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Why Is It So Hard to Stay Sober? – Vicki Tidwell Palmer LCSW, CSAT

Photo by Hatim Belyamani on Unsplash

According to the American Society of Addiction Medicine (ASAM), addiction is characterized by:

“an inability to consistently abstain, impairment in behavior control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response.”

The “inability to consistently abstain” is a concept that sometimes confuses loved ones and family members of addicts. They wonder, “How can we ever expect the addict to establish and maintain sobriety if ‘addiction’ means that’s something he can’t do?”

This confusion is understandable. What ASAM really means is that on their own addicts lack the ability to consistently abstain from addictive behaviors. They struggle to establish and maintain sobriety without help. Most addicts would stop their compulsive behaviors on their own if they could, but they can’t.

An addict’s inability to establish and maintain sobriety manifests in many ways. For instance, he might make promises to himself and others (loved ones, employers, the legal system, etc.) that he won’t engage in a particular behavior again, or he might promise himself and others that after a certain date in the future he will significantly cut back or quit altogether. However, these promises are rarely kept, even when the addict feels deep shame about his behavior.

Worse still, the addict’s craving for his “drug of choice” (whether it’s an addictive substance or an addictive behavior) increases over time. The addict experiences an increased tolerance, and this causes his addiction to escalate.

If he’s an alcoholic, he may require more drinks or stronger drinks to get the same level of intoxication. If he’s a drug addict, he might take more of a substance or a stronger substance, or he might ingest a substance in a way that gives him a faster and stronger high (like crushing pills and snorting them instead of swallowing them). If he’s a sex addict, he might spend more time engaged in a certain sexual behavior, or he might engage in increasingly more intense and/or risky sexual behaviors to get the desired high.

Over time, addicts develop chronic feelings of low self-worth. These feelings are caused by a combination of unresolved childhood issues, their inability to quit the addiction, and the secret, consequence-filled double-lives they lead. Typically, their relationships suffer, they have trouble at work or in school, they struggle with money or experience legal problems. And all of these issues tend to increase their shame and diminish their already low self-esteem.

This, of course, drives an addict right back into the emotional escape his addiction provides. This is the cycle of addiction. The addict feels shame, stress, anxiety, or some other form of emotional discomfort; he self-medicates, using his addiction to temporarily escape his feelings; and then he feels even worse because his life is out of control and filled with an escalating series of problems. Then he escapes his emotional discomfort by self-medicating yet again.

This is why it’s so hard for an addict to establish and maintain sobriety without help. It’s also why addiction is considered a lifelong, chronic issue similar to heart disease and diabetes. This means that addicts are never actually cured. Their addiction can, however, be managed with ongoing guidance and support, usually in the form of psychotherapy, addiction-focused counseling, 12-step groups, and, in more serious cases, inpatient treatment.

Vicki Tidwell

About Vicki Tidwell

Vicki Tidwell Palmer, LCSW, CSAT, is the author of Moving Beyond Betrayal: The 5-Step Boundary Solution for Partners of Sex Addicts, and a psychotherapist in private practice in Houston, Texas. She specializes in working with betrayed partners, and helping people heal from childhood trauma.

Vicki hosts an international online community for betrayed partners, offers several online courses for partners and therapists, and holds 4-day Reclaiming Wholeness Intensives for healing childhood wounds. She has presented at national conferences, for The Meadows Lecture Series, 12-step communities, as well as professional, healthcare, and faith-based organizations on a variety of topics including boundaries, relational trauma, and mindfulness.

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6 Comments

  1. A fine article. However, it doesn’t match up with real world statistics that the majority of addicts and alcoholics do , indeed, stop on their own. Additionally, the 12 steps, clearly promoted in the article, are not , as shown again by surveys (facts!), the most effective means to achieve long-term recovery.-**
    Those in 12-step programs live in a sort of bubble of delusion that their way is the only way. Not only are the 12 steps not the only way, they may be , for some, the worst possible alternative.

    *Deborah A. Dawson, “Correlates of Past-Year Status Among Treated and Untreated Persons with Former Alcohol Dependence, 1992” Alcoholism: Clinical and Experimental Research 20 , no. 4, (1996)
    ** Robert Granfield and William Cloud, Coming Clean: Overcoming Addiction Without Treatment (NYU Press 1999)

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  3. David, awesome commitment to your recovery! Your journey highlights the fact that sobriety is a multi-faceted endeavor. God/religion alone usually doesn’t work, just as 12-step without spirituality doesn’t either.

    Keep up the good work, you’re doing great!

  4. It’s real important to note too, that ONCE forgiven, we are forgiven. and we don’t have to drink, or use, over any thing, of any past. moments. or days.

    what’s encouraging, was the Basic text, of NA has different motivational phrases, that help, the addict, or alcoholic, keep sober and clean, because the MIRACLE is only 5 minutes away, IF we ask for Miracles, and we don’t relapse.
    key word being “Miracles” GOD I need a certain amount of Miracles, TODAY. He’s invisable Majestic LIGHT, POWER & LOVE & Compassion. so simply ask.

    because, we’re all forgiven. and we don’t need to loop on stuff , the divine blood of Jesus , heals, spiritual crashes, and 12 step’s help all, keep from spiritually crashing, again, or ever again. “Always HOPE, Great HOPE, in 12 step meeting, available at 12 step Meeting” Yoda

  5. I keep in the day, I ask GOD, to take away fear, and I ask everyday for GOD’s care & protection, for me and my loved ones, I ask every day, every 24 hours. THEN, I ask for GOD to keep me Sober, Clean and a nosmoker, “Just for Today” , then with saying the Rosary, “THY will be done, & deliver us from evil”, I get thru the 24 hour day. sober, clean, and a nosmoker.
    I saw GOD, He’s invisable LIGHT, and LOVE, he looks similar to a image of Brahma, one of his faces is alwsys the face of Jesus of Nazerith. I saw him, via meditation, @Yogananda-srf.org and it helped for when, I look for spiritual things, I find more happiness, though I would like to be rich, like Bill W.’s obsession, yet I lack business skills. so I write goofy songs, and I paint goofy paintings, Yet I’m sober and clean and a nosmoker, when I do things. or work.

  6. because alcohol is “legal” there’s a thing to it. also, “the phenomenon of craving” can only be overcome, with a simple prayer for “the AA, miracle” for deliverance, then seeing that it works better to keep sober.

    it took me 14-17 years to keep sober. I had to surrender, what helped me, was medical marijuana, and going to AA meetings. then, now I attend NA meetings, so I can keep clean. I’m sober 28 years, and clean 18 years, and a no smoker 5 years.
    YET for alcohol, I still read my BIG BOOK everyday, and I still attend 12 step meetings. and I had seen where some had relapsed, and I didn’t want that. and I remembered how difficult it was to get sober, then the Amazing Grace, when GOD granted me the miracle, of Sobriety, now I kinda like have zero friends, BUT , I’m sober and clean, and a no smoker, I also find great happiness, in listening to the Rosary, or saying the Rosary, and whatever happens, I keep sober, and clean, and I don’t smoke. “Just for Today”

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