Editor’s Notes from Jeremy Frank, PhD, CADC, Psychologist and Certified Alcohol and Drug Counselor:
This article addresses the second factor which is integral to anyone’s addiction recovery – Supervision.
Whether your goal is abstinence or moderation and harm reduction, these the five factors (S’s) – structure, supervision, spirituality, social support, and substitution – are essential components of successful and healthy drug and alcohol and other addiction recovery. You can link to articles about each of the five factors at the end of this post. Remember you don’t have to have all five factors for your addiction recovery to be successful. But you will need more than just one of the factors.
What follows is Teddy Kradzinski’s personal account through therapeutic journaling of the role that supervision plays in his recovery.
While most of the words herein are Ted’s, I have added and edited some to include elements of George Vaillant’s evidence-based research into these factors which I call “The Five S’s of Addiction Recovery.” We encourage all people seeking change in their substance use, or those looking for change in other mental health areas and general well-being to explore the ways in which they are engaged in these vital areas of life.
Part 2: Supervision
Over my decade-long struggle with addiction I’ve learned that supervision is a useful tool for staying out of trouble. I have been homeless, living on the streets of Philadelphia. I have been to rehab more times than I can remember. I have overdosed. The experience has been humbling. I’ve learned that my intellectual capacity as a human being is not enough to address and withstand addiction. I felt I knew what was best for me, but history proved that my thoughts are not always rational or sound, particularly when in the grip of the disease. Fortunately, supervision greatly reduces my chances of making decisions I’ll regret.
People With My Best Interests in Mind
Having people in my life who look out for me with my best interests in mind has been crucial. It is key that these people cannot be manipulated; significantly, those who have helped me most have been exposed to addiction previously and recognize the subtle signs indicating that I’m not thinking clearly. These people have learned to not buy into narratives I create, whether consciously or not, that serve to excuse and continue my drinking and drugging. The supervision they provide can be the difference between getting high and staying sober, between dying and living. Having people around who recognize the delusional, self-destructive thinking that is part and parcel of addiction, and help me get to the other side—where clear thinking allows me to resist cravings—is life-saving.
My supervisors are a range of differing people who, together, create an ecosystem in which each offers unique insights, guidance, and help and no one person has to take all the burden. I am lucky enough to be in a relationship with someone who truly cares about me and has my best interest in mind. I see her every day and she, subtly, monitors my sobriety. She can determine this by looking into my eyes—heroin makes your pupils very small and my blue eyes make this extremely noticeable. This is not sustainable as a sole solution, but it has helped along the way.
Family Members
My parents are another source of supervision. Through long exposure to my lies and other behavior patterns of my addiction, they developed a solid ability to recognize when I am in danger.
My mother texts inspirational quotes to me every morning; I respond with my plan for the day. While it once struck me as absurd and annoying in the past, I now find it keeps me accountable. For example, I do not let a day waste away because I do not want to tell my mother that I plan to watch television all day.
Being honest with her keeps me honest with myself. I, in addition, give my mother full access to my bank account. This is necessary for me – having money has always been a trigger. If I withdraw money from the ATM, my mother will inquire about it. If I do not have a solid answer, she will assume I am using. While this cannot prevent engaging in addictive behavior, it does keep me accountable.
Group Meetings Like AA
AA offers a different kind of supervision. One that takes place in the context of a community filled with people who share my struggle. We are there to find our way to recovery and to help and look after each other. I have a sponsor in AA and I am honest with this person. AA sponsors know how an addict’s mind works because they are addicts, too. I can tell my sponsor things that might be a burden for my mother or significant other to know. My sponsor guides me through the twelve steps of AA. This makes them something of a spiritual advisor – or spiritual supervisor, if you will.
A Therapist or Counselor
I see a therapist, as well, and that provides another form of supervision. I can be completely honest with him. Without the personal emotional attachment I feel toward family, friends, loved ones, and even my AA sponsor.
My therapist and sponsor both provide supervision but they do so drawing from different, but equally authentic and informed, points of view. I might talk to my sponsor about one issue and my therapist about another. Or I may discuss the same issue with both. I know they are likely to respond with differing – but similarly applicable and appropriate – advice and supervision.
What is essential is that supervision comes from people whom I trust to operate per my best interests. And that they will respond to me with a desire to help rather than scold. Rather than resent their involvement in my life, I appreciate and want to please those who have earned my trust. Who I know are here to help me.
References
Vaillant, G. E. (2005). “Alcoholics Anonymous: Cult or Cure?” Australian & New Zealand Journal of Psychiatry, 39(6), 431–436. https://doi.org/10.1080/j.1440-1614.2005.01600.x
Miller, W. R., A. Forcehimes, M. J. O’Leary, and M. D. LaNoue (2008). “Spiritual direction in addiction treatment: two clinical trials.” Journal of Substance Abuse Treatment, 35(4), 434-42.
Suttie, J. (n.d.). “Drug Addiction, Social Connection, and the Brain.” Retrieved from https://greatergood.berkeley.edu/article/item/drug_addiction_social_connection_and_the_brain
