RW: Is this what people refer to as hitting bottom, or surrendering somehow?
SB: That’s the first experience – to hit bottom, to surrender, and to reach outside the self. So people seek help, they go to 12-steps. They then shift their object attachment from alcohol to a 12-step group, or to a treatment or mission- based center. They shift to whatever substitute will take the place so that they are still taking in, they still have an attachment. They begin to go to meetings; they’ll get a sponsor. They begin to take in the new object replacement for the substance.
VY: Why do you think this shift is so crucial to recovery?
SB: It is important so that you are not asked to give up your substance for nothing. The recognition is that you need a substitute attachment, so you get it. When you reach out for help, you’re going to reach out for a new object that represents recovery. It represents abstinence in the 12-step model and so the process of transformational change is under way with the shifted object attachment and the substitute new behaviors. What are the new behaviors? Going to the meetings, reaching for the phone, being in action to substitute something that represents recovery.
She very clearly describes a challenge we see frequently when a psychiatric diagnosis has been made. We see clients attaching to that diagnosis or their medication more strongly than to their recovery. It’s a fine line. We must be and we are responsive to their emotional/psychological suffering, but we also need to be cautious and conscious of the iatrogenic harm that can result from an inappropriate diagnosis and treatment.
RW: How much does it matter what that attachment is?
SB: I now see a lot of people going into treatment for addiction who are taking so many legal medications. They’re making their object attachment to the medication, instead of, “I have hit bottom. I am attaching to recovery.” These people are struggling in AA and NA. They’re sitting at meetings thinking about, “How’s my level of medications, should I up my antidepressants?” They’re talking all about the new object attachment to their medications.