✌️✌️✌️LONG- FORM POST. For those who want to think… There are many reasons people promote the “one way only” philosophy of recovery. 1) Dogma: All human groups tend toward dogmatism. Dogma certainly contributes to our stubborn commitment to one size fits all models. Bill Wilson warned us of this possibility in 1965: “It is an historical fact that practically all groupings of men and women tend to become more dogmatic; their beliefs and practices harden and sometimes freeze. This is a natural and almost inevitable process…. But dogma also has its liabilities. Simply because we have convictions that work well for us, it becomes very easy to assume that we have all the truth….This isn’t good dogma; it’s very bad dogma. It could be especially destructive for us of AA to indulge in this sort of thing”. (Wilson, 1965/1988, p. 333) 2)Institutionalization of “one way only” recovery (this is particularly tragic part of the story): The fact that a group of people, focused on mutual support, becomes tied into “the one true way” is natural. Recovery dogma is a less intense version of religious denominations. Tens of thousands of different religious denominations and sects. Each one claiming the true pathway to salvation. In recovery, we proclaim knowledge of the one true pathway to recovery. The recovery version of SEPARATION OF CHURCH AND STATE: Things get much more complicated and problematic when state authority figures, de-facto treatment experts, and perceived “addiction medicine” experts proclaim the one way only dogma. Once the 12 step only dogma became institutionalized it was a done deal. This model was cemented into the American psyche as the only way to recover. The underlying dogmatic principles have been systematically reinforced over the decades. This one way only thinking underlies most substance use disorder policy and procedures. For example: we have professional monitoring programs embedded within agencies that claim to embrace “multiple pathways to recovery”. However, the monitoring program will only approve 12 step recovery. We also have court systems and child welfare programs that will reject medication assisted treatment as a viable option for parents trying to get their kids back. There is very inconsistent and variable levels of institutional support for multiple pathways to recovery. Less obvious, but just as problematic, 95% of government funding is funneled into clinic based, compliance models. Acute care “come and get it when you are ready” is part of the solution. But it is not 95% of the solution. 3) Stating the obvious. All of this is reinforced by the private industry business model (rehab especially). A business that always wins with the “you must be willing” ideology. In this hit bottom and surrender model there is no such thing as bad treatment. There is only a bad patient. An unwilling patient. Furthermore, the answer is to send him back for more treatment. Over and over. Until he gets it right. This is a pretty sweet deal for the treatment provider. No so much for the patient. 4) This one is more personal. On the individual level. We may be afraid to open up to multiple pathways because we were conditioned to believe “this is the only way”. If we believe the research (for example 46% of people resolve SUD issues on their own) what does that say about us? And, does this make us vulnerable to getting off track in our own recovery. If I believe there is another way….am I going to make a mistake in my recovery. A latent, shadowy fear that any “crack in the foundation” will lead to relapse and death. Because we were told that early on. And it saved our lives during our most vulnerable periods. We were told: Do not think for yourself. And it worked…..This scared straight type psychology works early on. At least it did for me. However, as time goes by you can open your mind. If you are years into recovery you can probably explore multiple pathways without abandoning your chosen pathway. If you can’t, I would argue that you have a bigger problem on your hands. Can a devout Christian explore the tenets of Islam? Can a staunch progressive Democrat explore the merits of conservatism?  Can a died in the wool 12 step veteran explore the necessity of life saving addiction medicine? And if you can not do so….can you still call yourself “open-minded”?

✌️✌️✌️LONG- FORM POST. For those who want to think… There are many reasons people promote the “one way only” philosophy of recovery. 1) Dogma: All human groups tend toward dogmatism. Dogma certainly contributes to our stubborn commitment to one size fits all models. Bill Wilson warned us of this possibility in 1965: “It is an historical fact that practically all groupings of men and women tend to become more dogmatic; their beliefs and practices harden and sometimes freeze. This is a natural and almost inevitable process…. But dogma also has its liabilities. Simply because we have convictions that work well for us, it becomes very easy to assume that we have all the truth….This isn’t good dogma; it’s very bad dogma. It could be especially destructive for us of AA to indulge in this sort of thing”. (Wilson, 1965/1988, p. 333) 2)Institutionalization of “one way only” recovery (this is particularly tragic part of the story): The fact that a group of people, focused on mutual support, becomes tied into “the one true way” is natural. Recovery dogma is a less intense version of religious denominations. Tens of thousands of different religious denominations and sects. Each one claiming the true pathway to salvation. In recovery, we proclaim knowledge of the one true pathway to recovery. The recovery version of SEPARATION OF CHURCH AND STATE: Things get much more complicated and problematic when state authority figures, de-facto treatment experts, and perceived “addiction medicine” experts proclaim the one way only dogma. Once the 12 step only dogma became institutionalized it was a done deal. This model was cemented into the American psyche as the only way to recover. The underlying dogmatic principles have been systematically reinforced over the decades. This one way only thinking underlies most substance use disorder policy and procedures. For example: we have professional monitoring programs embedded within agencies that claim to embrace “multiple pathways to recovery”. However, the monitoring program will only approve 12 step recovery. We also have court systems and child welfare programs that will reject medication assisted treatment as a viable option for parents trying to get their kids back. There is very inconsistent and variable levels of institutional support for multiple pathways to recovery. Less obvious, but just as problematic, 95% of government funding is funneled into clinic based, compliance models. Acute care “come and get it when you are ready” is part of the solution. But it is not 95% of the solution. 3) Stating the obvious. All of this is reinforced by the private industry business model (rehab especially). A business that always wins with the “you must be willing” ideology. In this hit bottom and surrender model there is no such thing as bad treatment. There is only a bad patient. An unwilling patient. Furthermore, the answer is to send him back for more treatment. Over and over. Until he gets it right. This is a pretty sweet deal for the treatment provider. No so much for the patient. 4) This one is more personal. On the individual level. We may be afraid to open up to multiple pathways because we were conditioned to believe “this is the only way”. If we believe the research (for example 46% of people resolve SUD issues on their own) what does that say about us? And, does this make us vulnerable to getting off track in our own recovery. If I believe there is another way….am I going to make a mistake in my recovery. A latent, shadowy fear that any “crack in the foundation” will lead to relapse and death. Because we were told that early on. And it saved our lives during our most vulnerable periods. We were told: Do not think for yourself. And it worked…..This scared straight type psychology works early on. At least it did for me. However, as time goes by you can open your mind. If you are years into recovery you can probably explore multiple pathways without abandoning your chosen pathway. If you can’t, I would argue that you have a bigger problem on your hands. Can a devout Christian explore the tenets of Islam? Can a staunch progressive Democrat explore the merits of conservatism?  Can a died in the wool 12 step veteran explore the necessity of life saving addiction medicine? And if you can not do so….can you still call yourself “open-minded”?
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ROAR RICH JONES!!!

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