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Whether someone is interested in the 12 Step philosophy or not, the first step is a good indicator of when your life needs some changes. The first step of Alcoholics and Narcotics Anonymous states step 1 as: “We admitted we were powerless over alcohol and that our lives had become unmanageable” (AA) and “We admitted we were powerless over our addiction, that our lives had become unmanageable” (NA).
Everyone’s bottom is different and depending on the person, their perception of it is too. Some people may feel their bottom is one DUI, others may still think it is the bartender, wife/husband and police officers fault after their 5th DUI. They don’t think their life is unmanageable, they just have to figure out how to do things differently and manage everyone else.
Bottom isn’t really something you hit, it is something you feel. A good start to feeling you’re at the end of your rope is when the person realizes that their way of fixing their problems doesn’t work, nor does blaming others for those problems. Feeling bottom comes from the realization changes need to be made and maybe, the person needs to take ownership for their own problems. So it would be safe to say, a precursor to feeling the bottom is when your perception changes, you see the role you play, and trying to control other people, places, and things is ineffective.
What Does it Mean to Hit Rock Bottom in Addiction?
When people think of a substance user hitting bottom, often visions of homelessness and jail come to mind. Although this can occur at one’s bottom, that is not necessarily the case for all. Bottom happens in all shapes and sizes and nobody knows for sure when one will realize they have had enough and need help. The average person believes the bottom is a loss of things, such as jobs, family, finances, home etc. For those that have suffered from addiction, they will tell you that losing those things was hard, and the bottom was when they realized they were to blame and felt something inside.
Two things we know for sure are, no two bottoms are the same and the bottom is never felt when things are going well. It is only felt when things are going bad. This is one of the goals of intervention specialists, to help the family change the environment that is preventing the substance user from feeling the consequences necessary to see the need for change. Telling a family they have to wait for the bottom makes no sense when the family is providing comfort so the substance user does not have to feel it.
We have to get away from speaking about the bottom in terms of material losses. It is a small part of the pain felt by a substance user. Bottom is felt when you get to the point of overcoming your fear of the unknown and when the current situation becomes more fearful than the fear of not knowing what life will look like without drugs or alcohol. When the substance user realizes the drugs and alcohol they were relying on to feel better turned on them and is trying to kill them; that is the bottom.
Signs of Hitting Rock Bottom
As you will see from some of these examples below, signs of reaching the bottom are when things are becoming progressively worse. The problem is, these things are often not enough nor do they happen swiftly enough to bring the substance user to surrender. The addicted person may suffer losses and depending how they feel as the result, they may or may not stop because of it. Although the consequences of substance use have to outweigh the benefits in order to feel bottom, it still comes back to perception and rationalizing insanity. Substance users justify negative consequences by asking themselves, how bad is it really? And, how do I just not do “that” again. Here are some things that should bring someone to the point of feeling their bottom and considering change and don’t always do:
- Using the Drug to Combat Withdrawals: Many people claim to continue using their substance of choice to fight off the negative effects of withdrawal; this may be partially true. It is often a justification and belief that they can’t live without drugs or alcohol. It goes back to perception and fear. What does withdrawal look like and what does it look like after? How will I live without my solution? Withdrawal isn’t bottom, the fear of what happens next and facing it without drugs or alcohol would be their bottom.
- Ignoring Legal Consequences such as Jail or DUI: You would think an arrest and possible prison time would be enough for any sane person to stop their behavior and do something different. This is often not the case for a substance user. Sure, while they are detoxing in jail or are sleepless the night before court, they may even ask God that if they just get through this without going to prison they will never drink alcohol or use drugs again. Once again, back to perception. If you don’t feel it, then you aren’t hitting the bottom. When you let go of working angles, rationalizing insanity, or trying to figure out how to not get arrested again, you are feeling the bottom. In this example the substance user is still using substances in spite of the consequences. The consequences are still often perceived as less fearful than the unknown life without drugs or alcohol.
- Losing a job, relationship, or property: As in the above example, these losses should be enough for the average person to hit bottom. Unfortunately, these losses are often met with justifications by the substance user and these things are sadly less important than their drugs or alcohol. When a substance user loses these things they almost always justify and blame the losses on others. I didn’t like that job anyway, my boss was a jerk. I didn’t love her/him, it’s their loss not mine, they were controlling. So and so threw me out for no reason. These examples and common responses help us understand that bottom is a perception of the mind. Until ownership and accountability is felt, losses have little to no effect.
When the substance user surrenders and feels the bottom, things begin to shift. When they realize there is more to gain from not using drugs or alcohol than they believed was to gain from using drugs or alcohol is when the substance user moves through the stages of change. Interventions are powerful tools that help change perception and move the substance user through the stages of change by changing their environment and family system. You may not be able to directly make them change and others can change things that are keeping them from feeling the negative consequences of their behavior and substance use.
Helping a Loved One Who’s Reached Rock Bottom
Interventions can help raise the feelings of bottom for a substance user. As stated above, waiting for the bottom is something that we have to stop suggesting to family and friends of substance users; it’s ineffective, it’s dangerous, and it doesn’t work for anyone other than the substance user. When family and friends have had enough, you are allowed to intervene before they feel the bottom. Your changes at the intervention and after can help them with their perception and accountability. Allowing them to run the show prevents them from feeling the need to do anything differently.
Many treatment centers and 12 step groups help addicts and alcoholics see the problem is in the behaviors, not the substance use. Just stopping substance doesn’t change your perception, nor does it resolve the issues as to why you self medicated. If you are able to stop using substances for any reason, and you don’t address the causes as to why you used the substances, then the person will most likely be using drugs or alcohol again as soon as the pain of the losses wears off.
Most people enter treatment for external reasons. They rarely stay to address the internal reasons and relapse often happens when the substance user’s life improves. In recovery groups they call it “getting their stuff back”. They believed the bottom was the things they lost and not the way they felt and they soon forgot what it was like. Once they get some things back, they feel they don’t have a problem any longer and they are back out using drugs and alcohol.
The best way for friends and family to help someone at rock bottom is to enter their own recovery groups such as Al-Anon or Families Anonymous and even see a counselor or therapist. Never let your guard down and think they were at the bottom because they lost things and learned their lesson. Always remember, the bottom is something they feel. If they forget that feeling and base their recovery on the symptoms and not the behavior then they are in for several more rounds. It is suggested you don’t ever get back in the ring with them and take care of yourself.
Drug and Alcohol Intervention at Family First Intervention
Families can bring the feelings of the bottom to their loved one. Waiting for them to feel physical consequences may not be enough as they may justify and rationalize them. Family First intervention specializes in healing the family system that has been affected while waiting for the illusion of physical bottom.
Staging the intervention accomplishes 3 important things:
- Allows the substance user the opportunity to see and feel the love from their family
- Provides the family with closure they did everything they could to stop it
- Changes the perception of the substance user so that bottom can be recognized and felt
The next time someone tells you there is nothing you can do until they want help or hit bottom, your response can be “that isn’t true. If the environment and family system is preventing them from feeling the bottom and they are comfortable, then why would they want anything to change and how would their perspective change? The answer is, it won’t. Families have the ability to change certain things that would allow their loved one to look at things another way. If nothing else, you can take their ability to hold you accountable for their problems away. They won’t fix a problem they don’t think is theirs. So it may be time to make it theirs, that way they may think about doing something about it.