This paper will address the importance of the grieving process to sustaining addiction recovery. In order to accomplish this I will utilize several sources which discuss the grieving process, including Elizabeth Kubler-Ross's stages of grieving, J. William Worden's book called "Grief Counseling and Grief Therapy", and Robert Helgoe's book "The Hierarchy of Recovery". Additionally, some personal and professional experience will also be included.
There are three reasons that the grieving process is important to sustained, rewarding recovery. The first is many addicts have unresolved grief issues from their pasts. Perhaps the death of a relative or the dissolution of a close personal relationship has occurred. The use of drugs and alcohol hamper the grieving process, resulting in a delayed grief reaction. The loss is not grieved until the addictive use of drugs and alcohol has ceased and the feelings surrounding the loss are felt and processed.
A second reason that grieving is important to recovery is the result of the losses that occur due to addictive use. Many recovering addicts grieve time they have lost with family, time lost in or starting their careers, and possibly potentials or opportunities that were lost. Recovering addicts compare their progress in their lives to that of non-addicted peers, and they appear to fall short. Their peers have moved on in their careers, have had and raised families, and have many amenities that a person new to recovery may lack.
In order to discuss the third reason that the grieving process is essential to rewarding recovery I must first introduce a theory from Helgoe's book, "Hierarchy of Recovery". Helgoe divides recovery into two phases. The push phase is defined by the focus of motivation, which in this case is toward the crisis or events which led to treatment. More concisely, the recovering addict is staying clean to avoid the consequences they experienced due to active addiction. Their motivation is largely to avoid the life they were living, being pushed from an old life to a new.
In the pull phase the recovering person is drawn toward a more spiritual and fulfilling life. The focus of recovery is no longer avoidance of an old way of living, but attraction to a new way of being, and enjoyment of the rewards of recovery in the present. Furthermore, focus on continued self-discovery, and eventually self-expression are the focus.
Helgoe believes that in order to move into the pull phase of recovery, in which the rewards of recovery are found, a person must complete the grieving process for their addiction. Facing the fact that the use of a substance such as alcohol or drugs can never be relied upon again is a painful experience for any addict. The reality of living the rest of your life without drugs and alcohol is sometimes nearly impossible to fathom to those dependent upon them. When an addict gives up substances they are giving up a friend, a lover, and possibly the only relief they know. True acceptance of powerlessness over substances is a true loss. And according to Kubler-Ross, an authority on grief and grieving, we experience grief whenever we lose anything of importance.
As identified by Kubler-Ross, there are six stages of grieving. They are:
Shock: the inability to grasp the situation as it is presented. The information is too overwhelming to process. Usually lasts only a few minutes.
Denial: a belief that the news can not be correct, due to the pain associated with the loss.
Anger: diminishes the experience of the pain that comes with the loss. Can occur at person or thing lost, at God, or at self.
Bargaining: hope leads to bargaining, a defense mechanism that delays the pain of the loss temporarily, until the hope is extinguished.
Depression: works to dull the pain of the loss because it dulls nearly all experience, internal and external. (Hierarchy of Recovery, pgs 56-59)
According to Helgoe, "at this point people go in one of two directions: they either continue defending against the pain or they drop their defenses and experience the pain." If they choose to continue to defend against the pain and not experience it, they "may resort to previously used (defenses, denial, anger, bargaining) and enter into what can be termed extended or chronic grief, a life debilitating situation often misdiagnosed". (pg59-60)
Acceptance: the acceptance of the pain associated with the loss.
In the book "Grief Counseling and Grief Therapy" by J. William Worden, the grief process is divided into four tasks, all of which relate to the stages of grief previously mentioned. They are described in the following:
Task I- Accept the reality of the loss.
During this phase the denial of the loss, including denial regarding the meaning of the loss and/or the irreversibility of the loss are resolved. Relates to shock, denial, and bargaining.
Task II- Working through the pain.
During this phase the grieving work in relation to the pain is processed and resolved. Avoiding the pain prolongs the process, as does avoiding the anger. People avoid anger due to feeling guilty, such as being angry at deceased or at God. In relation to addiction, the recovering addict may be angry with God for making them an addict, angry with the disease of addiction, angry at themselves for being an addict, and angry at those who can drink or use socially. They may have pain related to not being able to use again, and the acceptance of powerlessness may hurt their image of self worth. Relates to anger and depression.
Task III- Adjustment to the environment.
During this phase the individual may need to re-identify him or herself and take on new roles.
Relates to the beginning of acceptance.
Task IV- Emotional relocation of the loss.
The emotional energy once tied to the loss is relocated. This is the final task, and as it relates to recovery the individual has now accepted the loss. Relates to the acceptance stage. This would lend itself to entering the pull stage of recovery, as identified by Helgoe.
There are an array of feelings that are considered normal in the grieving process. These include but are not limited to: sadness, anger, guilt and self reproach, anxiety, loneliness, fatigue, helplessness, shock, yearning, emancipation, relief, and numbness.
There are several complications that can occur during the grieving process. These include:
Delayed grief -the immediate emotional response is insufficient to the loss. (Grief Counseling and Grief Therapy)
Extended grief -emotional flatness, feelings of guilt.
Chronic grief -the continued use of defenses and not dealing with the pain associated with grief results in this. (Hierarchy of Recovery, pg65).