An addict who has tried to kick their habit for years finally makes their way into recovery. What could they possibly have to grieve about?
Actually, recovering addicts have a lot to grieve. The activity that has been the central focus of their lives is now something they can never do again. The only comfort they have known is gone, and their life requires a complete overhaul. That’s a lot to take in, especially at a time when they are least prepared in terms of ego strength and coping skills.
Will all the effort be worth it? Is sobriety a realistic goal? Filled with doubts but motivated by hope, the recovering addict may be disappointed to find that they may feel even worse for a while. Having to face emotions that have long been repressed and take stock of the losses brought on by their addiction, the recovering addict may be filled with grief, anger and bitter regrets.
Accounting for the Loss
Grief is a universal emotion that can arise any time a person loses someone or something they value. For many addicts, unresolved grief, loss or trauma contributed to the addiction, and those feelings get compounded in early recovery when the addict gives up drugs or alcohol and begins to see all that they’ve lost to their addiction. Here are a few examples of what the addict grieves in recovery:
- The drug itself, and the quick, easy sense of relaxation or euphoria it provided
- The old support system, often made up of other drug users
- Time spent seeking out and using drugs, which must be filled with healthier pursuits
- Rituals surrounding drug use (e.g., people, places and things)
- Divorce, separation or loss of a significant relationship
- Loss of job, housing, health or income
- Missed time with loved ones who have grown up, moved or passed away
- Being absent for important milestones in other people’s lives
- Loss of freedom, which is replaced by accountability
- Morals or values that were compromised in the pursuit of drugs
- Sense of self, which became defined by drug use
- Dreams and goals for the future
Stages of Grieving
Although grief is highly individualized, people experience similar patterns. The process of grieving was first laid out by Elizabeth Kubler-Ross, who identified five specific stages of grief:
- Denial – Denial is a defense mechanism that allows the addict to avoid taking responsibility for their behaviors and recognizing the consequences of their actions.
- Anger – Anger, whether at self, God or others, diverts attention away from the addiction and allows the addict to blame others for their problems. This defense mechanism temporarily delays the pain of the loss.
- Bargaining – In response to the gradual realization that they have a problem, the addict begs for another chance, makes excuses and promises that they will change. The addict isn’t truly ready to face reality or ask for help. Bargaining is an attempt to maintain the status quo without making any real change.
- Depression – Rather than try to divert attention away from the addiction, the addict begins to understand that their behaviors have hurt people and that they have lost control. This acknowledgement prompts feelings of sadness, shame and fear as the addict tries to contemplate a life without their primary coping mechanism (drugs or alcohol).
- Acceptance – The addict now sees that recovery is possible. They have a vision for how their life can be, and have begun putting the pieces in place (such as a sober support system, ongoing counseling and coping skills) to reach their goals.
Not everyone goes through all of these stages, nor do they move through each stage in a predictable pattern. But understanding that grief is a process and that others experience the same feelings can be powerful for people struggling in early recovery. When grief inevitably surfaces again, the individual can work through the pain and let the process unfold rather than self-medicating.
Accepting the Loss to Appreciate the Gain
When grieving, it is normal for people to be impaired in their daily functioning. They may feel lost, overwhelmed, forgetful, irritable, anxious, lonely or angry. Sleep and diet patterns may be irregular and the recovering addict may fantasize about returning to their old lifestyle. All of these symptoms typically pass with time and support. If they persist, the individual may need to see a mental health professional to determine if they are struggling with depression or other issues.
It has been said that grief is not about forgetting, but remembering with less pain. According to J. William Worden, professor of psychology at Harvard Medical School, people must complete the following “tasks of mourning” to grieve a loss:
- Accept the reality of the loss
- Work through the pain (rather than avoiding or medicating it)
- Adjust to the environment (i.e., adapt to a new normal)
- Relocate the emotional energy once tied to the loss
Grief can be exacerbated if guilt, shame and stigma cause the recovering addict to suppress their feelings rather than openly acknowledge them. Those who grieve the loss of their addiction position themselves to move forward in their recovery. Trying new activities and modes of self-expression (such as art or journaling), practicing self-care, using healthy coping strategies, setting goals for the future, and leaning on others for support are all signs of progress. These skills can be learned and practiced in drug rehab, support groups and therapy.
Those who deny, minimize or ignore their loss or put a time limit on the grieving process may remain angry, sad or resentful for extended periods of time, become emotionally numb, have difficulty with relationships, or continually struggle with relapse. They are also at greater risk for other addictive behaviors (e.g., compulsive sex, eating, gambling or relationships), depression and self-harm.
Even the best things in life have trade offs. Recovery doesn’t provide immediate relief or constant joy, especially in the early stages. It is a rewarding, though sometimes painful, journey that unfolds over a lifetime. Along with the blessing of a fresh start comes the loss of giving up drugs and alcohol – a sacrifice that is well worth the effort, but must be recognized as a sacrifice nevertheless.
About the author: David Sack, M.D.
Dr. David Sack is board certified in psychiatry, addiction psychiatry, and addiction medicine. As CMO of Elements Behavioral Health, he oversees a nationwide network of treatment centers including drug and alcohol rehab programs at The Ranch in Tennessee and The Right Step in Texas.