Residential and Outpatient Handbook - Plymouth - 24

Residential Services
that alcoholics were just not motivated to change. Their
drinking meant more to them than anything else. " 2
Though society has become less prejudiced toward
substance use disorder, some people with substance
use disorder still think of themselves as moral lepers.
The inability to control our substance use, combined
with destructive using behaviors, justify self-beliefs that
we are bad, immoral and worthless. This self-criticism
significantly impairs our ability to abstain. If we do not
change our attitudes, we will be unable to admit and
accept our substance use disorder.
Stigma and denial
Denying one's substance use is an understandable
response when living in a culture that rejects and
stigmatizes people with substance use disorder. The
relationship between social stigma, substance use, and
denial is stated by Dr. Jon Weinberg in Why Do Alcoholics
Deny Their Problem?
" Alcoholics have historically been regarded as being evil,
morally and/or mentally inferior, and thus subject to
social punishments-disapproval, rejection, ostracism.
Who wants to be placed in the category " alcoholic " ?
Nobody! This is how cultural factors set the stage for
denial. " 3
Before the onset of our own substance use disorder,
many people with substance use disorder had rejected
others who had a substance use disorder. Imagine how
difficult it would be for us to admit our own substance
problem. Denial is common to those with a substance
use disorder, and it could be fatal because the inability to
admit a substance use disorder prevents recognizing our
need for help. If untreated, substance use disorder almost
always leads to a life of misery and premature death.
Breaking through denial is a vital first step in recovery;
most often, this can't be done without dealing with the
shame that perpetuates denial.
Admitting versus accepting
Admitting dependence and accepting dependence are
not the same. Many dependent people have admitted
a substance use disorder, only to experience a return
to use. " They haven't yet accepted their substance use
disorder, " is the common explanation by many AA
members. A lack of acceptance is a resistance to a total
commitment. An example of this would be a person
with high blood pressure neglecting or refusing to
take their medication despite their doctor's strong
recommendations. This irresponsible behavior might be
an unconscious resistance or a lack of accepting their
condition.
The Big Book, Alcoholics Anonymous,4 suggests that a
total commitment to recovery is of major importance.
In chapter 5, Bill W. describes the needed attitudes
to overcome substance use disorder. Phrases such as
" thoroughly followed our A.A.'s path . . . completely gave
themselves to this simple program . . . go to any length
. . . half measures availed us nothing, " 5
importance of total commitment to recovery.
all refer to the
Commitment to recovery is weakened by a lack of
acceptance. When we believe substance use makes us
inferior, we resist complete acceptance of our condition.
As a result, we often take unnecessary risks-such as
going to bars-or we only reluctantly participate in
recovery activities. The same stigma that causes denial
will also make us underestimate the seriousness of
our problem. We need to find ways we can overcome
this stigma and work toward full acceptance of our
dependence on substances.
No pain, no gain
People with substance use disorder usually go to great
lengths to avoid pain of any kind. Our use of substances
was largely an effort to anesthetize ourselves from the
discomforts of life. The willingness to experience pain
is essential in working toward acceptance of substance
use disorder. This is accomplished by changing our
attitudes about pain.
Pain has great value in the process of recovery. Just as
the physical pain of any open cut alerts us to take action
before it becomes infected, emotional pain alerts us to
take action to resolve an emotional issue. Imagine the
consequences of ignoring or denying all physical pain;
the unattended physical problems could make us very
sick or kill us. In the same way, denied emotional pain
permits unrestricted growth of psychological illness.
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