Recovery Choices

English: Choices, choices A network of paths a...

English: Choices, choices A network of paths and bridleways meets in the middle of Greathouse Wood, giving a choice of equally pleasant walks. (Photo credit: Wikipedia)

In the last post, I gave my burning building scenario of choice, which applies to lots of situations in life. All choices basically boil down to one of three kinds:

1) choices among possible good outcomes– do I want my pie with or without ice cream? Even if I pass on dessert, nothing bad will really happen;

2)  choices between good outcome or bad– do I want ice cream or a punch in the mouth? I won’t need to ask about flavors because whatever it is, I’ll take it. That’s the really clear choice I talked about before.

3) I can have all bad choices– there’s gangrene in my leg, and the longer I wait, the more of the leg I’ll lose. Amputate now, I save my knee. Wait, and I lose the knee. Wait longer, I die.  The choices are all bad, but one is better than the rest.

What’s interesting to me, having worked with so many people with addictive disease (or substance use disorders, if you will),  is that so many people see getting sober as a type (3) choice. This is the measure of the hold that addiction can have on a person. An outsider probably sees it as a type (2) choice– have a healthy life, free from DUI’s, drug busts, broken relationships, expensive problems, or get worse and worse until you lose everything. A choice between a good and a bad, right? The AA book puts it simply: “To be doomed to an alcoholic death or to live on a spiritual basis are not always easy alternatives to face.” (Alcoholics Anonymous, 4th ed. p. 44)

Considering how free-form AA is about what a person chooses for spirituality, and considering how many people are out there doing vision quests, meditation retreats, mindfulness practice, yoga, and so on, to say nothing of organized religious stuff, you’d think this is a type (2) choice: You can have any one of a number of flavors of ice cream, or be beaten, repeatedly,  with a big stick. But it’s a measure of the grip of addictive disease that people who are alcoholics or addicts see it as a type (3) choice. And it’s a measure of the insight of the original authors of the AA book that they understood it as such, as seen in the quote above. Stephanie Brown, in her ground breaking book Treating the Alcoholic, pointed out that the issue is a developmental one– the person has to change their identity completely, from “I’m someone who gets loaded” to “I’m someone who doesn’t get loaded.”  It’s true that people quit drinking without going to AA, and it’s also true that people get fit without joining a gym, people lose their depression without going to therapy, people lose weight and keep it off without joining Weight Watchers (or Overeaters Anonymous). It’s also true that you can get a refrigerator out of a third floor walkup apartment by yourself. But why do it the hard way– alone– when you don’t have to? Not many people get fit without a gym, not many people get the fridge out of the apartment without a friend, a dolly, and a pickup truck.  If you solve your problem without help, good for you. If not, there are various kinds of help– better to ask for help than to suffer (and in some cases die) all alone. this post is a lot longer than my usual, but that’s justhow it worked out. copyright James Matter 2013

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About jamesmatter

Marriage and Family Therapist (MFT) in private practice in San Francisco. I work with adults, adolescents, and couples, with focus on substance use and abuse and co-occurring disorders (having both a mental illness and an addiction).
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