One Saturday night, during the holidays in 2007, Joey B. went out to his favorite bar to have a couple of drinks. He remembers talking to the bartender when he first arrived but then nothing at all after that.
“The next memory I have is of waking up in a hospital, hand-cuffed to the bed frame. The police report stated that I had called a cab when the bar closed. The report said I beat up the driver, stole the cab and led police on a high-speed chase until I wrecked the cab”.
Joey was to spend the next five years of his life in prison where he discovered Alcoholics Anonymous (AA) and embarked on a path of recovery.
Individuals who suffer from the disease of Chronic Substance Use Disorder (CSUD) have three paths open to them- recovery, institutions, or death. Sadly, many do not choose that first path. This disease is powerful and over time only gains in strength.
Ron M. was a brilliant person who never had much interest in school. He had a talent for computer programming and became very advanced through self-study. After high school he discovered heroin and soon it became the dominant influence in his life, eclipsing all other activities. Ron was kicked out of his house, and sold his computer, and eventually his car, to support his drug use.
“One day I woke up in an abandoned building in the city and realized I could not go on like this anymore. I went to our family doctor because I was still covered under my parent’s health insurance plan, and he got me started on monthly injections of Vivitrol which reduced the craving and blocked the drug’s effects. I joined a support group and have been clean for two years”.
CSUD is unique in that it is a disease that can only be self-diagnosed. This diagnosis becomes realized when you know that you can’t predict how you will react when you are around alcohol or other drugs. For those ready to begin a program of recovery there are several popular methods for abstinence: 12-step programs such as Narcotics Anonymous (NA) and Alcoholics Anonymous (NA); pharmacological intervention with naltrexone, lofexidine, or their brand name equivalents, anti-addiction medications effective for both opioid and alcohol use; and a variety of therapeutic approaches such as Cognitive Behavioral Therapy (CBT), or Rational Emotive Behavior Therapy (REBT), to name just a few.
For those who do surrender and are called to action, who follow the long and difficult path towards recovery the destination is both a release from the physical and mental compulsion to use and the beginning of a meaningfully useful and engagingly productive life. It is a Hero’s Journey, one fraught with doubt, denial, distrust and dread, but the prize, the hard-won awakening to a renewed life, can be achieved and brought into a world made fresh in recovery.
The unfortunate fact is that many who begin a successful program of recovery do not stay away from drugs or alcohol. In an eight-year study of nearly 1200 people with CSUD it was shown that two thirds of people with less than a year of abstinence will relapse. For those achieving a year of abstinence, nearly half will relapse, and after 5 years of Abstinence the chance of relapse drops below 15 percent. People with decades of abstinence clearly can and do relapse but the incidence is low. When a celebrity relapses media attention refocuses on this disease of CSUD. The tragic overdose death of Phillip Seymour Hoffman is an example of someone who was reportedly abstinent from alcohol and drugs for over two decades and suffered a fatal relapse.
Why do people relapse? After having slayed the dragon of compulsion in its lair, why do they revive the beast only to fall into the pit of despair once more? It is like someone who, after years of pounding their head against a brick wall in a dark alley, finally escapes into a life free from self-inflicted misery and then suddenly one evening, seemingly out of the blue, walks back into that same dark alley. After Joey got out of prison, he became active in an AA community, got a sponsor, worked the 12-step program, and made many sober friends. He started a new business and stayed sober for five more years until 2017 when Joey disappeared.
“I told my fiancé that I was traveling to the west coast for a couple of days to visit family for Christmas”.
His family, it turned out, knew nothing of his visit, and he did not answer phone calls or texts from his fiancé or his friends. New Year’s day a friend got a collect call from Joey. He was at the airport in San Francisco. He had lost his phone, his wallet, two teeth, and had a broken hand. He needed a ticket home.
Ron had also turned a corner in his life. Things were looking up. After two years clean, he had an apartment, a new job, and a girlfriend. He felt he no longer needed the monthly injections of Vivitrol but stayed involved in his support group. Ron was recruited by a defense department contractor who recognized the value of his programming genius. The day he received his six-figure salary offer he decided it would be okay to celebrate. Ron contacted his old dealer, bought his usual bag, and was found dead in his bathtub the next day.
To stay on track and avoid a relapse it is advised that you begin to form daily routines that keep you away from people, places, and things that could cause you to fall back into chronic substance use. For someone with CSUD, relapse can be overwhelming, life threatening, even deadly. With alcohol, an individual quickly achieves the same state they were in when they reached the end of their drinking career the first time. With opioids the risk of overdose and death is magnified as their tolerance to the drug is lowered through abstinence or pharmacological intervention.
There are many approaches out there offering help to those who want to stop chronically using substances. These treatments are not one-size-fits-all. Expensive residential programs referred to as “rehabs” which combine medically assisted detox with other therapies such as faith based, spiritual, secular, and other behavioral programs, with and without ongoing pharmacological intervention, break the cycle of chronic use and embark many people onto long term recovery programs.
The most successful system for recovery of any chronic substance use or compulsive behavioral combines multiple treatment approaches. Studies of the success of individual systems are problematic. How long must healthy behaviors be maintained, defined by abstinence to be deemed successful? Most studies look within the first year of recovery and studies looking 2-5 years out are relatively rare.
With any program that has broken the cycle of CSUD, there are common recommendations to avoid a relapse. These include: The books Alcoholics Anonymous and Narcotics Anonymous whose essential elements detail through working a program of 12 steps of how to apply principals for life; group meetings providing support by others who identify and understand the dilemmas of CSUD; and the concept of acceptance of one’s powerlessness over every outcome – all seem to be essential elements of recovery.
People in recovery are advised to each day to try and:
- Start and end the day with prayer, meditation, or a reading from recovery literature or other spiritual writings.
- Maintain a connection with at least one other person in recovery whom you admire (preferably a network of people).
- Spend time with family members and friends who do not chronically use substances.
- Practice gratitude by expressing what you are grateful for in your life on a regular basis.
- Let go of trying to control outcomes and become accepting of those things out of your control.
These are established routines with a proven success in avoiding relapse. Over time though, routines lose their power to re-enforce change. They become habits and begin to lack the meaning they once had. People become complacent about recovery. Their disease, the very thing that initially brought them to recovery, lulls them to sleep and leads them back into that dark alley. While routines and habits can lose power, ceremony and ritual do not.
So how is there power in ritual? This is familiar ground for anyone who has the disease of CSUD. No one starts out with a chronic disease of this type. They start by trying a substance and enjoying what it does for them, for their mood, their self-confidence, for a physical glow of well being. They continue using with increased frequency often planning their substance use in intricate ways, reminiscent of ceremony, such as doing it with special people, in special places, or at certain times. They create ritual elements as well; a special container, glass, or other tools which may be employed in substance use. Even ritual behaviors may be created such as invoking emotions of anger or anxiety so that there is a reason to use.
Ask anyone with CSUD about the power of ritual and ceremony as it relates to their disease and most, if they are honest, would agree that these practices were indeed supporting, engaging, and powerful.
Dr. Onno van der Hart, a professor emeritus of the psychopathology of chronic traumatization, at Utrecht University in the Netherlands defines ritual this way: “Rituals are symbolic acts that must be performed in a certain way and in a certain order and may or may not be performed with verbal formulas. They involve preparation and meaning.”
By this definition, brushing one’s teeth can be described as a ritual. There are elements in preparation; the brush, the paste, the water. There is meaning; to make the breath fresh, to avoid tooth decay, to make the gums healthy. Brushing teeth is often performed in a certain way and in a certain order: do you wet the brush before or after putting on the paste? So, is it a ritual, or is it a habit?
In another definition of ritual, Joseph Campbell, an American mythologist, writer and lecturer, best known for his work in comparative mythology and comparative religion wrote: “A ritual is the enactment of a myth. And through the enactment it brings to mind the implications of the life act that you are engaged in.” In this sense, ritual is an engagement in mindfulness, not habitual action. Campbell separates ritual from habit in this way: “But you don’t know what you’re doing unless you think about it. That’s what a ritual does. It gives you an occasion to realize what you’re doing so that you’re participating in the inevitable energy of life in its exchanges. That’s what rituals are for; you do things with intention, and not just in the animal way, ravenously, without knowing what you’re doing”.
According to a May 2014 study in JAMA Psychiatry, chronic users of drugs and alcohol who utilized a mindfulness-based intervention reduced their risk of relapse when compared to 12-step participants. That is not to say that 12-step programs are at odds with mindfulness. Practice of the critical component in step 11, prayer and meditation, clearly employs mindful intention.
Ritual is a powerful way to manifest intention. It is a means to access the strength you need to accomplish a transformation you are committed to. Engaging in ceremony and practicing rituals that you create will help bring your internal desire for recovery out into the world and make it tangible, give it substance and power. Learning to craft effective ceremony and ritual is a bold approach to sobriety and can be a vital tool to add to those you have already gathered in your journey of recovery. Such techniques readily accessible and are easy to learn. Today there are specialist who can work with you to custom-create effective, life affirming, rituals and ceremonies that can be incorporated into your CSUD recovery plan and bolster its effectiveness.
In this modern era, important transitions and milestones are often ignored or glossed over. The power of ceremony and ritual in celebrating milestones such as births, coming of age, marriage, anniversaries, holidays, even death, have become rote routines and have lost much of their deeper meaning. As communities we do not collectively celebrate transitions as we had done for thousands of years. Ceremonies for naming, entering a new home, moving into a new community, elder-hood, and recovery from disease have been all but forgotten, however, there is a new kind of professional that breaths life back into these age-old traditions.
Certified Life-Cycle Celebrants® are trained professionals, certified by the Celebrant Foundation & Institute. They are not therapists or spiritual counselors but ceremonialists and ritualists. They work with clients to create unique personalized ceremonies and rituals that are customized to the clients’ beliefs, philosophy, and needs. They have gained in-depth knowledge on the theory and structure of rituals and undergone specific training for different types of rituals. If you have reached a crossroad in your life and are ready to cross a threshold with a renewed vision of who you want to be; if you are ready to let go of who you once were and embrace who are becoming; if you want your community to witness this transition in you and embrace your value, then a Certified Life-Cycle Celebrant® may be exactly what you need.
When Joey B. was asked why he relapsed, his answer reflected common reasons others have given for their relapse. He stopped going to meetings, calling others in recovery, and reading inspirational literature.
“I had been doing the same things for so long it got boring. I wanted to try new things. My business, and my girlfriend, provided me with new ways to look at being sober so I just stuck with that. Before long I somehow got the idea I could drink again without consequence.”
Certified Life-Cycle Celebrants® are professionals with whom you can explore new alternative methods to avoid relapse and provide new tools for staying on your path of recovery. They are steeped in the knowledge of ceremony and ritual and can be relied upon to provide you valuable insights as you collaborate together to create a customized ceremony that recognizes your crossing of a threshold in your return to the world. In one-on-one private sessions, where together you explore your personal narrative, detailing your goals in recovery and relapse prevention, you and your Certified Life- Cycle Celebrant® can surface unique personal insights to create tailored daily rituals that will help you stay on your path.
In your recovery from CSUD you have truly undertaken a Hero’s Journey. Find someone who can expertly help you celebrate your transition and provide support and creative guidance to regularly renew your ability to light the path ahead of you. If you or your loved one have recently been discharged from an inpatient treatment center or have completed outpatient care for a CSUD, or have suffered a relapse, I encourage you to arrange a no-obligation meeting with a Certified Life-Cycle Celebrant® who specializes in Healings and Transitions and see if they may be a good fit for you.
Together we can walk each other through your experiences and begin to design a recovery ritual plan tailored to your needs for moving forward. The surest way to walk back into that dark alley is by sleepwalking. The use of ceremony to actively embrace your transition into sobriety and the leveraging of personal rituals to recharge your mindful intentions each day will revive and maintain your spiritual condition and keep you wakefully alert.
Consider the powerful techniques of enhancing your recovery by using ceremony and ritual as a part of your discharge plan. Such a practice will help keep relapse at bay – preserving dignity and self-control, providing peace of mind. Contact a Certified Life-Cycle Celebrant® today.
Kevin Butler is a Life-Cycled Celebrant® certified by the Celebrant Foundation & Institute with specialties in Weddings, Funerals, and Healing & Transition.