- The concept of recovery from addiction has existed since AAs founding, but with no clear definition.
- A clear definition would be useful as an attractive guide and a measure of accountability.
- William White's 2007 essay still offers the clearest and most complete proposed definition.
My previous posts have focused on recognizing and preventing excessive substance use, with an emphasis on providing the latest information about my special interest – cannabis (see 20 Questions to Tell if You're Using Cannabis Safelyand Test Your Science Literacy About Cannabis). Now, since my blog is named “Healing from Addiction”, I will turn my attention to a series of posts focused on recovery, beginning with a definition designed to include and guide individuals suffering serious problems from excess consumption of alcohol and/or other drugs, their families, friends, and the professionals treating them.
Recovery is a medical term describing a return to health following trauma or illness. We often speak of an individual’s recovery from a heart attack, and this nicely illustrates two common uses of the term “recovery.” When people survive the acute attack, leave the hospital a week later and soon return to work, we say they are recovering well. A second meaning is illustrated when we contrast individuals who enter a heart-healthy stress reduction/mindfulness program after suffering a heart attack, lose excess weight, change their diet to avoid saturated fats and take statins if cholesterol remains high, establish an ongoing exercise program, monitor blood pressure, stop smoking, and limit alcohol use with individuals who neglect all these lifestyle changes following their heart attack.
This second meaning of recovery involves a process rather than a one-time event – a process that resolves issues underlying the heart attack, thus maintaining a level of wellness that reduces vulnerability to another heart attack. This deeper level of recovery requires an end to one’s denial that years of poor health habits caused the heart attack. Recovery from addiction requires a similar long-term process involving an end to denial and thorough alteration of lifestyle.
William White wrote a brilliant essay proposing a definition of recovery from serious addiction to alcohol and/or other drugs[i] following a Betty Ford Center meeting in 2006. Each word in his definition is carefully considered to include the wide variety of individuals in recovery, to emphasize the ongoing nature of recovery as a process more than a goal, and to indicate that recovery is more than attempting to achieve sobriety but consists rather of measurable milestones, both concrete and attitudinal. White proposed the following:
Recovery is the experience (a process and a sustained status) through which individuals, families, and communities impacted by severe alcohol and other drug (AOD) problems utilize internal and external resources to voluntarily resolve these problems, heal the wounds inflicted by AOD-related problems, actively manage their continued vulnerability to such problems, and develop a healthy, productive, and meaningful life.
This definition of recovery fits several quite distinct uses of the term: “1) recovery as a lived experience by individuals and families, 2) recovery experience as the connecting tissue within communities of recovery, 3) recovery as an outcome that can be measured by scientists and those responsible for monitoring and evaluating behavioral health care systems, and 4) recovery as both an organizing vision/goal and a benchmark of accountability.”
By describing recovery up front as an experience, White is emphasizing its personal and individualized nature. Everyone will filter the experience of recovery through their own unique history, age, gender, culture, faith, etc. Some will experience blinding transformative moments while perhaps most will experience a more gradual unfolding of recovery.
By emphasizing that his definition of recovery fits those with severe alcohol and other drug (AOD) problems, White is embracing Alcoholics Anonymous’ stance that many individuals (those who are not “real alcoholics” but rather are lesser problem drinkers) may make adequate adjustments to resolve any problems caused by their drinking without a recovery program. Recovery, as defined by White, is a necessary process for those who are more severely addicted in every physical, psychological, and spiritual sense of the word.
Tapping External and Internal Resources
The wounds caused by addiction are suffered by more than the individual. Whole families and communities are harmed and require healing. Recovery involves more than no longer doing harm. Attending to healing harms done while actively addicted is an ongoing part of maraging the vulnerability to relapse by reducing the shame inherent in recognizing the damage one has done.
By calling on people in recovery to use both internal and external resources, White is referring to the fact that BOTH are needed. No one recovers by relying only on their own strength of will. An internal commitment to recovery is not sufficient. Internal commitment is necessary, but only effective when combined with help from outside, whether from others in recovery, professionals, or one’s own unique relationship with spiritual forces. Recovery requires breaking out of self-contained isolation in favor of dependence on support from other’s experience, hope, and caring.
By including the concept that recovery must be voluntary (i.e., not mandated by legal authorities or the result of reluctant compliance to the demands of family members), White is emphasizing that recovery involves a deep transformation of an individual’s attitudes, beliefs, and behavior. Resentments, blaming, excuses, and denial must be voluntarily ferreted out and relinquished to disrupt the psychological and spiritual soil in which addiction thrives and to prepare soil where recovery comes to fruition. The best model for how to foster this profound transformation is provided by the Twelve Steps that record the experience of early members of A.A.
My next blog posts will mine these steps for the psychological and spiritual gold contained in their often confusing and archaic language. Until then, I encourage anyone with more interest in William White’s magnificent definition of recovery to visit his essay referenced below.
[i] \\White, W. (2007) Addiction recovery: Its definition and conceptual boundaries. Journal of Substance Abuse Treatment, 33, 229-241. https://www.naadac.org/assets/2416/whitewl2007_addiction_recovery.pdf