A couple weekends ago, I flew out to San Francisco for the American Psychological Association’s annual continuing education conference. I was working as a student volunteer, where I had to monitor a full-day workshop on ethical research methods. I must say, it wasn’t exactly my cup of tea, but part of my “repayment” for volunteering was free admission to the conference and free enrollment in another session of my choice.
For my free session, I chose a session about the trans-diagnostic model for improving outcomes in therapy. That probably sounds like gibberish, I know. In essence, the presenters gave a talk on 10 different ways to re-assess your work with therapy clients, in order to learn if therapy is working, and if it’s not, then why.
I really enjoyed this session, for a couple of reasons:
- As a student and intern, I am hungry for answers about how to make sure what I’m doing is working,
- As a person and therapy client myself, it made me step back and think about my own approach to progress and healing through therapy
One of the things that I really found interesting was a question the presenters kept posing to us:
What are the hidden costs of healing?
I feel like this is a question that is at the forefront of a lot of people’s minds when they choose to get sober. Maybe they don’t ask themselves in that specific way, or maybe it’s not even a conscious question, but the idea is still the same:
When I get sober (or: address my depression, leave this toxic relationship, learn to be more assertive, etc.), even if a lot of good things happen, there will still be “costs” that I’ll have to pay as part of my healing.
In sobriety, the cost we hear about often (and the one I, myself, have had to pay) has been the painful realization and reconciliation of past wrongdoings, failures, and embarrassments caused by our drinking/use. This is where we realize we’re going to have to sit with ourselves and come to terms with what our drinking has done to our lives—or, what we’ve done to our lives as a result of our drinking. This might be as common as embarrassment about drunk phone calls at 1am, or as serious as legal problems or irrevocably damaged relationships.
As we get sober and start down the path of recovery, we grow and often transform into a person we thought we’d never be, and as we grow we carry with us our most painful reminders of where we’ve been.
There are other costs to healing, too.
In gaining sobriety, we pay with the loss of our most trustworthy (if not toxic and dangerous) coping mechanism.
In gaining sobriety, we pay with the loss of friendships or other relationships that are no longer viable or healthy once our addiction is removed from the picture.
In gaining sobriety, we pay with a greater responsibility over ourselves and our actions: suddenly, we’re pulled to not only make amends for past wrongs, but to act according to our morals and values, and the morals and values of the people around us.
In gaining sobriety, we pay with the loss of stagnation. We’re pushed to keep pushing forward.
In gaining sobriety, we pay with the need for more accountability.
In gaining sobriety, we pay with greater expectations placed upon ourselves, and even more, we suddenly have greater expectations of the people who we surround ourselves with.
In gaining sobriety, we pay with the loss of complacency, indecision, and our most comforting of creature comforts.
In gaining sobriety, we pay with the loss of a part of our identity: the “me” that sustained itself on the addiction we were feeding it with.
Most of these losses are good. They benefit us. They are the necessary losses of healing and getting sober.
But they’re painful. They take time to adjust to. I mean, they’re losses, are they not? They are losses of relationships, loss of trust in a certain way of being, and loss of identities. It only makes sense that we would need to take time to grieve what we lose when we choose to heal. It’s no wonder the idea is so scary when we first get started—or that it remains scary or uncomfortable through the first bumpy months of recovery.
It reminds me of work I did with a client last semester. This person was a lifelong sufferer of Major Depressive Disorder, and on top of that, she had a pretty severe Alcohol Use Disorder with some accompanying neurological damage, as well. Every session with her, I could feel the depression in the room like a fog. Even when she was smiling and laughing, the depression seemed to tighten itself around her—it made her smile more constrained and timid.
I asked her one day, plainly: what would happen if you woke up tomorrow and you were no longer depressed?
It’s a common therapy question but one that often gets people with these types of issues to really stop and think.
After a few moments, she replied: I would have so many things that I’d finally need to take care of. So many loose ends to tie up, and responsibilities. I would finally have to take control and do all these things I’ve been needing to do forever. There would be a lot of pressure on me to get things done.
This woman understood and fully grasped the hold the depression and alcohol had on her life. I could tell that her drive to survive brought her into treatment, and that beneath the layers of self-doubt and fear, she truly did want to heal. She wanted to be able to experience a life without depression—or, at least, a life with less depression. But at the same time, she had a big and intimidating idea of what would happen if those thing were to go away. Her depression was holding her back in so many ways, and while she was able to envision a brighter life without it, she was also very cognizant of all the responsibilities and expectations that would be laid out in front of her were she to ever get better. As she once described it, her depression was like a blanket; it was starting to choke her, but at the same time, it kept her warm and protected from the rest of the world.
Addiction, like depression, is a tricky and deceitful beast. It depends on its ability to fool us in order to survive. It wants us to believe that we cannot afford the cost of getting better. It tells use that therapy doesn’t work, medications are useless, nobody will support us, and that nothing will ever change, so why should we? Anyway, it may not be pleasant here, but at least it’s comfortable in its own messed up way.
I’m here both as a therapist AND as a sober person to call bullshit.
Healing and growth is the most affordable investment we can make in ourselves in this life we’re given. Addiction and mental illness will try to get in the way, but I choose to believe that the spirit has a will to survive and thrive despite the shit circumstances any of us are dealt. We have to reach out and admit we need help—and on the flip side, we have to be more willing to reach out to others who are struggling and offer them our support.
Healing is affordable, whatever the cost may be. I know that I, myself, can handle grief and loss and greater responsibility now that I’m sober. Addiction will keep taking and taking ’til there’s nothing left to give: pockets are empty, and the bank account has dried up.
I know which one I’m sticking with.