Recovery what?

September is celebrated as Recovery month in towns and cities worldwide. It is a visible celebration of recovery from addictive behaviours, where people from various pathways connect, share stories, sing, dance and typically walk through their towns and cities in a show of solidarity. The recovery movement hopes to challenge stigma and act as a beacon of hope and inspiration for our communities, showing that we can and do recover.

This year however it comes around amidst a backdrop of record numbers of drug related deaths, rising suicide rates among almost every demographic and increased social isolation due to the pandemic, which will undoubtedly result in a surge of additional mental health and substance use issues. It is more important than ever to shine some light on a subject that is not a particularly endearing societal problem, despite so many families and communities being affected. There is an enduring stigma that pervades addiction and prevents people talking honestly and openly.

A quick bit about my early experience

I am a person in long term recovery from substance use and mental health issues and now a self employed recovery coach and consultant for a couple of peer led recovery services in the UK. Having worked for almost a decade within both NHS and charity services I want to share my experience as a person seeking recovery, working in treatment, and why i think that recovery coaching may be the answer to some of the issues we face.

The first time I ever sought ‘treatment’ was for my opiate habit and I was aged 18. I’d already dropped out of my A’ level studies after too much house partying in the late 90s, and my substance use had escalated onto harder drugs looking for some kind of escape from myself and my environment. I’d never heard of the concept of recovery then. I was living in a small market town in Lincolnshire, my mum was an addict, her bloke was a dealer and hope was something other people had. It was trainspotting without any of the nuanced relationship dynamics or scenic tourism. It was dawn raids, ODs in the kitchen and methadone not milk in the fridge. Shoplifters half price offerings and a who’s robbing who of giro junkies. I took my feelings of shame to the local surgery, broke down in tears to my GP and begged for some relief.

The well meaning but Ill equipped GP gave me some DFs and a few diazepam for which I was grateful (bless him) it was free drugs after all. The intention was there though, in that moment of clarity between giro days I imagined a life free from withdrawal, anxiety and depression, I was going to do it. Well, I did 3 long days on my grandma’s sofa pretending I had the flu before I necked the rest of the yellow tablets and clucked off to score again. I didn’t re-engage meaningfully with treatment again until I was 21 and left town with a methadone script and my first ever period of (MAT) recovery, and all manner of cross addictions (but that’s another story).

What’s new?

These first interactions of mine over 20 years ago with services raise some important points for me to reflect on today as a person in long term recovery.

Firstly a few questions, Can we honestly say that GP’s and front line services across the UK have the resources and knowledge necessary to provide more proactive interventions over 20 years later? Are traditional treatment services appealing and accessible for those new to them? Are waiting lists for accessing ‘treatment’ still in the future with very little in the present to support people during those brief moments of clarity? The best time to initiate change is when a person feels ready, that feeling is fleeting. Are aftercare services post treatment fit for purpose to maintain long term sobriety? I must say that I do see areas of good practice in some places in the UK with thriving well connected recovery communities, but i’m speaking here in general terms of the treatment system.

Secondly, what would it have looked like if I had access to an experienced guide who could advise me of different pathways and connect me to others in recovery, as well as wider community resources. Someone who could share their story of hope and recovery as well as ask tough questions from a place of experience and understanding?

My belief is that Recovery Coaching should be at the heart of every recovery support service and community. So, what is Recovery Coaching?

It is a form of strength-based, person centred support for people in or seeking recovery, and even their family members. It is similar to life or business coaching in that it is a type of partnership where the person seeking recovery self-directs their plan while the coach provides support, guidance and options. Recovery Coaching focuses on achieving goals important to the individual, without stigma, dogma or an agenda. They help people access recovery and the systems needed to support it and add to an individual’s recovery capital. They are not counsellors or therapists and as such are future focussed and goal oriented. They do not diagnose or treat substance use or any mental health issues, but can absolutely help with signposting to professional services that can, as well as offer an unparalleled level of understanding.

Peer based Recovery support

There are a myriad of different names for volunteer roles in the U.K, from mentor to recovery champion and others in between. These are primarily volunteer roles, and typically taken up by those still in treatment or at an early stage of their recovery. I am in no way dismissing these roles, they play a crucial part, and it is in these roles that I also gave back and volunteered at the start of my own journey. Nor am I speaking of the specific roles of a sponsor which again is a great part of a wider community approach.

There are however some distinct differences between existing unpaid roles of ‘peer support’ or ‘recovery champions’ and that of an experienced recovery coach. Not least a period of stable recovery, but also robust ongoing training and guidelines that incorporate values and ethics. The dynamic of the roles is also largely different, and an understanding of these differences can help ensure each role is maximised to its full potential in order to support existing treatment and public services. Support and development of these roles is critical to building a thriving recovery community.

There has been some great work across the pond by our American friends on peer based recovery support services, and their view is largely that we are very much behind the curve. “The history and future of peer-based addiction recovery support services,

There are areas of the U.K that have embraced similar models of peer based recovery support services, including rehabs and community organisations, and some great work has been done broadly by FAVOR UK on this as well as regionally by Red Rose Recovery. While this has been a great step in providing opportunities for employment and resources for people, we also need to be mindful to maintain the fidelity of the Coaching lane so these roles do not become appropriated into clinical, or “go-fer” type roles. Many treatment services over reliance on volunteers has reached new levels, sometimes in a way i have seen to be detrimental to their personal recovery. Whilst giving back is undoubtedly an important part of wellbeing and recovery it must be meaningful, and feature appropriate support and guidance. Once trained our experience and expertise provide us invaluable insight and become our tools to help others. There must also therefore be a pathway for volunteers through meaningful volunteer roles to employment when appropriate.

I am grateful to be working with a very proactive CIC in Grimsby that supports recovery through art and mutual aid. They recognise the importance of bringing some of these concepts to their recovery community to help it become a thriving space for people to get well and re-engage with the wider community. I will be initially delivering 8 sessions of recovery coaching based on the great work of many giants before me including William White, McShin Foundation, CCAR and Favor UK to name but a few, as well as including elements from my own experience and coaching practice. This will form a wider bit of co-produced work from which we aim to establish a number of local coaches and implement systems to support the local community.

When i attended my first recovery walk in Birmingham UK in 2013 the theme was ‘make it happen’ and this is a mantra i have continued to aspire to on my own journey. Recovery is not only possible, it is inevitable when we reconnect with a community and find our purpose.

Hope + Opportunity + Purpose = Recovery 💜

I am also looking to connect with people across the UK who would like to influence their local community to make visible and sustained recovery the new normal.

Contact me; carlo@purplemagpiecoaching.co.uk

If you are in or around Grimsby get in touch.

Dithering dogma…!

As UK pubs reopened to a mixed response, after the last three months of isolation Brits still seemingly still have a thirst on and aren’t too fussed about distancing.

With news articles declaring consumption has risen during lock-down, and some early studies also looking at potential increases it may be a good time to reflect on our choices. It has undoubtedly been a difficult period, particularly for many of our dependent drinkers, and the lure of getting back out there ‘connecting with friends’ or ‘disconnecting from current reality’. I’ve noticed it both on my social media timelines with friends and family’s daytime drinking patterns, and at work with those i support. One of the biggest protective factors for many was connection, and we have long stressed the importance of this as part of the 5 ways to wellbeing. So as social isolation has grown, as seen in Dr Alexanders rat park experiments of the 70s addictive behaviour invariably escalates.

So what is out there now if i want to get help?

There is of course your local treatment provider commissioned by your local authority, who can put you in touch with all local community assets. A quick online search should find the current one, after initially stopping seeing people face to face many are now opening their doors again. I know many people that simply will not engage with these services due to barriers, either real or perceived varying from stigma to a previous bad experience. There are also mutual aid meetings such as 12 step fellowships like AA or NA that are avidly promoted by GP’s and other public services. Some barriers to engaging with these groups can be the perceived ‘GOD issue’, the ‘powerlessness talk’, the ‘drunkalogues’ or just the perceived monotony of perpetual meetings. Alternatively there is SMART; barriers to engagement – over reliance on confusing concepts or acronyms, lack of community, and ‘recovery know it all’s’. You will often hear the phrase within the recovery community “take what you like and leave the rest” and that is generally the way to go. Whatever you decide do it with an open mind and positive intention. There are some excellent parts that make up the whole and can act as helpful recovery capital to support your goals.

So what about the large majority of those over reliant on substances that find the barriers to engaging with treatment providers or mutual aid too much or too stigmatising?

Recent PHE figures [1][2] before the pandemic also showed disturbing trends of fewer alcohol dependent people engaging with treatment services. Over the last few years we have also seen record numbers of drug related deaths across the UK. It is clear something is not working for many, as services have also faced drastic cuts to their commissioned treatment budgets repeatedly in recent years. The sector is asked to do more with less, but at what cost?

Having worked in “recovery services” of various guises over the last 9 years, and as a person who had a serious substance misuse problem/substance use disorder/addict/person in recovery/recovered* (*delete as appropriate today) I now find myself walking away from the sector i was once passionate about, recently made redundant and disillusioned at current service provision across most of the UK. Having traveled a lot for work i have been fortunate to see some fantastic practice in some areas, however the very nature of commissioning has led to a postcode lottery and dramatic variance in recovery ‘choices’. One thing i have learned in my time working in the sector is that there is no one size fits all approach to recovery, and my view is that recovery should be self directed and defined by the individual. Complete abstinence can be seen as a barrier to entering treatment, and perpetuate the shame following a lapse/relapse. The term recovery itself has become somewhat of an abstract cliche, and people in early recovery are often paraded out to prove a service’s outcomes and to add value to the service’s ever dwindling pot of money, as cuts continue to bite, with very little ongoing support. Volunteers are now finding themselves increasingly on the front line.

“It is an historical fact that practically all groupings of men and women tend to become more dogmatic; their beliefs and practices harden and sometimes freeze. This is a natural and almost inevitable process…. But dogma also has its liabilities. Simply because we have convictions that work well for us, it becomes very easy to assume that we have all the truth….This isn’t good dogma; it’s very bad dogma. It could be especially destructive for us of AA to indulge in this sort of thing”. ( Bill Wilson, 1965/1988, p. 333)

Disclaimer, as i know there is an almost tribal response to perceived criticism of ones ‘recovery pathway’ so I will say, i have spent time with various recovery programmes and fellowships over the years, i have sponsored ‘addicts’, chaired and facilitated meetings and repeated many of the dogmatic well rehearsed mantras. I have also bitten my tongue on a number of occasions in order to be diplomatic and not rock the recovery boat, however in my view services and commissioners should and can do better. The statistics are quite clearly showing that the existing model(s) are not working for many.

Dogma has had a stranglehold on treatment for people who use substances since treatment was conceived for ‘treating’ the feckless, right through the temperance movement and into the dominant philosophy of recent times being the 12 step approach, and abstinence being the “only way”. This is manifest still today in funding streams and also in rehabs, as well as local service providers.

As such it is good to see the rise of the moderation/ mindful drinking movement with Club soda putting on mindful drinking festivals (pre corona) and engaging people from across the spectrum, and hopefully more will follow suit and consider new models and ways to build community and a society that does not need to rely on substances or treatment in the way we currently do. Invariably we use substances for Fear or fun, both are short term rewards, but extremely gratifying. Our reliance on substances as an emotional crutch means may of us are floating through life like a carrier bag in the wind. The way out of my addiction was finding a purpose i was passionate about. I will be eternally grateful to my mentors that gave me the opportunity to make it happen, and will continue to support others in defining their own recovery goals without judgement or dogma.

Giving back is an important turning point in many peoples recovery journey (After mentoring i created a small community group to support individuals in my own community with the limited knowledge and resources we had at the time) however the biggest factor in me sustaining my own recovery was challenging my own limiting beliefs and feeling empowered enough to pursue my own personal growth, until then I was just ‘white knuckling it’ and going through the motions.

Change needn’t be difficult, only resistance to it is (to paraphrase the Buddha). Find something or someone that inspires you to be the best version of yourself and apply yourself wholeheartedly, you don’t need to have all the answers. There is no quick fix, and those that are pave a road to ruin. The future is yours. The future is now. 💜