If addiction is the lone island of hopelessness and despair, recovery is the bridge towards relief and gratitude. And, while this transformation journey is inherently beautiful, such freedom comes with a hefty emotional, physical, and spiritual cost. Where there is change, there is discomfort. Where there is making room for something new, there is letting go of something old. And saying goodbye, even when it is undoubtedly overdue and for the best, hardly guarantees a complete and final sense of closure.
In her brilliant book, On Death and Dying, Elisabeth Kübler-Ross identified five stages of grief (denial, anger, bargaining, depression, and acceptance) in her work with terminally ill patients facing death. Today, this model has been applied widespread to larger populations, and it remains a popular point of reference for understanding how we move through painful losses.
Recovery from addiction lingers as this ambiguous and even questionable loss. In one moment, it represents a firm goodbye to a detrimental lifestyle. In another moment, it represents a tantalizing, quasi-doorway left slightly ajar for the potential returned entry. The loss is not fixed or permanent. Even if the addiction feels “gone” today, it could very easily come back, with vengeance, tomorrow. Recovery, in its existential truth, is a powerful series of miniature deaths and rebirths. Grief- and usually immense waves of it- is, therefore, inevitable.
My individual psychotherapy with clients often entails a grief process similar to that of any other significant loss, There is confusion and pain; there is indecisiveness and fear and anger and questioning. Some of these stages last longer than others, and some don’t happen at all, but they each deserve a space for acknowledgment and processing. Let’s take a look.
Denial is the middle name of addiction- it is the classic, textbook symptoms. In active addiction, we see many people who fail to acknowledge having a problem. There are those who believe they could stop drinking if they really wanted to or those who believe they just need a few days of detox to get their lives back on track.
Denial maintains the insidious nature of addiction. It is not intentional, and usually, it is not even a conscious effort. Rather, denial is the inability to acknowledge and accept a situation at face value. Many sufferers will stay in this phase forever. Some will venture a few feet from denial’s crutches- only to quickly sink back into its cozy and unassuming bliss once things get hard.
In recovery, my clients often experience similar threads of this stage (denial that they have cravings; denial that they need to attend meetings/therapy/doctor appointments; denial that they can stay sober just doing X, Y, or Z). Denial lies in the sufferers who believe they are above relapse; it also lies in those who take lax and cocky approaches in their recovery maintenance. At its best, denial is minimization. At its worst, it is complete and utter ignorance of reality.
Deflated and thawed denial can lean into negativity. Anger exists on a lengthened spectrum ranging from mild discomfort to insufferable rage, and it is rampant in early stages of recovery. I see anger in the client who resents her friends for being able to drink normally. I see it in the client who does not want to face her legal or financial consequences. These people may be angry towards themselves, towards old girlfriends or boyfriends, drug dealers, parents, teachers. They are angry at counselors or sponsors or lawyers. In the deepest throes of this stage, they are angry that they have to sober at all.
Even justified anger often leaves a bitter and building sense of compounding resentment. It just continues to unfold and unfold and unfold. Like denial, anger represents another inability to accept the truth. However, if denial is a blindness to the truth altogether, anger is the deep manifestation of powerlessness and fear. And, as we see, in addiction work, when powerlessness is harnessed appropriately, it can foster tremendous positive change. However, when harnessed inappropriately, it paves a perfect path of utter defeat.
Anger in recovery, no matter how it looks, reveals a powerful glance at an unmet need. The best option for moving through this stage? Identify that need and what you can do to meet it.
Bargaining is the most manipulative of the five stages, as it is the tiny, pleading, even sweet-talking voice convincing the sufferer to just cut a few corners and take few shortcuts.
Laced with what-ifs and once-I’s, bargaining can exist in all stages of recovery and in so many forms: “I can just smoke weed…I can just drink on the weekends…I just need to stay in treatment for 30 days…if my mom lets me stay with me, I’ll be okay…if I just get a job, I won’t be bored and relapse…if I get pregnant, I won’t use drugs…if my boyfriend and I both go to rehab, we can both stay clean…if I make it out alive tonight, I’ll never use again.
Bargaining may entail making irrational deals with the universe, and even the best intentions can be wrapped in blurred delusion.
This complex stage has the capability to trick its sufferers into believing they have more power or control than they really do. It can also coerce them into thinking that certain actions or guarantee will guarantee a certain outcome.
This is the painful stage, the one characterized by hopelessness and despair, where I hear the cries out to the universe. This is where recovery feels impossible or all-consuming or devastating or terrible. This is where it just hurts; some have this prevailing complex that things will never get better, that nothing is really worth it, that, in the end, it’s going to fail and be good for nothing.
I hear depression in the client who tells me, with dismay, that she thought, life would be so much better sober. I hear it in the other client who tells me, I still feel insecure…I still feel like I’m so behind everyone else, like I have such a far ways to go.
Depression is a reminder of the mistakes and hardships the sufferer went through; if addiction is a trauma, lurking in its shadows compounds it.
This, of course, is the stage of peace. It is the representation of understanding- it is the feeling of serenity and calmness, of truly absorbing it is what it is. Acceptance is where most people want to be, but even the stage of acceptance is not an endpoint destination.
Acceptance is not a once-and-for-all, one-and-done process. Oftentimes, it is just a moment-by-moment choice. Acceptance can be slippery; even if one “accepts” recovery one day, he or she can still slink back into another stage the next day. Acceptance is not a guarantee- it requires active work and due diligence.
The movement towards acceptance is the most critical stage in this grief cycle. Only acceptance allows for true healing, and only acceptance allows for true reconciliation for the past.