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Alternatives to 12-Step Recovery

12-Step programs are a popular method for addiction recovery. It’s easy to access free meetings, both online and in person. You can even find rehab centers that support your journey through the Steps. And while these programs have clear benefits, they’re not the only way to heal from addiction.

Recovery is a personal process, and principles of 12-Step recovery aren’t right for everyone.

There are as many pathways to healing as there are people in recovery.

If you’re looking for an alternative to Alcoholics Anonymous or other 12-Step fellowships, non-12-Step rehabs and support groups can help.

Non-12-Step Treatment Models

In 12-Step rehabs, providers use the Steps to frame your healing process. You might attend A.A. or N.A. meetings, receive chips to mark sobriety milestones, or talk through each Step with your therapist. But if this approach doesn’t resonate with you, you may feel excluded or disconnected during addiction treatment.  In that case, these other approaches to recovery may be a better fit.

Evidence-Based Treatments

If scientific studies show that a treatment is effective, it can be called an evidence-based method. And it’s easy to find evidence-based treatment in rehab. But even the most respected methods may or may not be effective for you. Talk to your treatment provider about which types of therapy are the best fit for your personal recovery goals.

The most common evidence-based treatments are medication-assisted treatments (MAT) and behavioral therapies:

  • Medication-assisted treatment (MAT) uses pharmaceuticals to treat addiction and prevent overdose. These prescriptions are usually combined with talk or behavioral therapy. Studies show that MAT can decrease the risk of relapse  and increase treatment retention rates. If you’re curious about MAT, talk to your treatment team about your options. Medications can be helpful for some people, but you should only ever take them as prescribed.

Behavioral therapies teach you skills to manage your thoughts and feelings about addiction. The idea is that by improving your behavior, you can also improve your mental health. There are several popular types of behavioral therapy:

  • In cognitive-behavioral therapy (CBT), patients learn how to identify and interrupt behavioral patterns related to addiction.
  • Motivational enhancement therapy (MET) boosts your motivation to recover ((Motivational enhancement therapy (Alcohol, marijuana, nicotine). National Institute on Drug Abuse. https://nida.nih.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies/motivational-enhancement-therapy)) and stay sober using motivational interviewing techniques.
  • Dialectical behavior therapy (DBT) teaches you specific strategies for coping with life’s challenges. This treatment is formatted like a class and has a focus on mindfulness.

Experiential Therapy in Rehab

In a rehab that offers experiential therapy, patients heal through fun, interesting activities. These treatments let you learn new skills, discover your strengths, and process your emotions in a different environment.

There are many types of experiential therapy:

Because these activities let you heal by doing, they can be a welcome break from talk therapy. And since most of them are group activities, they also help you work on interpersonal skills.

These sessions can be fun and engaging, but they’re no substitute for other treatments. Rehabs typically offer experiential therapies alongside other modalities, like talk or behavioral therapies. This combined approach lets patients get to know themselves from several different angles. And it may give you a more complete picture of your own needs.

Holistic Treatment for Addiction and Mental Health

Holistic rehabs use a variety of treatment methods to address recovery. The goal is for people to heal not just from their addiction, but also from any other mental, physical, and spiritual issues they’re facing.

Many of these centers offer individualized treatment plans for all their patients. They may offer a wide range of holistic therapies:

  • mindfulness exercises, like meditation and body awareness
  • recreational therapy
  • massage
  • art therapy
  • mindful movement like dance therapy or Tai Chi
  • psychiatric care including talk, behavioral, and medication-assisted therapy
  • nutrition therapy ((Substance use recovery and diet: MedlinePlus Medical Encyclopedia. (n.d.). Retrieved from https://medlineplus.gov/ency/article/002149.htm))
  • spiritual or faith-based activities

Experts say that holistic therapies empower patients ((Breslin, K. T., Reed, M. R., & Malone, S. B. (2003). An holistic approach to substance abuse treatment. Journal of Psychoactive Drugs, 35(2), 247–251. https://doi.org/10.1080/02791072.2003.10400006)) to “develop a stronger sense of self-identity, self-esteem, and self-confidence.”

Non-12-Step Support Groups

Many people are drawn to 12-Step groups because they’re so easy to access. You can attend them in rehab, in your hometown, or even online. But if these support groups don’t meet your needs, there are other ways to build community while you recover.

There are a few reasons the 12 Steps might not be right for you. But commonly, A.A. and similar groups work best for people who find strength in spirituality. If you prefer a more scientific approach, you might consider alternative support groups.

SMART Recovery

SMART Recovery (Self-Management and Recovery Training) ((About us. (n.d.). SMART Recovery. Retrieved from https://www.smartrecovery.org/about-us/)) is a secular approach that encourages self-empowerment to overcome addiction. Meetings are free and led by people who have used SMART in their personal recovery. Members support each other in learning healthier coping skills throughout recovery.

As a social worker in New York explains, SMART Recovery helped them recover ((Abt Associates Inc. & Hart Research Associates. (2010). Pathways to Healing and Recovery: Perspectives from Individuals with Histories of Alcohol and Other Drug Problems. The Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Treatment (CSAT). https://www.samhsa.gov/sites/default/files/recovery_pathways_report.pdf)) because they are a “free thinker who is more oriented to understand addiction in logical and behavioral terms rather than spiritual or disease terms.”

Instead of adopting the 12-Step belief that you are powerless over your addiction, SMART Recovery teaches that you are capable of changing your life by consciously working on yourself, alongside peers and professionals.

Secular Organizations for Sobriety

Secular Organizations for Sobriety (S.O.S.) is a “nonprofit network of autonomous, nonprofessional local groups dedicated solely to helping individuals achieve and maintain sobriety.” Their meetings take place both in person and online.

These meetings are open to anybody trying to live a sober lifestyle. They welcome religious and non-religious people to support each other in a secular setting. According to their founder, James Christopher, S.O.S. is inclusive of all pathways to recovery. ((Sos. (n.d.). SOS. Retrieved from https://www.sossobriety.org)) In other words, you can attend S.O.S. meetings as part of a larger recovery plan.

Women for Sobriety

Women for Sobriety (WFS) hosts meetings in the US and Canada for women recovering from addiction. Led by women, WFS provides an inclusive environment for recovery for all women, including members of the LGBTQ+ community.

The meetings are based on 13 emotional and spiritual affirmations, and are facilitated by a person who has achieved 1 year of sobriety within the WFS program. They start with a reading of the affirmations, followed by introductions. Then group members take part in a discussion around the weekly topic.

One member explains that the WFS approach is “wonderful for women ((Abt Associates Inc. & Hart Research Associates. (2010). Pathways to Healing and Recovery: Perspectives from Individuals with Histories of Alcohol and Other Drug Problems. The Substance Abuse and Mental Health Services Administration’s Center for Substance Abuse Treatment (CSAT). https://www.samhsa.gov/sites/default/files/recovery_pathways_report.pdf)) because it’s such a positive program. It met my needs and built my self-esteem.”

LifeRing Secular Recovery

LifeRing Secular Recovery is an anonymous organization that encourages abstinence through their 3-S philosophy: sobriety, secularity, and self-help.

They require members to remain completely abstinent. And while these groups welcome members of any religious belief,

LifeRing supports “recovery methods that rely on human efforts ((Lifering recovery menu—Lifering secular recovery. (n.d.). Retrieved from https://lifering.org/lifering-recovery-menu/)) rather than on divine intervention.”

Moderation Management

For people who want to change their relationship with alcohol, rather than become completely sober, Moderation Management (MM) is a harm reduction non-profit group that encourages bringing mindfulness to your consumption of alcohol.

MM promotes moderation as a pathway towards a healthier lifestyle. Through small, attainable steps, and peer-led group meetings, they support participants in their journey towards more manageable drinking.

As one member explained,

“the support and encouragement of the MM groups ((Testimonials. (n.d.). Moderation Management™. Retrieved from https://moderation.org/about-mm-support-overview/program-member-testimonials/)) has been invaluable to me!! Never judgement or blame; always positive reinforcement and motivation.”

While harm reduction can be helpful for some people, it’s not the right approach for everyone. For example, if you have high-functioning alcohol addiction, you might not even realize how much of a toll drinking takes on your life. In that case, harm reduction could just push the problem farther down the line. Instead, finding treatment that helps you get completely sober—12-Step or not—might be a better choice.

Explore Alternative Pathways Towards Recovery

You have a wide array of choices for rehab. And while the 12 Steps are hugely popular, they’re not the only option. You have the right—and even the responsibility—to heal in a way that meets your needs. If 12-Step treatment isn’t right for you, there are countless other ways to start recovery.

Connect with a non-12-Step rehab today to learn about different treatment philosophies, insurance options, locations, and more.

Reviewed by Rajnandini Rathod

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Dopamine and Addiction: What’s the Connection?

Addiction changes how the brain functions. It especially impacts the brain’s “reward system,” which is largely based on dopamine. This hormone is responsible for our pleasure response, along with other important functions like memory, attention, and mood.

Understanding addiction is an important part of recovery. Knowing there’s a physiological reason for your addiction can relieve some of the shame around it, so you can move forward in your healing journey. And gaining perspective on what’s driving your behavior can help you make lasting change.

A Peek Inside the Brain’s Reward System

We can experience pleasure from all kinds of activities, whether it’s exercise or scrolling social media. Our brain’s reward system is responsible for that feeling, and the desire to seek more of it.

How It Works

Your brain produces a chemical called dopamine. Dopamine is both a hormone and a neurotransmitter, meaning it’s used to send messages between your nerve cells. It’s tied to many functions, from mood regulation and memory to learning. It’s known as the “feel-good” chemical for the large role it plays in pleasure and motivation.

Dopamine is released along different neural pathways when we anticipate and experience something pleasurable. ((Trevor Haynes. (2018, May 1). Dopamine, Smartphones & You: A battle for your time. Science in the News. https://sitn.hms.harvard.edu/flash/2018/dopamine-smartphones-battle-time/ )) As it’s released, it affects dopamine receptors that live along these pathways, resulting in feelings of euphoria or happiness. This is known as the reward circuit.

The reward circuit activates areas of the brain that relate to focus, learning, taking action, and motivation.

The brain builds connections between a stimulus and pleasure that follows. ((Martinez, J. L., & Derrick, B. E. (1996). Long-term potentiation and learning. Annual Review of Psychology, 47, 173–203. https://doi.org/10.1146/annurev.psych.47.1.173)) Your reward circuit strengthens each time this process occurs. The more frequently it happens, the stronger your response is. Also called a reinforcing effect, it’s involved in how we form habits. ((Volkow, N. D., Fowler, J. S., Wang, G.-J., Swanson, J. M., & Telang, F. (2007). Dopamine in drug abuse and addiction: Results of imaging studies and treatment implications. Archives of Neurology, 64(11), 1575–1579. https://doi.org/10.1001/archneur.64.11.1575))

Cues leading up to pleasure are important. Dopamine makes us pay attention to markers that lead to a reward. This means dopamine activates before you even engage in a pleasurable activity.

This system helped early humans survive by rewarding beneficial behaviors, like eating. When it’s in balance, it allows us to stay focused, motivated, and happy. Dopamine imbalance is linked to mental health issues, like depression, and substance use disorders.

The Reward System at Different Stages of Addiction Recovery

Substances bypass the body’s natural dopamine production by directly flooding the reward system with it. Some substances do this more intensely than others:

Stimulants like cocaine can release up to 10 times the amount of dopamine your body would naturally produce. ((The brain in recovery. (2017, January 28). Recovery Research Institute. https://www.recoveryanswers.org/recovery-101/brain-in-recovery/ ))

The Early Stages of Substance Use

The first time a substance is used, it creates a direct dopamine response. This intensity of this varies from person to person. According to neurotheology specialist Dr. Cyrus H. McCandless, “you can never accurately predict how much reward you’re going to get.” ((Misunderstanding dopamine: Why the language of addiction matters | Cyrus McCandless | TEDxPortsmouth. (n.d.). Retrieved September 30, 2022, from https://www.youtube.com/watch?v=aqXmOb_fuN4 ))

Your brain remembers everything leading up to a reward, so it can repeat the experience. This drives the desire to use more of a substance. As dopamine levels go up, serotonin, which helps us feel satisfied, goes down. This creates a cycle of wanting more while feeling less satiated.

This cycle doesn’t just apply to substance use. Altered dopamine pathways are seen in behavioral addictions, ((Grant, J. E., Potenza, M. N., Weinstein, A., & Gorelick, D. A. (2010). Introduction to behavioral addictions. The American Journal of Drug and Alcohol Abuse, 36(5), 233–241. https://doi.org/10.3109/00952990.2010.491884 )) including gambling, shopping, and sex.

Building Tolerance

Usually, brain chemistry returns to normal after a dopamine release. But continued substance use surges the brain with dopamine until it becomes overstimulated. Over time, the body wants to balance out, so it shuts down dopamine receptors. As a result, we won’t feel the same high from using the same amount of substances as before. This is how the brain builds tolerance. ((Volkow, N. D., Wang, G.-J., Fowler, J. S., Tomasi, D., Telang, F., & Baler, R. (2010). Addiction: Decreased reward sensitivity and increased expectation sensitivity conspire to overwhelm the brain’s control circuit. BioEssays : News and Reviews in Molecular, Cellular and Developmental Biology, 32(9), 748–755. https://doi.org/10.1002/bies.201000042 ))

Addiction

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) has 4 criteria for classifying and diagnosing substance use disorders: ((McNeely, J., & Adam, A. (2020, October). Table 3, dsm-5 diagnostic criteria for diagnosing and classifying substance use disorders [abc] [Text]. https://www.ncbi.nlm.nih.gov/books/NBK565474/table/nycgsubuse.tab9/ ))

  • impaired control
  • social impairment
  • risky use
  • pharmacologic traits

The reward system plays a significant role in these.

Substances artificially change dopamine production. This can signal to the brain that substances are more important than other natural rewards. Eventually, natural rewards become less exciting and the brain learns to value substances ((MIT scientists discover fundamental rule of brain plasticity. (n.d.). MIT News | Massachusetts Institute of Technology. Retrieved September 30, 2022, from https://news.mit.edu/2018/mit-scientists-discover-fundamental-rule-of-brain-plasticity-0622 )) above all else.

Neuroplasticity, or the brain’s flexibility, ((Castrellon, J. J., Seaman, K. L., Crawford, J. L., Young, J. S., Smith, C. T., Dang, L. C., Hsu, M., Cowan, R. L., Zald, D. H., & Samanez-Larkin, G. R. (2019). Individual differences in dopamine are associated with reward discounting in clinical groups but not in healthy adults. Journal of Neuroscience, 39(2), 321–332. https://doi.org/10.1523/JNEUROSCI.1984-18.2018 )) also plays a part in addiction. We can get used to higher levels of dopamine following prolonged substance use. But an overstimulated brain no longer produces as much of it. Instead, it relies on substances.

Withdrawal

It’s not possible to keep up substance-induced levels of dopamine at all times. Drops in dopamine levels can contribute to withdrawal symptoms:

  • depression
  • anxiety
  • cold sweats
  • headaches
  • and others

For many people, detox is the first step in the recovery journey. As substances leave your system, your body and brain recalibrate. Low dopamine levels during withdrawal can make this process difficult. But thanks to neuroplasticity, we can nurture our brain chemistry back to normal over time.

Note: Depending on the substance, detox can be life-threatening and shouldn’t be attempted alone.

How Long Does It Take for the Reward System to Recover?

Each person has different levels of dopamine and dopamine receptors. ((J R Beveridge, T., R Smith, H., Nader, M., & Porrino, L. (2008). Abstinence from Chronic Cocaine Self-Administration Alters Striatal Dopamine Systems in Rhesus Monkeys. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 34(5). https://doi.org/10.1038/npp.2008.135))  The time it takes for the reward system to return to normal after prolonged substance use varies. Factors like the type of substance and level of use will impact recovery time. In general, it takes the brain up to 14 months to recover.

brain recovery timeline

30 days of abstinence

Brain scans show significant improvement and more dopamine receptors in just one month of abstinence from methamphetamine. ((National Institute on Drug Abuse. “Treatment and Recovery.” National Institute on Drug Abuse, –, https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery.))

90 days of abstinence

Brain scans in one study showed no significant difference in dopamine receptors following 90 days of abstinence compared to 30 days. ((J R Beveridge, T., R Smith, H., Nader, M., & Porrino, L. (2008). Abstinence from Chronic Cocaine Self-Administration Alters Striatal Dopamine Systems in Rhesus Monkeys. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 34(5). https://www.researchgate.net/figure/Representative-autoradiograms-of-3H-SCH-23390-binding-to-D1-receptors-top-panel-and_fig1_23234006 )) This indicates that recovery is possible, but it takes time.

14 months of abstinence

The brain’s reward circuit, including dopamine receptor levels, returns to nearly normal after 14 months of abstinence. ((“The Brain in Recovery.” Recovery Research Institute, 28 Jan. 2017, https://www.recoveryanswers.org/recovery-101/brain-in-recovery/.))

Repairing Your Brain in Recovery

The human brain is capable of amazing things, including the ability to modify and change throughout your lifetime. For many, it’s comforting to know that changes to the brain caused by substance use disorder are reversible. Your brain can repair and heal, if you facilitate its healing.

Rehab can help you do just that. Learn more about RehabPath and its latest announcements, and compare your options in our directory of treatment centers.

Reviewed by Rajnandini Rathod

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Is 12-Step Recovery Right For You?

You’ve probably heard of the 12 Steps, but what exactly does this approach to recovery entail? The 12 Steps provide a guideline to recovery itself, and the programs supplement treatment. Attending meetings provides you with social support and the means to maintain sobriety after rehab. Many people enjoy these aspects of this approach, and choose to attend 12-Step meetings in rehab and after returning home.

But while popular, 12-Step rehab isn’t for everyone. For one, the 12 Steps are rooted in Christianity, which may not resonate with people of different religious backgrounds or frameworks for understanding the world. And while these groups provide important social support, they’re not the only way to find community. But many people enjoy the spirituality component, as well as the robust social structure these groups provide.

Let’s take a closer look at what 12-Step recovery entails, and what other options exist, as you determine what approach sits best with you.

What Is 12-Step Recovery?

In 12-Step programs, people follow 12 designated steps to recovery. Members gather regularly as a group to review the Steps, share their stories, and get support for their challenges. These 12-Step meetings can be in person (called face-to-face, or F2F), online, or via phone, all around the world. Meetings might take place in a number of places: office buildings, churches, rehab centers—even parks or beaches.

After you finish rehab, you can continue attending meetings with 12-Step groups. Most cities have some kind of 12-Step program. Membership is open to anyone—the only requirement is a desire to change.

Many people attribute their recovery success to their involvement with the Steps. In fact, numerous studies reveal that involvement in A.A. increases the likelihood that people will stay sober.1 Members take comfort in the structure and social support the community provides, which could contribute to higher rates of abstinence.

What Happens at 12-Step Meetings?

Most 12-Step programs follow a similar format. For example, A.A. meetings often open with a “chair” (an A.A. member who leads the meeting) reciting the A.A. Preamble (a short passage about A.A.’s mission).2 They might follow the passage with a moment of silence or a prayer. Newcomers can introduce themselves, which is encouraged but not required. Then, members might read from “The Big Book,”3 which outlines a template for recovery. Depending on the meeting, members might discuss a chosen topic, speak about their journeys, or review a Step. After meetings, people might mingle, meet newcomers and others, and exchange contact information. This format is similar to other 12-Step programs.

In A.A., meetings can be open or closed.4 Open meetings invite anyone to attend, even friends or family of the person with the addiction. Closed meetings are only open to members themselves.

And according to Alcoholics Anonymous, the purpose of all A.A. meetings5 is for people to “share their experience, strength and hope with each other that they may solve their common problem and help others to recover.” This is the foundation for the 12 Steps.

How The 12 Steps Guide Your Path to Recovery

According to A.A., the 12 Steps are a “set of spiritual principles”6 that serve as guidelines for a “way of life.” These fundamentals pave the way for life in sobriety.

The idea is that working through these steps will help you heal. But there aren’t necessarily any rules about how you approach them—you can follow them in order, or not. You can come back to different steps whenever you need to—whichever feels most relevant to what you’re going through. And while many of the steps reference “God,” you’re welcome to replace that with a higher power of your own choosing.

Spirituality and the 12 Steps

While the 12 Steps refer to a higher power—in this case, God—and have roots in Christianity, you don’t have to be Christian to attend meetings. In fact, you don’t need to have any religious background. It is helpful to be open to some degree of spirituality, especially since the goal of the 12th Step is to have a spiritual awakening. The program encourages members to develop a spiritual practice and to incorporate activities like meditation and prayer into their lives.

While spirituality is an important part of the 12 Steps for many people, the social factor is just as important—if not more.

Social Support in 12-Step Programs

People receive almost instant social support from 12-Step groups. You’ll be in a room full of people that have similar experiences and goals—and that makes it much easier to feel connected. And meeting other sober people is an essential part of the recovery process. People in A.A. find hope in being around others on the same journey.7 “The people I met thought like me,” said one member. “For the first time in my life, I felt like I wasn’t so crazy.”

Another member reflects: “I remember sitting in the A.A. meeting, and thinking, I’ve finally found a place where I belong.”

Research shows that people who have a good social support system are more likely to stay in addiction treatment longer,8 and less likely to relapse after rehab. Whether that’s friends, family, or friends you make at meetings, it’s important to surround yourself with those who support your journey.

Cutting ties with people who cue you to do things you’re working hard not to is a painful part of the recovery process. But the upside is that it creates more room in your life for relationships that support your well-being and growth. 12-Step groups make it easy to meet people with common goals, and even facilitate deeper connections by encouraging people to find sponsors. Sponsorship can have a profound impact on your success in sobriety—especially as a newcomer.

The Importance of Sponsorship in 12-Step Programs

Most 12-Step organizations connect people with a sponsor.9 A sponsor is a more senior member who supports your recovery journey. They’re available to talk to outside of meetings and can be a real lifeline in times of need. Sponsors also benefit from this relationship. Sharing what they’ve learned provides an opportunity to give back to the A.A. community, while reinforcing their own choice to live a sober life. It’s often helpful to find a sponsor with a similar background or experience, who can relate to you. They can share advice, hold space for what you’re going through, and be a place to turn to when you come up against an inevitable challenge.

One Crystal Meth Anonymous (C.M.A.) member describes how he owes much of his recovery to his sponsor.10 “I often think about how simple this tool is,” he says. “It helped me stay clean and sober that first year, especially in the face of so many challenges and temptations.” For example, soon after getting sober, he received a text from someone inviting him to do drugs again. He immediately thought of his sponsor, and how disappointed he’d be if he accepted. So instead of replying, he blocked the number.

“Everyone thinks their sponsor is the best, but I really believed it,” he said.

My sponsor demonstrated brotherly love, invested many, many hours, and instilled in me an unshakeable faith that gave me the strength and commitment to rebuild my life. For that, I am forever grateful.

How to Decide if 12-Step Recovery Is For You

If you still feel unsure whether or not 12-Step treatment is right for you, asking rehab admissions staff the following questions is a good place to start.

  • In this program, is attending 12-Step groups mandatory?
  • How much time will I spend in individual therapy, compared to time spent in groups?
  • Do all of your 1-on-1 therapists use the 12 Steps as a framework for recovery?
  • Will I be able to choose my own therapist?
  • Do your 12-Step groups include a sponsorship program?
  • In your philosophy, what does it mean for clients to connect with a higher power?
  • Does your program welcome people of all faiths?
  • Do you connect alumni with local support groups or 12-Step meetings after they complete inpatient treatment?

The more you know, the better. This will help prepare you for both rehab and your new life afterwards. But if you make the decision that the 12-Step approach isn’t for you, there are plenty of other options.

What Is Non-12-Step Recovery?

Non-12-Step programs are exactly that—any approach that doesn’t follow the 12-Step methodology. This can be anything from experiential to holistic to evidence-based treatment, and so much more. How you choose to go about recovery is entirely up to you.

Popular Non-12-Step Approaches to Choose From

While non-12-Step approaches can fall into many different categories, some are more commonly seen in treatment:

Non-12 Step programs are usually secular, meaning they don’t follow any particular religious guidelines. However, you can also attend rehab facilities that don’t follow a 12-Step approach but still have a spiritual emphasis. These may cater to specific faiths or be non-religious.

Note that while these are just some treatment approaches available outside of 12-Step, many more exist. Exploring rehabs by treatment approach can be a great way to learn more.

Building Sober Community Outside of 12 Step

12-Step programs are renowned for their fellowship aspect, but that doesn’t mean you can’t find sober community without one! While you’ll form relationships in rehab, it’s important to have a plan in place for securing a support network beyond it.

Non-12-Step Support Groups

And not all support groups for people in recovery follow the 12 steps. Some organizations don’t follow a spiritual model at all, like SMART Recovery and LifeRing. Similar to 12-Step programs, these groups have meetings in person or online, all over the globe.

Interest-Based Groups and Activities

Finding ways to have fun without substances is an important part of staying sober. Abstinence without meaning and joy isn’t very motivating! Boredom and loneliness are common in early recovery—and are also known relapse triggers. Getting involved in new hobbies, meet-up groups, and activities can be a great way to avoid feeling idle and make new friends in the process. These can range from picking up an old sport to learning a new skill. Look for adult classes, meet-ups, and community events in your city. Your rehab may even offer to help with this as part of your relapse prevention and aftercare plan.

Stepping Into a New Life Chapter

The 12-Step method may just be what works best for you. Or it may not be your thing, and that’s completely fine. It’s also possible (and common) to combine recovery approaches. For example, you might choose to enroll at a non-12-Step rehab, then attend 12-Step groups to maintain your sobriety after treatment. There are multiple paths to recovery, and facilities that can offer exactly what you’re looking for.

With any approach you choose, remember to be patient with yourself. Healing isn’t always straightforward. You might hit bumps in the road here and there, but it’s important to keep going. Remind yourself why you started your recovery journey, and reach out for help when you need it.

See rehab facilities that offer 12-Step and non-12-Step programs to find options that interest you, compare prices, take a virtual tour, and more.

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Successful Treatment, Despite Experiencing Post-Acute Withdrawal Syndrome (PAWS)

So you’ve done the hard work of detoxing. But now you’re having trouble remembering details. Or, you’re even more anxious than you were when you first quit. These feelings can be overwhelming, and you might not understand why. For many people, there’s a simple answer.

Post-acute withdrawal syndrome (PAWS) refers to a group of symptoms that continue long after you stop using drugs or alcohol. This condition can make it hard to focus on the work you’re doing in rehab. Thankfully, many rehab centers are prepared to treat PAWS. Talk to your providers, so they can help you manage your symptoms and avoid relapse.

What Is Post-Acute Withdrawal Syndrome?

PAWS, sometimes known as prolonged withdrawal syndrome, is a set of symptoms you experience after you’ve already gone through initial detox and withdrawal. ((Post-Acute Withdrawal Syndrome (PAWS) | Semel institute for Neuroscience and Human Behavior. (n.d.). Retrieved from https://www.semel.ucla.edu/dual-diagnosis-program/News_and_Resources/PAWS)) It can last for weeks to years after you last use drugs.

Almost all drugs have the potential to cause this condition. And if you’re recovering from alcohol, benzos, or opioids, you’re more likely to experience PAWS. In fact, 90% of people recovering from opioid addiction and 75% of people recovering from alcohol or other drug addictions have post-acute symptoms.

The Symptoms of PAWS

While regular withdrawal symptoms are mental, physical, and emotional, PAWS symptoms are mainly psychological. It’s common to feel these effects of protracted withdrawal: ((Substance Abuse Treatment Advisory: Protracted Withdrawal. (2010). Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment.))

  • irritability
  • depression
  • difficulty concentrating
  • short-term memory issues
  • fatigue
  • sleep problems like insomnia
  • anxiety
  • decreased sex drive
  • mood swings
  • intense drug or alcohol cravings
  • physical complaints of pain without a cause

These symptoms are similar for most people, but some substances lead to specific issues. For instance, people recovering from marijuana addiction often have strange dreams. And recovering from a benzodiazepine addiction can trigger obsessive-compulsive disorder or schizophrenia.

If you have acute withdrawal symptoms, they’ll set in immediately after detox. Some people also experience PAWS after that, but it may not set right away. You might not even have symptoms until 1-2 months into abstinence. Those symptoms might ebb and flow over time, or be triggered by stressful events.

The Causes of PAWS

When you consistently overuse a substance for a long time, it can make long-lasting changes to brain function. Usually, those changes are in the emotional or behavioral control centers. ((Abuse, N. I. on D. (2022, March 22). Drugs, Brains, and Behavior: The Science of Addiction. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain)) This explains why most PAWS symptoms are psychological.

How PAWS Affects Treatment

PAWS is frustrating at best. And at worst, it can interfere with your recovery. Data shows that PAWS is a common cause of relapse. ((Melemis, S. M. (2015). Relapse prevention and the five rules of recovery. The Yale Journal of Biology and Medicine, 88(3), 325–332. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/))

Stressful events can be triggers, and starting residential treatment is stressful. It’s no wonder that PAWS can get worse when you arrive at rehab. In this early stage of recovery, patients’ ability to deal with stress is already reduced by recent substance abuse. Add in lack of sleep, mood swings, or increased anxiety, and it gets very difficult to stay focused on recovery.

In this phase of treatment, patients are still learning healthy coping skills.

PAWS can mirror the same feelings that lead to addiction.

If you used alcohol to deal with anxiety, then PAWS-related anxiety might be even harder to handle. Or, if you used benzos to sleep, insomnia caused by PAWS might trigger cravings.

These symptoms can lead to other mental health issues. For instance, PAWS might make you feel like you’re not making any progress. You might wonder why you’re still dealing with the lingering effects of your addiction long after you’ve stopped using. People with PAWS sometimes even “catastrophize their chances of recovery.” ((Melemis, S. M. (2015). Relapse prevention and the five rules of recovery. The Yale Journal of Biology and Medicine, 88(3), 325–332. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/)) And these fears are valid. But with the right coping strategies, you can avoid relapse and recover from your addiction.

Plan for Success in Rehab

Recovery means more than quitting a substance. After detox, you’ll face the emotional issues that caused your addiction in the first place. It’s a lot for anyone to handle, even with professional support. And during early recovery, people are especially vulnerable to stress. (The Rebound Effect. (n.d.-a). Substance Misuse Prevention Newsletter: A Collection of Readings, 4(4). Thankfully, you can use certain techniques to manage that stress. And that’s the first step in healing from PAWS.

Come Prepared

You can prepare for PAWS even before you start detox. If you’re in inpatient treatment, you’ll be surrounded by experts who know how to help. If you’re not in rehab, you can talk to your doctor, therapist, or another healthcare provider. They’ll help you come up with a plan to manage ongoing symptoms. Then, if and when you’re triggered, you’ll already know what to do first.

Build Your Support System

Community support is vital to addiction recovery. ((Social support and stress as predictors of relapse in early recovery from alcohol and substance abuse—ProQuest. (n.d.). Retrieved from https://www.proquest.com/openview/89aae0f1bce52fe4e89b92a9caaa3bee/1?pq-origsite=gscholar&cbl=18750&diss=y)) In residential rehab, you can connect with other patients in the program. And outside a program, there are many different places to find support. Start by telling your therapist or doctor what symptoms you’re experiencing, so they can help you manage them. You can also attend group therapy or support groups to find peers going through the same thing.

Let your loved ones know how you’re feeling. Some symptoms, like mood swings or irritability, can put a strain on your relationships. By telling your support network about your symptoms, you’re offering them validation and support. In turn, that will help them support you.

Give Yourself Time Limits

A lot of people struggle with concentrating when they’re going through PAWS. And it can be frustrating to feel like you can’t focus. But there are several ways to work through this common symptom.

Instead of forcing yourself to concentrate, set a timer. Give yourself a limited amount of time to focus on one task. Start small. Limit yourself to 10 or 15 minutes, and then take a break. As your attention span improves, you can gradually increase the amount of time on the timer. Gradually increase the amount of time as you notice you’re able to concentrate for longer.

Keep Moving

Physical exercise can be a valuable part of addiction treatment. Staying active gives you a way to focus your excess energy. It also lets you practice new coping skills, which you can continue using in every stage of recovery. And best of all, the benefits of physical activity match up with some of the most common issues caused by PAWS.

Physical fitness improves both physical and mental health. ((CDC. (2022, June 16). Benefits of physical activity. Centers for Disease Control and Prevention.)) Specifically, it helps people sleep, reduces anxiety and depression, and improves thinking and judgment skills. Keeping active can also help you manage your stress, which may help prevent flare-ups.

As effective as physical activity can be, it’s not right for everyone. If your body is still recovering from addiction, you might not be ready for strenuous exercise. That’s also true for people with chronic conditions, including chronic pain. It’s important to know your own limits. The better you understand your needs, the more easily you can meet them.

Learn Your Triggers

Because stressful events can intensify PAWS, managing stress can help you heal. Start by identifying stressful situations. In some cases, you can avoid these. If reality TV stresses you out, you can just change the channel. But it’s not always that simple. Sometimes, types of stress are unavoidable. For instance, talking about trauma in therapy can be stressful. But that doesn’t mean you should avoid it. Instead, prepare yourself before entering these situations. Rehab can help you grow coping skills you can use to face triggers.

Be Patient With Yourself

It can take anywhere from 6 to 24 months to recover from PAWS. ((Carty , B. (2016). Post-Acute Withdrawal Syndrome. University of Texas Health School of Biomedical Informatics. https://sbmi.uth.edu/heroes/documents/Post-Acute-Withdrawal.pdf?language_id=1)) Some people may find themselves dealing with it for years after that. Eventually, though, your symptoms will go away. Until then, be patient with your progress. Celebrate small wins. Some days may be more difficult than others, but every moment is another step forward. Treatment can also pave the way for a faster recovery—or just an easier one.

Treatment Options for PAWS

Coping strategies are essential, but they’re just one part of healing. You can also make use of more formal treatments to heal from PAWS. ((Post-Acute Withdrawal Syndrome (PAWS) | Semel institute for Neuroscience and Human Behavior. (n.d.). Retrieved from https://www.semel.ucla.edu/dual-diagnosis-program/News_and_Resources/PAWS)) Talk to your care team to see which of these options fits into your recovery plan:

  • medications, such as acamprosate ((Post-Acute Withdrawal Syndrome (PAWS) | Semel institute for Neuroscience and Human Behavior. (n.d.). Retrieved from https://www.semel.ucla.edu/dual-diagnosis-program/News_and_Resources/PAWS)) for recovery from alcohol addiction, or methadone ((Protracted Withdrawal.(2010). Substance Abuse and Mental Health Services Administration. https://store.samhsa.gov/sites/default/files/d7/priv/sma10-4554.pdf)) for recovery from opioid use disorder
  • psychotherapy
  • behavioral therapy
  • group therapy sessions

Depending on your needs, these modalities may be a good fit in many stages of recovery. Because of this, they can help treat long-term symptoms of PAWS. Some treatments, like talk therapy, may even be helpful long after you complete inpatient rehab.

Managing PAWS Is a Step Toward Recovery

Early recovery can be overwhelming. Your life is changing rapidly—and so is your brain chemistry. PAWS symptoms can make it feel hard to keep up.

Remember that you set the pace of your recovery. There’s no external timeline you have to follow. By accepting your own symptoms, you can practice self-compassion and self-love. And that’s an important part of healing from addiction.

Don’t let PAWS get in the way of your recovery. Connect with an inpatient rehab center to learn about their treatment methods, onsite medical care, pricing, and more.

Reviewed by Rajnandini Rathod

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Breaking Toxic Bonds: How to Get Help for Love Addiction

Humans naturally seek love and connection. But because relationships are innately complex, it can be hard to tell the difference between an incredible feeling and a harmful dynamic. There’s not a lot of agreement among professionals about what love addiction is, exactly. But regardless of how they’re labeled, unhealthy patterns in romantic relationships can seriously affect your quality of life.

Fortunately, treatment for love addiction is available. It can help you find a healthier approach to your relationships with others—and most importantly, yourself.

Is Love Addiction Real?

Also called pathological love or relationship addiction, love addiction is not officially recognized in the DSM-5. ((What’s the DSM-5? (2022, August 3). Psych Central. https://psychcentral.com/lib/dsm-5)) While some professionals view it as a behavioral addiction that has to do with impulse control, others see it as a mood disorder.

Some researchers even believe that all romantic love has addictive qualities, ((Earp, B. D., Wudarczyk, O. A., Foddy, B., & Savulescu, J. (2017). Addicted to love: What is love addiction and when should it be treated? Philosophy, Psychiatry, & Psychology : PPP, 24(1), 77–92. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5378292/)) as it produces a similar effect to drugs and alcohol:

“Studies suggest that the subjective state (or states) of ‘being in love’ is intimately tied to characteristic biochemical reactions occurring within the brain. These reactions involve such compounds as dopamine, oxytocin, vasopressin, and serotonin and recruit brain regions known to play a role in the development of trust, the creation of feelings of pleasure, and the signalling of reward…Consequently, scientists have begun to draw a number of parallels between the naturally rewarding phenomena associated with human love and the artificial stimulation afforded by the use of addictive substances such as alcohol, heroin, or cocaine.”

This may explain why it’s so common—one study estimates that 5-10% of the U.S. population experiences love addiction. ((Sussman, S. (2010). Love Addiction: Definition, Etiology, Treatment. Sexual Addiction & Compulsivity, 31–42. https://doi.org/10.1080/10720161003604095))

When Does It Become a Problem?

Humans are social beings. As such, seeking out and prioritizing love is natural and normal.

Love addiction becomes a problem when you get stuck in a relationship (or cycles of relationships) that are unsafe or unhealthy for you. Often, these cycles form bonds that make the volatile dynamic between you and your partner addictive—which makes it very hard to know when you should leave. In abusive relationships, this is known as trauma bonding. ((Resnick, A. (2021, November 5). What is trauma bonding? Verywell Mind; Verywell Mind. https://www.verywellmind.com/trauma-bonding-5207136))

If you are experiencing any type of abuse, you can get help immediately. Call the National Domestic Violence Hotline at 1.800.799.7233 to speak with an expert.

These patterns usually arise from insecure attachment issues, which are rooted in codependency and childhood trauma.

How Pathological Love Shows up in Your Life

While there’s no official criteria, one group of experts names 6 core dimensions of love addiction: ((Costa, S., Barberis, N., Griffiths, M. D., Benedetto, L., & Ingrassia, M. (2021). The love addiction inventory: Preliminary findings of the development process and psychometric characteristics. International Journal of Mental Health and Addiction, 19(3), 651–668. https://doi.org/10.1007/s11469-019-00097-y))

1. Salience: Your life comes to revolve around your love interest.
2. Tolerance: The time you need to spend with them, or the time you spend thinking about them, increases over time.
3. Mood modification: You use time with your partner as your go-to strategy to cope with your feelings.
4. Relapse: You can’t cut down on how much time you spend with, or preoccupied with, your partner.
5. Withdrawal: You get frustrated, sad, or even have physical symptoms when you can’t spend time with them.
6. Conflict: Obsession with your love interest affects all other aspects of your life.

This kind of fixation is typical of early-stage relationships. But normally, the “honeymoon phase” eventually subsides. This level of obsession isn’t meant to be sustained long-term, and doing so causes other important parts of life—like friendships, family, work, and your own interests—to suffer.

People also report feeling these symptoms of love addiction: ((What is love addiction? (n.d.). Verywell Mind. Retrieved from https://www.verywellmind.com/what-is-love-addiction-5210864))

  • fear of being alone
  • feeling “empty” without their partner
  • a need to constantly be around their partner
  • no strong sense of self outside of the relationship
  • losing interest in life outside of their partners
  • a history of emotionally unavailable love interests

(Note that identifying a condition like this can be tricky, so it’s best to speak to a professional about your concerns.)

Neglecting other areas of your life causes it to fall out of balance, which affects your mental health. Obsessive love interferes with priorities like your performance at work and your relationships with others in your support network.

Staying in relationships to your own detriment can diminish your trust in, and respect for, yourself.

See our article on sex and love addiction for more on recognizing the difference between healthy, toxic, and abusive relationships.

Love Addiction and Other Mental Health Diagnoses

Like other mental health conditions, sex and love addiction commonly occur alongside other disorders ((Tripodi, M. F., Guiliani, M., Petruccelli, I., & Simonelli, C. (2012). Sexual Addiction Theory, causes and therapy. Institute of Clinical Sexology, Rome. https://www.researchgate.net/publication/234118847_Sexual_AddictionTheory_causes_and_therapy)) like depression, anxiety, and bipolar. The traits of certain conditions, like ADHD and borderline personality disorder, can complicate relationships and play into struggles with love addiction.

Attention Deficit Hyperactivity Disorder (ADHD)

Impulsiveness and craving stimulation are hallmarks of ADHD. This means that for people with ADHD, there’s a biological reason why relationships might swing between extremes.

“A rush of biochemical euphoria comes with ‘new love,’” says marriage and family therapist Jonathan Halverstadt. “Those of us with ADHD often hyperfocus on romance, not just for the sake of romance, but also to increase those pleasure-producing neurotransmitters (dopamine) that are in short supply in our brains. Highly charged emotions are not part of lasting love. They are just feelings — strong and wonderful feelings — but you need much more to make an ADHD relationship last.” ((Halverstadt, J. (2010, June 17). 10 ways to save your relationship. ADDitude. https://www.additudemag.com/save-your-adhd-relationship-marriage/))

Borderline Personality Disorder (BPD)

BPD makes it difficult to regulate your emotions. People with BPD struggle with setting boundaries and maintaining their sense of self in relationships. According to the National Alliance on Mental Illness, symptoms of BPD ((Borderline personality disorder. (n.d.). NAMI California. Retrieved October 3, 2022, from https://namica.org/illnesses/borderline-personality-disorder/)) can include “unstable personal relationships that alternate between idealization (‘I’m so in love!’) and devaluation (‘I hate her’),” also known as “splitting.”

The Mighty contributor Catherine Renton describes how BPD affects her romantic relationships: ((Renton, C. (2018, August 11). The “obsessive” way i fall in love as someone with borderline personality disorder. The Mighty. https://themighty.com/2018/08/love-triggers-bpd-borderline-personality-disorder/))

“I am obsessive in love — falling quickly, deeply and I always put my partner’s needs before my own…Once I become attached to someone, I get drunk on lust as dopamine floods my body. I’ve fallen in love so many times, it’s like an addiction. I crave the affection and touch of another human so much I have overlooked some questionable personality traits just so I don’t end up alone.”

It’s important to distinguish between BPD (which is a diagnosable disorder) and love addiction (which is not). These 2 conditions share some of the same symptoms, but BPD involves much more than just a predisposition to love addiction.

Learning How to Have Healthy Relationships in Rehab

Removing yourself from your usual cues and getting into a recovery-focused environment is a great way to set yourself up for success. Plenty of residential rehabs offer programs specifically for this addiction and the unique challenges it entails.

Treatment varies from program to program, but often involves these components:

  • Gender-specific care: Treatment may take place at a larger, co-ed facility with gender-specific housing and therapy groups, or at a dedicated center.
  • Healing underlying trauma: Love addiction often stems from core wounds like abandonment, which are rooted in childhood experiences.
  • Developing healthy coping skills: Patients grow their toolkit for managing their own lives and their connections with others.

Rehabs That Treat Love Addiction

Gentle Path at The Meadows is a men-only program that provides specialized treatment for sex and relationship addictions. Gentle Path’s approach is based on the Meadows Model, ((The meadows model. (2022, September 7). The Meadows of Wickenburg, Arizona. https://www.themeadows.com/about/the-meadows-model/)) developed by leading codependency expert and author of Facing Love Addiction, ((Pia Mellody Books. (n.d.). Retrieved from http://www.piamellody.com/books.html)) Pia Mellody.

Recovery Ranch in Nunnelly, Tennessee combines clinical, holistic, and experiential therapies to help patients explore past traumas and shift towards more mature, authentic love. ((Love addiction treatment center. (n.d.). The Ranch TN. Retrieved from https://www.recoveryranch.com/mental-health-treatment-programs-nashville-tn/process-addiction-treatment-center/love-addiction-treatment-center/))

Love is an important part of life—but it doesn’t have to come at a price. Rehab can help you navigate relationships in a way that keeps your best interests at heart.

Visit our sex and love addiction treatment directory to learn more about available programs and reach out to rehabs directly.

Reviewed by Rajnandini Rathod

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Does Trauma Cause Addiction?

Addiction rarely begins on its own. Something often triggers the need to use substances to self-medicate, cope, or forget painful events, even just briefly.

Uncovering and addressing the traumas behind your addiction is an important part of the recovery journey. And with rehab centers dedicated to treating trauma, you can work through this with the support and guidance of peers and professionals.

How Trauma Sets the Stage for Later Challenges

You may have experienced developmental trauma while growing up, or a traumatic event in the more recent past. In either case, addiction often arises as a way to cope with its effects—whether we realize it or not.

Childhood Trauma

Early traumas tend to show up in our present lives in a number of ways. Behavioral health professionals call these “adverse childhood experiences,” or ACEs, and they’re closely tied to all kinds of issues we may grapple with as adults. ACEs can involve abuse, neglect, and other forms of family dysfunction.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), “ACEs are strongly related to development and prevalence of a wide range of health problems, including substance abuse, throughout the lifespan.” That’s because exposure to high stress at a young age affects brain development. “Disruption in early development of the nervous system may impede a child’s ability to cope with negative or disruptive emotions,” says SAMHSA. “Over time, and often during adolescence, the child adopts coping mechanisms, such as substance use.”

Recognizing this in yourself for the first time can be overwhelming. But ACEs are extremely common. In a massive, long-term study by the CDC, “28% of…participants reported physical abuse and 21% reported sexual abuse,” and many had parents who divorced or struggled with mental illness or addiction.

Trauma isn’t okay, but it is common, even among those who appear to have had a “perfect” childhood.

Adult PTSD

Sometimes, symptoms of this develop into an ongoing condition: post-traumatic stress disorder, or PTSD. It’s surprisingly common for adults to experience symptoms from childhood trauma they don’t remember. It’s also possible for an experience as an adult to trigger a PTSD episode based on framework laid by traumatic experiences as a child.

Even though we may not be consciously aware of their origins, we might still see the effects of these traumas later in life. And they dramatically increase our likelihood of developing addiction and other mental health issues. Studies show that adult survivors of childhood trauma are more likely to engage in high-risk and self-harming behaviors, including substance abuse.

Using Substances to Manage Trauma Symptoms

The effects of trauma can be extremely hard to live with, no matter how old you are. Thoughts and feelings associated with trauma are invasive, repetitive, and can be terrifying and exhausting. Veteran mental advocate expert Dr. Harry McCleary explains, “Avoidance is a core symptom of PTSD. The last thing that anyone that has experienced a trauma wants to do is experience something similar.” One of the most common ways to do this is to use substances.

Substances are easily available, and the relief they provide is immediate.

The problem with this is that it works until it doesn’t. As soon as the effects wear off, the trauma comes back—and often even more so, due to a rebound effect. Regularly using substances to cope can quickly lead to dependence and addiction, which only creates more problems. And as long as you’re using substances to avoid your feelings, you’re not developing the coping skills necessary to manage them.

Addiction can also put you in high-risk situations—whether it’s getting more drugs in an unsafe way, or making uninhibited decisions—that lead to further traumas. As McCleary says, “Now you have multiple problems: a substance issue, and a PTSD issue, and one is feeding on another.”

The good news is that both addiction and trauma are highly responsive to treatment.

Why Treatment Should be Trauma-Informed

Trauma-informed care is “an approach in the human service field that assumes that an individual is more likely than not to have a history of trauma.” In practice, this can look like the following:

  • creating a trauma-informed culture
  • training all staff on trauma
  • screening all incoming patients for trauma
  • evaluating practices to make sure they’re not potentially retraumatizing

Trauma-informed therapists work with a knowledge of trauma and the cultural and socioeconomic factors that contribute to it. These treatment settings reduce the chance that patients will feel triggered, unsafe, or uncomfortable as they work through their trauma.

Learn more about this approach in our article on finding a trauma-informed rehab.

Learning to Manage Triggers

In rehab, you may spend some time learning how to identify and manage triggers. Substance abuse has a strong connection to PTSD symptoms, which makes managing them important. With the support of trained professionals, you can learn new ways of responding to stress within the safe environment that residential care provides.

Addressing Co-Occurring Disorders

Trauma and addiction very often go hand in hand. If you have PTSD or another diagnosis along with addiction, it’s a good idea to find a program that specifically treats co-occurring disorders. As Dr. McCleary says, “Substance use and PTSD are such close friends that we’ve developed multiple treatments to treat both at the same time. There are treatment facilities that treat both at the same time. Because that’s how prevalent this is.”

Plenty of qualified professionals specialize in treating people in exactly your position.

All you have to do is reach out to them to take the first step towards healing.

Finding Rehab for Trauma and Addiction

Trauma isn’t fair, but it is a fundamental part of the human experience. And if you’re struggling with its effects, you’re certainly not the only one.

You are normal.

There’s nothing wrong with you.

And you have endless opportunities to heal.

Looking into rehabs that specialize in treating trauma can be a great place to start that healing journey. Visit our directory to learn more about your options and reach out to treatment centers directly.

Reviewed by Rajnandini Rathod

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Understanding Anxiety’s Effect on Eating Disorders

Eating disorders don’t develop in a vacuum. They often go hand in hand with other mental health conditions, like anxiety. And that can make it hard to get the treatment you need.

In rehab for eating disorders, providers know that mental and behavioral issues are connected. Eating disorders are unhealthy coping mechanisms, but they exist for a reason. And with help, you can learn better coping strategies. These skills empower people to recover from disordered eating and the anxiety that can trigger it.

Understanding Eating Disorders

These complex conditions are about more than just food. In fact, eating disorders affect 30 million Americans. ((Caceres, V. (2020, February 14). Eating Disorder Statistics. US Health News; US Health News. https://health.usnews.com/conditions/eating-disorder/articles/eating-disorder-statistics)) There are a few different types of eating disorders, ((Guarda, A. (2021, March). What are Eating Disorders? American Psychiatric Association. https://psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders)) as defined by the American Psychiatric Association (APA):

  • Anorexia nervosa is the restriction of food intake. This “self-starvation” can result in weight loss and an unhealthily low weight.
  • Bulimia nervosa follows a cycle. People with this condition binge large amounts of food, then take extreme actions to avoid gaining weight. For example, a person might induce vomiting, restrict food intake, use laxatives, or exercise excessively.
  • Binge eating disorder follows a similar cycle, but does not include purging. It’s characterized by episodes of eating large amounts very quickly, followed by feelings of guilt, shame, and distress.
  • Avoidant/restrictive food intake disorder (ARFID) is an umbrella term. It describes any pattern of disordered eating that doesn’t fit the criteria for anorexia nervosa, bulimia nervosa, or binge eating disorder.

Disordered eating can appear as a wide array of symptoms and behaviors, and it’s important to not try to fit yourself into a box. Like any other diagnosis, the impact of these conditions goes beyond the definitions that you read online. And it’s especially complex for people with co-occurring disorders, like anxiety.

Where Does Anxiety Come In?

Much like eating disorders, there are a wide variety of anxiety disorders. And these 2 categories are more similar than you might think. In fact, research suggests that eating disorders could be classified as anxiety disorders. ((Altman, S. E., & Shankman, S. A. (2009). What is the association between obsessive–compulsive disorder and eating disorders? Clinical Psychology Review, 29(7), 638–646. https://doi.org/10.1016/j.cpr.2009.08.001))

Even if you don’t have anxiety, most people with eating disorders have at least 1 other diagnosis. One study found that 97% of people hospitalized for an eating disorder had a co-occurring disorder. ((STATISTICS & RESEARCH ON EATING DISORDERS. National Eating Disorders Association. https://www.nationaleatingdisorders.org/statistics-research-eating-disorders)) When you’re ready to start recovery, it’s important to seek treatment for every aspect of your mental health. Fortunately, many rehabs are prepared to treat co-occurring anxiety and eating disorders.

How Anxiety Impacts Eating Disorders: A Cycle

According to the team at Rosewood Ranch,

“about half of individuals with eating disorders also have an anxiety disorder ((Hunnicutt, C. (2020, February 18). The connection between anxiety and eating disorders. Rosewood Centers for Eating Disorders. https://www.rosewoodranch.com/the-connection-between-anxiety-and-eating-disorders/)) and most of the time, the anxiety disorder began prior to the eating disorder.”

These behaviors may form as coping mechanisms, albeit dysfunctional ones. Some people use eating as a distraction from anxious thoughts, ((Rosenbaum, D. L., & White, K. S. (2013). The role of anxiety in binge eating behavior: A critical examination of theory and empirical literature. Health Psychology Research, 1(2), e19.
https://www.pagepressjournals.org/index.php/hpr/article/view/hpr.2013.e19/pdf)) or to feel a sense of control. But when you rely on harmful tactics to deal with your emotions, it gets harder to learn healthy ones. This creates a cycle that’s hard to break. And that cycle can be seen in people with any type of anxiety disorder.

Social Anxiety

The U.S. Department of Health and Human Services defines social anxiety ((Division (DCD), D. C. (2013, February 9). What are the five major types of anxiety disorders? [Text]. HHS.Gov. https://www.hhs.gov/answers/mental-health-and-substance-abuse/what-are-the-five-major-types-of-anxiety-disorders/index.html)) as a “disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations.” And that self-consciousness can turn into anxiety about your appearance. This opens the door to eating disorders. In fact, the fear of being negatively judged is linked to a desire for thinness. ((Levinson, C. A., & Rodebaugh, T. L. (2012). Social anxiety and eating disorder comorbidity: The role of negative social evaluation fears. Eating Behaviors, 13(1), 27–35. https://doi.org/10.1016/j.eatbeh.2011.11.006))

These social fears are valid—but restricting your diet won’t necessarily make them go away. Studies reveal that levels of social anxiety are similar across all eating disorder diagnoses. ((Kerr-Gaffney, J., Harrison, A., & Tchanturia, K. (2018). Social anxiety in the eating disorders: A systematic review and meta-analysis. Psychological Medicine, 48(15), 2477-2491. https://doi.org/10.1017/S0033291718000752))

When you recognize how your anxiety impacts your eating habits, you can start developing healthier behaviors.

Obsessive Compulsive Disorder (OCD)

Obsessive compulsive disorder (OCD) is characterized by anxiety and intrusive thoughts. Because of this, repetitive, self-destructive behaviors are a common symptom. Disordered eating can sometimes be one of those behaviors.

An article from Timberline Knolls says that for both OCD and eating disorders, the goal of the behavior “is to reduce levels of apprehension, anxiety and overall negative effect.” ((The relationship between eating disorders & obsessive-compulsive disorder. Timberline Knolls Residential Treatment Center. http://www.timberlineknolls.com/about/blog/the-relationship-between-eating-disorders-obsessive-compulsive-disorder/)) For example, you might binge a large amount of food in an attempt to self-soothe during a panic attack. These behaviors can snowball and worsen your anxiety, and keep you from learning how to handle it differently. You may need professional support to interrupt this behavioral loop.

Breaking the Cycle With Treatment

Research shows that it’s important to treat eating disorders and anxiety together. ((Kerr-Gaffney, J., Harrison, A., & Tchanturia, K. (2018). Social anxiety in the eating disorders: A systematic review and meta-analysis. Psychological Medicine, 48(15), 2477-2491. https://doi.org/10.1017/S0033291718000752)) Because of the overlap between these issues, you might want to attend a rehab that treats co-occurring disorders.

The good news is, therapy for either of these conditions may help you recover from both. For instance, experts agree that anxiety lessens when people get treatment for anorexia. ((Kerr-Gaffney, J., Harrison, A., & Tchanturia, K. (2018). Social anxiety in the eating disorders: A systematic review and meta-analysis. Psychological Medicine, 48(15), 2477-2491. https://doi.org/10.1017/S0033291718000752)) When you’re ready to heal, several types of therapy can help.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) ((Cognitive behavioral therapy—Mayo Clinic. (n.d.). Retrieved August 12, 2022, from https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610)) is a type of therapy that teaches you how to interrupt negative thoughts. It’s also the most recognized method for treating eating disorders. ((Eating Disorders, Trauma, and PTSD. (n.d.). National Eating Disorders Association. https://www.nationaleatingdisorders.org/blog/eating-disorders-trauma-ptsd-recovery)) Most inpatient treatment programs offer some version of this therapy.

Holistic Therapies

Alternative therapies are an increasingly common way to treat mental health issues. These modalities encourage patients to heal their mind, body, spirit as one. In rehab, you might have access to a variety of holistic therapies. For instance, studies show that mindfulness is a powerful way to treat eating disorders. ((Wanden-Berghe, R. G., Sanz-Valero, J., & Wanden-Berghe, C. (2010). The application of mindfulness to eating disorders treatment: A systematic review. Eating Disorders, 19(1), 34–48. https://doi.org/10.1080/10640266.2011.533604))

Medication

Evidence shows that medication can treat eating disorders. ((Eating Disorders, Trauma, and PTSD. (n.d.). National Eating Disorders Association. https://www.nationaleatingdisorders.org/blog/eating-disorders-trauma-ptsd-recovery)) This treatment is normally combined with talk therapy. The combination can be hugely effective. But like any treatment, it’s not right for everyone. If you have any physical health issues due to an eating disorder, talk to your doctor (or treatment team in rehab) about your concerns.

Recovery From Eating Disorders and Anxiety

Whatever types of therapy you pursue, there’s good news: eating disorders and anxiety disorders are very treatable. ((Kerr-Gaffney, J., Harrison, A., & Tchanturia, K. (2018). Social anxiety in the eating disorders: A systematic review and meta-analysis. Psychological Medicine, 48(15), 2477-2491. https://doi.org/10.1017/S0033291718000752)) With proper care, these conditions have high recovery success rates. And if you’re living with both diagnoses, many rehabs offer specialized care.

Connect with a rehab that treats eating disorders to learn more about the therapies they offer, housing options, and recovery from co-occurring disorders.

Reviewed by Rajnandini Rathod

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Guide to Online Resources for Mental Health

A lot of life happens online. We rely on online resources for everything from business meetings to yoga classes—and healthcare is no exception. For many people, this is an issue of accessibility. And fortunately, there are more and more online options for treating mental health.

Use this guide to find websites, apps, and even trained experts to support your mental health, no matter where you are. All you need is an internet connection.

Remote Therapy

BetterHelp is the world’s largest therapy platform. You’ll connect with a licensed therapist whose expertise meets your needs for treatment. You can text, live chat, talk on the phone, or video chat with them in a private online “room.” The site saves your chat history, so you can go back and read previous messages at any time. You can also sign up anonymously.

Price: Insurance not accepted. Self-pay plans are $60-$90/week, and you can apply for financial aid.

Talkspace offers 24/7 online talk therapy. You’ll answer questions about your needs and match with a licensed therapist. Depending on your plan, you may be able to text, audio message, video message, or have live sessions with your provider.

Price: Accepts most insurance. Self-pay plans range from $69-$129/week

Cerebral offers online counseling and psychiatry. You can choose to work with a therapist, psychiatrist, life coach, dietician, or some combination thereof. If you get a prescription through Cerebral, it will be mailed to you each month. This platform treats many mental health concerns, including opiate addiction.

Price: Accepts some types of insurance. Self-pay plans range from $69-$325/month.

Anxiety and Depression Association of America (ADAA) lists contact information for mental health providers around the country. You can see a list of therapists and psychiatrists in your state, review their areas of expertise, and contact them directly to set up remote therapy sessions.

Price: Varies by provider.

Support Groups

Alcoholics Anonymous offers online 12-Step meetings for people in any phase of recovery from alcohol addiction. These peer-led groups encourage mutual support between members, rather than offering professional help. You can browse a list of meetings at various times of day, which take place in many different languages. Some also have ASL interpreters for d/Deaf members.

Price: Free

NAMI Connection Recovery Support Groups are hosted by the National Alliance on Mental Illness (NAMI). These 90-minute meetings may occur weekly, monthly, or every other week, depending on which group you join. Membership is open to any adult with current or past mental health symptoms. Each session is led by a trained peer facilitator, not a professional counselor.

Various state chapters of NAMI offer these meetings either online or in person. You can check the website to find out which options are available in your area.

Price: Free

Addiction Recovery Tracking Apps

Nomo lets you track the time you’ve spent in recovery. To keep it simple, you can just use the app’s clock feature to record your progress. It also offers many other features, such as a journal, a way to connect with other app users, and exercises to help you get through cravings.

Price: Free

I Am Sober tracks how long it’s been since you started recovery, and how much money you’ve saved. The app also records milestones, like your first month of sobriety, and lets you connect with other people healing from addiction.

Price: Free

Sober Time gives you an inspirational message every morning. It also tracks your time in recovery, and lets you see statistics that help you visualize your progress. You can celebrate the app’s built-in milestones, and add some of your own. People can also post about their experiences in recovery, and read each other’s stories.

Price: Free

Connect With Online Communities

Pace groups meet for 90 minutes every week. After signing up, members join a hand-picked online group of 7 people, led by a skilled facilitator. These guided conversations are not therapy sessions. Instead, they invite participants to socialize and support each other through the challenges of daily life.

Price: $89/month

Meetup groups and events are organized by people with shared interests. Through the site’s search function, it’s easy to find one-off events on topics that interest you, or special interest groups with regular meetings. You can connect online or in person, depending on which meetups you sign up for.

Price: Free for individual members. Paid $30/month per group for organizers.

Mindfulness and Meditation Apps

Headspace lets you access recorded meditations, as well as some articles and short videos. You can easily set up reminders to meditate on a regular schedule. If you’d like to learn even more about mindfulness, you can work through a course of meditations that progress over time. This lets you practice your skills, and learn how to implement them in the rest of your life.

Price: $12.99/month (billed monthly) or $69.99/year (billed annually).

Calm invites users to listen to mindful meditations, sleep stories, and relaxing music. They also offer pre-recorded classes about self-care, and guided stretch and exercise routines.

Price: $69.99/year

Insight Timer has a wealth of resources for everyone interested in meditation, from beginners to experts. The app includes talks and guided meditations from highly respected spiritual leaders. It also offers workshops, yoga classes, and live talks.

Price: Most resources are free. Premium memberships are $60/year.

The Hazelden Betty Ford Foundation apps are geared toward people in recovery from addiction. Various apps provide daily inspirational quotes, prayers, and meditations.

Price: Ranging from free to $5.99.

Online resources are a great way to start your path to healing. For even more support, learn more about treatment options, stay updated with our latest company news, and connect with facilities in our searchable directory of addiction and mental health providers.

Reviewed by Rajnandini Rathod

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Get Control of Your Anger—And Your Life

Everyone feels angry sometimes. It’s a normal emotion, and it can even be healthy. But anger can also become a problem. Chronic or extreme rage can damage your relationships. And it can interfere with your ability to enjoy the best parts of your life.

If it feels like rage is controlling you, instead of the other way around, you can go to rehab for chronic anger. In treatment, you’ll learn how to manage your emotions in a sustainable way.

Anger vs Aggression: What’s the Difference?

Anger is an emotion. Aggression is a behavior. ((Richard, Y., Tazi, N., Frydecka, D., Hamid, M. S., & Moustafa, A. A. (2022). A systematic review of neural, cognitive, and clinical studies of anger and aggression. Current Psychology. https://doi.org/10.1007/s12144-022-03143-6)) Aggression often occurs because of anger, but the two aren’t synonymous. You can feel angry without acting aggressively.

In general, anger only becomes an issue when it leads to aggression. Well-managed anger isn’t a problem. ((How to control anger before it controls you. (n.d.). Https://Www.Apa.Org. Retrieved from https://www.apa.org/topics/anger/control)) On the contrary, it’s a normal feeling. And like all feelings, it exists for a good reason. The American Psychological Association (APA) describes anger as “a natural, adaptive response to threats.”

Treating chronic anger doesn’t mean you’ll never get upset again. Instead, the goal is to feel your anger safely, without causing external harm. For many people, this means being assertive without getting aggressive. You can and should ask for what you need, and set appropriate boundaries. But it’s best to avoid hurting anyone else in the process.

There’s a fine line between these 2 types of behavior. And in order to find a healthy balance, it’s important to understand where your own feelings are coming from.

Trait vs. State Anger

There are 2 different types of anger, known as trait anger and state anger. ((Richard, Y., Tazi, N., Frydecka, D., Hamid, M. S., & Moustafa, A. A. (2022). A systematic review of neural, cognitive, and clinical studies of anger and aggression. Current Psychology. https://doi.org/10.1007/s12144-022-03143-6)) A person experiencing state anger sometimes feels frustrated by external factors, like getting cut off in traffic. But in general, they likely have a calm and balanced disposition. Almost everyone experiences state anger from time to time.

Trait anger, on the other hand, is more constant. People with trait anger might feel angry all the time. Or, they may be triggered very easily. These triggers can lead to both internal anger and outward aggression. Trait anger makes it hard to control how you react to difficult situations. ((Carroll, J. (2020). Trait anger. In M. D. Gellman (Ed.), Encyclopedia of Behavioral Medicine (pp. 2254–2255). Springer International Publishing. https://doi.org/10.1007/978-3-030-39903-0_854))

You might be tempted to blame someone for your anger. But if you blame someone else, it might compound the problem by making you even angrier. And self-blame can quickly turn into shame. Instead of getting stuck in either of these loops, you can think of anger as an issue that deserves care.

Anger Disorders

If it’s extreme enough, anger can be diagnosed as a mental health condition. Many of these diagnoses begin in childhood. And if they’re not treated, they can continue later in life. But with the right support, you can learn to manage your emotions, no matter how extreme they may feel.

Oppositional Defiant Disorder (ODD)

ODD first appears in early childhood, ((Aggarwal, A., & Marwaha, R. (2022). Oppositional defiant disorder. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK557443/)) and affects certain children and teens. People with ODD have a hard time controlling their feelings and actions. They may seem constantly irritated, argue with instructions, or feel angry with other people. To treat children with ODD, experts recommend both individual and family therapy. This condition often improves with age. But sometimes, it can develop into conduct disorder (CD).

Conduct Disorder (CD)

​​In most children and teens, occasional rebellious behavior is normal. For people with conduct disorder, ((Mohan, L., Yilanli, M., & Ray, S. (2022). Conduct disorder. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK470238/)) it’s a problematic pattern. People with CD consistently display aggressive behavior toward both people and animals. You may even set intentions to hurt someone, destroy property, or break rules. This condition is often described as a more serious version of ODD. If you think you might have CD, it’s important to get treatment as soon as possible.

Intermittent Explosive Disorder (IED)

People with intermittent explosive disorder (IED) ((Scott, K. M., de Vries, Y. A., Aguilar-Gaxiola, S., Al-Hamzawi, A., Alonso, J., Bromet, E. J., Bunting, B., Caldas-de-Almeida, J. M., Cía, A., Florescu, S., Gureje, O., Hu, C.-Y., Karam, E. G., Karam, A., Kawakami, N., Kessler, R. C., Lee, S., McGrath, J., Oladeji, B., … de Jonge, P. (2020). Intermittent explosive disorder subtypes in the general population: Association with comorbidity, impairment and suicidality. Epidemiology and Psychiatric Sciences, 29, e138. https://doi.org/10.1017/S2045796020000517)) experience severe anger attacks. During these episodes, you may be unable to control your aggressive impulses. You might even become verbally or physically violent. If you have this diagnosis, you may risk assaulting other people and damaging property.

Even if you have IED, you may not feel angry most of the time. ((Radwan, K., & Coccaro, E. F. (2020). Comorbidity of disruptive behavior disorders and intermittent explosive disorder. Child and Adolescent Psychiatry and Mental Health, 14, 24. https://doi.org/10.1186/s13034-020-00330-w)) These outbursts are intense, but not constant. This can be confusing, for both the person with IED and for loved ones. It might be hard to work around triggers, and difficult to follow through on plans. Treatment can help you make sense of your own feelings, and manage them in a healthy way.

Learn How to Manage Your Anger

Poorly controlled anger can undermine your mental health. ((Richard, Y., Tazi, N., Frydecka, D., Hamid, M. S., & Moustafa, A. A. (2022). A systematic review of neural, cognitive, and clinical studies of anger and aggression. Current Psychology. https://doi.org/10.1007/s12144-022-03143-6)) It also hurts the people around you, and can damage your relationships as a result. Anger may also interfere with your work life, if you express rage at your boss or colleagues. Data even suggests that anger can lead to addiction. ((Baharvand, P., & Malekshahi, F. (2019). Relationship between anger and drug addiction potential as factors affecting the health of medical students. Journal of Education and Health Promotion, 8, 157. https://doi.org/10.4103/jehp.jehp_145_19)) And experts agree that “​severe anger is generally associated with lower quality of life.”

You can focus on anger management in residential rehab. In these programs, patients learn how to stay calm even when they feel overwhelmed. During this process, certain therapies are especially effective.

Mindfulness-Based Cognitive Therapy (MCBT)

When used alone, both mindfulness and cognitive behavioral therapy (CBT) can reduce anger. ((Richard, Y., Tazi, N., Frydecka, D., Hamid, M. S., & Moustafa, A. A. (2022). A systematic review of neural, cognitive, and clinical studies of anger and aggression. Current Psychology. https://doi.org/10.1007/s12144-022-03143-6)) And these therapies work even better together.

In classic CBT, you’ll learn how to respond to your own negative beliefs. Often, your therapist will teach practical skills to modify unhealthy thought patterns. And in mindfulness practices, you learn how to accept your feelings as they are, instead of acting on them or trying to change them.

MCBT combines these 2 techniques. This treatment can help people reduce impulsive behavior. Research suggests that it’s the most effective treatment for anger issues.

Mindfulness can also have a powerful impact on brain chemistry. ((Richard, Y., Tazi, N., Frydecka, D., Hamid, M. S., & Moustafa, A. A. (2022). A systematic review of neural, cognitive, and clinical studies of anger and aggression. Current Psychology. https://doi.org/10.1007/s12144-022-03143-6)) Studies show that mindfulness techniques reduce activity in the amygdala. This is the part of the brain which processes feelings like fear, anxiety, and anger. In layman’s terms: this treatment can actually help you feel less angry. And that emotional stability will likely decrease your aggressive impulses.

Anger Management Through Video Games

Experts continue to seek out new ways to treat chronic anger. Some have even started to teach anger management through a video game. ((Anger management. (n.d.). Retrieved from https://hms.harvard.edu/magazine/science-emotion/anger-management))

RAGE Control (Regulate and Gain Emotional Control) is a game that monitors the player’s heart rate as they play. If your heart rate increases above a certain level, the game changes slightly to accommodate this. The goal is to teach teens how to stay calm even in the face of frustration.

Patients alternate between gameplay and talk therapy. This gives them the “opportunity to talk about their actions and feelings in the context of the game rather than having to revisit uncomfortable, demeaning topics such as past bad behavior,” says social worker Peter Ducharme. “Practicing the game lets them experience mastering the skills presented in therapy. This in turn allows them to open up about their difficulties.”

Although the game is still undergoing testing, it seems promising. In one study, children reported feeling less angry after playing the game. Another found that RAGE Control improved teens’ anger management skills. ((Ducharme, P., Kahn, J., Vaudreuil, C., Gusman, M., Waber, D., Ross, A., Rotenberg, A., Rober, A., Kimball, K., Peechatka, A. L., & Gonzalez-Heydrich, J. (2021). A “proof of concept” randomized controlled trial of a video game requiring emotional regulation to augment anger control training. Frontiers in Psychiatry, 12. https://www.frontiersin.org/article/10.3389/fpsyt.2021.591906)) This research may help experts treat both anger and other mental health issues in the future.

Treating Co-Occurring Disorders

Anger often appears as a symptom of other disorders. ((Fernandez, E., & Johnson, S. L. (2016). Anger in psychological disorders: Prevalence, presentation, etiology and prognostic implications. Clinical Psychology Review, 46, 124–135. https://doi.org/10.1016/j.cpr.2016.04.012)) It’s strongly associated with a number of mental health conditions, like borderline personality disorder (BPD) and bipolar disorder. Anger is also common in people with major depressive disorder (MDD). ((Anger management. (n.d.). Retrieved from https://hms.harvard.edu/magazine/science-emotion/anger-management)) Some MDD patients experience aggressive outbursts that appear related to their other diagnosis. In many people, anger resolves when they get effective treatment for co-occurring disorders.

Anger and Addiction

Anger is strongly associated with drug and alcohol addiction. Both “state and trait anger are risk factors for substance use and abuse.” ((Richard, Y., Tazi, N., Frydecka, D., Hamid, M. S., & Moustafa, A. A. (2022). A systematic review of neural, cognitive, and clinical studies of anger and aggression. Current Psychology. https://doi.org/10.1007/s12144-022-03143-6)) If you have a history of anger issues, you may be more vulnerable to developing an addiction in the future.

On the other hand, addiction can also lead to uncontrolled anger. Alcohol, in particular, impairs impulse control. This makes it hard to resist your aggressive urges. And without proper support, this can quickly become a vicious cycle. If you’re caught up in that pattern, it might be time to get treatment.

Stop Letting Anger Control You

You can’t completely rid yourself of anger—and it would be unhealthy to try. This emotion serves a valuable purpose. It can protect you from danger, and help you recognize your boundaries. But when it’s left unchecked, anger can also cause great harm.

In recovery, you can learn when and how it’s appropriate to express your anger. Ultimately, treatment can teach you to react in a way that doesn’t hurt anyone—including yourself.

In a rehab program that specializes in anger management, you can work with experts in mental health, addiction, and relationship dynamics. Visit our directory to learn more about this type of treatment and get in touch with centers directly.

Reviewed by Rajnandini Rathod

Posted on

Codependency Treatment: Healing Your Relationship With Yourself and Others

Codependency is born out of good intentions. It’s easy to miss the signs of this condition, because you might think your behavior is loving. But love isn’t always healthy. And when you take full responsibility for your loved ones’ problems, things can get out of hand. If you’re ignoring your own needs in order to please and care for other people, you might be codependent.

It may feel like the world will crumble if you ever put yourself first. But actually, the opposite is true. You can—and should—put on your own oxygen mask first. By prioritizing yourself, you avoid building resentment. And, you can respond to problems with a level head.

The idea of letting go can be daunting. You might worry about how your loved ones will get along without your constant support. Those feelings are valid. And the process of working through them is the process of healing from codependency.

Try to be compassionate with yourself. Breaking old patterns isn’t easy. You’ll make mistakes, and that’s okay. And remember that, just like your loved ones, you’re allowed to get support.

Everyone deserves care.

Codependency is a valid issue that has a serious impact on your well-being. It can be very challenging to recognize and undo—and if this is the case for you, intensive treatment can be helpful. Fortunately, that’s widely available. You can even attend a rehab center that treats codependency.

Let’s dive into what this looks like and how you can go about finding help to heal.

What Codependency Is—And Isn’t

Technically, codependency isn’t a mental health diagnosis. ((Happ, Z., Bodó-Varga, Z., Bandi, S. A., Kiss, E. C., Nagy, L., & Csókási, K. (2022). How codependency affects dyadic coping, relationship perception and life satisfaction. Current Psychology. https://doi.org/10.1007/s12144-022-02875-9)) Instead, researchers call it a “psychosocial condition.” It’s characterized by an extreme focus on other people, and a lack of emotional openness. People with codependency get a feeling of purpose from their relationships—and not from a strong sense of self.

The idea of codependency is controversial. Some feminists argue that “codependent” is a sexist term. ((Dear, G. E., & Roberts, C. M. (2002). The Relationships Between Codependency and Femininity and Masculinity. Sex Roles, 46(5), 159–165. https://doi.org/10.1023/A:1019661702408)) And some find the term itself acceptable, but think codependency is only possible because of sexism. Other experts argue that this concept is too vague to be actionable. But it can still be a helpful framework for recovery. Learning about codependency helps many people begin the healing process.

In a recent study, participants said that codependency felt real and tangible. ((Bacon, I., McKay, E., Reynolds, F., & McIntyre, A. (2020). The Lived Experience of Codependency: An Interpretative Phenomenological Analysis. International Journal of Mental Health and Addiction, 18(3), 754–771. https://doi.org/10.1007/s11469-018-9983-8)) This new perspective helped them understand a lifetime of emotional problems. “It explains everything,” one person said.

Codependent People, Not Just Relationships

It’s important to note that people, and not only relationships, can be codependent. Recovering from this condition means healing yourself as an individual. It can be empowering to admit that you have this quality, instead of blaming it on a relationship. This lets you take responsibility for your role in a relationship dynamic. And once you take responsibility for your behavior, you can begin recovery.

According to one study, codependent people shared 3 characteristics, ((Bacon, I., McKay, E., Reynolds, F., & McIntyre, A. (2020). The Lived Experience of Codependency: An Interpretative Phenomenological Analysis. International Journal of Mental Health and Addiction, 18(3), 754–771. https://doi.org/10.1007/s11469-018-9983-8)) regardless of their relationship status:

  • confusion around their sense of self
  • difficulty maintaining balance in life
  • feelings of parental abandonment and control in childhood

The Chameleon Self

The participants in the study all described feeling like chameleons. They felt such a strong need to blend in, they’d change themselves to fit into various situations. This came from a desire to feel liked, accepted, and more confident.

Participants also struggled in relationships. They needed acceptance so much, they stayed in relationships that weren’t working. Many of them felt they’d taken on more passive roles in which they felt powerless.

A Sense of Imbalance

Participants often felt they lived in extremes. They’d work too much or too little. They’d swing between excessive self-care and total self-deprivation. They found it difficult to find a happy medium, and struggled to regulate their emotions. Peace and quiet felt boring. According to one participant, “In order to relax I have to burn out almost, I don’t know how to just relax, ‘cause I somehow have to go to the extremes.”

Childhood Trauma

The study found that all participants had difficult childhoods. They lacked support from their parents, who were either physically or emotionally absent. As a result, participants felt both controlled and abandoned.

This data aligns with that of other studies. There is a well-documented link between childhood trauma and codependency in adulthood. ((Evgin, D., & Sümen, A. (2021). Childhood abuse, neglect, codependency, and affecting factors in nursing and child development students. Perspectives in Psychiatric Care. https://www.researchgate.net/publication/354183804_Childhood_abuse_neglect_codependency_and_affecting_factors_in_nursing_and_child_development_students)) But with the right treatment, you can learn to build sustainable relationships.

Treatment for Codependency

Healing from codependency can be joyful. This is the process of getting to know yourself. As you learn how to prioritize your own needs, you’ll get better at saying no. And when you’re protected by healthy boundaries, you can learn how to love yourself. That process not only improves your life; it also improves your relationships. The idea of stepping back from people you love might be scary at first. But eventually, it becomes liberating.

When you first start recovery, it’s important to take time and space away from your relationships. This lets you reset, and get to know yourself in a new context. Who are you without your partner, or your friends, or your boss? There is an answer to that question. And for some people, inpatient rehab is the right place to find it.

During your time there, you might engage in one or more of these treatments:

Talk Therapy

In 1:1 therapy, you’ll reconnect with yourself. You may start by talking about your relationships, and your role as a caretaker. But over time, your counselor will also help you process your emotions. This is an essential part of healing from codependency.

You might try more than one type of talk therapy during rehab. For example, some people benefit from cognitive behavioral therapy (CBT) for codependency. This treatment teaches you new coping strategies, and can help restore your sense of self. Your therapist will teach you how to respond to your own negative thought patterns. These habits can help you improve communication with other people.

In any form of therapy, you’ll learn to separate your sense of empathy from your own feelings. This can help you recognize the difference between your needs and your loved ones’ needs. With that awareness, you can choose when to help other people, and when to focus on yourself. And it’s healthy to strike a balance! You don’t need to control every situation. In fact, most of the time, it’s better to let go.

Family or Couples Therapy

Codependency doesn’t just affect you; it also affects your relationships. It’s important to start recovery with 1:1 therapy. That way, you’ll build a stronger sense of self before you expend any more energy on other people. But in time, you can involve your family members in the recovery process.

In family or couples therapy, you and your loved ones can process what you’ve been through together. But you won’t just talk about the past. You’ll also start to establish healthy boundaries, and make plans for the future.

Family therapy is more than a way to heal relationships; it can also help you heal as an individual. Studies show that support from relatives is just as helpful as treatment from a therapist. ((Karimi Ahmad Abadi, F., Maaref Vand, M., & Aghaee, H. (2015). Models and interventions of Codependency treatment, Systematic Review. Jurnal UMP Social Sciences and Technology Management, 3(2), 572–583. https://www.researchgate.net/profile/Rachel_Bachner-Melman/post/Are_there_any_articles_on_codependence_on_women_in_a_relationship_of_courtship/attachment/59d620)) One study even found that communication family therapy (CFT) lowered codependency scores ((Ahmad-Abadi, F. K., Maarefvand, M., Aghaei, H., Hosseinzadeh, S., Abbasi, M., & Khubchandani, J. (2017). Effectiveness of satir-informed family-therapy on the codependency of drug dependents’ family members in iran: A randomized controlled trial. Journal of Evidence-Informed Social Work, 14(4), 301–310. https://doi.org/10.1080/23761407.2017.1331147)) significantly.

However, know that sometimes, these relationships may be beyond repair. If that’s the case, you can take everything you learn from therapy and work on that in your new relationships.

Support Groups

Co-dependents Anonymous (CoDA) ((CoDA.org. (n.d.). CoDA.Org. Retrieved June 8, 2022, from https://coda.org/)) is a 12-Step program for people in recovery from codependency. They offer free meetings all over the U.S., internationally, and even online.

It can be extremely helpful to connect with peers who share your experience. They may be able to offer you insight and social support. And, this is a way for you to build new relationships in a safe, structured context. Think of this as a way to practice your interpersonal skills, without the pressure of caring for a loved one who needs help.

Codependency and Addiction

In the 1940s, the term “codependent” was used to describe the spouses of people with alcohol addictions. ((Bacon, I., McKay, E., Reynolds, F., & McIntyre, A. (2020). The Lived Experience of Codependency: An Interpretative Phenomenological Analysis. International Journal of Mental Health and Addiction, 18(3), 754–771. https://doi.org/10.1007/s11469-018-9983-8)) Since then, this definition has grown. Today, “codependency” describes dysfunctional relationships between partners, family members, and even friends. In a codependent dynamic, one person sacrifices their needs and sense of self for the other person.

Loving Someone With an Addiction

It’s common for people with addicted loved ones to be codependent. You may feel at home in that dynamic because of your codependency issues. Or you might become codependent because of a relationship. Either way, you may feel obligated to take responsibility for a loved one who’s struggling.

Despite your good intentions, too much generosity can be toxic. If you try to control their behavior, you’ll risk hurting them, your relationship, and yourself. According to one study, people with a higher codependency score had a harder time maintaining healthy relationships. ((Happ, Z., Bodó-Varga, Z., Bandi, S. A., Kiss, E. C., Nagy, L., & Csókási, K. (2022). How codependency affects dyadic coping, relationship perception and life satisfaction. Current Psychology. https://doi.org/10.1007/s12144-022-02875-9)) They reported issues with communication, setting and respecting boundaries, and expressing their feelings.

Codependency as Relationship Addiction

Codependency is associated with negative beliefs about relationships. But you might still get your sense of self from the very relationships you devalue. This can become a vicious cycle, and interfere with your sense of well-being.

Some experts believe codependency is an addiction to relationships. ((Co-dependency. (n.d.). Mental Health America. Retrieved June 8, 2022, from https://www.mhanational.org/co-dependency)) And it follows similar patterns to other addictions. You crave the other person like a drug, and prioritize time with them over your other needs. Over time, the relationship gets less satisfying, but you may not know how to get help.

The goal of recovery is more than fixing any single relationship. With the right treatment, you’ll learn to recognize your own needs, and walk away from dynamics that harm you. And even before you attend rehab, you can start learning about codependency on your own terms.

Resources for Recovery

There are many resources that can help you understand codependency. This information is no substitute for formal treatment, but it can help you plan for recovery.

  • Codependent No More, by Melanie Beattie, introduces the idea of codependency. You can also go through its companion workbook and relate what you’ve learned back to your own life. Beattie’s philosophy is very spiritual, which may not be a good fit for all readers.
  • Conquering Shame and Codependency, by Darlene Lancer, builds on Beattie’s work. This book takes you through 8 steps to heal from shame and build healthy relationships.
  • This codependency worksheet by CoDA lists common characteristics of codependent people.
  • You can get inspiration from these stories from codependent people in recovery.

The Love Language of Letting Go

The process of recovering from codependency is empowering. You’ll learn what it means to love yourself, and how to meet your own needs in a healthy way. And that with those skills as a foundation, you’ll be able to build stronger relationships. You may even get better at caring for other people, since you’ll know how to respect their boundaries. Best of all, that care will stop feeling like a burden. Instead, you’ll find new ways to appreciate the people around you—and yourself.

You deserve support, too. Learn more about treatment at these rehab centers for codependency, including pricing and insurance information, housing options, and which types of therapy are available.