Addiction, Recovery, and the Grieving Process (Part 1)
One of the less addressed issues in the public discussion of addiction and recovery is the concept of grief. The reality is, that for all involved in the life of an active addict, there will be trauma even as the recovery path leads to a favorable outcome. Here we focus this process as it can be experienced by the addict.
The process of grief generally follows a pattern first explained in the1970’s landmark book by Elizabeth Kubler-Ross On Death and Dying. Dr. Kubler-Ross was able to identify and differentiate the stages a person goes through when grieving a loss. Not everyone goes through every stage, nor do these stages follow a predictable pattern. Nevertheless, the feelings and situations that people go through in the recovery process can be aligned with these concepts. Grief is a process that takes time, support and self-acceptance to move beyond.
Stage One: Denial
The earliest stage of the grief process occurs when someone has not yet comprehended or been able to integrate the depth of the change in their lives. Denial is a safety mechanism that protects one from being overwhelmed by their feelings; it is a form of shock. Addicts utilize denial to avoid taking responsibility for their substance use or behavioral acting-out. They will not be able or willing to make the connection between the consequences of their addictions and the behaviors themselves.
Stage Two: Anger
The anger stage of grief exists as an attempt to avoid the true underlying addictive problem. Using anger, blaming, nagging and shaming, addicts and their loved ones project responsibility for the personal, family, financial, legal and other problems without identifying and acknowledging the addiction problem itself. The addict will conclude that it is the fault of a partner, job, children, etc. that causes them to use or act out. They will unconsciously but deliberately pick fights or create negative situations in order to justify their behavior.
Stage Three: Bargaining
In the bargaining stage of grief, the addict is coming to some realization that there is a problem, but to compensate they work hard to try to continue to avoid fully facing the reality of their circumstances. To bargain is to try to maintain control and continue to live without real change taking place. This is the time for “Just give me one more chance and I promise I will never…” kinds of statements. Not yet fully surrendered to the problem, the addict is attempting to hold on to control by making new excuses and promises, staving off the inevitable.
Stage Four: Depression
This stage marks the beginning of true surrender to the depth and meaning of the addiction. No longer assigning blame addicts begin to experience the sadness and fear of not knowing themselves as they thought they did. Addicts struggle to come to grips with the reality their history of addiction has cost them personally and to others. Unfamiliar with a life outside of their addiction the addict despairs of ever feeling comfortable or “in control” as they have known it.
Stage Five: Acceptance
This stage is inevitable provided that addicts stay in recovery and that partners begin to join the process. For the addict at this stage, they can now begin to see that there is a path laid out for their recovery which others have followed successfully. They can begin to entertain a new vision of how their life will be lived without being in relationship addictive substances/behaviors. New healthy recovery relationships and support have begun to replace isolation and lies. The addict has been sober long enough to begin to develop new ways of coping and managing their life circumstances, often utilizing hidden creativity and ingenuity formerly lost to their addiction.
Is it Grief or Depression?
Many signs of depression are similar to grief experiences except that these occur in a more severe and long-term form. Persistence of symptoms such as those listed below often indicate the need for additional professional counseling and possibly the use of anti-depressant medication.
- Inability to function in job or family roles
- Constant waking up or early morning awakening with ruminating thoughts, consistent loss of sleep
- Extreme fatigue or loss of energy
- Depressed mood
- Diminished concentration or confusion on a daily basis
- Strong feelings of hopelessness, panic — suicidal thoughts or plans
- Loss of interest in social activities, friends/family and or work
- Constant tearfulness, inability to feel emotionally stable
- Significant unintentional weight loss or gain (more than 5% of overall body weight in less than a month)Part 2 of this series will focus on the grieving process and life adjustment as experienced by the families, friends and other loved ones as they assist a recovering addict.Grief may or may not be death-related. It might be about loss of opportunity, loss of family, career, and/or lifestyle, or even the personal internal losses of dignity, self-respect, trust-worthiness, and integrity.