What are the varieties of recovery experience?

Because addiction touches upon so many dimensions of the human experience, recovery also manifests across these dimensions. That is to say, there are many dimensions to recovery, and, therefore, many varieties of the recovery experience. For example, recovery emerges at the level of behavior, emotion, and spirituality. Importantly, recovery at any one level may influence recovery at another level.

Behavioral changes

There are a variety of types of behavioral changes that can characterize recovery. In general, recovery can be conceptualized along a spectrum of behavioral changes, ranging from complete abstinence to moderate use to use of pharmacological interventions.

Abstinence 

Abstinence refers to the complete elimination of involvement with the substance or activity of addiction.

Moderation 

Moderation refers to a reduction, but not complete elimination, of involvement with the substance or activity of addiction.

Medication 

 Addiction-related changes in behavior may come about through the use of certain types of medication (e.g., buprenorphine, naltrexone, Acamprosate), which are typically used to treat the experience of craving that commonly leads to addictive involvement with a substance or activity.

Emotional changes

As with the behavioral changes observed above, there are also a variety of types of emotional changes that can characterize recovery, and many of these emotional changes coincide with the changes in behavior. For example, the earliest phases of abstinence are known to be accompanied by intense negative feelings, both bodily and emotionally, which tend to characterize the experience of withdrawal. At the emotional level, withdrawal can consist of increased anxiety, depression, irritability, restlessness, and anhedonia (the inability to experience pleasure). These experiences can last for quite a while, but typically subside after a few months of abstinence. Once these intense negative feelings pass, there may be a transition into what is commonly referred to as the “pink cloud” phase, which describes a shift in baseline feelings, where one’s outlook on life or on recovery is viewed through “rose colored glasses.”

Emotional sobriety 

Originally proposed in an essay written by Bill Wilson several years after the founding of Alcoholics Anonymous, the concept of emotional sobriety refers to a state of dynamic equilibrium with respect to the valence and intensity of affective experiences. In other words, emotional sobriety is a type of experience that is characterized by balance and stability at the emotional level, particularly in the context of recovery. Whereas short-term abstinence (less than five years) tends to be marked by negative feelings, including emotional instability and imbalance, research (and experience) has shown that long-term abstinence (greater than five years) is generally characterized by relatively normal emotional experiences. Research has also revealed that active involvement in the various elements of mutual-help organizations (e.g., AA) tends to enhance and sustain these emotional changes. While a great deal of such emotional balance probably coincides with the predictability of life in the absence of the addiction, there is emerging evidence that the experience of emotional sobriety also has underlying neuronal correlates.

Spiritual changes

There are also a variety of spiritual changes that emerge in the context of recovery. Before we can consider what these changes consist of, it’s necessary to clarify what is meant by use of the term “spiritual.” Spirituality refers to the experience and interpretation of ultimate meaning. A spiritual change, therefore, can be understood as a transformation of one’s meta-meaning system. Importantly, the concept of spirituality does not necessarily equate to supernaturalism – the dualistic worldview that reality is bifurcated and consists of both natural and super-natural entities. There are numerous ways of maintaining a materialist (non-dual) orientation toward ultimate reality, while simultaneously acknowledging the existence of realities that are not entirely reducible to their physical substrates.

Spiritual awakening 

One type of spiritual change that gets a lot of attention in the context of recovery is that of a “spiritual awakening.” A spiritual awakening refers to an expansion of consciousness, that is, a fundamental re-interpretation of the meaning and significance of one’s existence. These experiences are commonly reported to be both cause and consequence of the recovery process. For example, the Twelve-Step model of recovery suggests that such an experience is the result of working through the Twelve Steps. Step Twelve reads: “Having had a spiritual awakening as the result of these [preceding eleven] steps . . .” It should be noted that AA literature does not represent these spiritual experiences in supernatural or dualistic terms. Rather, it describes them in more-or-less psychological terms, particularly through reference to a description provided by the psychiatrist, Carl Jung, as a process whereby ‘the ideas, emotions, and attitudes that were once the guiding force [of life]. . . are suddenly cast to one side in favor of a new set of conceptions and motives.’ Elsewhere, the Big Book’s author describes these experiences as a “personality change sufficient to bring about recovery from alcoholism.”