Smart Recovery


Michael Stuart Kelly

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I received an email from a person knowledgeable about the Smart Recovery system (thank you E). Here is the link:

www.smartrecovery.org

It looks like a very good approach. It seems to be an outgrowth of Rational Recovery. Here are the first three questions in the FAQ on the website:

Q. What is the SMART Recovery® program of recovery?

A. The SMART Recovery® approach to recovery is summarized in the Four-Point program.

SMART Recovery® teaches how to:

1) Enhance and maintain motivation to abstain

2) Cope with urges

3) Manage thoughts, feelings, and behaviors

4) Balance momentary and enduring satisfactions

Q. What does SMART Recovery® stand for?

A. SMART Recovery® is an acronym that stands for Self-Management and Recovery Training.

Q. What is addictive behavior?

A. Addictive behavior is over-involvement with substance use (e.g., psychoactive substances of all kinds, including alcohol, nicotine, caffeine, food, illicit drugs, and prescribed medications), or over-involvement with activities (e.g., gambling, sexual behavior, eating, spending, relationships, exercise, etc.). We assume that there are degrees of addictive behavior, and that all individuals to some degree experience it. For some individuals the negative consequences of addictive behavior (which can involve several substances or activities) become so great that change becomes highly desirable.

One of the things I want to do later here on OL is an overview of the different recovery approaches. With that in mind, I only want to state one restriction I have about what I have read so far.

This seems like an organization into AA bashing, which is prevalent among non-religious-based approaches like Rational Recovery, Stanton Peele, etc. I find this to be tiresome. I was not active here in the USA, but I have no doubt that I would have lost patience with the bashing other organization approach had I sought them out for treatment.

In the 12 group (NA) I used for drug addiction, there was on guy who insisted that white sugar was one of the roots of all evil, and that used to tick me off terribly. I didn't feel that I was there because I overdosed on sugar. (Nowadays, I am one of those inconvenient dudes who does not eat sucrose, but that has nothing to do with my initial irritation.)

The point is, I was there for treatment of my problems, not listen to a litany of evils about some other organization that was helping people like me.

This is a minor point, but it is still there.

Another point where I differ is with the disease concept. Smart Recovery makes a blanket statement that addiction is not a disease. Twelve-step groups make a blanket statement that addiction is a disease.

(yawn)

I sometimes wonder if government money is involved in this issue...

In my concept, there are many kinds of addiction and different parts of the mind are affected. Some of these addictions and parts of the mind involve disease and others involve the equivalent of bad habits. There is a wide range in between and the whole spectrum has to be dealt with.

Addiction is more complicated than one-size-fits-all. That is, except for one condition. This condition fits all. The addict must stop his/her destructive behavior.

In short, ANYTHING that makes an addict stop is good. That means AA, NA, Rational Recovery, Stanton Peele, Smart Recovery, Hazelden, cold turkey - anything. (Strangely enough, despite the drawbacks, Scientology has a halfway decent recovery program called Narconon.)

So with these two restrictions in mind, the AA (12 step) bashing and the blanket stance on addiction not being a disease, what I read so far is VERY GOOD.

If you are an addict or alcoholic and reading this, I highly encourage you to visit the Smart Recovery site. This just might be the approach that will work for you and save your life. If it doesn't resonate with you, however, that's OK. Just go somewhere that does - including AA or NA if need be. Your life is the important value, not any theory.

You are important and don't ever forget that.

As I learn more, I will write more.

Michael

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This seems like an organization into AA bashing, which is prevalent among non-religious-based approaches like Rational Recovery, Stanton Peele, etc.

If the following quote from the bottom of the Intro page somehow contradicts the rest of the site, which I admit to not haven't read it in its entirety, I'd be very surprised:

SMART vs. 12-Step Programs

At SMART we believe that each individual finds his own path to recovery. For some that may include traditional 12-step programs like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). While the SMART approach differs from AA and NA, it does not exclude them. Some SMART participants choose to attend AA or NA meetings when they cannot attend a SMART meeting. Some find that what they hear at AA or NA meetings helps them on their path to permanent recovery.

It's quite possible that some of the posters in the SMART forums are anti-AA? (I certainly was for quite a while.) Which leads me to respond to this:

I sometimes wonder if government money is involved in this issue...

Oh my, have you nailed it! But this is a *huge* topic, and one that I will start a separate thread on.

In my concept, there are many kinds of addiction and different parts of the mind are affected. Some of these addictions and parts of the mind involve disease and others involve the equivalent of bad habits. There is a wide range in between and the whole spectrum has to be dealt with.

I share this conclusion. How much of addition is behavior, how much is biochemical and how does this symbiosis happen? Is it even helpful to compartmentalize the cognitive from the biology for the purpose of examination? These, I think, are questions for cognative scientists to answer first, although I think philosophers have something valuable to say about the methodology of scientific inquiry.

Addiction is more complicated than one-size-fits-all. That is, except for one condition. This condition fits all. The addict must stop his/her destructive behavior.

In short, ANYTHING that makes an addict stop is good. That means AA, NA, Rational Recovery, Stanton Peele, Smart Recovery, Hazelden, cold turkey - anything. (Strangely enough, despite the drawbacks, Scientology has a halfway decent recovery program called Narconon.)

While I'm largely in agreement here, I'm not uncertain about the claim of "anything that makes an addict stop is good." I need to work through that argument. But again, another another topic for another time.

I look forward to the evolution of this thread. I think SMART has a particular appeal to Objectivish-leaning people due to its evidence-based approach. The principles appear to be very sound and tough (for me, anyway) to equivocate with.

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  • 4 years later...

This is my first post to the group. I actually view the site occasionally and tonight I stopped by to see if there were any comments on the film Atlas Shrugged.

I became quickly distracted when I noticed SMART Recovery mentioned. The therapeutic model for recovery is bio/psycho/social, and a good therapist and/or addiction specialist is able to determine, often quickly what the causative factor's are.

I've attended SMART Meetings, worked indirectly with Thomas Horvath, (director of SMART, San Diego), and found them satisfactory. Moderators are trained and oftentimes, the groups are therapist conducted.

A number of other groups are doing well in either peer support, face to face or online. Women for Sobriety, started by Jean Kirkpatrick PhD, sociologist, SOS, (Secular Organization Society), for Women, LifeRing, Harm Reduction and Moderation Management.

(I'm now off to look for the AS film thread, unless distracted again)

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This is my first post to the group. I actually view the site occasionally and tonight I stopped by to see if there were any comments on the film Atlas Shrugged.

I became quickly distracted when I noticed SMART Recovery mentioned. The therapeutic model for recovery is bio/psycho/social, and a good therapist and/or addiction specialist is able to determine, often quickly what the causative factor's are.

I've attended SMART Meetings, worked indirectly with Thomas Horvath, (director of SMART, San Diego), and found them satisfactory. Moderators are trained and oftentimes, the groups are therapist conducted.

A number of other groups are doing well in either peer support, face to face or online. Women for Sobriety, started by Jean Kirkpatrick PhD, sociologist, SOS, (Secular Organization Society), for Women, LifeRing, Harm Reduction and Moderation Management.

(I'm now off to look for the AS film thread, unless distracted again)

Here is my basic position on addictions: stop, because stopping is the right thing to do. The rest is indulgence. However, sometimes indulgence is worthwhile to get to the stated basic position: Stop! Right and wrong is seriously under-rated.

--Brant

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Anna,

Welcome to OL. I'm glad you enjoy the site.

Don't be put off by negative reception. I learned the hard way that some Objectivists (and libertarians) are very uncomfortable with the idea of addiction. They tend to oversimplify and dismiss the hard stuff.

For example, saying, "Just stop," to an addict is like saying, "Go get some money," to a person who is in a financial crisis. You need to do that, of course, but then the addict already knows he needs to stop, just like the broke person knows he needs to get some money.

So that kind of advice isn't really useful. Actually it's not advice at all. When you tell people stuff they already know about a problem they have and desperately want to solve, then tell them their problem is trivial, you can call that many things, but advice is not one of them.

I think when Objectivists (and libertarians) do that and get dismissive, they are talking more to themselves than to any person out there with a problem. (I always get the image of a person closing his eyes, covering his ears and singing loudly, "La, la, la, la, la, la, la, la..." :) )

Incidentally, I have been doing a lot of reading on cognitive science and there are very powerful biological components to addiction. One of the most powerful is the dopamine flood and sudden stop. This is one common element in all addictions, even non-chemical induced ones like gambling and kleptomania. The fireworks hit when morality meets biology and they are not in harmony.

As to SMART, if it worked for you, I say do it. That's my view. I didn't go through it myself, but it has all the elements of a good program.

When you're desperate, whatever works works. Even the Scientology recovery program, called Narconon, is a decent one for some people from what I have read--although I believe an addict has enough problems to deal with and doesn't need all the controversy surrounding that program.

One of the best books I have ever read about changing human behavior is called Changing for Good by James Prochaska, John Norcross, and Carlo Diclemente--first published in 1995. These are university professors who made a scientific study of people who have changed radical bad habits on their own. Their theory is very compelling.

From their interviews with subjects from many different walks of life and many different problems, they identified six stages a person goes through when making a change (awareness--they call this pre-contemplation, contemplation, preparation, action, maintenance, and stopping all efforts because the problem is resolved).

As another cornerstone, they also identified the focus of nine different major schools of therapy (conscious-raising, social liberation, emotional arousal, self-reevaluation, commitment, reward, countering, environment control, and helping relationships).

Now here's the key. They noted that different focuses were used by those who were successful in changing depending on which stage they were at in making the change. By reverse-engineering this, they (including you and I) can easily predict what will not work and what has a greater chance of working. For instance, a person in the contemplation stage who tries to reward himself for good behavior will most likely (as in will most likely always) fail to make a permanent change.

For those who learn this stuff, this makes change appealing from one angle--the goal is not to stop right at the beginning. The goal is simply to move to the next level. That's a lot easier and a hell of a lot less stressful than going cold turkey. (But to be fair, cold turkey works well when it works. It just doesn't work for many people--in fact it only works for a very small portion of addicts.)

They also cover relapses from an interesting angle. A person relapses to one of the previous stages, but usually not to the beginning one. So he needs to concentrate on doing certain things to move back to where he was, not just start all over again.

I might make a new thread on this book.

Unfortunately, the authors went after the big bucks in getting grants from government programs and things like that, so they did not expand on this work in the manner of the SMART program. And the government did what governments always do--they turned the good ideas into a bureaucratic mess. That's one of the reasons I believe it is not as widespread as it should be.

I know what I read in that book is exactly how it worked with me in giving up smoking, alcohol and drugs--each with its own separate process.

Michael

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I didn't mean to denigrate the therapeutic, get-help model of dealing with addictions. But all do have the at least implicit premise of the exercise of free will and stopping the undesired behavior, not by the imposition of outside pressure so much as from within. Sometimes this may require extensive psychotherapy.

--Brant

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Michael

Thank you for the welcome.

The DSM has not used the words, alcoholic or alcoholism since the 1970's. What is used in diagnosis, is, "use, abuse, or dependence." There are many causative factor's that increase the possibility of substance abuse and to name a few, PTSD, childhood trauma, ADD, and depression.

As to the biological component there are three drugs I know of which are being used to help with cravings, or re-setting the brain chemistry, as one MD I know states, those being Campral, Topomax and Naltrexone. Naltrexone is more frequently prescribed with good results.

And there are those who need physical detox in a rehab setting, due to the body having reached a point it can no longer function without the drug/alcohol.

It's been a few years since I've read any studies on dopamine, but do remember reading the use of drugs/alcohol might well have been the brain's attempt to normalize dopamine in the brain.

I too am an advocate of finding the best approach to fit the individual. My experiences with LifeRing, Women for Sobriety, SOS for Women, Harm Reduction and Moderation Management have all been good.

As for the disease model, sigh, this was created to sell rehabs, who are a 14B per year industry. They are a powerful group of lobbyists in DC.

When I stopped smoking I used simple positive reinforcement. I gave myself the gift of scuba diving, and with alcohol I simply stopped. However, I did find I needed therapy for understanding, processing, and behavioral change, (what was driving me at the feeling level).

Any new threads on the topic will peak my interest :)

AnnaLisa

Edited by AnnaLisa
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Anna,

I have a speculation about dopamine (and serotonin for that matter). It is not a scientific one, but it helped me as a conceptual model.

I believe the synapses in brain cells are made for the cells to transmit information like pleasure, not for the actual brain cells themselves to experience pleasure. But when a dopamine flood holds the synapses connection in place for an extended period, the brain cells (or some kind of cells that should not be directly involved on the experience level) feel pleasure and want more of it.

Once felt, it cannot be unfelt and the brain cells want to party from that moment on.

Just a speculation. But even if it's wrong, it's helpful to grok brain chemistry a bit--at least to me.

Michael

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