People enter a drug rehab for all sorts of strange reasons. Some come in for an all expenses paid vacation. Others need some time out from their addiction because the drugs lose their edge and the lifestyle has become repetitive. Meanwhile, some come into rehab as a manipulative ploy to wiggle out of a tight corner. Perhaps their partner has threatened divorce, or they’re on the brink of losing their job. Rehab may be the alternative to a prison sentence, or simply as evidence to a third party that they are serious about stopping. Going into rehab is often the ultimate manipulative ploy. 

Resistance

Very few people actually come into rehab with the genuine intention of terminating drug or alcohol use. This often results in an early clash between the client and the facility when the clients realises what they have let themselves in for. Consequently, this is the first line of resistance in the treatment process. Resistance to treatment will manifest as trivial complaints about the food, the nursing, the accommodation, the environment or the weather. It is therefore imperative that the staff of an addiction treatment facility are well trained and dedicated to helping their clients through this difficult phase.

Compliance

After working through the resistance phase, the journey has only just begun. Clients must then grapple with the reality of the work and effort required to achieve a stable sobriety becomes evident. To this end, patients must attend lectures, participate in group therapy and engage one-to-one with their counsellors.

For many addicts, this is a new and very unfamiliar terrain. It requires a degree of honest disclosure about shameful behaviour. Such honesty does not come easily to addicts who have become skilled at manipulation, blame and deception in order to survive. Addiction prefers to keep the shameful stuff secret. An addict in this phase finds themselves presented with a choice. Do I move forwards, through full disclosure and engaging with the process? Or do I retreat back into the shame of my addiction. 

Those who soldier on often become compliant and hope no one will notice. The initial overt resistance morphs into compliance and treatment becomes a covert war of attrition.

Surrender

The final hurdle comes towards the end of treatment, when the programme implicitly expects the client to commit to sobriety and recovery. In reality, surrendering to a lifestyle without substances is extremely difficult after a lifetime of fighting an addiction. At this stage of the process, talk – in the form of promises, resolutions and agreements – is cheap. What determines the difference between compliance and surrender and adds credibility to the “talk” is a sacrifice. Something of value has to be given up.

Sacrifice invests value into sobriety and thereby makes it a precious commodity. Without it, recovery is often squandered and sobriety lost, despite the best intentions.

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