One of the first things I teach clinicians who want to support recovery from Substance Use Disorder (SUD) is how to accept and cope with powerlessness. This is a deeply spiritual lesson. Powerlessness is neither hopelessness nor helplessness. Powerlessness is the inability to control people, places, and things. That means that outcomes for those we care about will always be outside of our control.

One of the most painful forms of powerlessness is that sometimes people we care deeply about will self-sabotage, self-abuse, and/or return to using drugs and alcohol. Addiction is a matter of life and death. Recovery is a process of building a life so good you’d never want to risk losing it.

Not everyone gets a chance to recover and even in recovery, some of us find it impossible to live.

Addiction is the first demon

Amongst those who do escape the perils of addiction, other demons remain. Rarely have I met a person in recovery from SUD who did not have a great deal of repressed trauma, a wealth of unresolved grief and loss, and underlying mental illness. If we did not have those prior to developing an SUD, the places active use took us to created them.

Most of us used drugs and alcohol to numb pain. As my friends in AA say, “The good thing about being sober is that you feel more and the bad thing about being sober is that you feel more.” Many of us despair that getting sober left us feeling worse. I say the key to that is that it left us far more aware of what we feel, think, and remember.

My friend Ardis taught me, “Getting sober doesn’t necessarily make anything better. It keeps things (within our control) from getting worse.” It’s a vital starting point and it creates possibilities. We get to choose which to follow through on. My greatest hope for people in early recovery is that they build an effective support system of people who truly understand their disease.

I have a great love for 12-step programs and the fellowship they provide. The literature of these programs refers to the need for “outside help” from professionals of various kinds. I have had that honor for many years in facilitating recovery from trauma and mental illness.

My experience is that too many of us continue to carry shame and pain from our childhoods. We continue to hold secrets and live in fear that the past will repeat itself. This holds true even when we change our lives completely. The fears that trauma creates and perpetuates are often irrational and they undermine any chance we have for experiencing inner peace.

The intersection of trauma and SUD

Intrusive thoughts, memories, and flashbacks plague our days. Nightmares, night terrors, and sleep paralysis haunt our nights. These are most often part of living with PTSD. To resolve and gradually break free of trauma is to fortify our recovery. To grieve our losses is to elevate our healing.

These investments transcend what we think of as “relapse prevention.” To not drink or drug is the most important decision we make and maintaining this must come above all else. The life we build upon this choice is a matter of which investments we’re willing to make in our mental health and in our spiritual growth.

Make no mistake: Trauma recovery is a painful process. It is also incredibly liberating. There is no way to release pain in a manner that doesn’t hurt. There’s no way to let go of anger without being angry and there’s no way to overcome fear without being afraid. My hope for everyone in recovery from SUD is that we choose ongoing investments in self to guard against complacency and stagnation. By seeking ongoing, manageable, and sustainable growth and healing, we ensure that we will thrive and remain available to our loved ones.