Updated: Dec 14, 2019
Although little has been written and researched about grief as well as how it relates to addiction, it is a major factor for all who are affected by the disease. Normally we consider grief to be a natural reaction to life circumstances like the loss of a loved one, or loss due to someone moving away or when an important job or possession is lost.
Individuals who are addicted to substances (and family members) may not consider the strong role that the grief process plays in the early stages of recovery. However, the experience of grief is not only a result of losing a loved one or possessions, but also occurs when someone loses a way of living or a way of looking at themselves. Understanding and accepting this process of grieving helps recovery to be less of a mystery.
During active addiction, a bond is developed with the drug, however as the addict enters recovery they experience a loss. Loss, in this case, can both contribute to and result from addiction. Many people in active addiction use alcohol and other drugs to lessen, numb, or avoid distressing feelings of grief, sadness, depression, or anger related to the loss. If we don't allow ourselves to feel or talk about our emotions and we avoid or suppress those feelings, they invariably come out "sideways"—in indirect forms through behaviour. When feelings are expressed through behaviour, they typically operate unconsciously, outside of our ability to steward them. When this happens we are on autopilot, behaving reflexively and habitually, often engaging in behaviours that are unhealthy and self-defeating—even when we do not want to act that way.
Loss is a natural part of the process of recovery. There is a saying in some twelve-step programs that recovery requires changing the "playmates, playgrounds, and playthings" associated with one's active addiction. This can mean ending friendships, cutting ties with certain family members, leaving a lifestyle, giving up a job/career, or relinquishing certain possessions that conjure triggers to use alcohol or other drugs. Feelings of loss and subsequent grief occur with each "thing" that must be given up to achieve and maintain recovery. In addition to these significant losses, there is the most profound recovery-specific loss of all: that of mind- and mood-altering substances themselves and the immediate neurochemical reward and relief they provided. Despite the devastation and destruction addiction may have caused in a person’s life, giving up alcohol and other drugs usually represents the loss of one’s primary method of coping/best friend/closest confidant. The relationship that people with addiction have with these substances is often the most intimate they have. The significance of this loss is generally underappreciated and inadequately addressed in addiction treatment.
Becoming more aware of past and current sources of loss and grief, and developing skills to successfully tolerate and manage the emotions associated with them will help those in the early stages of recovery from addiction negotiate emotional obstacles and build pathways to sustaining recovery. Trying to avoid or suppress painful emotions is similar to being mired in quicksand. The harder we struggle to get free, the more anxiety and stress we experience, the deeper an individual sinks the more stuck they become. The avoidance of uncomfortable feelings inevitably backfires - extending and exacerbating our emotional pain. Further, it is only when we can move into our experience and accept our emotions, observe the emotions, allow ourselves to feel and express these emotions, and let what is there to simply be.
The loss of the Addiction Itself
It does not matter how much havoc or trauma the addict's substance use or other addictive behaviours caused themselves and loved ones or how grateful they or loved ones may be that the using or acting out has stopped, the addict is going to miss their drug. The individual addicted to the substance is going to miss the distraction, relaxation, intensity and high the behaviour or substance offered to them. The addicted individual is going to miss their "easy" way to escape difficult emotions and experiences and will be overwhelmed at times by all the emotions that they are now going to experience.
The Stages of Grief
In her book titled On Death and Dying, Dr Kubler-Ross stated that the process of grief itself follows a fairly understandable pattern and was able to identify and differentiate the stages a person goes through when grieving a loss. However, not everyone goes through every stage and /or do these stages follow a predictable pattern. These stages exist primarily to protect the person who is grieving from being overwhelmed by their emotions and experiences. Grief is a process that takes time, support and self-acceptance to move beyond.
The first stage - Denial
According to Kubler-Ross, this is the first 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. Denial is a safety mechanism that protects one from being overwhelmed by their feelings and can be seen as a form of shock. Addicts utilize denial to avoid taking responsibility for their substance use or behaviours associated with the disease and will not be able or willing to make the connection between the consequences of their addictions or the behaviours themselves. Addicts in denial will blame other people and circumstances for their problems as they deny any responsibility. Spouses/parents or anyone associated with the addict in the denial stage avoid drawing logical conclusions about the addict's problems. They will instead cover up or make excuses for the addicts' behaviour, sometimes even blaming themselves rather than being able to see the issues for what they are.
The second stage - Anger
Elizabeth Kubler-Ross noted that the anger stage of grief exists as an attempt to avoid the true underlying problems and in the case of addiction addictive problems. 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 to justify their addictive behaviour. They will blame partners for poor handling of finances or childcare even though their addiction is the real source of these problems. Partners/family will vent anger on the addicts’ friends, work and recreation time and attempt to use the control, complaining and negativity to tolerate their unhappiness, all the while hating themselves for the ways that they are acting.
The third stage - Bargaining
Kubler-Ross stated that 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, 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/family, bargaining is a last attempt to maintain the status quo. Not wanting to take the risk of confrontation of the real problem, family/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 behaviour.
The fourth stage - Depression
This is the stage that marks the beginning of true surrender to the depth and meaning of the addictive problem. When it comes to this stage the addict no longer tries to shift the blame or find a way out but rather begin to go through the sadness and fear of not knowing themselves as they thought they did. Addicts struggle to come to terms 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 unable to conceive of a life without their acting-out behaviours 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 family/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, family/partners may despair that their relationships will ever be right. As they experience the addict going off to N.A or A.A 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.
The fifth stage - Acceptance
This stage is inevitable provided that addicts stay in recovery and that loved one i.e family/ partner 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 embrace a new vision of how their life will be lived without being in active addiction and 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 or are still in a recovery programme trying to self-discover and learn new life or coping skills, often utilizing hidden creativity and ingenuity formerly lost to their addiction. Loved ones i.e family / partner at the acceptance stage can see light at the end of the tunnel and are starting to heal away from the addict as they are now informed and involved in recovery through their support groups, therapy and self-education. They are beginning to redefine their role to their partner, their families and themselves.
To conclude, one common misconception about ending active addiction and entering recovery is that there will be immediate relief and positive benefits for all. Individuals wishing to enter recovery need to understand that 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. Nevertheless, this is painful and difficult stuff. The real challenge is more than just sobriety for the addict; it is tolerating the clearing of the wreckage from the past while holding onto hope for the future.
Some 12 step programs may be helpful in passing through the grief stages of recovery. This can include the famous sayings such as “This too shall pass”, “Trust the process” and “One day at a time” which 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 and are now living a sober life.
The importance of meetings i.e Narcotics Anonymous / Alcoholics Anonymous is that it allows the addict to experience and even celebrate those who are in recovery a bit longer and have more hope to offer than the person(s) behind them. There is no doubt that the process of the 12 step works for those that are committed to it. Combined with therapy and living in spirituality do create meaningful change for those who work to have that happen.