Understanding The Role of Grief and Loss in Addiction Recovery
By Robert Weiss, LCSW, CAS
Addicts and family members in the early stages of recovery may not consider the strong role that the grief process plays in their experience. There are obvious times when we consider grief to be a natural reaction to life circumstances like when someone has died or moved away or when an important job or possession is lost. However the experience of grief is not only stimulated by losing loved ones or possessions, grief is also engaged when someone loses a way of living or a way of looking at themselves which had been a way of life. In the process of recovering from an addiction, grief emerges in reaction to the intense changes taking place in an individual and in a family as the addiction problem is addressed. Understanding and accepting this process of grieving helps recovery to be less of a mystery. Before exploring the grief process itself, it might be helpful to identify some of the losses that may be brought forth.
Samples of Addict Losses
Loss of the Addiction Itself (Substance or Behavior)
No matter how much havoc or trauma the addict’s drug/alcohol use or other addictive behaviors caused themselves and loved ones or how grateful they or others may be that the using or acting-out has stopped — the addict is going to miss their drug. They are going to miss the distraction, relaxation, intensity and high the behavior or substance offered to them. The addict is going to miss their “easy” way to escape difficult feelings and experiences and will in fact be overwhelmed at times by all they are now having to experience without a buffer.
Addicts come to miss the rituals surrounding their acting-out behaviors. The places, patterns and secret activities of their substance or behavior addiction were built into their life just as solidly as a job or home and changing these is difficult and sometimes painful.
The addict often loses relationships that were maintained with people they involved in their acting-out or using. For some whole social groups and specific activities like “happy hour”, “being online” or “sensual massages” have to be given up in the name of avoiding a return to the addiction.
Living an addictive life involves avoiding accountability and responsibility to people and activities that might interfere with the freedom to use substances or act out with sex, gambling etc. The life of a recovering person involves a great deal of being accountable, checking-out decisions and actions with other people as well as meeting all commitments and responsibilities.
As with the addict, the partner will experience losses as the transitions and challenges of addiction recovery take place. Despite the partner’s desire to have the addict stop using or acting-out, there remain painful challenges arising in this process of change even as that person gains sobriety.
Sample of Partner/Spouse Losses
Certain patterns of relating become ingrained into relationships particularly in those relationships where addiction is present. A partner who has been in the caretaking role for an addicted person, i.e. covering up their problems, smoothing over problems, making up for the addicts’ shortcomings (parenting, financial, etc.); will have a difficult transition in retaking the reigns of their own lives and trusting the addicted person to now actually be more responsible. Not being needed can be a difficult challenge for partners of addicts.
Loss of predictability
As difficult as being in a relationship with an addict can be, at least there is some emotional and situational predictability once the patterns of the addiction are established. Addicts in recovery can actually be more moody, vocal about their needs and wants and assertive than someone living in the shame of their addiction. These can be difficult changes for a partner to understand and tolerate.
Strangely enough, a lonely, disappointed partner, consistently abandoned, rejected or let down in their relationship with an active addict, can become comfortable in their misery. Having an identifiable person and situation to blame for ones’ unhappiness keeps the burden of self-examination and self-understanding away. A partner, now in a relationship with a more functional, responsible and connected recovering person, has to look more closely at himself or herself when feeling unhappy, disappointed or unfulfilled.
Time Taken by the Recovery Process
As the recovering person gets more involved in their 12 step program, therapy and self care, they may not be any more available for relating and spending time then they were in the days of their addiction. Once kept apart by substance use and acting-out, couples may now find themselves separated by support groups, sponsors and time spent in the recovery process. This can be a real disappointment to the partner expecting a lot of time to be closely spent together following the addict’s return to sane living.
Stages of Grieving
The process of grief itself follows a fairly understandable pattern first made clear in a 1970’s landmark book by Elizabeth Kubler-Ross called 0n Death and Dying. In her book, Dr. Kubler-Ross was able to identify and differentiate the stages a person goes through when grieving a loss. We now understand that not everyone goes through each and every stage, nor do these stages follow a predictable pattern. Nevertheless, the feelings and situations that people go through in the recovery process can be aligned with these concepts. These stages exist primarily to shield the person who is grieving from being overwhelmed by their feelings and experiences. Grief is a process that takes time, support and self-acceptance to move beyond.
Stage One: Denial
This is the earliest stage of the grief process that occurs when someone has not yet fully comprehended or been able to integrate the depth of the change to their lives. Typically a person in denial, when confronted with a major loss, will say things like “No this can’t be true” or “It must be someone else, not me or my loved one.” Denial is a safety mechanism that protects one from being overwhelmed by their feelings; it is a form of shock. Addicts utilize denial to avoid taking responsibility for their substance use or behavioral acting-out. They will not be able or willing to make the connection between the consequences of their addictions and the behaviors themselves. Addicts in denial will blame other people and circumstances for their problems as they deny any responsibility. “I’m no alcoholic, those kind of people live in the gutter and drink cheap wine, I just have a cocktail now and then” or “It clearly wasn’t my being high that caused me to get stopped by that cop it was the bad attitude the policeman had. When are those cops going to do the work they are supposed to do instead of picking on good citizens like myself?” Spouses in the denial stage avoid drawing logical conclusions about the addict’s problems. They will instead cover up or make excuses for the addicts’ behavior, sometimes even blaming themselves rather than being able to see the issues for what they are. “He really doesn’t gamble regularly, just on the weekends, besides, he only plays cards with his friends and goes to the track occasionally. It’s not like he goes to Vegas to gamble, besides we can afford for him to have some fun now and then.”
Stage Two: Anger
The anger stage of grief exists as an attempt to avoid the true underlying addictive problem. By using anger, blaming, nagging and shaming addicts and loved ones can seemingly throw around responsibility for the personal, family, financial, legal and other problems without identifying and acknowledging the addiction problem itself. The addict will conclude that it is the fault of a partner, job, children, etc. that causes them to use or act out. They will unconsciously but deliberately pick fights or create negative situations in order to justify their addictive behavior. They will blame partners for poor handling of finances or childcare despite the fact that their addiction is the real source of these problems. Partners will vent anger on the addicts’ friends, work and recreation time. They attempt to use control, complaining and negativity to tolerate their unhappiness, all the while hating themselves for the ways that they are acting.
Stage Three: Bargaining
In the bargaining stage of grief, the person is beginning to come to some realization that there is or might be a problem but to compensate they are working hard to try to continue to avoid fully facing the solution or reality of their circumstances. To bargain is to try to maintain control and continue to live without real change taking place. For addicts, this is the time for “Just give me one more chance and I promise I will never…” kinds of statements. Rather than being fully surrendered to the problem, the addict is attempting to hold on to control by making up new excuses and promises, thereby avoiding the inevitable. For partners, bargaining is a last ditch attempt to maintain the status quo. Not wanting to take the risk of confrontation of the real problem, partners may accept promises they know will not be kept or try to make changes to make life easier for the addict in the hope that they will stop their addictive behavior. “If I just look more like those women he is looking at online and offer the same kind of sex as his online sites, then his cybersex behavior will stop.” Or “If I just keep the kids out of her way and give her more time on the weekend, she will stop drinking during the day like she promised.”
Stage Four: Depression
This stage marks the beginning of true surrender to the depth and meaning of the addictive problem. No longer trying to assign blame or find a way out addicts begin to delve into the sadness and fear of not knowing themselves as they thought they did. Addicts struggle to come to grips with the meaning of their history of addictive actions and the costs these problems have created individually and in relationship to others they love. Often ashamed and confused in this early stage of recovery addicts may also be in unable to conceive of a life without their acting-out behaviors or substance use. Unfamiliar with a life outside of their addiction the addict despairs of ever feeling comfortable or “in control” as they have known it. For partners the depressive stage is one of beginning to comprehend the depth of the losses and challenges that the addiction has cost. Not fully understanding how addiction works and that the hope for recovery, partners may despair that their relationships will ever be right. As they experience the addict going off to 12-step meetings, making phone calls to other addicts and sponsors, the partner may feel left out of the process and fearful of the new barriers that seem to be encouraging separation rather than support and connection.
Stage Five: Acceptance
This stage is inevitable provided that addicts stay in recovery and that partners begin to join the process. For the addict at this stage, they can now begin to see that there is a path laid out for their recovery which others have followed successfully. They can begin to entertain a new vision of how their life will be lived without being in relationship to active addiction. New healthy recovery relationships and support have begun to replace isolation and lies. The addict has been sober long enough to begin to develop new ways of coping and managing their life circumstances, often utilizing hidden creativity and ingenuity formerly lost to their addiction. Partners at the acceptance stage can see light at the end of the tunnel. Now informed and involved in recovery through their own support groups, therapy and self-education they are beginning to redefine their role to their addicted partner, their families and to themselves.
The paragraphs below outline an understanding of the differences between a grief reaction and an episode of depression. Since the symptoms of grief and depression are similar and often vary only in the degree of the symptom, it is best to utilize the support of a professional counselor or clergy to help clarify and work through these issues.
Identifiable Differences Between Grief and Depression
Many of the symptoms outlined below are typical of the experiences people have when going through the early stages of a loss and are very normal. Usually these are accompanied by some reduced day-to-day functioning which passes as the person integrates the change and reorients to new life circumstances. These symptoms in their most severe form might persist for several weeks with gradual reduction over 2-3 months depending on the severity of the loss.
Normal Grief Reaction
- Feelings of being overwhelmed and less capable than normal
- Some day-to-day confusion and memory loss (loss of keys, forgetting appointments, etc.)
- Reduced interest in things which usually are interesting or pleasurable
- Sleeplessness and fatigue or oversleeping
- Tearfulness and feelings of loss and longing
- Imagining or dreaming about being back in addictive behaviors
- Self-blame, self pity, anger at the situation
- Reduced interest in eating or overeating
Signs of Depression
Many of these signs are similar to the above grief experiences except that these occur in a more severe and long-term form. Persistence of symptoms such as those listed below often indicate the need for professional counseling and the possible use of anti-depressant medication.
- Inability to function in job or family roles
- Constant waking up or early morning awakening with ruminating thoughts, consistent loss of sleep
- Extreme fatigue or loss of energy
- Depressed mood
- Diminished concentration or confusion on a daily basis
- Strong feelings of hopelessness, panic — suicidal thoughts or plans
- Loss of interest in social activities, friends/family and or work
- Constant tearfulness, inability to feel emotionally stable
- Significant unintentional weight loss or gain (more than 5% of overall body weight in less than a month)
The Adjustment to Loss Depends On:
- The flexibility of the person to adapt to change
- The emotional and physical state prior to the loss
- The amount of dependency the person has on that past relationship or experience
- How much the relationship to that person, thing provided self-definition
- The amount of social and/or family support
- Physical health and age
- Status and financial stability
A Word of Hope
One common misconception about ending active addiction and entering recovery is that there will be immediate relief and positive benefits for all. In fact recovery is a lengthy process which often can bring painful emotional and circumstantial realities forward in the early stages before the more comforting and feel-good benefits take place. Part of recovery is allowing long hidden secrets to be disclosed and long-buried disappointments and fears to be revealed.
This is painful and difficult stuff. The real challenge is more than just sobriety for the addict; it is tolerating clearing of the wreckage of the past while holding on to hope for the future. Some sayings common to the various 12 step programs may be helpful in passing through the grief stages of recovery. Saying such as “This too shall pass”, “Trust the process” and “One day at a time” have their roots in the hope that has been passed on to recovering addicts and their loved by others who have been down the same road.
One of the most important gifts of the 12 step meetings themselves is the opportunity to experience and even celebrate those who are in recovery a bit longer and have a more hope to offer then the person(s) behind them. There is not doubt that process of 12 step work; therapy and living in spirituality do create meaningful change for those who work to have that happen.