Why Treatment Alone Doesn’t Work (And What Actually Helps Recovery Stick)

Hey, Kim and I see so many clients who are so focused on getting their loved one into treatment, which is a great goal. It's a great goal if the person needs treatment. Unfortunately, what we see is that that is the goal. And once that goal is achieved, check, that's all done. And that's their primary focus. That's their single focus, to be honest. And what we see is that that's a great focus, But one that needs to be looked at through a different lens, and that there needs to be something beyond treatment because of brain recovery, which we'll talk about in just a second. But there needs to be a different lens, more of a timeline and a strategy and a process that's going to keep the person from treatment ultimately to sobriety, because sobriety is the goal, not treatment. And I think sometimes people get really confused that the goal is treatment. And so today what we want to talk about is The goal of sobriety and how to get a plan for that instead of focusing primarily and only on the on the goal of getting our loved one into treatment. Treatment is a great first step, but really we need to look at the next steps. So we think those are the most important steps. That's why we want to talk about them. Our definition for treatment in this video is either detox three to ten days of medical detox and and then thirty. 60, whatever days of 4th level care treatment where we go away to a facility. All right. So beyond that, we're looking at 30 days, 30 to 45 days, we have beginning of brain recovery. So you can hear the detox in a 30-day treatment stay. And then we bring our loved one home. There's no brain recovery. So that's why there's a problem. I want to look at this today from really like a metaphor. And some of you, most of you are probably not nearly as old as I am, but I remember when the lunar module landed on the moon, and Neil Armstrong took those first famous steps. And the lunar module, if you guys remember, kind of looked like my glass. And it came down and it got closer and closer and closer in this hushed environment. And as it got closer, it began to put out legs, and they came down and out and down. And it didn't just put out one leg, because then the lunar module would have come down like this. To me, that's what happens after detox. One leg. It didn't come down on two because then it would be wobbly, which would be thirty days of treatment. It didn't come down on three. It came down on like twelve, and each of these legs came down and then found its own unique depth on the surface of the moon because we'd never been there and we didn't know if it was cratered or dusty or what exactly. So each leg very slowly found its footing. And it found solidarity, and the module was able to land safely, securely, and the rest is history. To me, this metaphor is particularly appropriate for recovery, and we need to build as many of these legs, or what Kim and I would call scaffolding aspects, to ensure that our loved ones not only get the treatment that they need, but they also have the the environment, the procedures in place, the things in place that will keep them firmly landed on the land of sobriety. So today what we wanna talk about is what does that look like? What are those things? What is scaffolding? What does that look like? And, and not that there's one way, but what are some of those many ways? And we wanna talk about it from 2 levels because there are 2 levels. One is young adults. who are going to go to treatment and then not come home. And the other is established adults. So Kim, let's talk first about the first, the first young adults or young kids, young people.

Yeah. Young kids, we strongly recommend that they go.

And let's qualify that for 17, 17 and up. Because before that, that's a different category.

And that's a really hard treatment to even get into.

That's a tough, that's hard to scaffold.

Um, but 17, 17, and I would say there's not really an age as far as what would cut off a young adult versus an established adult, but I would say it's what their life looks like. So if they're married, if they have a career established in the city that they live in, if they have children in the city that they live in, I would say those would be qualifiers that would kind of put them more into the, the adult, older adult status, because in all the things I said, it would be really hard and possibly devastating to create a life outside of outside of their town that they live in. So for young adults, we want them to go somewhere else and get sober and then eventually get into recovery because that's— it's easier to stay in recovery versus coming home and not having any of the social support as a young person and be able to maintain sobriety. And because they know how to get high at home, they know how to get drunk at home, they know how to be sick at home, but they don't know how to be— they don't know how to be well at home. And so when we're looking at a young person, it would be we want them to be able to get Serotonin and oxytocin, and this is true for older adults as well. So the serotonin is going to be our pride chemical; it's going to be our content chemical; it's going to be that I like who I am and I like my life chemical. The other one is oxytocin, which is going to be our love chemical. I'm bonded to myself, to my loved ones, to my life, to a system above me. I'm bonded to something much bigger and greater than me, and I get oxytocin when I contribute or I feel that bond. And so when we look at young people, though, part of the mistakes that we see is they don't have enough financial skin in their own game. So we need. to make sure that part of that scaffolding is that they have financial responsibility and they get serotonin from that. They also may get a little bit of oxytocin depending on what they're living in there, what that serotonin is attached to. We also want to make sure that they have a good sense of independence so that they feel proud of their life. They feel like they have a sense of autonomy. Anything else you want to add on that piece, Kim?

I think that's really important for the disease of addiction to understand is that when we bring them home and they don't have anything Kim just talked about, they don't have any financial skin in the game, they don't have any autonomy, it is super easy for that addiction to say, why not? And get its little foot back in the door because it can. When they emerge from sober living or whatever level of treatment they're going to as financially independent and autonomous, as far as living and taking care of myself, it's much harder for the disease to get its foot in the door because the answer that the person would say is, yeah, that might be great, but I can't pay my rent, or I can't make my car payment, or I'll be kicked out of sober living, or my roommates will leave me, or whatever those things are that keeps sort of this— I would say maybe hurdles instead of the brake system, but it keeps hurdles for the disease to have to jump over that it usually doesn't jump over if there are enough of them.

Right. And so with the older adults though, it's different because just like I said before, for people that are married, they have their careers, their children are in the town, it doesn't make sense for them to go to a different city, a different town, get sober and stay there. They're not going to get serotonin. They're not going to get oxytocin. And it's just illogical. And so for the older adults, we want them to be able to go to detox, go to treatment that might be closer to home, and they might do better if it's closer to home so that their family has more involvement so that they're, you know, that it does, it doesn't feel so devastating for them. It may have to be far away just depending on what's, what's available and what kind of treatment you're looking for. But when they get home, and this is the part that's important for older adults, is there needs to be some form of accountability built in. And this built-in accountability, really, it's best if it's established while they're at treatment. That could be drug testing, that could be a Soberlink or some form of a sober device, that could be a, hey, you need, after you come back from treatment, you need to be in this, you know, 3/4 house, and this is how our family's gonna reestablish contact. But there needs to be some form of plan that the person that's struggling with addiction, that they are held accountable to. And if there's a slip, if there's, you know, something that happens, then the family can deal with it in that moment. But one of the biggest mistakes that I see, and I'm assuming you see it too, Campbell, is the let's look the other way because it's just once or it just happened, or I don't want to accuse them of doing something, so I'm afraid to do a drug test, or I'm afraid to put a Soberlink on the table since we didn't have it established. So I think it's important to really get this plan, a good plan before they come home. And if you miss it or you didn't think of something and later on you're like, oh man, I should have done that, it's not too late. Just push it in, be able to, be able to really kind of allow yourself to make changes as necessary.

I fully agree with that. But I think what you've said is super important, which is get it in place. And I think this is where people get stuck. Well, I got them to treatment. Now I'm afraid to rock the boat. And we say rock the boat early, as in if it's a 30-day program, tell them after the week of week 1, work with their counselor, whoever you can get to, and just say, hey, coming home is not an option. Or this is what I'm envisioning your return home into the returning back to our home would look like, or even back to our city. And go ahead and get that plan out of your mouth into their ears so that the treatment center and the counselor have plenty of time to sell that and put it in place. What happens so often, so sadly, often is that everyone agrees to all this, but we don't put it in place. And then the person comes home and they're first like, oh, I just want a couple days. I wanna sleep in my own bed and I just wanna have some really good food. That makes wonderful sense. But this is not a college kid coming home for the first time for Christmas break because what the disease will say is, well, we've been home for 3 days and we haven't even thought about using. So do we really need to go to an AA meeting? Do I really need to set up the sober link? Like, I feel like I've got this and I just wanna get back to normal. I just wanna get back to my Regular life. I don't want to have to live within this the confines of recovery or sobriety. That's the mistake. That sober link should be activated and being used prior to leaving treatment. They should already have had an appointment with the counselor set up, and hopefully a Zoom session already under their belt. Have gone on to some Zoom AA meetings or NA meetings or Celebrate Recovery or whatever they're going to participate in. Get these things in place so that when they come home, it's a much more seamless. Addiction loves change. And so when we come home as an established adult, the addiction's gonna try to get its fingers in because remember, this is like, remember, addiction is an entity and it's pretty quiet in treatment because it really doesn't have anything it can talk about. So everyone's like, oh, I've got this. Like, I feel confident. I've changed. I've got this. I'm good. But then we get home and the opportunities begin to exist and the addiction gets louder and louder and louder, like the song in Animal House, until everyone is dancing. And by everyone, I mean all those neuroreceptors, and then we're right back into it. So I think it's really important to remember addiction's not gonna play fair, you guys. It just doesn't play fair. So don't be afraid to play fair with your voice, with your requirements, with your demands, with the knowledge that you've gained from talking to counselors or reading or Zooming or YouTubing or whatever your source of information is. You hear good information. Use it. Say it. Hold it. This is where you this is where you got to get some boundaries and and and just hold them. I think I think this topic of it's strategic. It's a timeline. It's a process. And if you buy into that, fully buy into that, then all that we're talking about today and and what's gonna need to come from your lips, which is. I'm not comfortable with that. This is what I'm looking at. I'm sorry. This is what I'm going to need for you to come back to the house. Those things, then, then they're in place and you're much more likelihood of getting your lunar module firmly onto the land of recovery. Recovery is the goal, y'all. Recovery is the goal, not, not treatment. And just try to remember that because I think that's where we lose a lot of people is like, first of all, they don't, they get their person, a loved one, their loved one into treatment, and then they don't even We don't see them again until the relapse. And then they're like, well, right.

The other thing I want to add on to that is even if let's say that they never use and you're administering these drug tests and they're, and they're clean with bouncing off of what Campbell said with addiction being an entity, when that entity knows that there isn't an accountability process in place, it's quieter because it doesn't say, oh, I could just stop off at QT and, you know, do a little something there. They're not going to know, or I'll be sober enough by the time my loved one gets home. There, when we have these accountability processes in place, it really helps the addiction be quiet, quieter. It also helps the person that's struggling with newly being sober at home. It helps them just ease into this is what sobriety looks like because it takes the option off the table quicker than if that accountability process is not set in place. So even though it may sound rigid, it may sound like you're being a parole officer, It really is a very kind thing that you can do for the person that you love and for yourself.

Right. All right. So let's see if— let's answer some questions now. What does qualifier mean, Kim?

Qualifier is anything that is going to put you in the category that we're talking about. So a qualifier for someone that's going to have insulin treatment would be diabetes. The qualifier for someone that might be on a stimulant would be a diagnosis of ADHD. So a qualifier is going to be anything that puts you in the category of the topic that's being discussed. So with addiction, a qualifier could be using in spite of bad things happening. It could be crime, you know, it could be multiple DUIs, which would go into the first qualifier that I said. It could be a, I'm obsessed with either obtaining my drug, keeping my drug available, or recovering from using my drug. All of those be examples of qualifiers for addiction.

Yeah. All right. When my husband got sober 2 years ago, we could not find a hospital that did detox. Is that a thing of the past? No, it's not a thing of the past. It's a thing of the past in that only it's harder to get into because insurance only covers it if there's benzodiazepines involved, which could be alcohol or Klonopin or Xanax, anything in that family. And so it's harder to get your person in because you More often have to pay out of pocket, but there's lots and lots of detox centers. Lots. Hi, if 30-day inpatient treatment just isn't an option, what would the closest best replacement be? My husband is fearful he'll get into trouble at work if he has to miss a month.

Well, that's the addiction talking right there because, and it might be legit that that might also have. some truth to it. But I think even if we speak to the truth, what are we going to give up if we don't get into treatment? Because eventually he's going to lose that job. If the, you know, addiction ends in 3 ways: it ends in institutions, death, or recovery. And so it may take a while until that job is jeopardized, but ultimately when we're looking at either treatment, if that is the option, that is, that's the level of care that's needed, if we put a job before that, we're really just kicking the can down the road because it's only a matter of time until that, until the addiction is probably going to come after that job.

But that being said, since this is the situation, doesn't want to go, doesn't want to lose his job, let's meet them where they are on that, which would be, you could do an IOP in the evenings, which would, you could still keep his job. He could go to AA or NA meetings, depending on what would be applicable. He could get a sponsor, he could get an addiction counselor, he could go to Celebrate Recovery, any of those things. And if he does that determinedly, he could agree to drug testing. He could agree to a sober link, whatever. Again, I don't know the situation, but if you put enough of that scaffolding in, it could be successful, but it also could be successful in a different way, which would be all that would fail. And he would realize, I'm going to lose my job anyway, kind of what we— Kim just said, and I'm going to have to go ahead and agree to go and then come back and use all these scaffolding things as aftercare. If those things were really strong enough unilaterally, then there wouldn't be such a thing as a treatment. So we, our opinion is that those things are fabulous post-treatment. Once you get some brain recovery coming in and some sort of awareness of the situation, those things can keep you sober. It's difficult to get sober with just those things. Not impossible, difficult.

But they can, to kind of piggyback on what Campbell said, they can work as wonderful ways for the person to realize how sick they are and to meet them where they might be if this is a bargaining tool to kind of help move them through this bargaining stage faster.

And, you know, I can remember when we ran an IOP, which is an intensive outpatient program back in the day, Kim and Amber and I did. And it was in the evening. And then we met with spouses, partners, and parents who were like, we just want them in IOP. And we could say, this is not the right level of care. This is not going to stop the disease. This is not— and ours was super expensive. We'd say, you're wasting your money. And they'd say, I want him to do IOP. So a lot of times the family also needs to benefit from the fact that this level of care is not sufficient, whether it's for an adult or a younger person. So don't be afraid to try a lower level of care if that's what your heart is like, oh God, I can't do without him for 30 days because I need help with the children. Or he's saying, I don't want to get fired. Then you could try the low level of care. I just don't want you to naively believe wholeheartedly. Whoo! That's done like I did. Like I'm that fool. So like I get it, guys. But I want you to just if you need to try it, try it. But just be aware that this may not be the final resting place. My 30-year-old son has been sober for seven weeks. He lives with his dad. When would be reasonable for him to get a job? Now, now, before we— so you can't just walk into a room and say you have to get a job. 2 things: you have to create a need for the job. So you either need to be contributing financially to live here, you're responsible for your gas, your car insurance, whatever. You have to create a need. And then you have to deliver this news with a fair and feasible plan, which is Like it's December 18th, so you could say by January 15th, we expect you to take over these financial responsibilities. That gives them a month to find a job and have a paycheck in hand. So you can't just walk in and say, oh, BTW, starting tomorrow you have to pay rent. So think that through. But absolutely, now I would have said if you were coming into my home, in the next 30 days we'll expect $1,000 a month for you to live in our home. So now, my alcoholic wife was sober for five weeks, had a two-week relapse, and is now ten days sober. She's an introvert and won't ask for outside help, AA, or a sponsor. She says she doesn't have cravings now. What support options are available? Oh yeah, she's extremely stubborn too. For you, there's a guest room at Kim's house that you might want to come live. Um, I don't know, Kim, what do you think on that one?

I think all the things we've said before as far as, you know, IOP, PHP, and, and I do think that that's addiction talking as far as I'm an introvert. And there, I've ran plenty of groups. Campbell's ran plenty of groups. Introverts do really well in group once they get comfortable. You know, an introvert, just kind of think of them as they're, they're slower to warm up. They're going to share less. They're more particular about what they share, who they share it with, and when they share, but they're still people. So they, they benefit from group, and once they're connected in a group, they're generally pretty invested and they can get a lot out of it. So as far as the, I'm an introvert and that's not going to work for me, that, that's a cop-out. So I think as far as what options are available, all the options that we've listed, but mostly whatever options she's willing to do. Which it sounds like not many right now based on what you're saying, which is where my brain is thinking that might be addiction talking.

Yeah, I think it's addiction. Y'all, Kim and I are introverts and we do fine on— well, we do okay on this, but we do fine in groups. We do fine in the office. We do fine. It's where you put your energy. She's not going to have as much energy as an extrovert. She's probably not going to be signing up to make the coffee at AA on day 1, but there are millions of introverts who are sober. I just think I think she's in the bargaining process. I think she had the relapse and now has 10 days, and she's like, I don't need it, and I'm not comfortable with it. My guess is you're probably looking at another potential relapse, and maybe at that point you'll be able to say, hey, for you to live here, I need you to be doing these things, and, and go into that— those boundaries that you can set up. If not, then you probably should sign up for the Beyond Boundaries course so that you can figure out how to be comfortable with not holding boundaries while you lived with someone struggling with addiction.

Or holding whatever boundaries you can hold, because sometimes the boundaries can be an internal boundary. Right.

Good point. Oh, is that it? No more questions? All right, we have 8 more minutes. So let's think for a second. Is there anything else, Kim, that we can touch on, um, for the people watching this? Um, For the— for what they can do for themselves.

I think kind of piggybacking off of the last question that we got, I want, I want you guys— a very common thing is to see the families work really, really, really hard to offer support or to find the next solution. And that, that is great in so many ways. And I want all of you guys to be prepared and ready and have lots of options in your back pocket. So when the time comes, you know what card to play. And I want you to also recognize that when you're dealing with someone that's being stubborn because they're letting the addiction grow and that entity is just silently growing and growing and they're prepping for a relapse, I want you to be able to distinguish between the difference because the more you're trying to push and support when someone else is saying, no, I'm rejecting, I'm rejecting, you actually might be doing more harm than good. And so it's a, it's a really difficult line to, to find. But I do want you guys to be aware that there is a line. And so I want you to kind of develop your awareness around the fact that that line exists. And what does it look like in your own home?

Yeah, I agree. So, 2 more questions. Our live schedule for the next 2 weeks is there won't be one. Thursday is a major holiday for both of the weeks. So there we just, we won't, we'll be back on January. 8th, which is the Thursday following the New Year's holiday. There's also a comment in here about, um, the point of view that addiction is not a disease, that it's a criminal offense that people have control of. We don't believe in that at all. We believe it's a disease. We believe the brain is organically altered. Does it lead to criminal offenses? Absolutely. Because the brain is constantly trying to rationalize and justify anything and everything it has to in order to get whatever it is it needs. Money. I don't, I don't know what's going on, but, but yes, we believe it's a disease, not just a criminal. Um, how to bring to the surface my father is an enabler by silence over decades of drinking in my mother. He doesn't like to talk about her inappropriately and believes her not being violent and paying bills is good enough. You know, it's really difficult, you guys, to talk a spouse or anyone who doesn't want to believe that there's a problem into there being a problem. The only thing you can do is, in going back to what Kim just said, is stop pointing it out and let them see it for themselves, and/or put boundaries around your interaction with it so that you're, you're solid. But we see this all the time. Husbands just, or wives sometimes, but mostly husbands. Really, I have 2 clients like this right now. As long as like the mom's not causing that much trouble, she still goes to work, she still like makes lasagna once a month, so is it really that bad? My own dad was like that with my mom, so I get that. Um, there's really not much you can do about— just set boundaries for yourself about how you'll protect your heart. Your time, your emotions, yourself as it needs to be. She doesn't want her mom to hurt herself or lose memory, and they did nothing. I think you can try to have heart-to-heart conversations with her when she's sober and just express that. But until until something major shifts, as in either she says I need help and your father hears her, or something. That you don't want to happen happens and your father says, oh wow, I totally missed this, like, we do have a problem. It's— I just don't want you to damage your relationship with your dad by harping on this or focusing on this or beating it into the ground, because it will damage your relationship with him ultimately if he doesn't want to, can't hear it. It just could be a question of not that he's stubborn or— but he's maybe incapable of hearing it because it's too frightening. It's too scary. It causes too much anxiety. Remember, so your dad is codependent, which is not a bad word. It is an anxiety disorder based upon fear. So I think if you can, if you can really wrap your head around that, that that's most likely your father's perspective and where he's coming from, you might be able to talk to him differently. You might be able to understand it differently. It might make you feel better about it because Most of the people, like I would say 99.99%, are not stubborn or resistant maliciously or out of spite. They just—it's codependence. And this disease—that's why it's a family disease—is we all get super codependent, and we're terrified that something will or will not happen if we do or do not do something or say something. And that you can just hear in that in that sentence—that's like a giant quandary, and it puts you just like constantly on this seesaw. And it's really hard to find this exact even balance where you can move forward, right? You're usually way up here in fear land or way down here in anger land or way down here in confusion land. And so you sort of just keep propagating the system. But I just think if you could hear that from your dad's perspective, that might help your engagement with him. Oh, this person is putting up the definition of a disease. I don't see it yet. I went to, when I took my, my youngest son to treatment when he was 17, the psychiatrist, um, his residential treatment said that when you organically alter an organ, that that's the definition of disease. And we are organically altering the brain with addiction by the creation of extra neuroreceptors that shouldn't be there based upon the addiction's need to build them. All right, so hopefully this was helpful. I put links in for if you need a consultation with one of us, or if you want to join our membership, which has the live call every Wednesday, which will have the holiday schedule, which the live call will be on Tuesday next week and the week of New Year's, um, instead of on Wednesday. But that's a great place to ask a question. You can ask it verbally or you can post it and Kim and I will answer it. But that's a great way to get something asked without having to book a session. So plus there's just a font of information in that membership as well as tons of fabulous people that you can get some really good support from. So hopefully this was helpful, you guys, and we will see you in a couple weeks. All right, bye-bye.