Emotional Sobriety

You can conquer others with power, but it takes true strength to conquer yourself. – Lao Tzu,  Philosopher I asked Dr. Jason Powers, our Chief Medical Officer  to help me write on this topic and here is what we came up with: There are actually two types of sobriety: physical and emotional.  Physical sobriety is the easy part.  Anyone can quit a thousand times, but only the fortunate can stay quit.  Emotional sobriety is not automatically rendered with physical sobriety.   Emotional sobriety can be defined as resiliency, wisdom and balance.  It is a metaphor of sorts for addicts who develop emotional intelligence over the course of their journeys in recovery from substance abuse. Addiction is a chronic, relapsing disease that involves dysfunctional motivation, reward, impulse-control and stress response systems.  The addict’s changed brain is said to be high jacked.  We use this term because the ancient Limbic System commandeers the more recently acquired neocortex to use drugs like alcohol, cocaine or pain pills and avoid withdrawal to the exclusion of water, food, or even procreation. In animal models, drugs are preferentially used despite having food, water or mates in heat; and for drug dependent animals, drug are chosen until death in many studies.  Truly, then, the ‘high jacked’ brain is apropos. Since the brain changes are profound and take many years to normalize, addicts early in recovery often relapse due to decision-making impairments.  Many of my patients cannot explain the “what were you thinking” question.  Triggers, like environmental cues or emotional pain, can change the addict’s behavior automatically because the addiction center lies in the subconscious.  Researchers have discovered that we can strengthen the addict’s defense against a relapse by enhancing their overall wisdom, resiliency, equanimity and innate coping skill set – aka emotional sobriety. The need to reinforce addicts’ emotional sobriety was even recognized in the early years of traditional recovery fellowships.  In fact, in 1958, The Grapevine, a publication of Alcoholics Anonymous, Bill Wilson realized that emotional sobriety was the next frontier.  He actually was hopeful that the veteran members would make emotional sobriety an actual movement within AA. It is important to recognize that emotional sobriety never became a movement at all nor is it a formally recognized addition to AA or the Twelve Steps.  Emotional sobriety is nonetheless a crucial part of the addict’s growth necessary to not only stay sober but also to catch up on their emotional development. Addiction is a young person’s disease because use of substances usually begins during youth and before the brain has fully matured.  The addict becomes arrested at the stage of development when they started using.  So emotional sobriety is also fundamental to help the addicts catch up developmentally. Any one article cannot possibly do justice to the how of emotional sobriety.  But a brief overview is warranted here.  Resiliency comes with time, practice and guidance.  Meditation can be the most useful tool in developing resiliency because it enhances the neocortex’s ability to rise above the emotional noise of the lower brain structures so the addicts can choose to respond to life’s curveballs rather than react to it.  Mediators show a decrease in sympathetic stimulation so that even when stressed, are not as reactive as those who do not meditate. We cannot teach wisdom, it must be learned.  One of the worst mistakes I see parents of addicts make is that they do not let them fall down.  Without the benefit of learning from experience, there will be no wisdom.  If we do not fall down, how can we learn to pick up ourselves up?  What is wisdom, if not having the perspective of experience? Addiction is one of those inherently traumatic diseases that patients learn many lessons from but alone is not enough.  Recovery is a progressive path, not a perfect one.  And wisdom comes with lessons learned the hard way, in and out of recovery.  All human beings share this one. The last component of emotional sobriety is balance.  This one is tricky for addicts.   It can be easily argued that teaching a fish to ride a bicycle while underwater is easier than teaching an addict balance.  No matter the difficulty, if a blind human can climb Mt Everest, anyone can learn balance, right?  The type of balance inherent in emotional sobriety is the not the type associated with moderation as is seen in moderate drinking.  Instead, the balance I direct patients to incorporate is of the multidimensional living variety.  Some addicts get sober and throw themselves into work, neglecting their relationships, mental health, physical health and spirituality.   In short the balance of emotional sobriety is in the intentional behaviors in those 5 arenas mentioned above.

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