Rational Recovery

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Rational Recovery (RR) was a commercial vendor of material related to counseling, guidance, and direct instruction for addiction designed as a direct counterpoint to Alcoholics Anonymous (AA) and twelve-step programs.

Contents

Rational Recovery was founded in 1986 by Jack Trimpey, a California-licensed clinical social worker. Trimpey is a recovered alcoholic who works in the field of treatment of alcoholism and other drug addictions. Rational Recovery is a commercial trademark, [1] along with the Addictive Voice Recognition Technique (AVRT). [2] The organization published a periodical, the Journal of Rational Recovery, from at latest 1993 [3] [4] until at least June 2001. [5] The former "Rational Recovery" website ("rational.org") and a newer website www.avrt.com are now both 'parked' domains.

Program

The program (AVRT) is not a form of therapy, counseling, or addiction treatment. Some assistance is free, but the program requires some "very modest charges" for goods and services including books, articles, and audio CDs to assist in the recovery process. [6] Much of the material is offered for free via the Internet, and an interested person can begin the Rational Recovery program through the Internet. The Rational Recovery program is based on the premise that the addict both desires and is capable of permanent, planned abstinence. However, the Rational Recovery program recognizes that, paradoxically, the addict also wants to continue using. This is because of their belief in the power of the substance to quell their anxiety; an anxiety which is itself partially substance-induced, as well as greatly enhanced, by the substance. [7] This ambivalence is the Rational Recovery definition of addiction.

According to this paradigm, the primary force driving an addict's predicament is what Trimpey calls the "addictive voice", which can physiologically be understood as being related to the parts of the human brain that control our core survival functions such as hunger, sex, and bowel control. Consequently, when the desires of this "voice" are not satiated, the addict experiences anxiety, depression, restlessness, irritability, and anhedonia (inability to feel pleasure). In essence, the RR method is to first make a commitment to planned, permanent abstinence from the undesirable substance or behavior, and then equip oneself with the mental tools to stick to that commitment. Most important to recovering addicts is the recognition of this addictive voice, and determination to remain abstinent by constantly reminding themselves of the rational basis of their decision to quit. As time progresses, the recovering addict begins to see the benefits of separating themselves and their rational minds from a bodily impulse that has no regard for responsibility, success, delayed gratification, or moral obligation.

While nomenclature differs, the methods are similar to those used in Cognitive Therapy of Substance Disorders (Beck, et al.) and other belief-, attitude- and appraisal-challenging and cognitive restructuring schemes. [8]

The RR program is based on recognizing and defeating what the program refers to as the "addictive voice" (internal thoughts that support self-intoxication) and dissociation from addictive impulses. The specific technique of Addictive Voice Recognition Technique (AVRT) refers to the practice of objectively recognizing any mental thoughts that support or suggest substance use as AV (addictive voice). This passive recognition allows the practitioner to realize that they don't need to do what the AV says, but can effortlessly abstain. This technique relies heavily on basic semantics, essentially relegating the AV to an objectively recognizable "it" and retaining the control and free will of the "I." Rather than saying to oneself, "I drink", one can use AVRT to understand that "I don't want to drink, it (the AV) wants to drink." Once this "separation" is achieved, and the practitioner has personally experienced that they indeed can observe objectively their own addictive voice, maintaining abstinence is a matter of self-control and becomes a personal choice of free will.

In his book, Rational Recovery, Trimpey calls the addict's addictive voice "the bark of Beast", "the Beast" being the desire for intoxication. He proposes that this is the sole reason why addicts continue their self-destructive ways. Furthermore, by recognizing any feeling, image, urge, etc. that supports drinking/using as "Beast activity", the compulsions will fall silent, and the person can eventually regain control over their life and never worry about relapses. Rather than making addiction a lifelong battle, it is much easier to say "no" to the addictive voice, than to give in. Moreover, this separation of the rational self from the relentless "Beast" will, Trimpey says, enable addicts to always remain aware of the repercussions associated with a single relapse.

The notions that internal thoughts support self-intoxication and that the practitioner is in control of the addictive voice have become foundational in "evidence-based" treatment schemes at more progressive substance abuse treatment facilities in the US, Canada, Australia and the UK. These facilities base their programs on the success of rational emotive behavior therapy, [9] cognitive behavioral therapy, [10] cognitive appraisal therapy, [11] and schema therapy [12] for anxiety and depression, as well as for substance abuse.

Comparison with Alcoholics Anonymous

While Rational Recovery and AA promote abstinence, the programs use radically different strategies. Rational Recovery repeatedly claims that there is no better time to construct a "big plan" to abstain from drinking/using than now, and that AA's idea of "one day at a time" is contradictory to never using again. That is, Rational Recovery says, if AA proposes that you are never going to drink again, then there isn't a reason to keep track of time. [13]

Court-mandated twelve-step program attendance

In the United States, psychologist and lawyer Stanton Peele has encouraged legal action against mandated attendance of 12-step programs, stating an objection to the courts and other government and tax-supported agencies mandating attendance at meetings run by organizations with spiritual or religious content. They[ who? ] interpret state-mandated 12-step program attendance as a violation of the Establishment Clause within the First Amendment. This view has been upheld in Griffin v. Coughlin, [14] Grandberg v. Ashland County, Warner v. Orange County Department of Probation, Kerr v. Lind, and O'Connor v. State of California. [15] In his book, Peele notes the five most popular secular alternatives to AA at the time of publication, namely Rational Recovery, SMART Recovery, Women for Sobriety, Secular Organizations for Sobriety, and Moderation Management. [16]

Religious neutrality

Trimpey asserts that some have accused Rational Recovery of being anti-religious. The Rational Recovery FAQ states:

Rational Recovery has voiced the conscientious objections of tens of thousands of persons who have received unwanted, unconstitutional, religious indoctrinations in the course of addiction treatment. To them and others, we provide a program that is free from religion. By advocating for their religious freedom, and identifying the 12-step program as a religion that competes with established religions, we have been accused by some of being irreligious, sacrilegious, or even anti-religious. Ain't so. [17]

Rational Recovery claims to remain neutral on the subject of religion and sobriety. Rational Recovery founder Jack Trimpey explains, "...Rational Recovery is not interested in having people give up any of their religious beliefs; it's just none of our business what people believe about gods and saints. The only exception here, of course, is when one is 'depending' on a rescuing deity in order to remain sober. If that is one's preference, then AA is an ideal program." [18]

Meetings canceled

Rational Recovery claims that "AVRT has made recovery groups obsolete."[ citation needed ] In 1998, Rational Recovery announced, "The Recovery Group Movement is Over!...Beginning January 1, 1999, all addiction recovery group meetings for Rational Recovery in the United States, Canada, and abroad are hereby canceled and will not be rescheduled ever again, it's just a waste of time and is completely unproductive."[ citation needed ] Despite those remarks, there are still some groups in existence today, although the numbers are dwindling.[ citation needed ]

In a 1993 research study led by Marc Galanter, former president of both the American Society of Addiction Medicine and the American Academy of Addiction Psychiatry, attempted to measure the impact of Rational Recovery on members. The research found that "Rational Recovery succeeded in engaging substance abusers and promoting abstinence among many of them while presenting a cognitive orientation that is different from the spiritual one of AA. Its utility in substance abuse treatment warrants further assessment. The results of the impact on this type of recovery are too few to make an educational assumption" [19] This research was conducted before Rational Recovery disbanded their meetings in favor of self-recovery treatment. SMART Recovery split from Rational Recovery just after this research and continues to offer these same groups.

See also

Related Research Articles

<span class="mw-page-title-main">Alcoholics Anonymous</span> Sobriety-focused mutual help fellowship

Alcoholics Anonymous (AA) is a global, peer-led mutual-aid fellowship dedicated to abstinence-based recovery from alcoholism through its spiritually inclined twelve-step program. AA's Twelve Traditions stress anonymity and the lack of a governing hierarchy, and establish AA as free to all, non-promotional, non-professional, unaffiliated, non-denominational, and apolitical. In 2021, AA reported a presence in approximately 180 countries with nearly two million members—73% in the United States and Canada.

Twelve-step programs are international mutual aid programs supporting recovery from substance addictions, behavioral addictions and compulsions. Developed in the 1930s, the first twelve-step program, Alcoholics Anonymous (AA), founded by Bill Wilson and Bob Smith, aided its membership to overcome alcoholism. Since that time dozens of other organizations have been derived from AA's approach to address problems as varied as drug addiction, compulsive gambling, sex, and overeating. All twelve-step programs utilize a version of AA's suggested twelve steps first published in the 1939 book Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism.

<span class="mw-page-title-main">Drug rehabilitation</span> Processes of treatment for drug dependency

Drug rehabilitation is the process of medical or psychotherapeutic treatment for dependency on psychoactive substances such as alcohol, prescription drugs, and street drugs such as cannabis, cocaine, heroin, and amphetamines. The general intent is to enable the patient to confront substance dependence, if present, and stop substance misuse to avoid the psychological, legal, financial, social, and medical consequences that can be caused.

<span class="mw-page-title-main">Cocaine Anonymous</span> Twelve-step program

Cocaine Anonymous (CA) is a twelve-step program formed in 1982 for people who seek recovery from drug addiction. It is patterned very closely after Alcoholics Anonymous (AA), although the two groups are unaffiliated. While many CA members have been addicted to cocaine, crack, speed or similar substances, CA accepts all who desire freedom from "cocaine and all other mind-altering substances" as members.

Substance dependence, also known as drug dependence, is a biopsychological situation whereby an individual's functionality is dependent on the necessitated re-consumption of a psychoactive substance because of an adaptive state that has developed within the individual from psychoactive substance consumption that results in the experience of withdrawal and that necessitates the re-consumption of the drug. A drug addiction, a distinct concept from substance dependence, is defined as compulsive, out-of-control drug use, despite negative consequences. An addictive drug is a drug which is both rewarding and reinforcing. ΔFosB, a gene transcription factor, is now known to be a critical component and common factor in the development of virtually all forms of behavioral and drug addictions, but not dependence.

Dry drunk is an expression coined by the founder of Alcoholics Anonymous that describes an alcoholic who no longer drinks but otherwise maintains the same behavior patterns of an alcoholic.

Stanton Peele is a psychologist, attorney, psychotherapist and the author of books and articles on the subject of alcoholism, addiction and addiction treatment.

Nicotine Anonymous (NicA) is a twelve-step program founded in 1982 for people desiring to quit smoking and live free of nicotine. As of July 2017, there are over 700 face-to-face meetings in 32 countries worldwide with the majority of these meetings occurring in the United States, Iran, India, Canada, Brazil, the United Kingdom, Australia, Russia and in various online community and social media platforms.. NicA maintains that total abstinence from nicotine is necessary for recovery. NicA defines abstinence as “a state that begins when all use of nicotine ceases.

Drug addiction recovery groups are voluntary associations of people who share a common desire to overcome their drug addiction. Different groups use different methods, ranging from completely secular to explicitly spiritual. Some programs may advocate a reduction in the use of drugs rather than outright abstention. One survey of members found active involvement in any addiction recovery group correlates with higher chances of maintaining sobriety. Although there is not a difference in whether group or individual therapy is better for the patient, studies show that any therapy increases positive outcomes for patients with substance use disorders. The survey found group participation increased when the individual members' beliefs matched those of their primary support group. Analysis of the survey results found a significant positive correlation between the religiosity of members and their participation in twelve-step programs and to a lesser level in non-religious SMART Recovery groups, the correlation factor being three times smaller for SMART Recovery than for twelve-step addiction recovery groups. Religiosity was inversely related to participation in Secular Organizations for Sobriety.

SMART Recovery is an international community of peer support groups that help people recover from addictive and problematic behaviors, using a self-empowering and evidence-informed program. SMART stands for Self-Management and Recovery Training. The SMART approach is secular and research-based. SMART has a global reach with a presence established in more than 30 countries. SMART Recovery is effective with a range of addictive and problematic behaviors.

Project MATCH began in 1989 in the United States and was sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). MATCH is an initialism for Matching Alcoholism Treatments to Client Heterogeneity. The project was an 8-year, multi site, $27-million investigation that studied which types of alcoholics respond best to which forms of treatment. MATCH studied whether treatment should be uniform or assigned to patients based on specific needs and characteristics. The programs were administered by psychotherapists and, although twelve-step methods were incorporated into the therapy, actual Alcoholics Anonymous meetings were not included. Three types of treatment were investigated:

<span class="mw-page-title-main">LifeRing Secular Recovery</span> Addiction and recovery organization

LifeRing Secular Recovery is a secular, non-profit organization providing peer-run addiction recovery groups. The organization provides support and assistance to people seeking to recover from alcohol and drug addiction, and also assists partners, family members and friends of addicts or alcoholics. It is an abstinence-based recovery program with three fundamental principles: sobriety, secularity and self-empowerment. The motto of LifeRing is "empower your sober self."

Moderation Management (MM) is a secular non-profit organization providing peer-run support groups for anyone who would like to reduce their alcohol consumption. MM was founded in 1994 to create an alternative to Alcoholics Anonymous and similar addiction recovery groups for non-dependent problem drinkers who do not necessarily want to stop drinking, but moderate their amount of alcohol consumed to reduce its detrimental consequences.

<span class="mw-page-title-main">Secular Organizations for Sobriety</span> Non-profit network of autonomous addiction recovery groups

Secular Organizations for Sobriety (SOS), also known as Save Our Selves, is a non-profit network of autonomous addiction recovery groups. The program stresses the need to place the highest priority on sobriety and uses mutual support to assist members in achieving this goal. The Suggested Guidelines for Sobriety emphasize rational decision-making and are not religious or spiritual in nature. SOS represents an alternative to the spiritually based addiction recovery programs such as Alcoholics Anonymous (AA). SOS members may also attend AA meetings, but SOS does not view spirituality or surrendering to a Higher Power as being necessary to maintain abstinence.

Women for Sobriety (WFS) is a non-profit secular addiction recovery group for women with addiction problems. WFS was created by sociologist Jean Kirkpatrick in 1976 as an alternative to twelve-step addiction recovery groups like Alcoholics Anonymous (AA). As of 1998 there were more than 200 WFS groups worldwide. Only women are allowed to attend the organization's meetings as the groups focus specifically on women's issues. WFS is not a radical feminist, anti-male, or anti-AA organization.

Recovery coaching is a form of strengths-based support for people with addictions or in recovery from alcohol, other drugs, codependency, or other addictive behaviors. There are multiple models, with some programs using self-identified peers who draw from their own lived experience with substance use and recovery and some utilizing people who have no lived experience but some training in support, depending on local standards and availability. They help clients find ways to stop addiction (abstinence) or reduce harm associated with addictive behaviors. These coaches can help a client find resources for harm reduction, detox, treatment, family support and education, local or online support groups; or help a client create a change plan to recover on their own.

About 1 in 7 Americans reportedly suffered from active addiction to a particular substance. Addiction can cause physical, emotional and psychological harm to those affected by it. The American Society of Addiction Medicine defines addiction as "a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual's life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences."

Linda Carter Sobell, Ph.D., ABPP, is the President's Distinguished Professor at Nova Southeastern University (NSU) in Fort Lauderdale, Florida. She is a professor of clinical psychology, addiction specialist, co-director of NSU's Guided Self-Change clinic, a Motivational Interviewing Trainer, and is board-certified in cognitive and behavioral psychology.

Guided self-change (GSC) treatment has been accepted by American Psychological Association Division 12, Society of Clinical Psychology, as an empirically supported treatment.

References

  1. ↑ "Trademark Status & Document Retrieval". Tsdr.uspto.gov. Retrieved 1 June 2019.
  2. ↑ "Trademark Status & Document Retrieval". Tsdr.uspto.gov. Retrieved 1 June 2019.
  3. ↑ "Rational Recovery and Professional Issues" . Retrieved 11 December 2016.
  4. ↑ Salomone, Gaetano (1998). "What Is Buchmanism?".
  5. ↑ "Customized Public Speaking and Negotiation Skills Training". Archived from the original on 2016-12-20. Retrieved 2016-12-11.
  6. ↑ "Rational Recovery | My AVRT-Based Recovery". Rational.org. Retrieved 2016-09-26.
  7. ↑ See Beck, et al.
  8. ↑ See Garrett.
  9. ↑ See Albert Ellis, et al.
  10. ↑ See Aaron Beck, et al.
  11. ↑ See Richard Wessler, et al.
  12. ↑ See Jeffrey Young, et al.
  13. ↑ "Rational Recovery | Lens of AVRT". Rational.org. Retrieved 2016-09-27.
  14. ↑ "Griffin v. Coughlin, 88 N.Y.2d 674 (June 11, 1996)". Cornell Law School. Retrieved 2008-01-27.
  15. ↑ Peele, Bufe & Brodsky 2000, p. 110-129.
  16. ↑ Peele, Bufe & Brodsky 2000, p. 22.
  17. ↑ "What is Rational Recovery?". Archived from the original on 2008-01-07.
  18. ↑ Trimpey, Jack (1995). The Small Book: A Revolutionary Alternative for Overcoming Drug and Alcohol Abuse. Dell. p. 247.
  19. ↑ Galanter, Mark; Egelko, S; Edwards, H (1993). "Rational Recovery: Alternative to AA for addiction?". American Journal of Drug and Alcohol Abuse. 19 (4): 499–510. doi:10.3109/00952999309001638. PMID   8273770. Archived from the original on 2010-04-20.

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