital and does quite well.  He leaves and gets a period of sobriety.  He thought he had the answer and that he had enough self-knowledge to remain sober.  He thought this was the end of his using.

But it was not, for the frightful day came when I drank once more. The curve of my declining moral and bodily health fell off like a ski-jump. After a time I returned to the hospital. This was the finish, the curtain, it seemed to me. My weary and despairing wife was informed that it would all end with heart failure during delirium tremens, or I would develop a wet brain, perhaps within a year. She would soon have to give me over to the undertaker or the asylum.
    They did not need to tell me. I knew, and almost welcomed the idea.  (Alcoholics Anonymous pgs 6-7)

Those who have lived this know the feelings, the thoughts, the despair, the hopelessness and everything else that comes at this point.  Those who use heavily but have not gone this far (yet) may not recognize some of the latter details, but if you think about it, you can see how these things are the logical end to the continued using.  They may not look exactly like this or be in exactly the same order, but this sounds like the stories of many, many others who have gotten this far along in addiction.

Now, for those of you who are the friends and loved ones of the person like this or somewhere in the process of getting more and more like this, this has been outlined mainly for you.  This is not a scientific analysis of addicts and alcoholics, or a series of long term studies:  This is one of us describing the process exactly as we experience it.  This is a glimpse into the mind of the person you are worried about.  This is his or her perspective. 

Every situation is different and your response to this information in every case probably needs to be different also.  Some of you may not be as intense in harassing the person, and some of you may need to be more direct and blunt due to your new realization about how serious the situation is.   That is a detail that you probably need to work out with a local professional in the field or a local support group etc. 

I hope this post is simply a new look at the person and the struggles that person is facing.  So now back to the passage we started with:

How could men who loved their wives and children be so unthinking, so callous, so cruel? There could be no love in such persons, we thought. And just as we were being convinced of their heartlessness, they would surprise us with fresh resolves and new attentions. For a while they would be their old sweet selves, only to dash the new structure of affection to pieces once more. Asked why they commenced to drink again, they would reply with some silly excuse, or none. It was so baffling, so heartbreaking.  (Alcoholics Anonymous pg 107)

When you reread this with the insights we have just gone through, we get answers to those questions.  Not the perfect answers and possibly not even satisfactory answers, but at least an understanding of what is going on. 

I hope that this information is helpful  for all who read it.

Wade H.

Clear Cut Directions – Steps 1, 2, and 3

clear-cut directions are given showing how we recovered. (Alcoholics Anonymous pg 29)

All things 12 step and The Alcoholics Anonymous book (the original source for all things 12 Step) are supposed to be clear cut directions, but why such detail?  What
are they getting at.  Lets look at the importance of these clear cut instructions looking at Steps 1 through 3.  Let’s start at step 1:

I saw that will power and self-knowledge would not help in those strange mental blank spots. I had never been able to understand people who said that a problem had them hopelessly defeated. I knew then. It was a crushing blow. (Alcoholics Anonymous pg 42)

There was a post I did previously about hitting bottom and Step 1.  This is a part of
the reality of that idea that makes recovery work.  I repeatedly go back to this concept as many of the struggles a person has in recovery can be traced back to a failure to properly work Step 1.

A person who reaches a step and uses an idea like, “Why do we have to do this, This isn’t gonna help” to keep himself or herself from doing that step properly (or from doing it at all) has not fully grasped that reality.  Asking or having the question is not the problem (I think questioning is good and good sponsors should have or at least know where to get the answers), not recognizing how desperate the situation is so you feel that it is safe to cut corners is where it becomes a breakdown in Step 1.

We were in a position where life was becoming impossible, and if we had passed into the region from which there is no return through human aid, we had but two alternatives: One was to go on to the bitter end, blotting out the consciousness of our intolerable situation as best we could; and the other, to accept spiritual help. (Alcoholics Anonymous pg 25)

The next reality is that there is one possibility for escape, but it is one that some struggle with.  The point is bigger than that however.  The point is the first the previous recognition that I am trapped in a hopeless and helpless place.  The second point to get is that I there are large numbers of people that were in the same holes and helpless position who were helped through “spiritual help.”  If there is no hope whatsoever and suddenly someone shows me something that not only is the only hope, but has worked for others in a similar position, how desperately should I go after it?

We, in our turn, sought the same escape with all the desperation of drowning men. (Alcoholics Anonymous pg. 28)

How about, the same desperation that a drowning man would have?  That sounds like real desperation, doesn’t it?   That feeling a drowning person gets the moment he or she realizes that “I am not getting any air and I am going to die quickly if I don’t.”

That is a major point here, but there is more.  Notice the words: “the same scape”.   Whatever those that originally did this went through to get recovery you should be desperately seeking to do the same thing.  Not just the parts you are comfortable
with, or just how you feel like doing those things:  “the same escape”.

If discussing spirituality is a problem, then the problem is not that you struggle with the idea; it is only a problem if you do not desperately seek to figure out how to get over it to get the “same escape”.

To one who feels he is an atheist or agnostic such an experience seems impossible, but to continue as he is means disaster, especially if he is an alcoholic of the hopeless variety. To be doomed to an alcoholic death or to live on a spiritual basis are not always easy alternatives to face.

But it isn’t so difficult. About half our original fellowship were of exactly that type. At first some of us tried to avoid the issue, hoping against hope we were not true alcoholics. But after a while we had to face the fact that we must find a spiritual basis of life – or else. (Alcoholics Anonymous pg. 44)

This is where a person transitions from Step 1 to Step 2 then to Step 3.  Some can go faster than others but a person should not (and really cannot) go to a later step until having fully completed all of the preceding steps properly.  Not if that person is looking to get “the same escape”

That means a person not thoroughly convinced of his or her powerlessness in Step 1 will not be ready to look at Step 2 “with all of the desperation of drowning men.”  A person who does not fully understand that learning to “live on a spiritual basis” is his or her only hope cannot see the need to nor have a desire to turn his or
her will and life over to God.

This moves us into a conversation about Step 2 which is tied to Steps 1 and 3.  These are the 3 questions:

  1. Do you know that your situation is so desperate that you have no choice than to do whatever these people did to get recovery (especially those things which you find uncomfortable)?
  2. Do you realize that a major part of their idea of recovery was willing to “find a spiritual basis of life – or else” and are you willing to desperately pursue “a spiritual basis of life”?
  3. As part of pursuing “a spiritual basis of life”  are you willing to turn your will and life over to God (even if you do not know that much about Him)?

The Alcoholics Anonymous book puts these questions this way:

Our description of the alcoholic, the chapter to the agnostic, and our personal adventures before and after make clear three pertinent ideas:

(a)   That we were alcoholic and could not manage our
own lives.

(b)  That probably no human power could have relieved our alcoholism.

(c)   That God could and would if He were sought.

Being convinced, we were at Step Three… (Alcoholics Anonymous pg. 60)

These are the keys to moving on to Step 3 and you must be convinced.  Originally there was a sentence right before the words “Being convinced” in the original manuscript that were removed for their bluntness, but they do convey the concept I have been describing well.   The original passage looked like this in the manuscript:

Our description of the alcoholic, the chapter to the agnostic, and our personal adventures before and after, have been designed to sell you three pertinent ideas:

(a)   That you are alcoholic and cannot manage your own life.

(b)  That probably no human power can relieve your alcoholism.

(c)   That God can and will.

If you are not convinced on these vital issues, you ought to re-read the book to this point or else throw it away!

If you are convinced, you are now at step three… (Alcoholics Anonymous Original Manuscript)

If you are not convinced, YOU CANNOT GO ON, STOP AND GO BACK!  SO the real question is can you answer yes to all three propositions or not (no matter what addiction you are trying to get over).  Again I will put the question in clear words:

  1. Do you know that your situation is so desperate that you have no choice than to do whatever these people did to get recovery (especially those things which you find uncomfortable)?
  2. Do you realize that a major part of their idea of recovery was willing to “find a spiritual basis of life – or else” and are you willing to desperately pursue “a spiritual basis of life”?
  3. As part of pursuing “a spiritual basis of life”  are you willing to turn your will and life over to God (even if you do not know that much about Him)?

Those are the clear cut instructions and if a person cuts a corner on or skips any of the Steps the rest will not have the proper results.

The 4 Necessary Discussions for Recovery – (The 4 Flat Tires)

Of necessity there will have to be discussion of matters medical, psychiatric, social, and religious. We are aware that these matters are, from their very nature, controversial.  (Alcoholics Anonymous pg 19)

If you are going to talk recovery, you have to talk about things going on with the body, things going on with the mind, things that contribute to your addiction socially and about your spiritual health.  Let’s take a brief introductory look at these areas and give them some thought.

MEDICAL – the body is a very important area as far as recovery.  There are physical aspects to drug and alcohol recovery that are fairly obvious such as withdrawals, changes in eating habits, liver issues and on and on that must be addressed.  A person in recovery from drugs and alcohol must get ongoing medical care and be diligent in regularly visiting the doctor.

Beyond all of that there are physical aspects of recovery that go beyond drug and alcohol addiction that are common to all addictions.  There have been studies on gambling addiction such as those done by Illinois Institute for Addiction Recovery, the National Institute on Alcohol Abuse and Alcoholism and the Emotion Neuroscience Centre at the Massachusetts General Hospital that suggest similar responses in gambling addicts that are using no drugs or alcohol as those found to be major factors in why some drug addicts and alcoholics use.  The point research is starting to point to the fact that other (non-chemical) addictions can have similar physical traits as chemical addictions that must be considered.

Another point in terms of the physical discussion is the positive and stress managing benefits of healthy amounts of exercise and healthy diet management in recovery.   Emotions and so on can be managed quite a bit by simply getting on an exercise program and making some dietary changes.

PSYCHIATRIC – On a very basic level it is often the case that there are some pretty heavy psychological or emotional issues that either led to or result from heavy addictions.  The idea of getting professional help for these issues is something that all of us going through recovery have to remain completely open to.

There is also this idea of being “dual diagnosis.”  I am always astonished by the number of people in recovery who go on for years using and when confronted with the idea that they might be bipolar they respond with something like, “Yeah, a couple of doctors have told me that, but I don’t believe them so I ignore them.”   Please do not ignore things like this!  If you do not trust the clinician that is giving you such a diagnosis, the proper response is not to just ignore such things.  The proper response is to get second, third or more opinions.  If you don’t like or trust clinicians, find one that is friendly to the type of recovery you are working and try to work through these things.

There are cases where a main push for the person to partake in whatever addiction he or she prefers is based largely on some psychological issue that he or she is “self-medicating.”  The addiction may be directly self-medicated such as the depressed person using a stimulant or may be more indirect such as the person simply partaking of the addiction to keep his or her mind distracted from something mentally tormenting.

There is also some overlap with the physical aspects of recovery in that some levels of the psychological issues common to many in recovery can be somewhat managed through exercise and dietary changes.

SOCIAL – There are many social aspects to addiction that must be addressed and so many possibilities it’s ridiculous. There are some more obvious like the person who is raised in an abusive home with one or more parents who are addicts. This person may grow up to have the symptoms of what has been termed an ACA or ACoA (Adult Children of Alcoholics or of Addicts).  There are people who come into recovery with damaged marriages and relationships of all kinds that must also be repaired.   In some cases these are environments where there are others still using and this person is trying to go through recovery.

There is also the way that a person has learned to interact with others in general during the period of addiction and the various cycles associated with the addiction that must be unlearned if they are unhealthy.

RELIGIOUS – For some the words religious and spiritual have some clear definition, for others these words present an alien concept.  No matter how you are looking at these words, this is an area that must be addressed.    This requires letting go of whatever you have believed before and looking at this all with fresh eyes. 

If this is not clearly defined to you, consider the amount of recovery information that says you should seek this “spiritual awakening” (as outlined in Step 12 of Twelve Step programs).

If you feel this is clearly defined to you, can you be open to the idea that your understanding might be wrong or incomplete.  It is possible that that is why your understanding has not provided you with what you need for recovery.

There is a lot more that can be stated about these areas and the work in these areas.  The real importance is to not only discuss these four areas, but to work in all four areas.  Think of recovery as trying to get a car moving that has four flat tires.  Many people in recovery try to just focus on one area of recovery which is like inflating one tire and expecting it to be just fine.  You have to put air in all for tires to get going.  If you don’t you may get going a bit, but the end result is like one of those police chase shows we see on TV where the police put out spikes to pop the tires of the person.

Many in the field specialize in one are or another and ignore the other areas assuming that work in their area of focus is all that is needed.  Take the medical, why is it that there are so many cases where smokers using patches or alcoholics using drugs such as Disulfiram (which often induces vomiting etc.) still use.  It is often not because these things do not deal with the physical aspects of the using, it is because there are other contributing reasons for using that are not addressed.

Or the counselor who works with someone in addiction on all his or her issues, making great progress only to find that person smelled or saw the chemical or object related to his or her addiction and used without thought.  The physical craving may have been overpowering and extremely hard to resist even with a far more stable mental state.

No matter how you cut it, the truth is there is a lot to not only discuss, but to work on in recovery.  Four of the most necessary for all of us are what is happening in our bodies, our minds, areas of our social life (past, present and future) and our spiritual life. 

It may not be all or nothing, but it seems to be all or ‘nothing lasting’ for many in recovery.