Risk and Resiliency in Recovery

While thinking about the topic of "risk" for this article, I was intrigued by a colleague's description of the disease model used by the Public Health Department. A simplified version of their perspective is that "the risk factors of any chronic disease combined with resiliency creates outcome. Prevention and education focus on reducing risk factors and increasing resiliency factors."

It got me thinking that those of us who have the chronic disease of addiction are lucky in that we have a step-by-step program which shows us exactly how to get healthy and prevent relapse. The book, Alcoholics Anonymous, is a manual for education and action. The book shows us a proven method to not only understand our disease and reduce the risk factors for relapse, but also how to become and stay resilient enough to be able to deal with life without using.

Before the book Alcoholics Anonymous was published in 1939, there was little hope for the alcoholic. In 1933, when Bill Wilson went to treatment the first time, drinking was illegal and a "habitual drunk" conviction could bring jail and even prison time. Alcoholism was a huge social problem. Everyone was trying to help the alcoholic. Alcoholics were institutionalized in insane asylums, given shock treatments and frontal lobotomies. It wasn't until Dr. Silkworth brought a new "modern idea" to the world that defined alcoholism as a legitimate disease that a new stage was set for hope. His solution to what he called the physical "allergy" was withdrawing and drying out alcoholics and educating them on the need for complete abstinence. Solving the "illness of the body," however, was only part of the issue. With that information alone, Bill was unable to stay sober, and he continued to relapse. A solution arrived in the form of an old drinking buddy, Ebby Thatcher. Ebby brought the "simple religious idea and a practical program of action" of the Oxford Group to Bill. Bill brought it to Bob in 1935 and tweaked it to make it work for alcoholics; "by late 1937, the number of members having substantial sobriety time behind them was sufficient to convince the membership that a new light had entered the dark world of the alcoholic." Alcoholics were staying sober. They were decreasing the risks and increasing their resilience with a very specific, step-by-step program for recovery. This program has proven useful with all types of addictions and all types of people all over the world.

As I see it, the simple spiritual idea is that underneath our addictive behaviors, our real problem is that we tend to "go it alone" (often initially for very good reason). However, long after outliving its usefulness, this trait becomes ingrained and holds us in "the bondage of self," and we usually don't see it. I believe that the human animal is not equipped to deal with life alone. So when we decide to go solo, we are putting ourselves at risk for relapse. This is the spiritual lapse that always happens before we "pick up."

The "first 40" together developed a way to live without drinking. They developed steps and tools to deal with life which required connection. The strong sense of community and trust was core to their resilience and made them less susceptible to the risk of relapse. This is our legacy. We have a network of people who speak our language, who get us, who show us how to live without needing, or wanting, to "pick up." We have a support network that we can call with our problems any time of the day or night. We have a way to deal with life that works. We stay connected so we can't forget our truth and our penchant for wanting to go it alone. The Big Book is filled with directions, promises and warnings. There are stories of hope as well as cautionary tales with warnings of our common pitfalls. This is a manual and a program for reducing risk and building resiliency.

I relapsed repeatedly for 20 years and am now able to sustain sobriety. During my own battle with addiction and relapse, I didn't have the level of support and accountability needed to not only take the actions outlined in the book, but to get clean and sober by actually taking the actions needed daily to stay clean and sober. From my sponsor and fellows, I'm learning to stay resilient, honest, open and willing to grow one day at a time.

Delia Jurek, renewal specialist at the Dan Anderson Renewal Center, is a teacher, artist, and actor with more than 25 years at the Hazelden Betty Ford Foundation. She sees the Big Book as a source of wisdom for daily living and teaches the simple, practical use of this manual for recovery. She has been a presenter at the Dan Anderson Renewal Center.