To abstain means quite simply to not dosomething; whether that is not to drink alcohol, take heroin or other drugs, consume pornography on the internet or gamble. For addicted people, abstinence does not happen naturally and spontaneously due to some in-built, health-restoring mechanism. It requires a conscious decision: “I am not going to do this any more.”
The trouble with abstention is what follows, which goes a long way to explaining why addicted people find it so difficult to stick to their decision and relapse is so common. Because they will have built up a degree of tolerance, whereby they progressively require more and more of the mood-altering behaviour or substance to get the same effect, withdrawal kicks in when this is no longer available to them. With varying degrees of severity — depending on the form of the addiction — withdrawal symptoms are both physical and psychological. They are invariably unpleasant and in some cases, intensely so. The quickest way to get rid of them is to return to the addictive behaviour, even though that quickly restores the range of harms which may have prompted the choice of abstinence in the first place. Beyond the withdrawal symptoms lie the experiences and feelings that have both instigated and been “managed” by the addiction. While anxiety provoking, this also presents an opportunity.
There is an important psychological shift to make from the purely “not- doing” of abstinence to the “doing” something positively different of recovery. For one thing, “not- doing” on its own can seem rather boring; a relapse-risky state of mind. Others may see it as all that is needed to recover from addiction. But abstinence and recovery are not synonymous.
Given the challenge involved in giving up alcohol, drugs like cocaine, addictive behaviours like gambling or excessive sugar consumption, one can only admire addicted people who manage to abstain. The pride taken in the number of years to the day since giving up is understandable but it can also give the impression that they are not taking full advantage of the possibilities for self-development they themselves have created. They are still looking back, oriented to the not-doing of abstinence; to the stopping rather than the forward-looking creative work of recovery. Abstinence does bring immediate benefits in the reduction of harms but on its own, the benefits may well be limited.
In choosing abstinence as the basis for recovery from addiction, it may be wise to begin the process in the safety and security of a treatment or rehabilitation centre offering an integrative, holistic treatment where medical, psychotherapeutic and complementary expertise combine. Detoxification can be negotiated safely in reasonable comfort while the patient works with support to make sense of the feelings that emerge, creating in the process, a recovery personal to them.
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