CLINICAL REFLECTIONS
Change, control, and compliance are terms often used in addiction treatment. So too are surrender, adherence, and recovery.
It is known that addiction is a struggle for control and relinquishing control is a critical step in the recovery journey. We are struggling to gain control over what happens to our minds and bodies when we use substances. We fight to be right, to continue to use, to end the pain of withdrawal, and to make life easier to bear. We fight long into allostasis, believing that we will one day reach homeostasis. We simply do not believe that we cannot feel euphoria one more time.
We fight like seasoned warriors for the right to use drugs and alcohol with abandon. This is the great surrender everyone talks about: laying down our weapons and admitting that we cannot control what happens when we use. That we are controlled by it.
The way clinicians work with patients during this phase is critical. When this work is not done respectfully and from a recovery-informed place, patients may either rebel or “submit” by making the motions to please others, without being fully invested. Either way, the result is more suffering—possibly even death.
Let’s face it: No one likes to recreate themselves, to admit when they are wrong, or to restart their lives. Yet, for those of us with substance use disorder (SUD), that is exactly what we are doing. We are admitting we were wrong, starting over, and creating a new identity for ourselves. That is hard work for anyone, whether they are struggling with substance use or something else.
In addiction treatment, the term compliance is often used by clinicians as a gauge for surrender into the change process. If we are “compliant,” we must be on the road to healing through conformity. Seeking “compliance” is a derogatory removal of patients’ freewill that sets them up to resist, as adults naturally seek autonomy and freewill. Inadvertently, clinicians may be setting patients up for…
Read the full article here