Accountability is a virtue generally void of meaning when an individual is absorbed in the cycle of addiction. Accountability is an 'accounting' for one's actions or having the obligation to report, explain, or justify action. Accountability is therefore a normative feature of behavior that promotes social cohesion and, most proximate, promotes cohesion between family members.
Accountability is a binary term. Yes, it advances cohesion between family members, friends, and society at-large, but it is also creates a framework of responsibility for the individual. Responsibility does not mean, in the context of addiction, that we are to necessarily blame individuals for their behavior in some shameful way. And though that is a common viewpoint within many perceptions about responsibility, a much more empowering definition of responsibility is the opportunity or ability to act independently and make decisions without authorization.
If an authority questioned the individual's decision making she could 'account' for her actions accordingly because the justification would be immediately understood by another person in that same situation. An 'accounting' in this instance is the awareness that the individual brought about outcome y as a result of the action x, from which, they are responsible for through independent action. Commonly, we think of a person as being driven to use drugs and alcohol through a hijacked brain which blurs the lines of autonomous action, but there is a difference between a desire or want for something than being forced into action against a person's will. This becomes an important distinction when thinking about concepts of accountability and responsibility.
When gripped by addiction the capacity of the individual to justify her decisions becomes disrupted by her profound desire and pursuit of drugs and alcohol. The potential lying, stealing, cheating, etc., that follows from the pursuit of drugs and alcohol lacks justification in the normative sense, disrupting social and family cohesion. Meanwhile, the lying, stealing, and cheating all reveal the lack of control or independence that the individual once had. But how can we as family members hold individuals accountable when addiction science tells us that the individual's autonomy has been hijacked by a rewired brain?
This conversation is difficult to engage in without first bringing up the topic of free will, meaning, could the person have chosen otherwise? Addiction science certainly points to the reality that events both prior to and during the process of getting high were caused events i.e. the individual's decision making was a derivative of prior events and could not have happened in any other way without someone or some event intervening on the situation. And if this is truly the case, as family members and members of society, we might be more compassionate when responding with punitive measures.
If the individual's decision making was purely volitional we might also find compassion when responding punitively. For example, if your daughter happened to be molested when she was in her youth and, as a result, suffered years of depression and social anxiety around men, we might see her substance abuse as a rational decision. Why? Because the goal of using, in this instance, was not to wantonly get high, but to escape the harsh reality of the underlying issues. Issues that, accept it or not, aren't always easy for people to seek help for and thus formulate ways to medicate themselves. Not only is self-medication a common practice for many people, it also explains why addiction treatment programs need to work on co-occurring disorders and not just the addiction.
But whether or not a person's decision was caused or entirely voluntary should not really impact our capacity as spectators for empathy. People, whether addicts or not, make bad decisions all the time. The human being is a vulnerable being, that, depending upon the individual, originates from a wide variety of biological, social, and political backgrounds. Our capacity for compassion and empathy, then, should not be a derivative of caused or contra-causal free will, but should permeate from our understanding of the fact that life is in-no-way equal for all.
Therefore, family members have every right to hold individuals accountable, even when the individual is gripped with addiction, because they are approaching accountability from an empathetic framework that encourages change without shaming the person for becoming the type of person they are. Empowering individuals toward accountability brings about their independence, reestablishes social and family cohesion, and establishes reasonable expectations and boundaries that can be followed.
Peer Driven Accountability
Within all our homes, you will find, at the very least, two beds per room. The reason behind having roommates is to renew the process of accountability toward others. After months or even years of strained family relationships surrounding addictive behaviors and attitudes, empathy and communication can wear-thin. This constraint, at times, disrupts family members from hearing one-another clearly. Roommates then give our client's the opportunity to work on their accountability toward others while recognizing the benefits of holding others accountable. In this process, they can start to appreciate the binary nature of accountability toward self and others.
We always emphasize with our clients, especially in the present heroin epidemic, that holding members of our milieu accountable could be the difference between life and death. If a client mentions to another client of her secret intent to use drugs and alcohol, that client is justified in informing staff members. The justification is simple, you are potentially saving another person's life and now our staff members can intervene.
Many clients, however, at least initially, perceive the notion of accountability as tattle-telling or not being loyal to secretive discussions. But tattling is a person reporting wrongdoing and there is nothing wrong about having cravings while in treatment, feeling depressed, or even having suicidal ideations. And so it follows that individuals are justified in their reporting of a person's intent to harm themselves or others. It is a compassionate response that allows that person to get immediate help. The reporting of a desire to use drugs or alcohol or harm oneself is, even on a peer-to-peer basis, a mechanism of 'accounting' for one's (potential) actions toward another.
From the moment our client's wake up in the morning until they go to sleep at night we programmatically seek to establish a culture of accountability as a process for re-establishing social and family cohesion, while empowering each client toward renewed independence from drugs and alcohol.
12 Step Approach
At Peaks Recovery we believe our client's long-term success is strengthened by their participation in the 12 Step program, especially outside the clinical setting. The 12 Step program is impactful because it enables our clients to supplant distorted, self absorbed behavior associated with substance use with an existential framework for growth. In our professional experience, when clients immerse themselves in the 12 Steps and its traditions, the opportunity for achieving a sober life greatly increases.
While considering the introduction above, it is important to recognize that Peaks Recovery is not dependent on the 12-steps for clinical outcomes while further recognizing that there are many approaches to long-term recovery. The steps are, in this regard, not a turnkey solution. In fact, if your daughter has relapsed post treatment with other providers it is common, from her prior experience, to state things like, “the steps don't work for me.” However, this sort of thinking misplaces the value in the steps.
To be clear, the steps don't do work, the individual does the work. This is why it is an existential approach. The steps are not wrapped around essential features of human existence that guarantee a sober life, rather the steps reveal a different approach toward life with the intention of empowering continued growth for the addict by introducing new meaning to life.
For example, step one says that we have become powerless over drugs and alcohol and that our lives are unmanageable. In the framework of accountability and responsibility this makes a great deal of sense. If responsibility is about independent decision making and, when gripped by addiction, we begin to lie, steal, and cheat, etc., then it is clear life has become unmanageable to the point that we can no-longer “account” for or justify our actions. Addiction, in that regard, has disrupted individual autonomy and in this transaction the individual is powerless. Why? Because they've, in the literal sense, lost control of their independence and are now, more than ever, dependent on others for their survival.
The more challenging steps are, especially in today's empirically laden society, steps two and three that state: 2) Came to believe in a power greater than ourselves could restore us to sanity; and, 3) turn our will and lives over to God as we understand Him. Clearly, given the historical genesis of the 12 Steps, the 12 steps has western spiritual components laden within its philosophy. However, the 12 steps have expanded into eastern spiritual practices such as Buddhism and have even gone as far as touching on more secular agnostic or even atheistic approaches.
Again, these two steps do not do anything for us. As an existential practice, these steps help us to discover meaning to our life as a derivative of the mind, body, and spiritual healing that the holistic framework of addiction treatment wishes to promote. Empirical based readings of the 12 steps fall short of the intended purpose. When read literally it's easy to see how the 12 steps can be easily ignored by those with distant views about western spirituality. However, the steps are ambiguous and this ambiguity serves well for all individuals when they seek to redefine or discover meaning within their lives.
Step into any AA, NA, CA, or ACA meeting and the ambiguous perceptions are abound. The value in this is recognizing that all paths are different. The beauty in the ambiguity is that each person discovered their own foundational meaning for life that gave them hope for a life of recovery. And it's these multiple interactions and insights that allow individuals in our program to develop healthy relationships with people they identify with as having discovered meaning in life outside of drugs and alcohol that can work for them.
Fellowshipping, as it's called, supplants client isolation with intimate friendships, giving them the best opportunity to communicate their struggles and work toward a new framework for a more meaningful life. In his famous TED talk, Johann Hari says, "The opposite of addiction is not sobriety, the opposite of addiction is connection." The 12-Steps play an integral part in this idea of connectedness.
Contrary to popular belief, drug and alcohol use is often associated with isolation rather than partying or trying to fit in. Having a community of individuals to interact with extends accountability beyond our program walls. We require all clients to not only obtain a sponsor, but to pursue “coffee dates”, twice per week, with individuals in the community rooms. The goal being to continually work toward the foundation and discovery of new meaning to life outside of drugs and alcohol.
To learn more about the 12 steps, please check out our blog section and stay tuned for new articles surrounding this topic.