Do you know the most important part of an inpatient treatment program for addiction? The first hour after discharge. Learning much about the “addict self” which looms large, while supporting and building a sometimes underdeveloped and undernourished “sober self” is quickly put to the test when on one’s own, often feeling vulnerable and raw. There are many crucial aspects of early recovery that can either support or sabotage someone dealing with addictive behaviors.

The “Pink Cloud”

Many times an individual leaves treatment “high on life.” All the support, validation, and approval can reawaken a new lease on life with renewed intentions and hope. It’s difficult to realize that some families are not yet ready to deal with a person who was once labeled the “identified patient” and daily life doesn’t continuously give high fives or praise each baby step. This is not to minimize an addict’s renewed sense of purpose and empowerment in the least; it’s just reality which makes early recovery all the more challenging.

Facing “Freedom Unconditionally”

Feelings. It’s okay to feel your feelings, yet keeping feelings at an unhealthy distance is why many people self-medicate. Sometimes feelings can be intense and uncomfortable, but they are never fatal! Getting those unwelcome feelings out of your head and giving yourself a voice is a healthy first step towards renewal and acceptance of self and others. Feelings such as long held resentments can be reframed into healthier and more functional thought patterns. You can also learn to reframe an alcoholic behavior like isolation into positive solitude. Turning a numb brain into a feeling brain in early recovery can be challenging and scary. Never be afraid to share with someone you trust.

Family. Addiction is a family disease that causes much dis-ease in life and family relationships. Early recovery isn’t easy for all family members. When someone is used to their partner coming home from work and passing out on the sofa at 7:30 at night and then, in early recovery, that partner all of a sudden wants to relate more, it may be greeted negatively. Change and built-up resentment in others can take time and patience to heal.

Friends. It might be a hard pill to swallow (no pun intended), but a person in early recovery might need to make some new sober friends. This can be difficult and heart wrenching as some long-term relationships might have to end and some emotional housecleaning may have to take place. Remaining sober is the goal and sometimes there’s pain in this very touch-and-go, day-to-day experience.

Freedom vs. Structure. It is often said that there is much more freedom in a structured life than a life where one always does as they please (the “I want what I want when I want it” syndrome). There are many benefits and rewards for leading a more accountable life, especially in early recovery. Probably the most important thing we have to offer in life is keeping our word, showing up, and being fully present.

Fun. People sometimes forget how to have fun and to make time for fun in early recovery. Letting that inner child come out to play and to be silly, and a good hearty belly laugh can help to recalibrate a depressed brain and depressed mood.

Other important aspects of early recovery that can support greater success include:

Awareness of Triggers. A trigger is something that can immediately and sometimes subtly make early recovery challenging and can lead to a relapse. I advise people to make a list of their triggers and keep them close. An example might be seeing bottles of liquor, beer, etc., in the supermarket or waiting in line at a pharmacy. The more aware you are, the less chance of relapse. But, remember, recovery isn’t necessarily a single event, so self-compassion when you slip with knowledge that you can get right back into recovery mode maintains hope and can turn shame into healthy shame that elicits positive change.

Accountability. Facing the mess you made and making healthier choices to clean up those messes equals a good, solid dose of humility. I can’t say enough about how humility is the backbone of recovery and can support a person to come full circle in life.

Cravings/Urges. It’s a good idea to explore problems of reactivity and/or impulsivity; allowing time and space can help in early recovery. Sometimes, a medical detox protocol might be warranted for a person who has had many relapses. Speak with a trusted physician about this treatment option. Remember, just because cravings disappear doesn’t mean psychological issues do as well. Therapy combined with this medical protocol can be an ideal mix.

PAWS: Post Acute Withdrawal Syndrome. Post Acute Withdrawal Syndrome can occur from one month to several years with symptoms such as irritability, sleep issues, intermittent anxiety, depression, and lack of motivation. It’s always a good idea to see a psychiatrist if an individual has a history of a mood disorder. Psychotropic medication may be warranted. Remember, addiction is a symptom, not the cause.

Meetings. Not everyone believes that recovery happens only within an AA framework. It can occur in a qualified therapist’s office, in another support group format, or another venue of choice. It’s been my experience that some form of immersion in the AA program has been quite beneficial, especially in the days, weeks, and months of early recovery. If one adheres to an AA program philosophy, it’s a good idea to adhere to the 90/90 plan – 90 AA, NA, SAA, OA, etc., meetings in 90 days. In the first 90 days, trust your feet, not your head.

Nutrition, Exercise, Sleep. Living a healthy lifestyle supports early recovery. Not eating or sleeping well can affect mood regulation, and exercising can help a person to get out of their head and into their body (with a doctor’s thumbs up).

Self-Compassion. Be extra gentle with yourself in early recovery. A few pats on the back and decreasing negative self-talk and thoughts will certainly help.

Spirituality. Religion is for those who are afraid of going to hell. Spirituality is for those who have been there. If you’re not religious, it doesn’t matter. A beautiful sunset can serve as a reminder to reach out, somewhere outside of self for solace. Nurture yourself. You don’t have to go through early recovery alone. Ever!

I’ll leave you with this. If you can think of one positive thought or feeling today, you’ve begun to reinforce a more positive memory to look back on tomorrow…

“Courage is fear who has said its prayers.” My best to you always in early recovery and beyond.

Dr. Amy Austin is a licensed marriage and family therapist (MFC # 41252) and doctor of clinical psychology in Rancho Mirage. Dr. Amy can be reached at (760) 774.0047.