Author: Kayla Gill

With 9 years in the rehab space, Kayla has overseen the creation of comprehensive addiction treatment content for online audiences worldwide. Her experience managing content for a luxury destination rehab, and her personal path to healing via residential rehab and various therapeutic modalities, inform her first-hand understanding of recovery. She takes inclusion seriously and is especially interested in how trauma and minority experiences shape readers’ journeys.
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Adult Children of Alcoholics: Healing From Childhood Trauma and Learning to Thrive

Growing up with a parent addicted to alcohol can make for a difficult childhood. And that struggle continues to affect many into adulthood. Some adult children of alcoholics, (or ACoAs) turn to alcohol themselves, while others find themselves disconnected from the world around them. Others may develop a mental health condition that holds them back from fully living life. No matter how your childhood affects you in the long term, rehabs that treat trauma can help you release the hurt of a childhood affected by alcohol. 

Understanding Adult Children of Alcoholics

Adult children of alcoholics (ACoAs) are people who grew up in a home with one or more parents addicted to alcohol. And while many ACoAs enter adulthood without any long-lasting effects,1 some people continue to experience problems stemming from trauma during their childhood. Whichever camp you’re in, it’s important to remember that whether or not you develop issues from your childhood is not a reflection of your character. 

In many cases, an alcoholic home is also an abusive home. Parental alcohol addiction increases a child’s risk of sexual and physical abuse. According to one study, 85% of reported child abuse cases involve alcohol.2 Child neglect is also common. 

It may seem like nobody understands what you’ve been through, but you’re not alone. In the U.S., there are over 76 million adult children of alcoholics,3 many of whom have shared experiences. 

One common experience for ACOAs is growing up in a home with many unspoken rules that they have to follow to avoid trouble:

  1. Keep the addiction and any other family problems a secret.
  2. Don’t express your feelings.
  3. Always be perfect.
  4. Taking care of your own needs is selfish.
  5. Don’t relax or play.
  6. Avoid conflict at all costs.

These rules of operation create an environment where trusting others, expressing your needs, and having feelings is bad. And learning these kinds of lessons when you’re developing your understanding of the world means you may carry them into adulthood.

Common Traits of ACoAs

Because so many children of alcoholics experience similar trauma, many ACoAs face similar challenges. 

Distrust of Others

It’s common for parents addicted to alcohol to show affection inconsistently.4 One moment they may be loving, while the next they’re cold or cruel. And when someone becomes addicted to alcohol, drinking becomes the priority.5 As a result, working, providing food, and attending school functions fall by the wayside. So many ACoAs quickly learn that they can’t trust people6 for love or survival. 

The outside world becomes a scary place when you have a parent addicted to alcohol. Your parents may have taught you to keep their secrets so they wouldn’t get into trouble. Or maybe you couldn’t confide in your friends or teachers for fear of losing your family or getting into trouble yourself. People and systems that are there to protect you instead become something you fear. 

This distrust then makes it difficult to accept love from others. You become so accustomed to doing everything on your own that it may be scary to lean on someone else for your needs. And even when you do start to rely on others, it’s very common for ACoAs to fear abandonment.7 The volatility of your childhood makes it difficult to believe that love can be consistent.  

Hyper-Responsibility or Lack of Responsibility

It’s common for ACoAs to feel responsible for their parent’s addiction and its consequences. Sometimes that’s because a parent directly places blame on their child through their words or actions. Children start to believe that they’re responsible for any negative event that happens, but positive events are the result of luck. And feeling this way can lead to a dysfunctional sense of responsibility. 

Many ACoAs also grow up feeling like it’s their job to keep their family afloat. You may have started working to earn money for your family very early in life or taken on a parental role to younger siblings. This hyper-responsibility doesn’t disappear when you turn 18 or move out. Many ACoAs will continue to feel responsible for the happiness and well-being of everyone around them—an impossibly big task. 

On the flip side, some children growing up with addicted parents fully reject any responsibility.8 They become dependent on others for functioning. This is because they never had someone show them how to healthily identify, label, and communicate their needs. And because they rely on others for almost anything, it’s common for these children to grow up feeling like they can’t do anything right. They lose all confidence in their abilities because they never have to practice them. And that makes adulthood much harder. 

Perfectionism

Many ACoAs seek recognition from the outside world for their achievements as an escape from the dysfunction at home. When you don’t receive consistent affection just for being you, you grow up feeling worthy only because of your accomplishments. And especially when you’re young, the only parts of your life in your control are often your performance in school or extracurriculars. 

This obsession with external success combined with self-blame for your parent’s addiction quickly turns into perfectionism for many ACoAs. Your focus becomes avoiding any reason for people to criticize or blame you. And in turn, you feel like you can never make mistakes. It’s also very common for ACoAs to have a hard time having fun. Life is not about being happy, but about being in control. 

This is an exhausting way to live, and can easily lead to burnout. It’s important to remember that you’re worthy of love and kindness regardless of your resume or report card. Pursuing healing through rehab or therapy can help you develop a truer sense of self-love. 

Negative Self-View

Studies show that having a parent addicted to alcohol causes lower self-esteem9 in many cases. One reason for this is that many children of alcoholics believe they’re to blame for their parent’s addiction. Your parents may tell you that they drink to deal with your misbehavior. Or they’ll purposefully create conflict with you so that they “need a drink to calm down.” And when you blame yourself for such an intense issue at a young age, you may begin to believe there’s something wrong with you.

Another underlying cause is the theme of selfishness in an alcoholic home.10 ACoAs learn that their emotional needs are less important than everyone else’s and that they’re selfish if they prioritize themselves. Your sense of worth becomes rooted in how well you take care of others. But the truth is that your needs are important too, and learning how to communicate them is essential in adult relationships.  

Emotional Dysregulation

Many ACoAs also have trouble regulating their emotions.11 You most likely didn’t grow up with a positive model of emotional self-control because you may have seen your parents use alcohol to cope with unwanted feelings. Or you may have witnessed them become extremely emotionally volatile while drinking. So you didn’t have a chance to learn how to manage your emotions or react to others’ emotions in a positive way. 

Anger is especially difficult to deal with for ACoAs. Witnessing a parent’s rage at a young age is frightening. You may start to fear your own anger, needing to control it at all times. But bottling up your emotions or avoiding them isn’t healthy. Through rehab and therapy, you can develop the skills to be able to mindfully react to feelings without feeling threatened. 

Conflict Avoidance

In many alcoholic homes, conflict is intense and prevalent. And without a healthy model of conflict resolution, many children develop avoidance techniques like hiding in their room or dissociating.12 The cause of this is completely natural: you’re just trying to survive and stay out of harm’s way. But the result is that you never learn how to resolve conflicts in a healthy way. You might even learn that it’s your job to keep your family dynamic running smoothly, which means sweeping major issues under the rug. As such, many children of alcoholics continue to avoid conflict in their adult lives, which affects their mental, physical, and social health. 

When left untreated, these issues can continue well into adulthood. In fact, issues stemming from addicted parenting can still impact older adults. 

The Impact of Growing Up with an Alcoholic Parent

Growing up in an alcoholic home is chaotic. It’s hard to predict your parents’ next move and you never really know if your needs are going to be met or ignored. And that kind of unpredictability can create problems down the line. 

Increased Risk of Substance Abuse

ACoAs are up to 10 times more likely to become addicted to alcohol13 themselves. Having a father addicted to alcohol increases both men’s and women’s risk of alcoholism while growing up with a mother addicted to alcohol tends to increase women’s risk more than men’s. And ACoAs are also at greater risk for addiction to drugs other than alcohol. 

This could be because of a genetic predisposition for addiction, or because you learned to cope with stress by drinking after watching your parent do the same. Childhood abuse also increases your risk of addiction in adulthood.14

Difficulties in Relationships

Many ACoAs have trouble both forming and maintaining healthy relationships,15 especially romantic ones. Growing up without being able to trust others or even rely on your parent for consistent affection may make you fear intimacy in adulthood. And if your relationship model growing up involved somebody addicted to alcohol, you may not have a good blueprint for what a healthy relationship looks like. 

Every relationship involves some level of conflict. But because ACoAs didn’t have the chance to learn positive resolution skills, conflict can quickly trigger aggressive behavior. Or you may be conflict avoidant, meaning you handle conflicts by pretending they don’t exist. 

Physical Health Issues

Growing up with an alcoholic parent also affects your physical health. In fact, ACOAs face a higher risk of many physical health conditions:16

  • Diabetes
  • Sleep problems including insomnia
  • Fatigue and delirium
  • Gastrointestinal disease
  • Cancer
  • Heart disease
  • Cirrhosis 

Mental Health Issues

Instability in your childhood can affect your mental health17 into adulthood. Studies show that ACoAs have an increased risk for certain mental health conditions:18

In addition to these mental health conditions, post-traumatic stress disorder (PTSD) is a common result of growing up with a parent addicted to alcohol.19

Simple and Complex Post-Traumatic Stress Disorder (cPTSD)

The intensity and chaos of alcoholism is traumatic. And childhood trauma tends to stay with us in many forms, sometimes without us realizing it. Many ACoAs experience the symptoms of post-traumatic stress disorder (PTSD) as a result of their childhood. For example, hypervigilance is a common symptom of PTSD. And studies show that ACoAs learn to be hypervigilant20 from a young age to protect themselves. 

Many ACoAs also have all 3 of the defining symptoms of complex PTSD (cPTSD):21

  1. Difficulty managing emotions
  2. A negative self-view
  3. Trouble forming and keeping healthy relationships

Even if you don’t have a diagnosed mental health condition, the trauma of your childhood can affect you in many ways. But it doesn’t have to follow you forever. Many rehabs offer trauma-informed programs to help you heal from your past, and learn healthy ways to communicate and cope.

Overcoming the Lingering Effects of Alcoholic Parenting: Strategies for Healing and Moving Forward

Emotional Sobriety

Tian Dayton, psychologist and author of ACoA Trauma Syndrome, compares growing up with addiction to secondhand smoke:

We inhale the thinking, feeling and behavior of the addict emotionally, psychologically and behaviorally; we take who they are while using, into our own inner world…Many of the clients that I treat have never had a problem with substance abuse. But they still act drunk.

“Emotional sobriety,”22 a term first coined by AA founder Bill Wilson, is what people in recovery gain once they learn to regulate their emotions. Because this is often a major theme for ACoAs, learning to feel and work through emotions healthily is a crucial step in the recovery process.   

Rehab for Adult Children of Alcoholics

Thankfully, there are plenty of places to find support.

Some rehabs have dedicated treatment programs for ACoAs. Residential rehab programs give you access to multiple therapies and a supportive community to help you in your healing journey. Some rehabs even specialize in treating ACoAs. For example, one of the 9 phases of Affect2U’s treatment program focuses on ACoA-specific challenges. And if you’re not sure if a rehab you’re looking into offers informed support, you can always call their admissions team to ask. 

Going to rehab can help you resolve the trauma of your childhood, manage resulting mental health conditions, treat your addiction, and learn positive coping skills. And attending a residential program allows you to take a step back to give you space to re-evaluate your life. You’ll have access to professionals who understand what you’ve experienced in childhood and how it’s still affecting you. And you can work through your struggles through a variety of therapy methods. 

Treatment Options in Rehab

One treatment option that can help ACOAs is family therapy. This can open up lines of communication that have been shut down, helping you and your family heal the ways in which you relate to each other. Learning healthy conflict resolution alongside loved ones can help your relationship function more positively. 

Behavioral therapies are another option for ACoAs.23 Treatments like cognitive behavioral therapy (CBT) can help you learn new ways to resolve conflict, communicate your needs, and cope with stress. Your therapist will teach you how to identify and monitor your emotions and give you strategies to deal with unwanted feelings like relaxation techniques. The goal is to interrupt your regular patterns of reacting to emotional situations and replace them with more positive behaviors.

Resources for Adult Children of Alcoholics and Their Families

Support Groups

Rehab offers a supportive community to heal. At many rehabs, you can find support groups for people experiencing the same issues. You may attend meetings like Alcoholics Anonymous, which even if you aren’t addicted to alcohol could help you gain an understanding of what your parents have experienced. Some rehabs also offer Al-Anon meetings, specifically for loved ones of people with addiction. There are also rehabs for parents.

You can also attend support meetings outside of rehab. You’ll find others who understand what you’re going through and can support your healing journey. Al-Anon and other organizations offer virtual meetings for your convenience. 

Books for ACoAs

Books about growing up with addicted parents that can expand your understanding of your own experiences:

It may initially feel daunting to uncover past traumas, but you can heal—and multiple pathways can help you get there. 

Take Back Control of Your Life in Rehab

When you’re a child, life is mostly out of your control. And growing up with a parent with addiction makes it feel even more so. But you’re no longer a child. You are in charge of what happens next. And you’re in charge of your own healing. 

You don’t have to heal on your own: going to a rehab that treats ACoA-related trauma can provide the expertise and support you need. 

Explore rehabs that treat trauma to learn more about treatment methods, pricing, and more, and reach out to centers directly. 

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The Role of Nutrition in Addiction and Mental Health Recovery

Nutrition is a foundational element of well-being. Not only can good food provide a sense of pleasure and joy, but eating a nutritious diet helps your body and mind perform at their very best. If you’re seeking addiction or mental health treatment, establishing supportive eating habits is especially vital. The right nutrition plan can help you rebuild your health and prevent relapse.

Finding the right rehab program includes understanding the role of nutrition in your treatment plan. Helping your mind and body get back to functioning at their optimal levels will set you up for recovery success.

The Relationship Between Addiction and Nutrition

If you’re using drugs or alcohol, it’s common for substances to become a higher priority than your diet. People are more likely to feel depressed, anxious, or lethargic when they don’t get the nutrients they need.1 In turn, a poor diet can make it harder to resist drug cravings2 and contribute further to addiction.

Physical Symptoms of Poor Nutrition

Addiction can make you more likely to choose meals with low nutritional value, or not eat enough in general. As such, many people struggle with malnourishment in early recovery3 and may be underweight. While different substances impact your health and nutrition differently, regular substance use is likely to result in one or more of these symptoms:

Nutrition for Recovery

Addiction takes a huge physical toll on the body. Using alcohol or drugs requires your body to work extra hard to process and eliminate toxic substances and repair the damage they cause. From detox to post-rehab recovery, good nutrition helps to heal your body and mind.

Good Nutrition Can Ease Withdrawal Symptoms

Replacing lost nutrients is an important aspect of detox. The detox process can take a lot of mental and physical energy to complete. You may experience symptoms such as stomach pain, nausea, vomiting, and fatigue.10 When you’re ready to recover, eating healthy, nutrient-dense foods can help you ease withdrawal symptoms and avoid relapse.11

Food Provides Energy During Early Recovery

Recovering from addiction requires energy, resilience, and motivation. If you’re not eating well, you’re more likely to feel overwhelmed or drained in the early stages of sobriety. But with a nutritious diet, you’ll have the energy you need to stay motivated in recovery. Eating well helps you think more clearly,12 pay attention for longer periods of time, and enjoy a more balanced emotional state.

Plus, a balanced diet helps your body heal from addiction.13 Good nutrition helps your immune system improve, and your organs and tissues to repair themselves. Eating well is a key part of building healthy habits to support your new lifestyle—a main goal of residential rehab.

Eating Well in Life After Rehab

Nutrition supports every stage of recovery, even well beyond inpatient addiction treatment. Eating a balanced diet contributes to an elevated mood,14 higher energy levels, and better physical health.

It’s even proven that learning about nutrition helps people heal from addiction.15

Addiction and Disordered Eating

There’s a strong link between eating disorders and addiction. Up to 35% of people addicted to drugs or alcohol also struggle with an eating disorder—11 times higher than the rate of the general population.16

For some patients, disordered eating habits develop during the addiction recovery process.17 Weight gain is common in early treatment, when appetite increases and drugs are no longer depleting you. Weight gain can contribute to mental health issues, including eating disorders. But with the right medical care and nutrition plan, you can find lasting physical and emotional health during your recovery journey.

Learn more about eating disorder recovery here. 

The Link Between Diet and Your Mental Health

Nutrition is often linked to physical health. However, there’s a powerful connection between nutrition and mental health, too. Eating nutritious foods is an essential part of healing mental health issues including depression and anxiety. While nutrition has historically been undervalued in mental health treatment, it’s now gaining popularity and acceptance among experts.

The Gut-Brain Axis

According to nutritional psychiatry, there’s a direct link between your gut health and your brain.18 The “gut-brain axis” describes the physical connection between these 2 organs via the vagus nerve.

The vagus nerve starts in your brain stem and connects to your gut via the central nervous system. It not only plays an important role in digestion and nutrient absorption, but also sends nerve signals back and forth between the brain and the gut.

This means that a healthy balance of gut bacteria helps your brain produce the right chemicals to stay healthy and emotionally stable. And in turn, your brain helps your gut maintain the right balance of bacteria. In fact, studies show that healthy gut bacteria can improve your mood.19

Nutrition for Mental Wellness

If you’re struggling with your mental health, eating healthily might feel out of reach. Many people enter treatment for their mental health with poor nutrition.20

To help you heal, comprehensive rehabs programs leverage this gut-brain axis and use nutrition to support your recovery. Tailored meal plans can support healing and restore nutritional balance. This naturally helps you feel better and maintain energy and focus on your work in treatment.

Find Calming Relief

The right nutrition plan can provide structure and peace during early recovery. Inpatient mental health programs provide regular meals at routine intervals. This helps patients find a greater sense of calm,21 as well as maintain blood-sugar levels for stable energy throughout the day.

Nutritious food can also allow those healing from mental health issues to experience much-needed pleasure. Eating tasty foods releases dopamine in the brain,22 boosting your sense of joy. Studies also show a link between certain amino acids and omega-3 fatty acids and improved mental health23 during treatment.

Boost Your Mood

Neurotransmitters like dopamine and serotonin are vital for your mental health, mood, and overall wellness. Inpatient treatment programs that focus on nutrition can ensure you’re getting the right balance of vitamins and minerals for brain health:24

  • Probiotics
  • Magnesium
  • Tyrosine
  • Curcumin
  • Theanine
  • Amino acids

Heal Your Relationship with Food

Healthy eating is an important element of healing for people in eating disorder recovery. When you enter treatment, you’ll start to replenish nutrients your body needs by eating regular, nutrient-dense meals.

Treatment programs also give you the opportunity to learn how to stay healthy beyond your time in rehab. In some centers, you’ll work one-on-one with a nutritionist or dietitian to plan meals, shop for groceries, or even learn to cook. Over time, eating nourishing meals in treatment can help you rebuild trust with yourself25 and repair your relationship with food.

Eat Well to Build a Foundation for Recovery

Eating for recovery provides nourishment, energy, and comfort during every stage of your healing journey. And while the link between recovery and diet is universal, everyone’s needs are unique.

Search rehabs to discover the right fit for you. You can sort searches by various dietary needs, find programs with healthy meals, and even find treatment centers with vegetarian and vegan offerings.

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Build Resilience in Acceptance and Commitment Therapy

Do you constantly ruminate on negative thoughts, and then chastise yourself for thinking them? It’s easy to get stuck in that spiral. For a lot of people, acceptance and commitment therapy is the way out.

Rehabs with acceptance and commitment therapy teach you to be mindful of your thoughts instead of judging them. And that acceptance can be freeing. When you stop trying to “fix” your feelings, they might just guide you toward recovery.

What Is Acceptance and Commitment Therapy (ACT)?

Acceptance and commitment therapy ((Dindo L, Van Liew JR, Arch JJ. Acceptance and Commitment Therapy: A Transdiagnostic Behavioral Intervention for Mental Health and Medical Conditions. Neurotherapeutics. 2017 Jul;14(3):546-553. doi: 10.1007/s13311-017-0521-3. PMID: 28271287; PMCID: PMC5509623.)) (or ACT, pronounced like the word “act”) is a behavioral treatment. It can treat a range of mental health conditions, including addiction. ACT centers on the idea that unwanted thoughts and emotions are an inevitable part of life.

In this approach, you’ll learn that your feelings are not inherently problematic. But the act of avoiding unpleasant thoughts and feelings can cause serious issues. ((Pohar, Ron, and Charlene Argáez. Acceptance and Commitment Therapy for Post-Traumatic Stress Disorder, Anxiety, and Depression: A Review of Clinical Effectiveness. Canadian Agency for Drugs and Technologies in Health, 2017. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK525684/.)) Treatment helps you accept unwanted emotions. And that gives you room to re-engage with the parts of life you value most.

Avoiding emotional pain can have negative consequences. For example, you might go out drinking to distract yourself from work or family stress. And if you just do that once, it’s not necessarily a big deal. But if you keep leaning on substances to avoid how you feel, it can quickly lead to addiction. ACT helps you notice your coping behaviors, and see if they’re working in your favor.

How Do ACT Sessions Work?

You can learn ACT techniques in one-on-one therapy, group therapy, or via telehealth. Like many other behavioral treatments, most ACT programs have a set number of sessions. ((Pohar, Ron, and Charlene Argáez. Acceptance and Commitment Therapy for Post-Traumatic Stress Disorder, Anxiety, and Depression: A Review of Clinical Effectiveness. Canadian Agency for Drugs and Technologies in Health, 2017. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK525684/.)) These programs last an average of 8 weeks, but that can change based on your exact needs.

In a typical ACT session, your therapist will lead you through exercises and role playing scenarios. They might also use metaphors to help you see your life from a new perspective. Because ACT is a behavioral therapy, it focuses on teaching you practical skills. Then, you can use those skills to make meaningful changes in the rest of your life.

ACT for Addiction Recovery

ACT for addiction ((Osaji J, Ojimba C, Ahmed S. The Use of Acceptance and Commitment Therapy in Substance Use Disorders: A Review of Literature. J Clin Med Res. 2020 Oct;12(10):629-633. doi: 10.14740/jocmr4311. Epub 2020 Sep 21. PMID: 33029268; PMCID: PMC7524566.)) helps you accept your desire to use drugs or alcohol—without acting on it. Some other treatments, like cognitive behavioral therapy (CBT), teach you to work against these urges. But ACT has a different goal. Patients learn to live with their cravings, and use coping skills to tolerate them.

The lessons you learn in ACT can also help you navigate relapse. For many people, it can take more than one try to enter sustained recovery. ((U.S. Department of Veterans Affairs. “Reducing Relapse Risk.” Whole Health Library. https://www.va.gov/WHOLEHEALTHLIBRARY/tools/reducing-relapse-risk.asp)) ACT helps you accept the fact that healing isn’t linear. And that can make it easier to admit when you need help, and recommit to your own recovery.

Experts agree that ACT can effectively treat addiction. ((Osaji J, Ojimba C, Ahmed S. The Use of Acceptance and Commitment Therapy in Substance Use Disorders: A Review of Literature. J Clin Med Res. 2020 Oct;12(10):629-633. doi: 10.14740/jocmr4311. Epub 2020 Sep 21. PMID: 33029268; PMCID: PMC7524566.)) It can even help people recover from multiple addictions at a time. And it can help you heal from other mental health issues.

ACT for Mental Health

ACT is a transdiagnostic therapy, which means it works for many different conditions: ((Na, Euihyeon. “Acceptance and Commitment Therapy for Addiction.” Korean Academy of Addiction Psychiatry, vol. 25, no. 1, p. 3. www.academia.edu, https://www.academia.edu/19527124/Acceptance_and_Commitment_Therapy_for_Addiction. Accessed 8 Mar. 2023.))

  • Anxiety: Data shows that ACT reduces the symptoms of anxiety.
  • Chronic pain: ACT improves quality of life for people with chronic pain.
  • Depression: After ACT for depression, patients are less likely to have mental health relapses.

Because it’s so versatile, ACT might be a good choice for people with co-occurring disorders. That way, you can use the same approach to work toward all your recovery goals.

The Core Principles of Acceptance and Commitment Therapy

ACT promotes psychological flexibility. ((Osaji J, Ojimba C, Ahmed S. The Use of Acceptance and Commitment Therapy in Substance Use Disorders: A Review of Literature. J Clin Med Res. 2020 Oct;12(10):629-633. doi: 10.14740/jocmr4311. Epub 2020 Sep 21. PMID: 33029268; PMCID: PMC7524566.)) In other words, it helps you find your flow, even as life presents you with challenges. You can use the 6 principles of ACT ((Zhang CQ, Leeming E, Smith P, Chung PK, Hagger MS, Hayes SC. Acceptance and Commitment Therapy for Health Behavior Change: A Contextually-Driven Approach. Front Psychol. 2018 Jan 11;8:2350. doi: 10.3389/fpsyg.2017.02350. PMID: 29375451; PMCID: PMC5769281.)) to respond in a way that honors your values.

During treatment, your clinician may or may not talk about these core principles. But either way, they’ll serve as the basis for your work in therapy. And because all these concepts support each other, you probably won’t go through them in a linear fashion. Instead, your therapist will bring them up organically.

Defusion

You are not your thoughts. And your thoughts aren’t always facts. But what you think and feel can have a huge impact on your behavior. For instance, if you constantly tell yourself that treatment is too hard, you might start to skip therapy sessions. And then, it doesn’t matter if treatment is actually too hard. If you’re not attending therapy, then your therapist can’t help you heal.

To address this, ACT uses defusion to remove some of the power of your thoughts and feelings. You’ll learn how to look at your thoughts and feelings objectively, and not as intrinsic truths. This can help you accept what you feel and let it go, instead of allowing it to define you.

Acceptance

Acceptance is the ability to feel your feelings without trying to change them. In ACT, you learn how to approach emotions with curiosity instead of judgment. For example, you might get angry at a loved one during family therapy. And then, you might judge that feeling. You could feel ashamed of your own anger, or sad about what caused it. And while those feelings about your own anger are valid, they can quickly lead to a spiral.

Acceptance empowers you to hold space for yourself. If you get angry at a loved one, you can simply sit with that feeling. You don’t have to yell, and you don’t have to shut down your own emotional response. Instead, you can practice mindfulness, exploring how and why you might feel angry. And over time, you can work through that anger, release it, and move forward.

Contact With the Present Moment

Through ACT, you’ll learn to be more present in each moment. It’s all too easy to lose yourself in regret about the past or anxiety about the future. This therapy helps you stay grounded, so you can take action to improve what’s actually happening in your life.

To achieve that, you can learn any number of mindfulness techniques. For example, you could practice breathing exercises, or take up yoga. These skills invite you to engage with the world as it actually is, instead of how you fear it could be.

The Observing Self

This principle of ACT encourages self-awareness. You’ll learn to tell the difference between yourself, your thoughts, your feelings, and your actions.

This objectivity helps you develop self-compassion. For example, feeling bad doesn’t mean you’re a bad person. And by the same token, relapsing into addiction doesn’t define who you are. Objectivity lets you move through painful thoughts, feelings, and situations without giving up on yourself or your goals.

Values

You’ll begin most ACT programs by defining your values. ((Zhang CQ, Leeming E, Smith P, Chung PK, Hagger MS, Hayes SC. Acceptance and Commitment Therapy for Health Behavior Change: A Contextually-Driven Approach. Front Psychol. 2018 Jan 11;8:2350. doi: 10.3389/fpsyg.2017.02350. PMID: 29375451; PMCID: PMC5769281.)) Your therapist will guide you through an exercise in which you identify your highest ideals. Then, you’ll write them down and refer to them throughout treatment. They may also change over time.

Once you define your values, you can start to plan around them. You can even do that during rehab. For instance, if you value creativity, you might try art therapy or music therapy.

Treatment is just the beginning. As time goes on, your core values can guide you through life. And you can lean on them when you make major decisions. So if you value spontaneity, you might turn down a 9-5 job. Or if you value physical fitness, you might make time to work out every day. There’s no wrong way to live your life. But in recovery, it’s important to build a life that feels meaningful—however you define it.

Committed Action

With this ACT principle, you’ll make and keep commitments to yourself. Typically these commitments are tied to your values. For example, if family is one of your core values, you might commit to cooking dinner for them twice a week.

These simple actions can help you develop confidence. And over time, they’ll build toward larger patterns of behavior. That way, you can improve your relationship with yourself while you work toward external goals.

ACT in Accordance With Your Values

ACT recognizes that your goals are unique. This treatment doesn’t try to change the way you think. And it doesn’t define recovery for you. Instead, ACT guides you gently toward your own values. With the skills you’ll learn in treatment, you can start building a life you love—on your own terms.

View our list of rehabs with ACT to learn about their pricing, housing, insurance options, and more.

Reviewed by Rajnandini Rathod

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Alcohol Detox and Withdrawal: What to Expect During Treatment

Deciding to heal from alcohol addiction is exciting. You’re finally ready to reclaim control of your life and start reaping the benefits of sobriety. But it’s important to start your recovery safely. Detoxing and going through withdrawal are important first steps, but suddenly stopping or decreasing your drinking can be dangerous—even life-threatening.

Rehabs with detox programs offer a safe and more comfortable experience that can set you up for long-term success in your recovery.

Treatment for Alcohol Withdrawal During Detox

Each year, more than 1.5 million people in the U.S. go through alcohol withdrawal ((Saitz, Richard. “Introduction to Alcohol Withdrawal.” Alcohol Health and Research World, vol. 22, no. 1, 1998, pp. 5–12. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761824/.)) in a rehab or a medical setting. And while even more people withdraw at home, alcohol withdrawal can be very dangerous, and in some cases lethal. It’s a good idea to detox with medical supervision so you can stay healthy, safe, and as comfortable as possible.

Where Can You Detox?

Options for detox include hospitals, inpatient rehabs, or outpatient programs. Which option is the best for you depends on your health history, severity of symptoms, and personal needs. For example, people who are more likely to develop severe symptoms like seizures may require hospitalization. People with co-occurring disorders may also need a higher level of care to protect their health. But others who experience less severe symptoms may be able to detox through an outpatient program that offers regular check-ins with a medical professional to ensure they’re staying safe.

Some residential rehabs offer medical detox onsite, which allows you to immediately move into a residential addiction treatment program afterwards. This can provide you with stability in early recovery by easing your transition into inpatient care.

How Long Does It Take To Detox From Alcohol?

Everyone’s detox and withdrawal timeline ((“Detox.” Recovery Research Institute, 8 Nov. 2018, https://www.recoveryanswers.org/resource/alcohol-and-drug-detox/.)) is different and depends on several factors:

  • How long and how much you drank
  • Family history of addiction and other health issues
  • Co-occurring disorders like depression, anxiety, or physical health conditions

Withdrawal can start just hours after stopping or reducing your drinking. ((Alcohol Withdrawal: MedlinePlus Medical Encyclopedia. https://medlineplus.gov/ency/article/000764.htm. Accessed 7 Mar. 2023.)) But it can also take up to 48 hours for symptoms to set in. It’s most common for symptoms to peak between 24-72 hours after you begin detoxing. However, some symptoms may linger for weeks.

Alcohol detox programs usually last 3-7 days depending on your symptoms. It usually begins with an evaluation ((“Detox.” Recovery Research Institute, 8 Nov. 2018, https://www.recoveryanswers.org/resource/alcohol-and-drug-detox/.)) to get a better picture of your overall health and any pre-existing conditions that may cause complications, like high blood pressure.

Then, your treatment team will address your alcohol dependence, usually by using a stabilizing medication that’s tapered down over the course of your detox. This process minimizes withdrawal symptoms and lessens your risk of complications. Staff will closely monitor you, especially in the first 48 hours after you begin to detox as that’s when most symptoms set in. They’ll check your vitals, ask how you’re feeling, and may perform blood tests as necessary to check your hydration levels.

If you don’t develop any withdrawal symptoms after about 48 hours, you may be released into outpatient services. If you’re detoxing in a rehab, you may instead move to their inpatient center to begin their treatment program.

The goal of alcohol detox ((Hayashida, Motoi. “An Overview of Outpatient and Inpatient Detoxification.” Alcohol Health and Research World, vol. 22, no. 1, 1998, pp. 44–46. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761814/.)) is to help you reach an alcohol-free state, relieve your symptoms, and address any co-occurring conditions to prepare you to enter addiction treatment.

Managing Withdrawal Symptoms

While withdrawal is typically uncomfortable, there are certain things you and your team can do to manage the symptoms and reduce your discomfort. When you detox in a facility, they’ll monitor your symptoms and adjust your conditions to relieve pain.

Medications

In many cases of alcohol detox, a doctor will prescribe certain medications to lessen withdrawal symptoms ((Shivanand Kattimani and Balaji Bharadwaj. “Clinical management of alcohol withdrawal: A systematic review.” Industrial Psychiatry Journal. v.22(2); Jul-Dec 2013
)) and prevent complications. Benzodiazepines are the most common medication for managing alcohol withdrawals.

Depending on your detox program and health history, your doctor may give you medication right away. People with physical health conditions or a history of severe withdrawal symptoms may take a single dose of a benzodiazepine prior to detoxing. Or, you might take medication only after presenting certain symptoms like seizures, high body temperature or blood pressure, or agitation.

Comfortable and Safe Conditions

Detox centers consciously design their spaces to make the experience more comfortable. The ideal environment for alcohol withdrawal is quiet with low lighting ((Shivanand Kattimani and Balaji Bharadwaj. “Clinical management of alcohol withdrawal: A systematic review.” Industrial Psychiatry Journal. v.22(2); Jul-Dec 2013
)) and minimal stimulation to keep you calm. To ensure patient safety, they will also not have any potentially dangerous substances or items in the room.

You may also have access to a therapist to talk through your feelings ((2 Settings, Levels of Care, and Patient Placement. Substance Abuse and Mental Health Services Administration (US), 2006. www.ncbi.nlm.nih.gov, https://www.ncbi.nlm.nih.gov/books/NBK64109/.)) and cravings during this vulnerable time. And depending on the center, you may interact with others in the program for peer support.

Nutrition and Hydration

Your diet and hydration levels affect the severity of your symptoms ((Shivanand Kattimani and Balaji Bharadwaj. “Clinical management of alcohol withdrawal: A systematic review.” Industrial Psychiatry Journal. v.22(2); Jul-Dec 2013
)) and the development of complications. This is partly because alcohol addiction causes nutritional deficiencies that may prolong detox. ((Center for Substance Abuse Treatment.Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No.(SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment, 2006.)) And because detox is hard enough on your body, supporting it with healthy foods that may bring you joy is important.

Your detox center’s initial assessment may even include a nutritional evaluation. This tells your doctors exactly which nutrients you’re lacking. Depending on the results, your doctor may recommend vitamins or other supplements for the first 3-5 days of detox ((Shivanand Kattimani and Balaji Bharadwaj. “Clinical management of alcohol withdrawal: A systematic review.” Industrial Psychiatry Journal. v.22(2); Jul-Dec 2013)) to address those deficiencies.

Your medical team will also keep a close eye on your fluid and electrolyte levels. In more severe cases, you may receive fluids through an IV. Staying hydrated can alleviate some withdrawal symptoms.

Understanding Alcohol Withdrawal

Studies show that over half of people who are dependent on alcohol experience withdrawal ((Rahman, Abdul, and Manju Paul. “Delirium Tremens.” StatPearls, StatPearls Publishing, 2022. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK482134/.)) when they stop or slow their drinking. And 3-10% of people experience severe alcohol withdrawal. Withdrawal looks different for everyone, but it’s safest to have medical supervision to ensure your symptoms don’t become life-threatening.

What Causes Withdrawal?

While you might assume that withdrawal only happens when you completely stop drinking, you can actually start experiencing withdrawal symptoms from just decreasing your alcohol consumption. ((Saitz, Richard. “Introduction to Alcohol Withdrawal.” Alcohol Health and Research World, vol. 22, no. 1, 1998, pp. 5–12. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761824/.)) In fact, some people who are dependent on alcohol can start to experience withdrawal even at a blood alcohol level that would normally cause someone to feel very intoxicated. You may not realize how much alcohol your body is used to before you stop drinking, especially if you’ve been functioning “normally.”

Alcohol withdrawal causes imbalances in the brain, ((Saitz, Richard. “Introduction to Alcohol Withdrawal.” Alcohol Health and Research World, vol. 22, no. 1, 1998, pp. 5–12. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761824/.)) which lead to your symptoms. After a certain point of heavy drinking, your body—specifically your brain and central nervous system—become used to having alcohol in your system. Your bodily systems have learned to constantly adjust their functioning to compensate for the depressive effects of alcohol. So when you suddenly stop or reduce your drinking, your body doesn’t adjust as quickly and still operates on hyperdrive, causing withdrawals.

Symptoms of Alcohol Withdrawal

Certain symptoms of alcohol withdrawal ((Saitz, Richard. “Introduction to Alcohol Withdrawal.” Alcohol Health and Research World, vol. 22, no. 1, 1998, pp. 5–12. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761824/.)) are more common:

  • Tremors
  • A strong urge to drink
  • Sleep problems, including difficulty falling or staying asleep and intense dreams
  • Anxiety
  • Hypervigilance
  • Irritability
  • Loss of appetite
  • Nausea and vomiting
  • Headaches
  • Sweating

These symptoms typically start about 6-12 hours ((Sachdeva, Ankur, et al. “Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond.” Journal of Clinical and Diagnostic Research : JCDR, vol. 9, no. 9, Sept. 2015, pp. VE01–7. PubMed Central, https://doi.org/10.7860/JCDR/2015/13407.6538.)) after you begin detoxing. While they may make you uncomfortable, they’re usually not life-threatening. However, you may also experience a more severe form of alcohol withdrawal called delirium tremens, ((Rahman, Abdul, and Manju Paul. “Delirium Tremens.” StatPearls, StatPearls Publishing, 2022. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK482134/.)) which is more dangerous.

Delirium Tremens (DT)

Delirium tremens is a severe form of alcohol withdrawal. It’s most common in people who have chronically used alcohol in high quantities over the years, or consistently for months. Without proper treatment, it can be deadly. Early detection and professional treatment can prevent death or serious injury.

With DT, you’ll experience common symptoms of alcohol withdrawal, plus more severe symptoms: ((Delirium Tremens: MedlinePlus Medical Encyclopedia. https://medlineplus.gov/ency/article/000766.htm. Accessed 7 Mar. 2023.))

  • Seizures
  • Deep sleep for 24 or more hours
  • Sudden and extreme confusion
  • Feeling very excited or scared
  • Hallucinations
  • Quick bursts of energy
  • Sudden changes in mood
  • Fatigue
  • Light, sound, and touch sensitivity

If you do experience DT, you’ll probably need to stay in the hospital until your symptoms subside. Your medical team will check your vitals consistently. As dehydration is very common, they’ll test your blood for electrolytes levels and body fluid levels. They’ll also likely give you medicine to help you stay calm, prevent seizures, and lessen your symptoms.

DT symptoms typically start about 48-96 hours after you suddenly stop drinking and can last up to 5 days. However, sometimes it takes 7-10 days after your last drink for DT symptoms ((Delirium Tremens: MedlinePlus Medical Encyclopedia. https://medlineplus.gov/ency/article/000766.htm. Accessed 7 Mar. 2023.
)) to begin. And some people even experience certain withdrawal symptoms like mood swings and fatigue for years after.

Post-Acute Withdrawal Syndrome (PAWS)

It’s common for people recovering from alcohol addiction to still experience withdrawal symptoms during rehab or even long after. This is called post-acute withdrawal syndrome (PAWS), or protracted withdrawal.

With PAWS, your withdrawal symptoms ebb and flow over time and may be triggered by stress. PAWS symptoms mainly resemble acute withdrawal symptoms, but there are a few additional ones to be aware of:

  • Concentration and memory issues
  • Decreased sex drive
  • Complaints of pain without a cause

PAWS can cause relapse, ((Melemis SM. Relapse Prevention and the Five Rules of Recovery. Yale J Biol Med. 2015 Sep 3;88(3):325-32. PMID: 26339217; PMCID: PMC4553654.)) so it’s important to prepare yourself for it. While you may be ready to manage immediate withdrawal symptoms, coming to terms with prolonged withdrawal may be more difficult. In rehab, you’ll learn new coping skills to help you deal with these symptoms and prevent relapse. You can even ask your clinical team to help you come up with a plan ahead of time, so if you do begin to experience PAWS, you know what to do. Successful recovery is still very possible with PAWS.

Recovery: The Light at the End of the Tunnel

Detox is just the first step in your recovery journey—long-term recovery requires follow-up care, ideally starting with residential rehab. And while detox may not be the most pleasant experience, doing so in a safe, supportive place can help you stay sober, healthy, and well.

Search our list of detox centers for information on pricing, post-detox programming, and more.

Reviewed by Rajnandini Rathod

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Who Works in Rehabs? Understanding Roles and Titles

When you choose something as important as a rehab, you want to be sure you’re in good hands. Addiction treatment is a life-changing process, and surrounding yourself with the right people can set you up for success. Everyone who works at your treatment center has an important role to play in your recovery.

As you consider different rehab programs, knowing what to look for in a treatment team can help you find one that meets your needs.

Who Takes Care of You in Rehab?

Rehabs employ a diverse range of professionals. The size and expertise of the staff vary from program to program. But at most facilities, you’ll interact with these team members:

Rehabs in the U.S. are regulated at the state level. That means staff credentials and licensing requirements vary by location. If you have specific questions, you can easily learn more about the laws in a given area. The U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) lists state regulations for substance use disorder programs ((The National Association of State Alcohol and Drug Abuse Directors (NASADAD). July 2013. “State Regulations on Substance Use Disorder Programs and Counselors: An Overview.” https://nasadad.org/wp-content/uploads/2010/12/State_Regulation_of_SUD_Programs_and_Counselors-7-26-13.pdf.)) and staffing requirements. You can also view credentials and licensing requirements of substance use disorder workers, ((U.S. Department of Health and Human Services Assistant Secretary for Planning and Evaluation Disability, Aging and Long-Term Care Policy. November 2019. “CREDENTIALING, LICENSING, AND REIMBURSEMENT OF THE SUD WORKFORCE: A REVIEW OF POLICIES AND PRACTICES ACROSS THE NATION.” https://aspe.hhs.gov/sites/default/files/private/pdf/263006/CLRSUDWorkforce.pdf.)) as outlined by the U.S. Department of Health and Human Services.

The Admissions Team

Admissions team members are your first point of contact with a rehab. Their job is to help you find a program that suits your needs. To do that, they’ll want to learn as much as possible about your recovery goals. While admissions staff essentially function as a sales team, they may also have recovery-specific skills:

  • Program knowledge: They know the center’s programs inside and out and can give you the information you need.
  • Communications training: They can communicate with people in different mental and emotional states.
  • Intake assessment: They’re qualified to conduct an initial rehab intake assessment. ((Treatment, Center for Substance Abuse. Chapter 4—From Precontemplation to Contemplation: Building Readiness. Substance Abuse and Mental Health Services Administration (US), 1999. www.ncbi.nlm.nih.gov, https://www.ncbi.nlm.nih.gov/books/NBK64968/.))
  • Treatment planning: They can help you plan for treatment, including logistics and travel.

First impressions matter, and your initial contact with a rehab is no exception. This call is your opportunity to make sure they have your best interests at heart. Unfortunately, that’s not always the case. There are even fake hotlines designed to trick people who are looking for treatment. But there are ways to determine whether a rehab center is legitimate, even over the phone.

A good admissions specialist should be able to address your concerns and share clear, helpful information. A great one makes you feel seen and supported.

Qualifications

Admissions specialists must have a high school diploma. ((Data for Occupations Not Covered in Detail : Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics. https://www.bls.gov/ooh/about/data-for-occupations-not-covered-in-detail.htm#Healthcare%20practitioners%20and%20technical%20occupations. Accessed 12 Dec. 2022.)) Many also have 1-2 years of experience in admissions or healthcare settings.

Mental Health Experts

Talk therapy is a core component of most treatment programs. There are many different approaches, but a few are especially common during rehab:

These are examples of evidence-based treatment. In other words, data shows that they can help with addiction recovery. Your therapist may recommend these methods as part of your care plan.

Counselors

Counseling helps people work through acute issues ((Therapy vs. Counseling: Is There a Difference? https://health.osu.edu/health/mental-health/therapy-vs-counseling-is-there-a-difference. Accessed 12 Dec. 2022.)) and kickstart the healing process. A counselor is more like an ally than a guide. They’ll get to know you, learn about your goals for recovery, and help you decide what to do next.

Counseling is a broad field, so most counselors choose a specific focus. For instance, you might see someone who mainly treats gambling addiction, or helps patients heal from trauma. Substance abuse counselors concentrate on addiction treatment.

Qualifications

“Counselor” is a job title. Most addiction counselors hold at least a bachelor’s degree, but that’s not always required. LPCs need a master’s degree and a state license.

Psychotherapists (M.S., M.A.)

A psychotherapist, or talk therapist, can provide longer-term treatment than a counselor. They serve as a guide during talk therapy, helping you explore your mental health. In many programs, they also take the lead on designing your treatment plan.

During rehab, you’ll likely attend both 1:1 and group therapy sessions. You may also receive talk therapy sessions from another type of expert, like a psychologist or psychiatrist.

Qualifications

Therapists need a master’s degree ((“What Degree Do You Need to Be a Therapist?” Point Loma Nazarene University, https://www.pointloma.edu/resources/counseling-psychology/what-degree-do-you-need-be-therapist. Accessed 12 Dec. 2022.)) (M.S. or M.A.) in a mental health field and a state license.

Psychologists (Ph.D., PsyD)

Psychologists are licensed mental health professionals, much like therapists. However, they have more rigorous educational requirements.

Practicing psychologists need a doctoral degree. They are qualified to both treat patients and do clinical research. Because of their academic background, psychologists might use more specialized treatment techniques. It’s also more common for psychologists to treat patients with severe mental health symptoms. ((“Counselors vs. Therapists vs. Psychologists: Key Differences.” Northeastern University Graduate Programs, 16 Feb. 2021, https://www.northeastern.edu/graduate/blog/counselor-vs-therapist-vs-psychologist/.))

Qualifications

Practicing psychologists have a Ph.D. in a field of psychology or a doctorate of psychology (Psy.D.). They also adhere to state licensing laws.

Certified Addiction Specialists (CAS)

A certified addiction specialist (CAS) is a mental health professional with advanced training in addiction treatment. Usually, a CAS treats addictive disorders ((Certified addiction specialist (Cas) certification. (n.d.). American National Standards Institute . https://share.ansi.org/wc/Shared%20Documents/Workcred-Reports/Understanding-Certifications-Study/Certification-Overviews/American-Academy-of-Healthcare-Providers-in-the-Addictive-Disorders-Certified-Addiction-Specialist.pdf)) in 5 main areas:

  • substance use disorders

The responsibilities of a CAS depends on their background and specialization. For example, you could see a medical doctor certified to treat alcohol use disorder. They would take a different approach than a CAS whose background is in psychology.

Some states require that certain professionals have an addiction specialist certification. ((Certified addiction specialist (Cas) certification. (n.d.). American National Standards Institute . https://share.ansi.org/wc/Shared%20Documents/Workcred-Reports/Understanding-Certifications-Study/Certification-Overviews/American-Academy-of-Healthcare-Providers-in-the-Addictive-Disorders-Certified-Addiction-Specialist.pdf)) For example, all opioid medical directors in Ohio must be addiction specialists.

Qualifications

All certified addiction specialists must have a bachelor’s degree. To provide patient care, they also need a master’s degree and certification from an accredited organization.

Licensed Marriage and Family Therapists (LMFT)

Addiction can damage relationships. For the person with addiction, unhealthy relationships can trigger mental health symptoms. And those symptoms can lead to drug use, which can erode your loved ones’ trust. Without professional support, it’s easy to get stuck in this loop.

LMFTs provide family or couples counseling to help you heal interpersonal dynamics. Treatment can be transformative for your relationships and for each individual family member. For many people, this is an essential part of healing from addiction. A strong support network increases your chances of long-term recovery. ((Atadokht, A., Hajloo, N., Karimi, M., & Narimani, M. (2015). The role of family expressed emotion and perceived social support in predicting addiction relapse. International Journal of High Risk Behaviors & Addiction, 4(1), e21250. https://doi.org/10.5812/ijhrba.21250))

Qualifications

LMFTs hold a master’s or doctoral degree. They also need a state license from the Association of Marital & Family Therapy Regulatory Boards. ((State Licensure Comparison – AMFTRB. https://amftrb.org/resources/state-licensure-comparison/. Accessed 12 Dec. 2022.))

Medical Professionals

Many rehabs also employ medical professionals. Depending on their licensure, they may treat physical issues, prescribe medication for mental health, or both.

Some facilities have a special focus on medical treatment. If you’re planning to go through medical detox, for example, it’s important to find a qualified provider. Unsupervised detox can be extremely dangerous. These professionals can help you manage the physical and emotional symptoms of recovery.

Psychiatrists (M.D., D.O.)

A psychiatrist is a medical doctor (an M.D. or D.O.) ((American Psychiatric Association. “What is Psychiatry?” Retrieved December 9, 2022, from https://www.psychiatry.org/patients-families/what-is-psychiatry)) who specializes in mental health. They can give you an official diagnosis and prescribe medication. For people in addiction recovery, this type of treatment usually requires close supervision, to make sure you only take your meds as directed.

Talk therapy almost always accompanies psychiatric treatment. Your psychiatrist may provide therapy, or they may work in tandem with another professional, like a psychologist. But even if you’re seeing some else for psychotherapy, you’ll have regular check-ins with your psychiatrist. They’ll ask you about your life, your symptoms, and whether you’re experiencing unwanted side effects. Over time, they may adjust your dosage to achieve the best results.

Some patients need ongoing medical treatment for mental health issues, even after finishing rehab. In rare situations, you may be able to keep seeing the same person when you return home. But most of the time, you’ll need to sign a release form so they can share your medical history with your new psychiatrist.

Qualifications

Psychiatrists may be medical doctors (M.D.s) or doctors of osteopathic medicine (D.O.s). They also need a state physician’s license.

Medical Doctors (M.D.)

Many rehabs have doctors on staff. In medical detox programs, they ensure patients’ safety throughout withdrawal. ((Detoxification and Substance Abuse Treatment. (2006). Center for Substance Abuse Treatment. https://store.samhsa.gov/sites/default/files/d7/priv/sma15-4131.pdf)) But they can also support other aspects of recovery. For example, some people develop addiction in the attempt to manage chronic pain. In that case, a doctor might help you find non-addictive medications to serve the same purpose.

Some diagnoses, like eating disorders, have both physical and psychological symptoms. Medical care can be a major component of treatment for these conditions.

Qualifications

M.D.s have doctorates. They may also need a certification in addiction medicine, ((Statutes, Regulations, and Guidelines. https://www.samhsa.gov/medication-assisted-treatment/statutes-regulations-guidelines. Accessed 12 Dec. 2022.)) or relevant state licensing.

Addiction Medicine Physicians (ADM)

Drug addiction can take a toll on your physical health. ((Abuse, National Institute on Drug. “Addiction and Health.” National Institute on Drug Abuse, –, https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/addiction-health.)) If that’s your experience, your provider may refer you to an addiction medicine physician (ADM).

ADMs specialize in addiction-related health issues. They can give you an official diagnosis, and treat both physical and emotional symptoms. ADMs may also treat the loved ones of a person in recovery.

Qualifications

ADMs need a doctorate and a certification in the ADM subspecialty from ABMS. ((Abuse, National Institute on Drug. “About the Addiction Medicine Subspecialty.” National Institute on Drug Abuse, –, https://nida.nih.gov/nidamed-medical-health-professionals/health-professions-education/adm-fellow-toolkit/about-addiction-medicine-subspecialty.)) This is a relatively new credential.

Nurses (LPN, LVN, RN, APRN, etc.)

There are numerous different types of nurses. ((Licensed Practical and Licensed Vocational Nurses : Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics. https://www.bls.gov/ooh/healthcare/licensed-practical-and-licensed-vocational-nurses.htm#tab-2. Accessed 12 Dec. 2022.))

  • Licenced practical nurses (LPNs) and licensed vocational nurses (LVNs) can check your vital signs, update your records, and provide basic care.
  • Registered nurses (RNs) have more responsibilities. ((Registered Nurses : Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics. https://www.bls.gov/ooh/healthcare/registered-nurses.htm#tab-2. Accessed 12 Dec. 2022.)) For example, RNs can assess your symptoms and help coordinate your treatment plan.
  • Advanced practice registered nurses (APRNs) ((“APRNs in the U.S.” NCSBN, https://www.ncsbn.org/nursing-regulation/practice/aprn.page. Accessed 12 Dec. 2022.)) are nurses with master’s degrees or higher. They can diagnose patients, prescribe medication, and design your plan of care.

Qualifications

LPNs and LVNs must complete a year-long program ((Licensed Practical and Licensed Vocational Nurses : Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics. https://www.bls.gov/ooh/healthcare/licensed-practical-and-licensed-vocational-nurses.htm#tab-4. Accessed 12 Dec. 2022.)) and pass a state licensing exam.

RNs may have a bachelor of science in nursing (BSN), an associate’s degree in nursing (ADN), or an associate of science in nursing (ASN). All of these programs include supervised clinical training. RNs are also licensed by the state. ((Registered Nurses : Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics. https://www.bls.gov/ooh/healthcare/registered-nurses.htm#tab-4. Accessed 12 Dec. 2022.))

There are several types of APRNs, ((“APRNs in the U.S.” NCSBN, https://www.ncsbn.org/nursing-regulation/practice/aprn.page. Accessed 12 Dec. 2022.)) which require various degrees and types of education. APRNs often have specific areas of focus, like chronic illness or counseling.

Holistic and Complementary Health Practitioners

Mental health and addiction can affect every aspect of your life, from relationships to nutrition.

In holistic treatment, you’ll approach recovery as an integrated, whole-self experience. Instead of just treating your symptoms, you’ll reconnect your mind, body, and spirit with each other.

Holistic addiction treatment is increasingly popular. ((Junyue, Jiao, et al. “Complementary and Alternative Medicine for Substance Use Disorders: A Scientometric Analysis and Visualization of Its Use Between 2001 and 2020.” Frontiers in Psychiatry, vol. 12, Nov. 2021, p. 722240. PubMed Central, https://doi.org/10.3389/fpsyt.2021.722240.)) As a result, it’s easier than ever to find a rehab that employs the following specialists:

Some rehabs also offer experiential therapies, like equine and adventure therapy. Qualified experts lead these sessions, sometimes with the help of a talk therapist.

Qualifications

Requirements for holistic practitioners vary widely. For example, massage therapy is regulated at the state level. And in most U.S. states massage therapists must pass the Massage and Bodywork Licensing Exam (MBLEx) ((“Massage Therapy State Licensing Requirements.” Associated Bodywork & Massage Professionals, 3 June 2015, https://www.abmp.com/practitioners/state-requirements.)) to get a license. But in some states, like Minnesota, there are no licensing regulations.

Other complementary treatments are relatively new to the U.S., even if they have a long history in other countries. As a result, not all of these professionals require licenses. But as researchers continue to study these therapies, those requirements may change.

Find Recovery With the Support of a Strong Treatment Team

Starting recovery is a major commitment—to yourself and to the program. You don’t need to spend your time in rehab wondering if you can trust your team. Look for a center that employs experienced professionals who work well together. With their support, you can focus on what really matters: your healing journey.

Review our list of rehabs to compare the essentials about each center, from treatment team information to pricing and insurance options.

Reviewed by Rajnandini Rathod

Posted on

Nourishing the Recovering Body: Nutrition in Rehab

Eating well is a huge part of feeling well. Food doesn’t just support wellness—it can also be a source of joy. When you go to rehab for addiction or mental health treatment, great meals can be the thing you look forward to.  

Food is both a source of pleasure and an important tool for long-term recovery. Addiction and chronic stress deplete your body and compromise its ability to absorb nutrients. That’s why it’s crucial for your treatment plan to include healthy meals. And in some rehabs, nutrition is a major part of the program. 

Nutrition and Addiction

Addiction takes a toll on the body and mind. As the experts at Siam Rehab know, “if your body is healthy, you have a healthy mind with it as well.” Healing—both physically and mentally—starts by learning how addiction affects your eating habits.

How Substance Use Depletes Nutrients

Malnutrition is common among people with addiction.1 While you’re actively using, drugs and alcohol might be a higher priority than your diet.2 In some cases, drug use can even damage the organs that absorb nutrients. Different types of addiction have different effects on the body:

Diet During Detox and Withdrawal

When you’re ready to recover, detox is often the first step. You can expect this process to have immediate physical and emotional effects. For example, you may have digestive symptoms during withdrawal,8 like nausea, stomach pain, and a reduced appetite. Eating well supports your body’s natural healing abilities. 

Eating Well in Early Recovery

Drug cravings are a normal part of early sobriety. Food cravings might be, too. Data shows that your appetite can increase in your first 6 months of sobriety.9 You may even have more of a sweet tooth than usual. As a result, weight gain is common during inpatient rehab.10

For some clients, weight gain and body image become mental health issues. Gaining weight can even be a trigger for relapse.11 And experts believe that women in particular “increasingly report weight-related concern as motivation for drug use.” Some people even develop disordered eating habits during treatment.12 Without proper medical care, these issues can work against your long-term physical and emotional health.

With the right treatment, food can support your recovery—not undermine it. Eating balanced meals and learning about nutrition can help you heal from addiction.13 Plus, most people’s cravings and appetites return to healthy levels 6 months into addiction recovery.14 That’s especially likely for people who use structured eating plans. 

Food as Aftercare and Relapse Prevention

Good nutrition is important in every stage of recovery—even after you complete treatment. Eating well improves your physical health, of course. But that’s just the beginning. Poor eating habits also increase your risk of relapse.15 Studies link good nutrition with ongoing sobriety,16 overall mental health.

Nutrition and Mental Health

Balanced meals are a powerful way to boost your mood.17 As nutritional therapist Julia Ross writes, “this is the law of malnutrition: when your food quality or quantity deteriorates, your mood is the first casualty, even before your physical health begins to deteriorate.” Ross and many other experts report a link between food and emotional well-being.

The Gut-Brain Axis

There’s a direct line of communication between your gut and your brain.18 Experts call this the “gut-brain axis,” and it’s key to your mental health. Gut health impacts your mood, “motivation, and higher cognitive functions.”

Stress and changes in diet can affect digestion19 by harming the bacteria in your gut. That can cause a range of issues, from inflammation to leaky gut syndrome. Researchers have linked these conditions with depression and anxiety. On the other hand, several studies show that healthy digestive bacteria can improve your mood.20 

Eating Right for Your Brain

Studies indicate that people with certain mental health issues are very likely to have nutrient deficiencies.21 Those with depression, bipolar disorder, and obsessive-compulsive disorder are especially vulnerable. But, research also found that patients’ mental health improved when they took certain supplements. 

If you have any of these diagnoses, you can talk to your doctor or nutritionist to learn more. Make sure to get an expert opinion before taking any over-the-counter supplements. They may interact with other medications, or impact other parts of your recovery plan. 

Eating Disorders

If you’re healing from an eating disorder, good nutrition is a vital part of recovery. Because these conditions change your eating habits, they often damage your physical health. The exact risks vary, depending on your specific symptoms. 

Most eating disorder treatment programs include nutrition education,22 meal planning, and therapeutic meals. These activities bolster your skills around healthy eating, and give you the nutrition you need to fuel physical and emotional recovery. 

Studies show a strong connection between eating disorders and the need for control.23 This can make it feel especially scary to enter a treatment control. But, by learning to trust a team of professionals to help you heal, you’re working to take back control of the rest of your life. And good nutrition can empower you to do the hard work of building better habits.

Improve Your Energy and Clarity

Recovery takes effort. And in the early stages of treatment, you might not be used to keeping a strict schedule. You’ll also be working through heavy emotional issues, which can be tiring. Good nutrition boosts your energy and improves mental stamina, helping you focus on treatment. Certain nutrients are especially important for regulating energy and preventing fatigue:24

  • complex carbohydrates
  • fats
  • minerals like iron, magnesium, and zinc
  • vitamins like B vitamins and vitamin C

Because of the link between addiction and poor diet, eating well might feel like a big change when you enter rehab. This is also an issue during mental health treatment. For instance, studies show a link between depression and low vitamin levels.25 

Your mental health can impact your dietary requirements, and vice versa. But everyone’s needs are different. Your care team may advise a meal plan, IV therapy, or even fasting. Ask your admissions team about their approach to nutrition, and how that will impact your treatment plan. 

How Do Rehabs Provide Proper Nutrition?

Because nutrition is such a large part of both recovery and everyday life, it can affect every aspect of rehab. Every center has its own way of integrating nutrition into the healing process. 

In-House Nutrition Experts

Some rehabs employ nutrition specialists or other food experts. For example, you might work closely with a nutritionist or dietitian. These specialists create balanced meal plans, which they can tailor to meet each client’s needs. They may also give you vitamins, minerals, or other supplements. And when talented chefs design the daily menu, you can look forward to every meal. 

At Soberman’s Estate, a men-only rehab in Arizona, culinary excellence is a big part of the healing process. Using local ingredients from their on-campus greenhouse, their executive chef creates meals that are “as good as or better than most five-star restaurants,” as one previous patient said. 

If you have a refined palate, dietary restrictions, or other food-related needs, talk to your rehab’s admissions team about their ability to accommodate you. 

Designing Your Meal Plan

Addiction and mental health issues affect everyone’s body differently. Some rehabs create individualized meal plans to bring your body back into balance. They may take a blood test as part of your initial screening to see what nutrients you’re lacking, then work to remedy that throughout your stay. 

At Istana, a 1:1 rehab with locations in Bali, Barbados, and Ibiza, menus are designed to “address deficiencies in your diet and strengthen your body’s nutrition.” Each meal plan is designed by their team of professionals to meet clients’ unique dietary needs.

You’ll also have regular check-ins with the nutritionist to track how your body responds to meals throughout treatment. They can then make changes based on real-time feedback. By taking part in this process, you’ll learn about your own evolving needs and practice listening to your body. And when you leave the center, you’ll be more empowered to eat healthy and respond to your body’s needs.

Planning for Long-Term Recovery

Recovery doesn’t end when you leave rehab. Many centers offer nutrition education, so you can learn life skills before finishing treatment. This helps clients make long-term plans for their ongoing nutritional health. 

You can continue to benefit from proper nutrition on your own after learning about balanced eating from professionals. Inpatient treatment centers like Paracelsus Recovery in Switzerland help you set up long-term nutrition plans. These aren’t fads or quick fixes. Instead, they’ll show you how to care for your body and mind sustainably, using food as a tool.

Some centers even help find support for you closer to home in your aftercare. Rowland Tweedie, the center’s Health and Fitness Manager, explains, “I often try to find a local person that [clients] can be supported by: a personal trainer or nutritionist. Someone locally they can go to, to help them maintain or reinforce what they’ve been doing during the program.” 

Find Joy in Nourishing Your Body

Recovery isn’t just about moving away from unhealthy habits. It’s also about learning how to enjoy your life in a healthy way. And for many people, food can be a positive, healthy way to find that joy. Eating a tasty, nourishing meal can be a source of pleasure, no matter what else you’re dealing with.
Explore our searchable list of rehabs and filter your search by dietary preference, see centers that offer gourmet dining, and more.

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Learning True Strength in Men-Only Rehab 

Men face a unique set of challenges that affect the types of mental health issues they have, their likelihood of seeking help, and their experience in treatment once they do. Thankfully, more rehabs are specializing in care for men, addressing male-specific struggles in a safe and supportive setting.  

Mental Health Challenges Facing Men Today

Growing up in a culture with specific expectations about what it means to “be a man” shapes male psychological development. This impacts the types of mental health issues men have, and the methods they use to cope:  

Because it can be harder for men to voice their problems, this suffering often happens in silence. Men’s mental health researcher Benita Chatmon, PhD says this raises concern: “These statistics are troubling because they reinforce the notion that males are less likely to seek help and more likely than women to turn to dangerous, unhealthy behaviors.”

A Note on Gender

In the past, gender has been thought of as being either male or female, but we now understand it to be far more nuanced. Those who aren’t cisgendered men may still be affected by cultural expectations of masculinity. And those who don’t see gender as a major factor in their experience may not find gender-specific treatment necessary. Ultimately, it’s up to you to decide which aspects of your care are most important.

sobermans estate mens group
Soberman’s Estate in Cave Creek, Arizona offers daily group therapy and equine therapy as part of their men-only treatment program.

Masculine Norms

“Men are subjected to a culture where the standards of masculinity are literally killing them,” says Chatmon. 

This happens through what men’s mental health activist Dan Griffin calls the “internalization of the ‘man rules.”4 Sometimes called “toxic masculinity,” this set of rules tells men how they’re supposed to behave:

  • Don’t show weakness. 
  • Don’t express your emotions. 
  • Don’t cry. 
  • Don’t admit that you’re afraid. 
  • Don’t lose control.
  • Don’t ask for help. 

Unfortunately, following these rules leads many men to struggles with depression, anxiety, stress, and substance abuse. And, it cuts them off from support when they need it most. 

“When men adhere rigidly to the kinds of norms that encourage them to not share their emotions, to be sort of relentlessly self-reliant without seeking the help or support of others, they can have poorer mental health outcomes,” says health behavior professor and men’s mental health expert Wizdom Powell, PhD, “because doing so cuts them off from the social networks and social supports that might help them get through a difficult time.” 

Everyone’s Journey is Their Own

Of course, just because certain issues tend to be more challenging for men doesn’t mean all men experience them in the same way. These norms show up differently for different people, affect men to different degrees, and vary according to context. “A man who enacts a particular masculinity in the boardroom may enact a very different kind of masculinity on the street corner,” says Powell.

Why is it Harder for Men to Ask for Help?

Mental illness is often overlooked in men,5 and is therefore more likely to go untreated. SAMHSA’s guide on Addressing the Specific Behavioral Health Needs of Men states that there are “specific issues facing men that can affect all elements of the treatment process,6 including the decision to seek treatment in the first place.”

Social conditioning can influence how likely men are to talk about their feelings or reach out when they’re struggling. And there’s far more to this picture than what appears on the outside: 

Trauma and Shame 

Intense shame is a common theme for men in recovery,7 in addition to “histories of violence, sexuality, family issues, and difficulty accessing emotions.” Some men feel this as a result of trauma they’ve experienced, or inflicted on others. And some feel shame around violating masculine norms. 

Shame is a powerful emotion.8 It affects the way you see yourself, how you interpret the world around you, and the choices you make. That includes your willingness to address the traumas underlying your addiction, anxiety, or depression. 

But working through shame is a necessary part of healing. Psychologist and former president of the American Psychological Association Ronald Levant explains: “We have to brave the shame. We were made to feel ashamed of ourselves for not being fully masculine,9 and that was nonsense…Those lessons you learn as a child are not valid. A better approach is to have an open heart, an open mind, and to freely express your emotions to the people you care about.” 

That includes yourself. 

Stigma

Mental health stigma exists across all genders, but especially so for men, who are under extra pressure to seem like they have it all together.

In a report from the 2019 Behavioral Health Aspects of Depression and Anxiety in the American Male, experts agreed that “stigma is an extreme barrier to those needing mental health treatment,”10 and that men’s acculturation affects the way they experience mental health issues.

When men do get into treatment, that acculturation also affects how receptive they are to the process.

next step adventure therapy
Next Step Recovery in Asheville, North Carolina is a 12-Step intensive outpatient program offering adventure therapy and optional sober living.

Adjusting to the Treatment Process

Many of these unspoken rules are the opposite of what recovery asks us to do. The healing process requires us to be vulnerable, make room for our emotions, and be unflinchingly honest with ourselves. Residential rehab, where feelings are shared with therapists and in groups, may feel inherently unsafe to someone with little practice doing any of these things. 

“Men are expected to be independent, self-sufficient, stoic, and invulnerable,” says SAMHSA. This means that, often, men struggle with certain issues during treatment:11 

  • Inability to see or express weaknesses
  • Difficulty opening up to therapists or peers
  • Competitiveness with other patients 
  • Defensiveness 
  • Unwillingness to take direction or accept suggestions 
  • Anxiety around privacy and confidentiality 
  • Lack of ability to connect feelings to the problems they stem from 
  • A false sense of security in their recovery status 
  • Resistance to attending continuing care or ongoing meetings 

Intensive treatment is only the beginning of the recovery journey. After treatment, men return to their home communities, where they face the same societal pressures as before. That’s why it’s important to prepare for life after rehab by gaining tools that reduce your chance of reverting to old coping habits. 

Common Male Coping Strategies 

Suppressing Emotions

Men are often taught that expressing emotions is wrong. But regularly holding them in doesn’t make them go away—it just makes them come out sideways.

“Suppressing emotion in and of itself isn’t necessarily harmful,” says Powell. “It’s when you do it habitually; if it’s your go-to response to all the stress that you experience. Eventually, that suppression will cause a rebound in some other areas, like whack-a-mole. You hit it down in one place and it pops up in another.”

Humans are blessed with an astounding range of emotions—and ideally, we should be fluent in all of them. But this is easier said than done. Many men are limited to just a handful of emotions that are considered acceptable to express. 

Anger 

When we’re stressed, we tend to respond with the emotion that’s most readily available to us. And for men, who may not be well-versed in expressing sadness or fear, that emotion is more likely to be anger. 

Sometimes, we channel anger and other “negative” feelings into behaviors—some of which are harmful to us. Especially if we feel the need to “suck it up” and get through hardships on our own, those behaviors are less likely to look like talking through our problems with a friend or therapist, and more likely to look like social withdrawal, overworking, aggression, or alcohol and drugs. 

Substances 

Substances are a common way to cope with problems we’d rather not face head-on. And for men, anger and the inability to untangle difficult emotions can lead to more substance use. 

Data shows that “men tend to use more alcohol as opposed to women when they are stressed.”12 According to Powell, “we can see higher rates of substance abuse in males because of that anger and emotional response.”

Mental Health Among Minority Men 

Mistrust of treatment professionals comes from a particularly deep-rooted place for men and boys of color. There’s not only a verified link between racism and poor mental health,13 but an established history of racial trauma and access inequities in the American healthcare system.14  

The good news is that this can be changed. “Even with those experiences in the background,” says Powell, “when Black men have more patient-centered, empathic experiences with physicians, they report lower medical mistrust. So in other words, mistrust is not immutable. It can be fixed. It can be intervened upon.” 

Fortunately, some treatment programs are evolving to be more responsive to the societal issues their patients are grappling with. 

How Treatment Can Help  

Looking at deeply held traumas and unprocessed emotions is a necessary step toward healing. “When they feel safe enough, [men] are willing to look at many important, although difficult, issues commonly overlooked in traditional treatment. Some of these are relationships, sexuality and sexual behavior, power and control, criminal behaviors, privilege and entitlement, and grief,” say the authors of Helping Men Recover: A Program for Treating Addiction. 

Rehab can be a safe place to do just that. 

Gender-Responsive Care Takes Men’s Issues Into Account

“The keys to developing effective treatment for men,” says Griffin, “are acknowledging their life experiences and the impact of living as a man in a male-based society.”

In men-only rehab, patients can ease into the treatment process alongside others facing similar issues, with less distraction and a chance to build lasting bonds. 

Soberman’s Estate in Cave Creek, Arizona caters exclusively to adult men. They find that this gender-specific grouping raises the comfort level, leading to more sharing and honesty in group sessions. This creates an environment conducive to recovery, comradery, and true release. And because they make special efforts to accommodate working professionals, business access time is built into the daily schedule. 

For those who prefer to live at home during treatment, Next Step Recovery in Asheville, North Carolina offers a men’s-only intensive outpatient program (IOP) with optional sober living options for men ages 18-40. In addition to a focus on building a healthy daily routine, the center offers a range of therapeutic outdoor activities including river rafting, paintball, and high ropes.

Face the Fears That Keep You From Your Best Life

Being a man doesn’t need to mean foregoing care that will make you well, and ultimately more capable of living to your full potential. 


See our directory of men-only rehab centers to learn more about their programming, facilities, activities, and more.

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8 Ways Healing Can Be Joyful 

Challenges are a natural part of any growth process—but that’s not all there is to it. Healing can also be punctuated by small wins, big triumphs, exciting breakthroughs, and deep connections.

At the end of the day, the self-knowledge, empowerment, and resources you gain are immeasurably rewarding.

Here are 8 ways to find joy in the journey of addiction recovery.

1. Changing Your Relationship With Fear

This may not exactly sound joyous, but the payoff is nothing short of life-changing.

So much of addiction and maladaptive behavior comes from avoidance. ((“Maladaptive Behavior: Causes, Connection to Anxiety, and Treatment.” Healthline, 18 Mar. 2020, https://www.healthline.com/health/maladaptive-behavior.)) As humans, we avoid the things we’re scared of: our past traumas, our emotional pain, and our deepest insecurities. Substances are an easy way to check out of feelings we’d rather not deal with—and sometimes, with very valid reason. Maybe we’re not emotionally ready, we don’t have adequate support in place, or we can’t afford the disruption in our lives. Avoiding is a coping strategy ((https://www.verywellmind.com/avoidance-coping-and-stress-4137836#:~:text=Avoidance%20coping%20involves%20trying%20to,reduce%20the%20stress%20it%20causes.)) that’s designed to help us survive. But the problem is that it works until it doesn’t. And some coping strategies have serious consequences for our health.

True healing requires the deep, vulnerable work of facing our fears. While it’s not easy, doing so in a therapeutic environment means you’ll be surrounded by professionals who guide you through the process, and peers who are doing the same thing right alongside you. Taking on this brave task taps you into your personal fortitude and shows you what you’re really capable of. As you get used to facing life’s challenges head-on, they’ll start to feel more like normal ebbs and flows and less like full-on crises.

2. Getting to Know Yourself Better

The healing journey is a deep dive inward. Parts of it may be uncomfortable—but growth requires us to move beyond our comfort zones.

The upside of recognizing our pain (and the need to do something about it) is that it can serve as an entry point onto a path of self-discovery. As Rumi famously said, “The wound is the place where the Light enters you.” ((https://www.goodreads.com/quotes/103315-the-wound-is-the-place-where-the-light-enters-you)) Being utterly honest with yourself is an illuminating process. You’ll discover strengths you didn’t know you had.

Knowing yourself puts you in control of your own life. It increases your self-acceptance, self-trust, emotional intelligence, and ability to have healthy relationships. “I argue that we are in an inescapable relationship with ourselves ((https://www.researchgate.net/publication/329216347_Knowing_Yourself_and_Being_Worth_Knowing)) that requires both self-love and self-respect,” says Jordan MacKenzie, Faculty Fellow at the NYU Center for Bioethics. “Self-love gives us a noninstrumental reason to know ourselves, while self-respect demands that we take this reason seriously.”

One way to honor this relationship is to reconnect with your physical self.

3. Coming Back Into Your Body

A common response to trauma is dissociation—that is, mentally and spiritually disconnecting from ourselves when physical escape isn’t possible. Dissociation is the body’s natural way of protecting us. But when we do this habitually, it becomes our default state. By numbing ourselves to negative emotions, we also numb ourselves to positive ones, diminishing our ability to feel fully engaged with life.

Movement- and touch-based therapies are helpful for reconnecting with the body in a safe and guided way. Many rehabs offer these as part of a holistic treatment program:

It’s especially important for physical and sexual assault survivors to do this in a trauma-informed setting. And while it may be challenging, it can also be one of the most transformative, and ultimately enjoyable, aspects of the healing process.

By grounding into our bodies and staying present with ourselves, others, and the world around us, we experience more of what life has to offer.

4. Practicing New Ways of Doing Things

Changing long-held patterns means dealing with life in ways that don’t rely on old coping mechanisms—and that can feel awkward at first. Thankfully, rehab is a great place to practice. Whether it’s letting yourself cry instead of looking for a distraction, or talking through a problem with a recovery peer instead of stewing in resentment, you’ll get to try new approaches until you find what works for you. And, you’ll have encouragement from counselors and support staff along the way.

By the end of your stay, you’ll be empowered with new knowledge of how to navigate relationships that you can take with you into the real world and continue to build on.

5. Setting Healthy Boundaries

“We get our needs met by communicating them. And that can be really hard,” says Nedra Glover Tawwab, therapist and author of Set Boundaries, Find Peace.

Boundary-setting sounds easy, but in reality, it’s an advanced skill. Insecure attachment (a result of childhood trauma) tells us that if we upset our loved ones, they might leave. And that makes it hard to state a need or preference when you’re unsure how the other person will take it.

“Boundaries are statements that make you feel safe and comfortable in your relationships,” ((https://www.vox.com/even-better/23310442/vox-conversations-boundaries-nedra-glover-tawwab-even-better)) says Tawwab. And, contrary to what our fears tell us, they help to preserve them. Learning to tolerate the discomfort that often follows these statements takes time. With practice, you’ll see how boundaries set a healthier tone for your relationships and create the space necessary for you to meet your needs. This grows your sense of ownership over your life—and what’s more rewarding than that?

6. Discovering Therapies That Resonate With You

Residential rehab gives you a chance to try healing modalities that you may not have otherwise. You may find that you relate to the philosophy behind DBT, that acupuncture reduces your cravings, or that the path of yoga aligns with your recovery journey. Hopefully, you’ll walk away from rehab with resources for ongoing therapy, which can lead to a beneficial relationship with a new therapist.

Many rehabs include complementary therapies as part of their treatment program, even if it’s clinically based. Often, patients choose to continue with therapies or activities they find helpful, adding to their fulfillment in life after rehab.

7. Knowing Where to Turn When Things Get Rough

Being healed doesn’t mean hardship stops happening. It means you get better at dealing with it.

In addition to treating your symptoms, rehab also provides a training ground for life. Most residential programs have a 28-day minimum because this allows enough time to establish a rhythm in a new, healthy routine. Much of your time in treatment is spent building a toolkit of healthy outlets, coping strategies, and connections you can turn to when you need them. These can include exercises for self-soothing, processing, or releasing emotions; connections for professional care; sober community; and restored relationships with your loved ones.

8. Learning Self-Love

Addiction is a form of self-harm, and is often fueled by negative self-talk. ((https://www.verywellmind.com/negative-self-talk-and-how-it-affects-us-4161304)) The healing process teaches us now to recognize when we’re telling ourselves a story, ask whether that story is accurate, and replace it with a more helpful belief. Especially when we have less than nurturing childhoods, we get the message that self-criticism will help us achieve the change we desire. But what if all it achieves is turning us against ourselves?

“We are often at war with our difficult emotions—judging and hating ourselves for our fear, anger, clinging or shame,” says meditation teacher Tara Brach. But “our continued evolution, healing and freedom depends on learning how to embrace what we have pushed away. ((Lavery, Shannon. “Loving Ourselves into Healing – Part 1.” Tara Brach, 16 Dec. 2021, https://www.tarabrach.com/loving-ourselves-healing-i/.))

We deserve love, even when we’re not exactly where we want to be. The journey toward healing is a lifelong process—and approaching it with acceptance and self-compassion helps us find joy in it all.

Longtime yogi Richard Rosen challenges the idea that we have to punish ourselves in pursuit of progress: “But must the process of ending sorrow be sorrowful itself?…What about the idea that our effort toward happiness can itself make us happy?” ((“The Joy Is in the Journey.” Yoga Journal, 28 Aug. 2007, https://www.yogajournal.com/yoga-101/philosophy/joy-journey/.))

Reclaiming Your Happiness in Recovery

We may never fully “arrive,” but things can get better and easier along the way, and we can learn to enjoy the ride.

Rehab can be a great place to start. An immersive environment gives you space to do this vulnerable work in a safe, supported way, with all the necessary tools at your fingertips.

Browse our searchable directory of residential rehabs to learn more about their programs, facilities, and staff, and reach out to centers directly.

Reviewed by Rajnandini Rathod

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What Happens When You Get Sober?

When you’re living with an addiction, it can be hard to imagine recovery. Many people get lost in the negative, thinking about life without drugs or alcohol. But what about life with more time, energy, and emotional stability?

Addiction eats away at your resources. People lose money, relationships, their physical health—the list goes on and on. When you start healing, you’ll have so much more to work with. If you decide to attend a residential treatment center, experts can help you put those assets to use. And from there, you’ll start dreaming of—and planning for—a better future.

1. Your Mental Health Gets Better

Addiction affects both your physical and mental health. ((Addiction and health. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/addiction-health)) And when you’re actively using drugs, the idea of withdrawal might sound even worse. That’s a valid fear. But it might not be a reality. With the right support, detox doesn’t have to be dangerous. Best of all, withdrawal and detox are temporary. And unlike continued substance use, they offer a lot to look forward to on the other side.

Focus More Easily

Addiction makes it hard to focus, ((Gould, T. J. (2010). Addiction and cognition. Addiction Science & Clinical Practice, 5(2), 4–14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3120118/)) reason, and learn new things. It can also interfere with your memory. This is because drugs quite literally change your brain. You might not even notice these issues at first, since they start so gradually. But shortly after getting sober, you can expect your mental state to improve. ((Module 10: Sobriety Sampling. (n.d.). Boston Center for Treatment Development and Training. https://www.mass.gov/doc/module-10-sobriety-sampling-0/download))

Manage Co-Occurring Symptoms

Studies show that 50% of people with addiction also have a mental health condition. ((Part 1: The connection between substance use disorders and mental illness. National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness)) Because of this, many rehabs treat co-occurring disorders.

In these programs, you’ll learn how to manage your conditions in a healthy way. You may even find that just one type of treatment helps you heal from both addiction and another health issue. ((Pettinati, H. M., O’Brien, C. P., & Dundon, W. D. (2013). Current status of co-occurring mood and substance use disorders: A new therapeutic target. The American Journal of Psychiatry, 170(1), 23–30. https://doi.org/10.1176/appi.ajp.2012.12010112))

2. Your Physical Health Improves

Addiction takes a serious toll on your body, as well as your mind. And before treatment, you may not even be aware of all your physical symptoms. Most rehabs can treat these issues alongside your mental health. And during recovery, your health may start to improve in some unexpected ways.

3. You Kickstart a Healthy Lifestyle

There’s more to recovery than therapy. Even in rehab, you can engage in fun, fulfilling hobbies, like martial arts or cooking. These healthy coping tools can help you stay grounded after you complete treatment.

Sobriety can help you get your life on track in measurable, practical ways. Studies show that most people’s finances improve during addiction recovery. ((Laudet, A. (2013). Life in Recovery [Report on Survey Findings]. Faces and Voices of Recovery. https://facesandvoicesofrecovery.org/wp-content/uploads/2019/06/22Life-in-Recovery22-Report-on-the-Survey-Findings.pdf)) And that, in turn, can improve your mental and even physical health. Experts agree that financial stability decreases your chance of depression, ((Bialowolski, P., Weziak-Bialowolska, D., Lee, M. T., Chen, Y., VanderWeele, T. J., & McNeely, E. (2021). The role of financial conditions for physical and mental health. Evidence from a longitudinal survey and insurance claims data. Social Science & Medicine, 281, 114041. https://doi.org/10.1016/j.socscimed.2021.114041)) anxiety, and heart disease. This solid foundation can empower you to take healthy risks, like meeting new people.

4. You’ll Build a Sober Community

Sobriety can improve your relationships. ((Kemp, R. (2019). Addiction and addiction recovery: a qualitative research viewpoint. Journal of Psychological Therapies. 4. 167-179. https://www.researchgate.net/profile/Ryan-Kemp-3/publication/337410578_Addiction_and_addiction_recovery_a_qualitative_research_viewpoint/links/5e54e278299bf1bdb8395e12/Addiction-and-addiction-recovery-a-qualitative-research-viewpoint.pdf?_sg%5B0%5D=started_experiment_milestone&origin=journalDetail)) Many residential programs are built to support this.  In rehab, you’re surrounded by people who support your healing goals. And once you start to repair your relationship with yourself and others, you’ll get to build a support network that has your back as you continue your journey.

This new community can be found through 12-Step meetings, non-12-Step support groups, sober living, or outpatient aftercare. Or, you could connect with people who share your interests. Whether you find a new hobby or pick up an old one, this can be a fun, low pressure way to find like-minded people.

If your previous social circle was built around drug use, this is your chance to form new, healthy relationships. And because forming social connections with other sober people can help prevent relapse, ((Study shows impact of social interactions on addictive behavior. (2018, October 15). National Institute on Drug Abuse. https://nida.nih.gov/news-events/news-releases/2018/10/study-shows-impact-of-social-interactions-on-addictive-behavior)) it’s an important part of your recovery.

5. You Have the Chance to Reconnect With Loved Ones

Addiction damages close relationships ((Lander, L., Howsare, J., & Byrne, M. (2013). The impact of substance use disorders on families and children: From theory to practice. Social Work in Public Health, 28(0), 194–205. https://doi.org/10.1080/19371918.2013.759005)) with both given and chosen family. But recovery empowers you to hone your interpersonal skills. And, in time, those skills might help you heal your family dynamic.

For Michael Waggoner, sobriety is an opportunity to reconnect with family. ((Michael waggoner. (2020, September 9). Faces & Voices of Recovery. https://facesandvoicesofrecovery.org/story/michael-waggoner/)) “I am rebuilding relationships with my family, I am rebuilding trust,” he says. “I am able to be a dad today and a positive influence in my son’s life.”

6. You Can Realize Your Higher Purpose

Experts say that “addiction is a response to boredom, loneliness, meaninglessness, and other existential struggles.” ((Thompson, G. R. (n.d.). Meaning Therapy for Addictions: A Case Study. https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.1026.5596&rep=rep1&type=pdf)) Sobriety can help you find your purpose, and go on to live a meaningful life. Instead of just coping with a series of problems, you can build confidence and start moving toward the future you want for yourself.

When he was addicted to alcohol, James Gibbon had “no hope for the future.” ((James gibbons. (2020, September 9). Faces & Voices of Recovery. https://facesandvoicesofrecovery.org/story/james-gibbons/)) He faced  legal, financial, and relationship problems as a result. “I accepted the fact that I would never own a home, have a career, graduate from college, meet somebody special, and start a family,” he says. But after treatment:

“I began to see potential in myself. My confidence began to grow.”

The hard work of recovery can help you resolve past trauma, and teach you healthier coping strategies. With those skills, James achieved all the goals he thought were beyond him. And that isn’t unusual. When you stop using drugs and enter recovery, your potential for success only grows.

Sobriety Is Just the Beginning

It takes hard work to get and stay sober.

Healing isn’t just about stopping drug use. It’s about starting a new chapter.

And once you commit to recovery, you might be surprised by your own strength. That self-confidence is a powerful starting point.

Visit our directory of inpatient rehabs to learn more about their locations, services, pricing, and more.

Reviewed by Rajnandini Rathod

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How to Prepare for Rehab

When you decide to go to rehab, you might not have a lot of time to prepare. This is likely an emotionally fraught process, but there are still ways to set yourself up for success. If you can take care of obligations at home before you leave, you won’t have to worry about anything but your recovery while you’re in treatment.

When you’re planning to start an inpatient rehab program, here’s how to prepare for recovery.

Learn More About Rehab

For many people, uncertainty causes a great deal of anxiety. So if you’re feeling nervous about treatment, or if you haven’t chosen your program yet, it’s a good idea to do some research about how the process works.

Find the right treatment program for you. Every person’s path to recovery is unique. And if this is your first time seriously considering rehab, you might not even know your options or where to look.

Learn more about what you can expect in rehab, from arrival to detox and withdrawal and beyond.

Take Care of Obligations to Your Loved Ones

If you have loved ones who rely on you, like children, dependent adults, or animals, it’s important to make a plan for them before you leave. When you know they’re being cared for, you can focus entirely on your own healing. And with non-dependent loved ones, it’s still helpful to let them know you’re going into treatment. That way they can process their own feelings, and prepare to support you after you come home. This is one way to set your relationship up for success after treatment.

  • Tell your loved ones that you’re going to rehab. If it’s difficult for you to talk about, tell just one person that you trust. Then, you can ask them to tell anyone else you’d like to keep informed.
  • Offer resources to your support system. If you can empower them to learn more about your addiction or mental health issues, they’ll have more tools to support your recovery.
  • Make a care plan for dependents. Know who will take care of them, where they need to go, and how they’ll get there.
  • Prepare your home for your sober return, if you’re planning on coming back after rehab. Throw away any drugs or alcohol, drug paraphernalia, and perishable food. Arrange for someone to collect your mail, water your plants, and so on. Turn on your security system if you have one. Do some light cleaning if you feel up to it.

Inform Your Workplace

Aside from your loved ones, it’s also important to let your workplace know that you will be gone.

  • Request time off, if you plan on returning to the same job when you come back. If you work in a place where the Family and Medical Leave Act (FMLA) applies, you may be entitled to up to 12 weeks of unpaid leave. Check in your employee handbook to see if this applies to you.
    • Disclaimer: this post is for general informational purposes only, and should not be construed as legal advice. Do not substitute this information for legal counsel. Speak with a lawyer about your specific rights before taking action.
  • You may have special considerations depending on your occupation. If you’re an athlete, executive, or attorney, read more about the different factors that might affect your rehab experience.

Manage Your Financial and Legal Obligations

You may or may not have access to your phone or computer during rehab. And even if you do, you might not have the time or energy to check your email during rehab. If at all possible, it’s best to handle any time-sensitive financial and legal responsibilities before you start treatment.

  1. Set-up automatic payments for things like your phone, electricity, water, utilities, and credit card bills.
  2. Contact your legal representative if you have any ongoing legal cases, to make sure they know you’ll be in rehab. If you’re attending rehab because of a court order, you may have to complete paperwork to document the process.
  3. Talk to your insurance provider to find out if they’ll cover the cost of rehab.

Pack for Residential Treatment

There’s a lot to consider when you’re packing for rehab. Make sure to account for the length of the program, its location, and any special activities, like swimming or yoga. This packing list is an excellent place to start.

  1. Call your treatment center to ask for specific recommendations.
  2. Leave the following items at home:
    • All drugs and alcohol (including non-approved prescription medications and opened non-prescription medications)
    • Pornography
    • Weapons of any kind
    • Mouthwash, perfumes, or colognes that contain alcohol
    • Nail polish or nail polish remover
    • Outside food or drinks

Practice Self-Care Throughout Addiction Recovery

Preparing for rehab can be a lot of work. But it’s also an opportunity. You can spend this time centering yourself, and processing how you feel about recovery. Use these skills to meet your emotional needs, even as you take care of practical logistics.

  1. Use relaxation strategies like breath work or mindful meditation, if you feel anxious about starting treatment.
  2. Stay present. Once you start treatment, you’ll have plenty of time to plan for the future. And you’ll have professional support while you do. For now, though, thinking too far ahead can be counterproductive. Try your best to stay present. Recovery is an opportunity to create a better life for yourself. Use a journal or other techniques to help you focus on what’s happening right here, right now.
  3. Stay safe. This can be a stressful time, especially if you’re used to using drugs, alcohol, or self-harming behaviors to cope. But you don’t have to go through it alone. You might want to stay with a friend until your program starts, or ask someone to drive you to rehab. And once you arrive at treatment, you’ll have the support you need.
  4. Get professional advice before you stop taking drugs. You might feel so motivated to begin recovery that you want to quit cold turkey. However, suddenly quitting some drugs, like opioids or benzos, can be extremely dangerous. If you have questions about how to stay safe, talk to a doctor or your rehab center before taking any action.

Prepare Yourself Now to Find Success in Rehab

The time between deciding to go to rehab and actually entering your treatment program comes with a mix of emotions–excitement, anxiety, and more. If you can take time to prepare for rehab, you’ll set the tone for the rest of your recovery. But it’s okay if you let some things go. Give yourself some grace. You’re going through big changes, and you deserve patience and compassion—even from yourself.

Learn what to expect from a rehab program, such as their pricing, therapies, specialties, and more.

Reviewed by Rajnandini Rathod