The idea that everyone in recovery needs to find a point of discomfort, where things are so bad that they will never want to resume that behaviour again, rock bottom is often seen as central in the road to recovery. But is rock bottom real, or is it a myth? If it is a myth, is that myth a danger when left unchallenged?
What actually is rock bottom?
In recovery, early intervention, accurate diagnosis and effective treatments are the most successful ways to bring about change. However, in some arenas, the myth still exists that individuals need to hit rock bottom before they can hope to begin their recovery process. The rock bottom fantasy suggests that reaching rock bottom supposedly creates a platform which triggers a desire to change and leads to seeking support. The problem I have over and over again is that some professionals and loved ones state that for some who are in addiction, ‘they have not reached their rock bottom yet.’
The issue with this statement is that it creates a permission slip to step back from offering support. Instead of increasing effective interventions, more phone calls, use of Motivational Interviewing or creative approaches to offering support – the person in addiction is left in limbo, and expected to make the changes independently and to come towards support when they feel worthless, vulnerable and a burden.
Ironically, it is at this point that they may invest more in their network of substance using associates. So a passive response to a belief in a rock bottom can make addiction more sustained and reinforce links to the life of problematic substance use.
Perhaps worse than a passive response to this belief is the approach of making life even worse for those in addiction by taking away much of the support previously offered. Some loved ones withdraw much of the support they had previously offered in order to ‘help’ using the concept of ‘tough love.’ It comes from a good place, but tough-love induced rock bottom can make the person feel unwanted, and feed into their existing sense of worthlessness.
A key issue with the concept of rock bottom is that it can always get worse until we are dealing with a fatality. People can lose jobs, marriages, access to their loved ones,homes and then things can still get worse.
This is possible because anyone in addiction can easily compare themselves to someone else who is in a worse state, and use that to justify continuing their addictive cycle, but even if they cannot, they can and do distort their views:
1: I do not deserve a good life so I will not try to make my life change.
2: My family are better off without me.
3: I am enjoying this life, so I am better off without others telling me what to do.
The reality is, things can always get worse. By waiting for rock bottom to occur we are colluding in progressing the pain. Whilst we invest in the concept of rock bottom, addicts can go on to believe that they are not bothered about themselves, they are not worth a good or better life and eventually people lose aspects of their health, even limbs, and still they are not finding their rock bottom.
There are other versions of rock bottom where the professional deals themselves a ‘get out of treatment card’ in a more refined way but it is still a rock bottom defence. ‘They aren’t ready’ is a nebulous version of rock bottom, or even the mystical ‘it’s not their time.’ Better would be to upskill yourself in reducing DNAs rather than seek to adopt a pattern of resignation.
Rock bottom not only is problematic for carers to offer effective support, but it also deskills those in recovery from taking responsibility for their choices. This idea that rock bottom exists as a psychological state removes responsibility from those using – if you haven’t reached the stage where you’ve been broken down enough to commit to change, how can you be able to want to change and break this destructive behaviour?
Supporting those suffering
If we accept that people do whatever feels right at the time, then making people feel desperate, isolated, rejected and offering a fatalistic ‘it is not your time’ response is really inviting more and more opportunities for people to die, instead of minimising that risk today. Much more useful to supporting those around you who are struggling is to continue to challenge the behaviour, minimise the risks as much as is possible and continue to offer kind words, high expectations and hope. Reframing the conversation in this way helps you move away from the concept of rock bottom.
There are much better ways to address addictive behaviour than waiting for things to improve. Works around Motivational Interviewing, reducing DNA’s, persuasion techniques for recovery and CBT tools for substance misuse will all help your team to deliver sustainable change. Contact Betterminds for the support you need to move forward, leaving those rock bottom myths in the past.