Monthly Archives: April 2013

What is depression?

Depression is one of those words that is widely used in a rehab/treatment center and in meetings of Alcoholics Anonymous and other 12-step fellowships.

In many ways the word depression can mean anything that anyone want to mean, although it doesn’t have a very clear clinical and medical meaning.

A rehab may have, in fact should have qualified medical personnel who would build to diagnose clinical depression, but that is not normally a part of the treatment process that can be fully relied upon in a rehab or anywhere else.

The significance of the word depression, and its meanings, can be looked at in a number of different ways in order to help alleviate whatever the underlying condition.

It is a given, but anyone who feels the need should seek medical attention or diagnosis of a condition, any conditions, and depression is certainly a condition that can be diagnosed and treated if appropriate.

In many ways it is more important in a 12 step fellowship sense to talk about some of the underlying emotional drives that can make a person feel depressed.

Given that there can be differences of view about what the word depression means, it is important that when a person enters a rehab goes to an AA meeting, they have the freedom to acknowledge who they are and how they are feeling.

A rehab will from day one, hopefully, encourage an alcoholic to own whatever feelings are going on as being valid in their own right and looked at.

The need to look at feelings and see what is giving rise to them is hugely important in a recovery context.

Recovery from alcoholism whether it begins in a rehab or an AA meeting, is about learning to live with oneself sober.

This means that acknowledging one’s feelings and understanding where they come from in terms of emotional drives is a key part of sobriety.

Many people begin the journey of recovery in a rehab, and the time spent there will be fairly minimal in comparison to the time needed to really deal with these underlying emotional drives.

It is important that a rehab does not dismiss feelings of depression or low energy levels are simply being that of self-pity or some other oversimplification.

There is a tendency in AA meetings to do this sometimes, and it is important that the rehab does not encourage this.

A rehab will often have a programme of recovery that is modelled on the first five steps of Alcoholics Anonymous.

Whilst the therapeutic work itself will be different, it will open the alcoholic up to an awareness of some of the feelings that are going on inside them, and if the therapists who are working at a rehab know what they are doing, the alcoholic will be guided gently bringing these feelings and encouraged to seek out ways of processing them.

A rehab all quite often have a number of physical therapies available to help the alcoholic whilst in treatment.

These may be fairly normal activities such as a gym, yoga classes, chi kung, breath work and other types of activity that can promote physical health and well-being.

Resident in a rehab will be encouraged to try out these different activities, and certainly an improvement in physical health is welcome.

It is important to recognise however that recovery in a rehab for an AA meeting begins first and foremost with someone’s spiritual development not their physical improvement or physique.

Working on someone’s inner world is an important process, and if done appropriately in a rehab will help the person heal a number of the hurts and emotional drives that have fuelled their drinking and their alcoholism.

Some rehabs will have a detox as part of their treatment center facilities. Other rehabs will have arrangements with local hospitals where detox can take place if necessary.

It is important to note, and a rehab should certainly be aware of this, that anyone who has very recently come off a period of sustained drinking needs a reasonable amount of time for their body to begin to regulate itself properly.

This applies to their mental health as well as their physical health, and should be taken into account by a rehab when dealing with any issues of depression, clinical or otherwise.

What does surrender mean?

Surrender is one of those terms that is widely used in the recovery movement, normally used in the context of a person surrendering in the sense of admitting that they have a problem with alcohol and/or drugs.

Such an admission that they have a problem is normally also followed by a request for help of some sort.

This may result in the person entering a rehab or treatment center, or going to meetings of Alcoholics Anonymous or Narcotics Anonymous.

Whatever the context, surrender as a term implies that the person has either given in or given up, and ended up in a rehab or an AA meeting as a result.

It has almost become a bit of a cliché to say that in order to deal with a problem of any sort someone has to acknowledge that problem in the first place.

This admission of a problem is key and may seem fairly obvious, but is a much more difficult process than perhaps might be realised when dealing with alcoholism/drug addiction.

When entering a rehab, an alcoholic will be faced with a number of different emotions.

One of these will most likely be a real sense of trepidation about what is likely to happen in the rehab.

This is not so much at a practical level, as most rehabs have quite well published itineraries and timetables as well as rehab mission statements.

What is more likely to be scary for the alcoholic is the sense of what is likely to happen to them in terms of having surrendered.

The word surrender is in many ways unfortunate. It implies a sense of giving in and being defeated, which can often be followed by a sense of hopelessness.

It is absolutely imperative when a person acknowledges they have a problem with alcohol or drugs and seeks help that they are offered a solution at the same time.

This approach is key to any rehab being effective in terms of helping an alcoholic get sober and stay sober. An admission of a problem should be a liberation, not a message of doom.

A rehab will have many different approaches to dealing with alcoholism.

They will likely have a number of different therapeutic approaches, depending on the type and nature of the rehab.

A rehab will most likely have a programme based on the first five steps of Alcoholics Anonymous, there will likely be group therapy, possibly one-to-one counselling as well as a number of so-called alternative treatments.

When researching the type of rehab, or where a rehab is, it is important to look at the different types of programs that the rehab is offering to see that they are in line with what the alcoholic or whoever is looking for them feels is most appropriate as a way forward.

There are a number of rehabs which follow the basic principles of the 12 step fellowships, while other rehabs do not.

A rehab will sometimes have a specific christian approach or possibly be geared towards one or more different professions.

Whatever the approach of a rehab may be, it is important that the notion of surrender not be seen as defeatist.

Acknowledging a problem over alcohol or drugs is an admission of reality, nothing more nothing less.

That reality should be a platform for freedom that the rehab should be encouraging the alcoholic to take up and embrace.

What is a personality change?

The idea of a personality change can be a scary prospect for many people, especially those who have no idea really what it means and feel they have no control over exactly how it happens.

This is the scenario that quite often applies to people who enter a rehab, normally to deal with a problem connected with alcohol/alcohol dependency. Upon entering a rehab, they will be told either directly or indirectly that the problem is not so much alcohol, it is them as people.

Hopefully the message that they get in a rehab will not be a judgemental one. Judgement of a person will block any chance of them being able to change.

If and when a person admits that they have a problem with alcohol or drug addiction, it often seems a fairly hopeless admission, in that it seems the end of the road ,the end of a line.

Quite often when the person reaches a stage of admitting that they have a problem, there is at the same time some type of a solution offered to them, even if it’s not a solution they particularly welcome or like.

The solution may be the offer of being taken to an AA meeting, or an NA meeting or possibly a residential stay in a rehab/treatment center.

The offer of residential treatment may come by way of an intervention, or simply a fait accompli by family members or an employer.

Whichever way it comes, the alcoholic will at some level be aware that a transition is taking place, and they are in effect moving from one direction to another.

A rehab will have a number of structures and therapeutic practices in place which will become the world that an alcoholic lives in for a fixed period of time whilst in treatment, in a rehab.

A big part of the purpose of this structure and the therapeutic practices will be to create an environment in the rehab that both feels safe, and will help give an alcoholic an insight into the emotional traits that underly their alcoholism and fuel their drinking.

The idea of a personality change in terms of recovery from alcoholism originated pretty much with the book Alcoholics Anonymous and the early recovery movement that took its name from the book.

The idea was to impress upon people that what needed to change was them, not conditions that they might have blamed for their drinking, or believed were the cause of their drinking. It is this notion that it is the inner world of a person that needs to change, that is really significant, whether this realisation comes whilst in a rehab, or in an AA meeting, or post recovery when the alcoholic has left a rehab.

The importance is that it will generate a sense of awareness within an alcoholic that they need to look internally to see what is making them uncomfortable, rather than looking externally, and blaming the situation around them for how they are feeling, or for a desire to drink.

It is quite likely that a rehab will prove to be an uncomfortable environment in many ways for an alcoholic or drug addict, especially in early recovery. This will most likely be because they may well not have had much of a choice about going into treatment, and feel they have lost control of what is happening to them.

A rehab can do much good in many ways, but it can also damage an alcoholic if they do not recognise this loss of control, and do what they can to minimise its impact and give the alcoholic back a sense of control over their own life.

What does love mean to an alcoholic?

It is often said that an alcoholic only loves themselves, and this is usually said in such a way as to imply that the alcoholic is chronically self-centred and only thinks about themselves and their own lives and has no regard for anyone else.

This analysis of an alcoholic’s behaviour and being is one that is commonplace in the recovery process, and often used as a bit of a big stick for an alcoholic either to go into a rehab, or to put pressure on an alcoholic to stop drinking either by going to Alcoholics Anonymous or some other means.

The real importance of this approach is that it fundamentally misunderstands both the alcoholic and the nature of their alcoholism. In truth only an alcoholic will be able to really make sense of their own drinking and their own behaviour, which may happen in a rehab more gradually over a process once they have left a rehab and hopefully going to meetings of Alcoholics Anonymous.

People assume that alcoholics drink for a particular reason. In fact this is not true. Whilst it is always difficult to generalise about anything in life,

it is probably fair to say that an alcoholic will drink because it is in their nature, rather than because of specific life events, hopes or fears.

Inevitably consequences, often quite significant such as that of entering a rehab, will happen and because of these consequences being linked to alcoholism/alcohol abuse there will be an inevitable assumption that they are causes of reactions to some as drinking.

An alcoholic will drink because it is in their nature to do so. Life events and circumstances will add a dimensional to that but will not cause or cure the persons drinking.

It is also worth making the point that there is a difference between an alcoholic and a heavy drinker, although from the outside that may be quite a subtle distinction.

An alcoholic will drink because they have to. As such the prospect of going into a rehab for alcohol it will be quite a scary one.

This is because they will lose alcohol.For many an alcoholic this will be a terrifying prospect. A rehab will hopefully recognise this is and make the transition from not be able to drink to rebuilding a sober life a less harrowing experience than it would otherwise be.

Mistaking self-centredness for love of self is a fundamentally wrong perspective on human nature and what it means both to be self-centred and to love oneself or to love other people.

When entering a rehab, an alcoholic and their family will be given insights into the nature of their self-centredness, as it has affected all of them.

Through a number of therapeutic approaches a rehab will show hopefully, how a person’s alcoholism and that persons need to drink has devastated their own lives and caused a fair degree of destruction in other people’s lives.

A rehab will also hopefully show love of self actually means. It may not address this question directly, but an understanding that alcoholism is an illness and that the alcoholic is an ill person will begin to put their behaviour and that alcoholism into context.

This may take a long time to really materialise as a belief in the alcoholic, but the seeds can be sown whilst in a rehab. Love of self works at many different levels, for many different people, but is fundamentally much more about a level of self acceptance and the freedom that comes with that, rather than obsessively trying to be in control of their own lives or those of other people.

Family Expectations

In this context the term family can apply to many different types of extended network of people in the life of an alcoholic.

The type of family set up is not particularly important, what is more important is that there is a huge area of recovery that exists alongside that of an alcoholic, which may or may not be properly addressed if an alcoholic goes into a rehab.

The family of an alcoholic, when entering a rehab will often have huge expectations about what is likely to happen.

These expectations will normally focus on the alcoholic and and quite often a hope that the alcoholic will get sober, and that when they have left a rehab life will be as it once was, and that everything will be pleasantville.

Not wishing to be a merchant of doom, it is important for the family to recognise a couple of important factors concerning the nature of alcoholism once an alcoholic is in rehab. Hopefully a rehab will address these issues, but it is possible they may not fully do so.

It is often important for the alcohol to have space away from the people who have been a part of his or her life in the buildup to them entering a rehab.

This physical aspect of separation is actually one of the main benefits for people being in a rehab. It will give both sides a physical space and distance apart with each side going that the alcoholic is in a safe place that can give them a breather.

The time spent in a rehab should also be a time when both sides can prepare for what happens after an alcoholic leaves a rehab.

Unrealistic expectations are often a real cause of problems both for the alcoholic and for the family, once an alcoholic has left a rehab. Having an understanding of how they have been affected prior to the alcoholic going into a rehab will help the family cope much better afterwards.

The real issue as far as this approach is concerned, is for the family members to really be aware of and to own the fact that they have been affected by the alcoholic.

This means a huge shift in the emotional focus of the family members of an alcoholic whilst they are in a rehab. It means that a family has to remove away from a position where they blame the alcoholic for what has happened to them and their lives, and the fact that they in some ways are accountable for what has happened to them.

This is in many ways a huge deal, as it necessitates a complete emotional turnaround for family members of an alcoholic, whilst in a rehab. It may take a long time for family members to really understand this or begin to agree with such an approach.

Hopefully a rehab will have a number of so-called family days where they bring the family into the treatment process, and begin to help them understand the nature of alcoholism, as it has affected the alcoholic in their lives, and how it has affected them as well.

A rehab will open a door that can help remove unlikely expectations, and help both sides gain an awareness of the reality of the situation that can help them genuinely heal past hurts and be able to grow in a healthy way towards their own individual futures.

Dealing with the Family !

There is an assumption that an alcoholic, upon entering a rehab will have some type of family as part of their lives.

This is not always the case but in the majority of situations it is. A family may consist of an immediate family, an extended or birth or natural family, a group of close friends or possibly even a company or business where co-workers are concerned and feel close to the alcoholic.

The important point is not so much the nature of the family, but the sense that there are a number of people who in some way or close to a concerned with an alcoholic who have acted as some degree of pressure to get the alcoholic into a rehab, and acknowledge they have a problem with alcohol/alcoholism.

The focus of being in a rehab is twofold. The main focus is primarily on the alcoholic and in helping them, or trying to help them understand the nature of their alcoholism, the recovery process and what it involves, and hopefully give them some sense of a way forward once they have left a rehab, and how they can rebuild their lives through programs such as that of Alcoholics Anonymous.

The rehab will also have a focus towards the family of an alcoholic. This will be in some ways at a practical level. A rehab will have a number of what it refers to as either family days or family meetings. These can often be quite tense affairs. The nature of the relationship between an alcoholic and his or her family, is likely to be quite strained putting it mildly.

A rehab should recognise this and should use the family days more as a way of trying to open an understanding between the two sides, rather than act as any type of mediation or family group therapy. In many ways the people who are closest to an alcoholic will have been hurt as much at the alcoholic themselves by the alcoholics drinking and behaviour.

A rehab will hopefully have an approach that can give the family members an opening into organisations such as Al-Anon, possibly family therapy and any other appropriate group of help.

Whatever approach a rehab takes, part of its mission should be to help a family understand that they have been damaged as much, if not in many ways more, than the alcoholic themselves. If they are to rebuild any type of relationship either with themselves, or with the alcoholic, then they need to own that they have been affected by the person’s alcoholism and need help themselves.

A rehab can do much to help an alcoholic in the process of recovery. A rehab can also do much to help the family understand the context of what has happened to them and to the alcoholic. Bringing the two together is a lifelong process, and raises the question of what part a rehab can really play in that process.

Perhaps the best that can happen whilst in a rehab is that both sides can realise that they have been affected by alcoholism and need help. Only if all parties try and help themselves, will they stop blaming each other for what has happened, and have any hope of a happy and secure future.

Instant Recovery?

It is often said when talking about recovery from alcoholism, that it is very much a process rather than something that is instant.

The comparison is often made that there is an expectation in society today, that everything should be instant.

This sense of everything needing to be instant has become even more pronounced with the advances of technology in the last few years.

The process of entering a rehab, is often seen as instant of itself.

This means that for many people the actual determination to enter a rehab, either by someone who is an alcoholic or through family pressure, or through an intervention is seen effectively as the solution to their problems.

The reason for this is simply that there is a huge buildup of pressure to the point where something actually happens.

The act of entering a rehab is often seen as that something, and there is an expectation amongst many people that the process of being in a rehab will affect a change that is the solution to their problems.

There is a really important point to this which concerns the level of pressure that is put on someone who is an alcoholic and seeking to stop drinking or to try and recover.

When entering a rehab, although it is difficult to generalise, someone who is an alcoholic will have a real sense of, or is likely to have a real sense of foreboding and fear about what is going to happen.

Not so much at a practical level, as a rehab will have a lot of information available beforehand, about its facilities and structure and the work of a therapeutic nature that will be done to deal with a person’s alcoholism/alcohol abuse.

People who work in a rehab will have a very clear idea, or should have a very clear idea about the reality of alcoholism and other addictions. Hopefully they will make it clear to the alcoholic and to the alcoholics family, that alcoholism is an illness and that recovery is a process that is something that happens once the person hopefully stops drinking.

A rehab will work for whatever period of time the person is present having treatment there, to help the alcoholic try and understand the reality of their alcoholism, and try and help them put their lives in the context as a result.

It is likely that the alcoholic themselves will fully understand that the recovery process is a process not an instant result. For many people who are alcoholics, the act of stopping drinking is simply the beginning of the process.

The rehab will encourage a number of therapeutic approaches to helping an alcoholic change, most likely based on the 12 step programme of Alcoholics Anonymous, largely on the basis that the alcoholic will begin to realise themselves that they need to change in order to stay sober.

This realisation will most likely come from the realisation of how they feel about themselves and to themselves once they get sober.

A rehab is somewhat of a closed environment, but hopefully one aspect of it is that it will be a safe place for an alcoholic to get sober and begin to realise the reality of their alcoholism both in terms of where it has taken them, the underlying emotional drives, and the nature of the work that can help heal those drives and therefore stay sober.

If any of this understanding comes whilst in a rehab, then the alcoholic will be very clear that this is a process and there is very little that instant about it.

The main challenge is often trying to make either the family or an employer or other interested party really understand this.

This is really important, as once an alcoholic has left a rehab, whatever else they do, an absence of pressure is hugely important in helping them stay sober.

Research into cocaine addiction

New research by scientists at  Michigan University show insight into way cocaine works in the brain, and how addiction loop might be broken

‘Researchers say cocaine alters the nucleus accumbens, the brain’s pleasure center that responds to stimuli such as food, sex, and drugs.

“Understanding what happens molecularly to this brain region during long-term exposure to drugs might give us insight into how addiction occurs,” says A. J. Robison, assistant professor in the department of physiology and the neuroscience program at Michigan State University.’

via futurity

Published in The Journal of Neuroscience 

Abstract : The transcription factor ΔFosB and the brain-enriched calcium/calmodulin-dependent protein kinase II (CaMKIIα) are induced in the nucleus accumbens (NAc) by chronic exposure to cocaine or other psychostimulant drugs of abuse, in which the two proteins mediate sensitized drug responses. Although ΔFosB and CaMKIIα both regulate AMPA glutamate receptor expression and function in NAc, dendritic spine formation on NAc medium spiny neurons (MSNs), and locomotor sensitization to cocaine, no direct link between these molecules has to date been explored. Here, we demonstrate that ΔFosB is phosphorylated by CaMKIIα at the protein-stabilizing Ser27 and that CaMKII is required for the cocaine-mediated accumulation of ΔFosB in rat NAc. Conversely, we show that ΔFosB is both necessary and sufficient for cocaine induction of CaMKIIα gene expression in vivo, an effect selective for D1-type MSNs in the NAc shell subregion. Furthermore, induction of dendritic spines on NAc MSNs and increased behavioral responsiveness to cocaine after NAc overexpression of ΔFosB are both CaMKII dependent. Importantly, we demonstrate for the first time induction of ΔFosB and CaMKII in the NAc of human cocaine addicts, suggesting possible targets for future therapeutic intervention. These data establish that ΔFosB and CaMKII engage in a cell-type- and brain-region-specific positive feedforward loop as a key mechanism for regulating the reward circuitry of the brain in response to chronic cocaine.

Is smartphone addiction a real problem ?

Smartphone addiction may be hiding a real problem, or is it just people wanting to jump on an addiction bandwagon ?

Interesting article with some seemingly valid research here : One in ten people have revealed that they are addicted to their smartphone, according to a new study.

The US study conducted on 2,000 college students has found that ten per cent respondents have claimed to have a full-blown addiction to the gadgets, the Sun reported.

The study found that 85% people constantly checked their phones for the time, while three-quarters slept beside it.

Via DNA India

Crystal Meth Addiction Story

Harrowing story of the reality of addiction to crystal meth

A 32-year-old elementary school teacher — we’ll call her Jamie to protect her identity — never felt like she belonged. Not in her small town, not in the home she was raised in, and not in her own skin.

Now a recovering methamphetamine addict, she tells the story of why she made the choice to use meth as a way to lose weight, as a way to help make her feel like she belongs.

Jamie knew what junkies looked like and she’d smile at herself driving down empty stretches of highway. All she’d see were her white teeth filling up the rear view mirror, looking past the purple cheek lesions and hollowed-out shadow of a meth addict.

Via :

Eating disorder awareness

Interesting piece about a student run awareness week for eating disorders – education is a key part of helping to deal with this problem, and initiatives like this can help significantly.

The aim of promoting awareness spread further than just Portsmouth with a Parliamentary debate taking place in Westminster Hall on 14th February 2013.

The inquiry – which heard from academics, magazine editors, the public, and other experts – were informed that 1.6 million people in the UK have eating disorders such as anorexia or bulimia.

The SRSH has created groups to support students with eating difficulties with the aim of revolutionising access to support across university campuses.

These groups provide low level support from trained students and allow a safe and informal space in which peers are able to reflect, listen, be listened to and have a chance to share pro-recovery stories.

Article via  Galleon news

Hazelden introduces maintenance programme

For the first time, Hazelden will begin providing medication-assisted treatment for people hooked on heroin or opioid painkillers, starting at its Center City, Minnesota facility and expanding across its treatment network in five states in 2012

This so-called maintenance therapy differs from simply detoxifying addicts until they are completely abstinent.

Instead, it acknowledges that continued treatment with certain medications, which can include some of the very opioid drugs that people are misusing, could be required for years.

Via : Time Magazine


The use of slogans in recovery has become an important part of the process for many people, albeit unwittingly at times.

This slogan, awareness, acceptance and action is often referred to as the 3 A’s, and essentially refers to a process that many people quite naturally go through when beginning the process of recovery from alcoholism, either in a rehab, or at an AA meeting.

The term acceptance is often used, especially in a rehab, to focus on the need to own the fact that an individual has a problem with alcohol or other drugs before they are able to move forward and do something about it.

Whilst this may be a fairly obvious position to take and to understand, the need for an alcoholic to accept that they have a problem with alcohol is actually much more complicated than might first seem the case.

The whole process of entering a rehab and doing any of the various programs that might be on offer as part of the recovery process, are geared towards developing both a sense of awareness and as such a sense of acceptance about the reality of a person’s life and their drinking or drug use.

The very fact of entering a rehab is of itself a form of action, but this may not be an action of free will by an individual. It may effectively have been done by an intervention or simply to appease family pressure or work/employment pressure.

Staff who work in a rehab will mostly be either trained medically, or be trained addiction counsellors as well. Many staff who work in a rehab will also be in recovery themselves from alcoholism, and will refer to themselves as recovering/recovered alcoholics.

This does have some advantages in that they will have been through the process of recovery, either in a rehab themselves or by virtue of having gone to AA meetings.

They will have a much better felt understanding of the need for awareness and acceptance than would otherwise have been the case.

A rehab is often seen as quite a stark and rigid environment, given the fairly strict set of rules and regulations they have regarding admission and residential treatment programs.

This rigidity in a rehab and quite often seem very oppressive from the outside, yet at the same time give a sense of security to an alcoholic who has entered a rehab for the purposes of recovery.

Awareness and acceptance of alcoholism/drug abuse can take a long time, for a number of quite complex reasons.

Perhaps the main reason or think I understand is one that hopefully will be raised and come to be processed whilst in a rehab.

This is the fact that an alcoholic will see alcohol, quiteoften subconsciously, as the only thing that is really holding them together, and will see the idea of trying to get them to stop drinking as much more of a threat that a solution.

This will have very little to do with the reality of where life has got to, both internally and externally.

The job that a rehab should be doing is helping the alcoholic to understand the nature of their denial, the reasons for it, the acceptance that it is natural for them to see alcohol as the solution not the problem, and a way forward that gives them hope that they can reconcile these seemingly irreconcilable positions.

If a rehab can do this, and give the alcoholic hope, then they will have done a good job. Often the most a rehab can do is to sow seeds as to what the problems are, and give the alcoholic a way out once they have left the rehab.

The journey forward in terms of recovery is a long one, for many people it starts in a rehab, others go direct to 12-step meetings such as AA/NA, either whilst on a rehab or directly.

What ever the beginning of the process, the need for people to accept themselves and the reality of what they are doing and why they are doing it is a key part of loving themselves, and understanding why their destructive behaviour is something they held onto and believe is of supreme value in their lives.

What does faith mean ?

People are often told to have faith, but often not told what have faith in. There is quite often an assumption that having faith means believing or trusting in God, but this again can have many different meanings and implications.

For many people, this is anything but an academic question, but something upon which their lives may depend.

That may sound a bit dramatic, but the reality for anyone entering a rehab or beginning the process of recovery from alcoholism, the need to make sense of their life and what is happening to them is profound and often overwhelming.

When many people enter a rehab, they are quite often in something of a daze, either literally or emotionally. It is likely they have had a fairly traumatic journey through their alcoholism, and the fact they have ended up in a rehab may well feel to them like a mark of failure in their lives.

The admission of having a problem with alcohol may not come until much later in the recovery process, when the alcoholic has actually left a rehab and has done significant amount of therapeutic work on himself.

It is a self-evident truth of alcoholism/alcohol abuse that most people see the reality of someone else’s drinking way before they do.

In fact many an alcoholic if not most alcoholics, the worse the drinking gets, the more they believe that alcohol is anything that is holding them together.

This is why their denial and their refusal to enter a rehab or go straight to AA or NA is so powerful.

The structure and tone of being in a rehab is both very institutional, and at the same time should be setting a framework for the alcoholic to realise the nature of their problem, and get some measure of what the solution is.

The work that is done in a rehab, depending on what type of a rehab the person enters, should mainly be of a therapeutic nature rather than anything else.

The nature of rehabs means that some very focused on the Alcoholics Anonymous model, whilst others are much more focused on what they refer to as life skills.

Both these approaches can work for different people, and it is up to the individual to decide what type of a rehab is most appropriate to them.

There is no doubt however that a rehab that encourages alcoholics to attend a meeting is that take place either at a rehab venue or an outside venue such as a local church, will enable the alcoholic to tap into a resource that will stand them in very good stead once they leave a rehab.

When in a rehab, an alcoholic will be introduced to a number of principles of recovery, which will effectively center around spirituality, God, higher power and faith. If the alcoholic is lucky, there will not be much sermonising or preaching by the people who work in a rehab as to what these terms mean.

If the alcoholic is unlucky, then the time spent in a rehab potentially do more harm than good.

Whilst the question of faith and what it means is a very broad one, one of the lessons that someone who spends time in a rehab should get is that the person they need to have most faith in is themselves.

This does not mean that dealing with their alcoholism it is a matter of will power, far from it, it leaves at the alcoholic will have to learn to trust themselves as to what their needs are, and how they can best go about meeting those needs.

Spiritual development

The idea of spiritual development in relation to recovery from alcoholism/alcohol abuse whether in a rehab or by directly going to Alcoholics Anonymous meetings is sometimes a difficult concept for many people to grasp.

This is because most people who have a fairly limited understanding or experience of alcoholism will see the problem as being that of alcohol, whereas people who work in a rehab, or have experience of having been in a rehab and worked with alcoholics will understand that the real process of recovery concerns a person in someway changing their inner world.

The original members and founders of Alcoholics Anonymous realised that the nature of recovery from alcoholism necessitated a profound spiritual change within the person. What became more difficult to define is what this actually meant.

When people enter a rehab, there is normally a fairly clear tipping point by way of external pressures or problems that may include alcohol and other life issues.

Once in a rehab the person will be confronted with the reality of life in some sense. It is probably fair to say at an alcoholic, through the progression of their illness, will have come to see alcohol as being the solution to their problem not the problem itself.

This is an attitude and approach that anyone who works in a rehab should understand and be sympathetic to.

Many people who work in a rehab in either a therapeutic or nursing or medical role are often recovering alcoholics themselves, as well as having been in a rehab at the beginning of their recovery process.

A person’s spiritual development will be unique to them both at the beginning of the process in a rehab or by directly attending meetings of Alcoholics Anonymous.

These meetings may be held in a rehab itself or outside premises.

When people talk about a spiritual development, they inevitably think that it means becoming a good or better person. In fact the real process around a spiritual development or growth has much more to do with a person’s authenticity than whether they have involved themselves in any type of character building.

The recovery process in a rehab will often focus more extensively on the alcohol than the therapeutic recovery process.

This does vary quite considerably within different types of rehabs, with some being exclusively focused on the early process of recovery, whilst many a rehab will work through an adaptation of the first five steps of Alcoholics Anonymous.

The time spent in a rehab will be seen as a precursor to living life in recovery outside a rehab, and hopefully the rehab will encourage meetings of Alcoholics Anonymous/Narcotics Anonymous.

Many a rehab will actually make it a condition of people spending time in a rehab/treatment center that they attend a specified number of AA/NA meetings a week.

This is something that people need to consider when deciding what type of rehab they want to enter.

It is important not to be frightened by the term spiritual development.

Of itself it is simply a process that will begin in a person once they enter a rehab, or make the decision to enter a rehab, which is of itself an admission that in some way they need help.

What happens when the person leaves a rehab can vary considerably, but time spent a rehab means that seeds will have been sown that hopefully over time will root the person in their own spiritual life.