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In an earlier blog, we briefly commented on how Special Forces (SF) use meditation techniques as part of training and preparation (see Meditation and Addiction Recovery). What can we learn more broadly from SF when we think about addiction treatment? It might seem surprising to hear that we can learn from SF. There might be some things that we would not want to learn! Undoubtedly, they are at the pinnacle of physical fitness. But they also have much to teach us about mental (and spiritual) fitness. They need mental resilience in combat and many have had to apply the techniques subsequently to help recovery from post-traumatic stress disorder (PTSD). Sufferers from “substance use disorder” are also fighting an enemy and attempting to keep control. I've mentioned before the case of the American Gulf War veteran Eric Arauz in You Can’t Do It On Your Own. Another observation here is that some addicts coming into treatment for the first time resist therapy believing it to be “wishy-washy” or “psychobabble” and think they don’t need it. It’s interesting, at least to me, that we can rebut this argument by pointing to SF as tough role models who use these techniques. Perhaps some will be more willing to listen to what these have to say rather than medical practitioners, at least in the first instance? I was introduced to this topic when I was given a book by a young work colleague and friend who is a Royal Marine. The book is called Life Under Fire by Jason Fox (Penguin, 2020). The author was a Marine who was selected for the Special Boat Service (SBS). Fox later had to overcome PTSD and earned fame on British TV as one of the leaders and participants in SAS: Who Dares Wins. He is now actively involved in coaching techniques to strengthen resilience. The book immediately reminded me of a similar famous work by James Stockdale, who was captured during the Vietnam War. Stockdale was introduced to Stoic philosophy during his training. He carried a copy of Epictetus’ Enchiridion with him and applied Stoic techniques during his captivity. Later, he became an esteemed public speaker (see Thoughts of a Philosophical Fighter Pilot, Hoover Institution Press, 1995). As I read the first few pages of Fox’s book, a phrase jumped out at me – the Existence of a Brotherhood – because it reminded me of the mutual help groups used by alcoholics and drug addicts. We could just as easily talk of a Fellowship, which is more inclusive. The point, of course, is that participants are part of a close-knit community supporting each other in a common cause. Fox says that there are four cornerstones to what he calls the Commando Spirit; courage, determination, unselfishness and cheerfulness in adversity. These also apply to those making their way through addiction recovery treatment. On the first of these, see my earlier blog titled The Courage To Be. It takes courage for addicts to admit openly to a problem and embark on recovery treatment. He says that posters are pasted on the walls of the training camp as reminders of these principles, just as we see in fellowship meeting rooms. Is this a form of propaganda? Yes, of course, why not? Isn’t this just the same as the use of subliminal advertising in social media and elsewhere? Turning to the mission or operations, what we could call the recovery path, Fox says the first step is defining a Purpose. Ask yourself the following questions. Why are you doing this? What are you hoping to achieve? What is the target? Be single-minded about pursuing it. We can apply this to entering recovery treatment. It’s hard going and many dropout. It’s worth taking stock from time to time and reminding yourself of why you are doing it. Fox then talks about Situational Awareness - don't think about yesterday or tomorrow, focus on where you are here and now, and your next move. In alcohol and drug recovery treatment, we take it one day at a time. There will be relapses and we don’t deny their significance but we focus on today and the task at hand. Fox discusses what he calls Gratitude in Suffering. This appears on first reading to be a strange concept but it partly reminds me of a different well-known saying in fellowship groups –“the gift of desperation”, which is meant to imply that suffering is part of the process in reaching rock bottom or a turning point. Fox uses this to say that you always have more in the tank, you are alive. He says this is drummed into SF through their physical training. You can always go the extra mile if you push. There will be setbacks but don’t give up, don’t despair – use these as reminders to strengthen your resolve. Fox says "I'd had to be comfortable in feeling uncomfortable", (see p.79). Building resilience in recovery treatment is important but it’s uncomfortable and takes effort. “Cheerfulness in adversity” is about adopting a positive frame of mind – you are allowed to laugh at yourself in fellowship meetings! Listen and share in the group. Fox says that it’s very important to debrief properly. It’s essential to hear what everybody on the team has to say. That is because recollections may differ and it is possible to learn from the collective experience and be better prepared the next time. It is just like this with recovery. Hearing and sharing experiences with fellow addicts is a very useful part of the recovery path. It calls for self-awareness, honesty and openness. Brotherhood (or sisterhood) is not exactly the same as friendship. It's about having trust in others totally committed to the same goal. The existence of a brotherhood is about something deeper when we think of what it is to be human. Part of what it is to be human is to live in community with others. We can look to SF for many key insights – define your purpose, make a plan, prepare properly, approach it with discipline, reflect and learn from mistakes. Look to fellow sufferers, learn from their experience, approach recovery as a life-changing mission and do it in community.

Relapse is an important topic in alcohol recovery treatment. It’s not inevitable but it can be a serious setback if it happens. It’s important to understand the triggers of relapse and how to move forward from the experience. The lessons can be used more widely in any form of slipping back when coping with difficulties in life. What do we actually mean by relapse? We don’t mean the occasional lapse – the odd glass of wine here or there. Some will argue that you shouldn’t even do that. But abstinence may not work for everybody. Instead, what we mean by relapse is a collapse back into full-blown loss of control and all that goes with it. What are some of the triggers of relapse? Happiness – sometimes we drink because we feel good about ourselves and the world. Drinking is often part of celebration, of course, and we enjoy the sense of well-being it brings – at least initially, in moderation. But alcoholics can’t stop and we end up overdoing it. I remember going to a local village charity auction dinner and spending most of the next day lying in the grass with a massive hangover. Sadness – on the other hand, sometimes we drink because we feel sad and down. We drink for consolation because we believe that it will help our mood. Initially, it’s true, of course and the first few drinks give us a pick-up. But alcohol is a depressive and we end-up in a downward spiral. Just about the only times in life that I’ve cried have been when drunk – usually out of self-pity. Stress – we’ve been running around all day, we have been multitasking, firefighting, getting bombarded by emails. Having a drink may help us to unwind. I did this enough times but on most days I would go to work the next day feeling nauseous. I’d sit with my head in my hands in a panicky cold sweat, thinking to myself – why do I keep poisoning myself? But I’d be drinking again by lunchtime and certainly in the evening. The cycle would just keep repeating itself. Trauma – very often, alcoholics seek oblivion. In recovery treatment, we talk about self-medication. But let’s not beat about the bush. We do it to bury something in our past because we want to block it out. It’s not the answer, of course! Actually, we know it’s not the answer but we find it painful to address the underlying causes. Boredom – we’re restless and unsatisfied. We are not comfortable in our own company. We can’t sit still. We need to be busy. This is different from experiencing sadness, as such. It shows a lack of meaning and purpose. We genuinely don’t know how and where to find enjoyment, possibly because we’ve never tried. We’ve just been swept along in the flow. So we drink because we’re bored, with the idea that we’ll feel better. Social Circumstances – often we feel pressured to take a drink by friends and colleagues who don’t understand our condition. They don’t understand that even having one drink can put us back on the slippery path to full relapse. We join in to please them and we perhaps think this time it will be different. Ultimately, we drink to get drunk because that’s what we do. Alcoholics don’t need a reason. It becomes habit and learned behaviour, reinforced by craving. When relapse occurs, it can be devastating for the addict and others. The interruption to recovery is damaging to self-confidence, especially following a sustained period of sobriety. Sacrifices have been made and it’s been very hard work. The temptation is to fall back into negative ways of thinking about the possibility of getting better. It can be equally devastating for family and others who are close to the alcoholic because they have invested so much time and effort in providing support. It’s important not to collapse into a sense of hopelessness, however. What can we learn about coping with the experience from relapse? What positive steps can we take to get back on the recovery path? First, take some time to examine the experience. Be honest and open about it. Discuss and share with others how you feel about it. This could be with care workers, treatment practitioners, or fellow sufferers perhaps at a fellowship meeting. Perhaps write down what you recall about the circumstances leading up to relapse. Second, try to identify the triggers. If you’ve done it before, probably more than once, what do you recognise from the above list of possible triggers? The list is not meant to be exhaustive. Ask yourself - what were the circumstances leading up to relapse? Was it a particular situation, person, or something said? What was the appeal of having a drink? Third, comment on your recovery path – what worked for you previously to sustain sobriety? What do you believe did not work for you? Do you have some ideas of your own as to what might work better? Consider what you expected when you resumed drinking. Do some soul-searching with the help of others to guide you through the process. Fourth, do some contingency planning. Recognise in advance the circumstances that might make you vulnerable – for example, a wedding or other social event, going to watch football with friends, being away on a business trip for a few days or having a few days of holiday on the beach. Picture the circumstances and how you will respond when the drinks are offered. If you’ve built up the habit of refusing and taking non-alcoholic drinks then it will become easier. Finally, here is what not to do. Don’t hide away from those who are part of your support group. Don’t beat yourself up. Don’t deny it or clam up – we are not going to judge you. The really important thing here is not to collapse into a state of resignation. Look at what had been achieved prior to relapse. Reflect on the benefit you were receiving – the sense of being wide-awake – and focus on getting that back. I reached a point where the therapy had run out. I was preoccupied with the panic attacks but once they were under control I was lulled into a false sense of security. It wasn't long before lapses turned into an attempt at "controlled drinking" before full-on relapse had taken hold. On reflection, I hadn't appreciated that recovery treatment needs to be ongoing, albeit it might move from medical supervision to relying on some form of more informal support. Keep in mind, relapse is not inevitable. But be on your guard. Remain aware!

Suffering is part of what it is to be human. The “art of living” (Discourses of Epictetus, 1.15.3) is in large part how we cope with suffering. How can we approach the topic of suffering with positivity and encourage those recovering from alcohol treatment to find new meaning and purpose in their lives? We all have our share of suffering, some perhaps more than others. Some cope well and others don't. I suffered with my family when my brother died. In some respects I coped well and in other respects I perhaps did not. It probably did play some part in my “alcohol abuse disorder” but I’ve now been sober for more than twenty years. Alcoholics and others with addictive disorders suffer. Some say this is a chosen path and not worthy of sympathy. Fair enough, there may be some element of truth in this, although modern neuroscience would say something more nuanced about choice. In any case, often the addiction is the result and not the cause of suffering. Many fall into addiction through self-medication to alleviate suffering. How we cope with suffering plays a very important role in our progression through life. It's part of who we are and of who we become. The response of many is to turn inward. We blame others or we ask, perhaps with some justification, why me and not that person? We are often resentful of others, although we are not fully aware of what is happening in their private lives. This response to suffering becomes a vicious circle. It only makes things worse. In modern language, a stoical response to suffering means keeping a "stiff upper lip". Basically, grinning and bearing it or getting on with life is the interpretation. But this is a betrayal of Stoic philosophy. The latter does not mean revelling in suffering either. Instead, it says much more about our attitude to suffering and finding meaning and purpose in life. Epictetus starts his Enchiridion (handbook or manual) by saying “Some things are under our control, while others are not under our control”. This echoes a saying well-known to those who attend fellowship meetings! We are more than simply the outcome of physical events. It is how we respond to others and the world around us that determines the type of person we become. We form impressions and core beliefs about others and the world. Our response often gives rise to emotions and suffering. Instead, we need to be more accepting of others and our place in the world. We have to accept that bad things can and do happen. We have to let go of attachments, change the way we think about things, and practise the “virtues” of courage, justice, wisdom and moderation, however hard this may be. This all sounds a bit complicated. What do these ideas mean in practice and how can we use them in recovery from addiction? Where can we see the broader significance of Stoic influence and why it matters to human development? One prominent example is given by Viktor Frankl. In Man’s Search for Meaning (1946), he writes as a survivor of the concentration camps. Based on his experiences, he developed his concept of logotherapy – a form of psychotherapy to help people find new meaning and purpose in their lives. Frankl contrasts two approaches to suffering. One approach, as we have already noted above, is to self-isolate, form resentments about others, and lose hope. This generally does not work out very well. Instead, those who fare better engage with the community of fellow sufferers, look out for one another with selfless acts, find beauty in small things, and enjoy humour. He says we retain our inner freedom – a key insight of Stoic philosophy - we have a choice as to how to respond to the most challenging of circumstances. Our spiritual freedom is the ability in some sense to transcend space and time to make sense of our “provisional existence” – a version of what we have previously called keeping “eyes on the prize”. We don’t forget suffering and simply move on. We don’t just sweep it under the carpet. That’s not the idea. I was always struck by old soldiers breaking down in tears as they recalled experiences from seventy years earlier as though it had happened yesterday. I remember my family suffering almost fifty years ago. You never forget but with time and healing you can come to terms with it, although it’s not easy. We need to find a sense of purpose in the future that will reach back and give hope in the present. Some find this in religion but others don’t. Have the courage to let go of preconceptions of the old self. Take a leap of faith in working out your own destiny. What did I do? I shared my suffering as an alcoholic. I tried to understand and learn from it through treatment and study. This sent me on a journey that continues to this day. What are the lessons for addicts or those in recovery still suffering? Don't remain mired in the past. Look outward, not inward. Be appreciative of beauty wherever you find it. Get help from others, listen to the stories of others, and reach out to those who suffer. Discover where you find real enjoyment and a sense of happiness in life. This is how and where you will find freedom. All of this is much easier said than done, of course. Nobody said it was easy – but there are many who have been there before you and they are ready to give you support.

We find ourselves in others. We come to know ourselves as others know us. That is how we find our identity in relation to others. It is by engaging with others that we discover our purpose and self-worth. This has important lessons for those suffering from “substance use disorder” and for recovery treatment. The title of this blog comes from a famous work by the French philosopher Paul Ricoeur (1990) in which he brought together his ideas on how self-identity is defined and expressed through time in relation to the other. Like many alcoholics, my drinking started in my early teens. I was soon deliberately drinking to get drunk. It wasn’t just teenaged bravado. I liked the feeling. It gave me a sense of release, even if it often came at the price of painful hangovers. My drinking spiralled out of control through my twenties, however, until my first collapse and admission to treatment at the age of thirty two. Despite acknowledging my loss of control, suffering greatly, and genuinely wanting to get well, it was another ten years before I finally had my last drink. That is now more than twenty two years ago. It was only following my final crisis and turning point that I properly started to take on board what I had learned from this journey. The seeds of interest in my addiction and recovery were sown during my initial introduction to psychotherapy. I was curious about the process. I started to read Freud and Jung. I had always had an amateur interest in philosophy and my curiosity led me to read more widely. I became more interested in what we might broadly call spirituality and about fifteen years of formal study culminated in a doctorate in philosophical theology. Perhaps surprisingly – or perhaps not, on reflection – my heavy drinking continued throughout almost the entire period of study. How did I manage it? Good question. But I only started properly to put in practise what I had learned when I started to pay more attention to others around me suffering from “alcohol abuse disorder”. I first attended group meetings during my initial course of psychotherapy. It was actually me who suggested it rather than the therapist. I didn’t find it all that helpful. On reflection, I think that was probably because I was too focused on myself. But as I began to emerge from darkness into light ten years later, I came to believe that I needed something more to sustain my recovery because I hadn’t been able to achieve that previously through my own effort. I started to join online meetings in chat rooms – there were no video meetings in those days. I wanted to hear about what others were doing. One of the regular attenders was Brian H, who had been sober for twenty five years. I used to thank him for his regular insights but I didn’t really understand why he was there. Why would somebody who hadn’t touched drink for such a long period of time still feel the need to participate? I had the same feeling when I re-engaged a few years ago but this time in face-to-face meetings. It was very striking that many of the regulars had been sober for even longer than me – some for more than thirty years! Why were they there? Why did they keep coming back? Indeed, I was actually worried about going into meetings because I thought that others would ask the same question of me! Now after years of study and volunteering with fellow sufferers in my current role, I really get it at last. I’ve become one of the group of recovering alcoholics who have been sober for many years but who continue to sit down and share their experience. So, why do so many of us still do it? We go partly because we still need it, of course. It reminds us of where we've come from and what we did. It sustains our own recovery. We go in gratitude for the help that we’ve received in sustaining recovery. We also go back to help and encourage others. We receive something back from this “service”, as previously discussed in Giving and Receiving in Recovery. The fundamental point here, however, is that it is through talking, sharing and listening that we find ourselves in others. We are not isolated self-determined subjects. We are subjects as we encounter others and we are personalised - made persons - in relation to others. Building on recovery in this way is a bit like coming home – it’s a process of self-discovery. I completely understand why some people do not want to participate in group meetings. Some find it intimidating. Some find it provides uncomfortable reminders of what they’ve been going through. Some are still battling their demons. For many, it’s simply too early in the recovery process, just as it was for me all of those years ago, and they need more intensely personalised treatment. All of us, not just alcoholics, belong in community. Don't take the view that your recovery is done. It's just a work in progress. It's unfinished. Continue to engage with others who have come before you and, hopefully, you may find yourself one day looking back after many years of sobriety. You can't be a subject without an object. You can't truly be a self without another. Keep in mind the saying of John Donne the Elizabethan poet – “no man is an island”.

We hear the cry of many, and perhaps we have done it ourselves on occasion – “what is the point of it all?” We do it when we are sick, when we have lost a loved one or perhaps when we are simply at a low point and fed up with life. How can we counter this in alcohol and drug recovery treatment? I remember screaming from a clifftop into the wind one night when drunk as a young teenager. It’s not hard to see what prompts the cry when we look at the suffering around us. I was suffering at the time. Alcohol or drug use may then be a way of coping – self-medication – or escaping. But this is a temporary solution. It’s shutting out the underlying reality, whatever that is. For some, it just leads to a downward spiral and greater despair. It doesn’t provide an answer. It leads to more suffering. We see some of this in the movie Trainspotting based on the 1993 novel by Irvine Welsh. It’s a tough watch. In the movie, drug taking posits a filling of the gap in users’ lives through inhabiting an alternative reality. It’s a removal from the world or a detachment, without purpose or meaning. Ironically, it leads to another form of self-destructive attachment – enslavement by drugs. It stems from a spiritual malaise. The poem Choose Life by John Hodge is narrated in the movie and presents what for many is the only “normal” alternative to “substance use disorder”. Rather than sitting in a squalid flat taking heroin (or drinking to oblivion), why not choose the semi-bourgeois existence of higher education, a job, a salary, two cars and two holidays per year. But this is precisely an expression of what the ancient philosophers called acedia – listlessness or agitated boredom. I suppose that sitting on a sofa bingeing on TV box sets, having pizzas delivered to the front door, and planning the next flight to the Costas is preferable to a life of misery blighted by addiction. For some, it might provide the comfort of ordinariness or normalcy. But is this really all that there is to life? It’s not a genuine alternative. The fundamental question is how we assert the self over and above this flawed form of existence and whether or not we have the means to do it. The wretchedness of our condition has to be revealed to us and provoke a response in self-recognition. Similar sentiments are expressed by Jean-Paul Sartre in his philosophical novel Nausea (1938). Sartre narrates the mundane life of Antoine Roquentin, with his repeated behaviour, surroundings and so on. The text achieves a sense of being overwhelmed or stifled by inane detail reported over and again. Roquentin wallows in melancholy and experiences this as nausea – but he is transformed in a famous passage when he contemplates the root of a cherry tree. He realises that there is no going beyond the brute fact of the tree root. It’s not accessible to the intellect for us to discern its ultimate meaning. It has no meaning. Instead, existence for Sartre is what we ourselves perceive and how we impose meaning in responding to it. We sometimes experience this “nausea”, if we can call it that, in our everyday lives. Cycles are repeated relentlessly. We get up in the morning. We take the kids to school. We go to work. We come home again in the evening and slump in front of the TV, endlessly surfing through channels of dross. Finally, we give up and go to bed, and then repeat the whole thing the next day. We search for a sense of release and, for some, it comes in the form of Friday night binges. The Danish philosopher Kierkegaard says that “the sickness unto death is despair” and equates this with loss of self. This is more than just listlessness or boredom. It implies a sense of giving up caring about oneself and one’s place in the world. Indifference leads to despair. This is the danger of apathy. Wrongly directed desire then turns to bodily craving, and the search for a “high” to deal with suffering. There are surely greater possibilities than those expressed in Choose Life. The genuine choice is one between merely existing and being-in-the-world. The answer or the strategy proposed by Sartre is that we can transform ourselves by how we think and act in the world. This is existentialism. We can use imagination and ambition. Do what you want to do. Be whoever you want to be. Sartre is saying – you don’t have to accept as normal what others do. You don’t have to be what others tell you to be. You do have the freedom to make choices. He says that our lives are practical. Our existence is not defined by speculating about ultimate reasons and matters. Instead, it’s defined by the use of our practical reason – the things that we choose to do. But exercising this freedom requires courage and many are fearful of making change. So, in a way, he is saying Carpe Diem – grasp the day! Don’t be a couch potato! Make your own life! This is all well and good, of course, but it’s easier said than done. An existentialist approach to life risks becoming mere subjectivism. In the “real world” – whatever that is, however, we all face objective constraints in the form of our upbringing, education and circumstances. True, we can make more of ourselves. We can exercise our imagination but can never deny the basic facts of our day-to-day lives. Instead, genuine freedom is only achieved when we become more accepting of the world, let go of false attachments, decide what really matters to us, discover what makes us truly happy and become an authentic self – a human person living life in communion with others. The meaning of life is not found at the bottom of a bottle!

There is a fundamental difference between not drinking and living sober. The former is tough because you focus on being deprived. You feel left out because you are no longer able to carry on with past behaviour. You are likely also resentful of others who are trying to impose change upon you and you may be jealous of those who don’t seem to suffer with the same problems as you do. It might be a choice you have made not to drink. But it often doesn’t really feel like a free choice. In a sense, I chose not to drink any more when I was stricken down by panic attacks that were clearly brought on by “alcohol abuse disorder”. I made the connection and I was desperate to get well. It felt like the choice was imposed on me, however, because there was no alternative. If you adopt this attitude, then recovery is going to be very challenging and, indeed, will likely not be sustained. That is because you are viewing not drinking as a burden, almost as a form of punishment. It’s something to get through, a bit like Dry January. Of course, as we know, even regular drinkers find Dry January to be a challenge. Imagine how much harder it is for somebody who has become psychologically and perhaps physically dependent on alcohol. I imagine that much the same feelings would be experienced by anybody suffering from "lack" of something or having to undergo a fundamental change in behaviour and lifestyle. It’s easy to think of examples. These might include physical disability, life changing illness or whatever. Those who cope best accept their circumstances and the need for a change in lifestyle. Living Sober is different from simply not drinking. It’s a commitment to living one’s life differently. It’s about attitude, commitment, habit, practice and who you mix with. The chances of sustained recovery are far greater if you can bring about meaningful changes in your life rather than adopting an attitude that not drinking is a burden that deprives you in some way. In the early stages of recovery, the lessons have not been fully learned. We are surrounded by temptation and vulnerable to relapse. It’s very tempting to think that we are well again, we’ve demonstrated that we can stay dry for a period of time, and that this shows we have the problem under control. In the Confessions, Augustine says of his own desires: “They tugged at the garment of my flesh and whispered: ‘Are you getting rid of us?’….I hesitated to detach myself, to be rid of them, to make the leap to where I was being called. Meanwhile the overwhelming force of habit was saying to me: ‘Do you think you can live without them?” (Book 8, chapter 26). Augustine felt unable or unwilling to commit in terms of changed behaviour. The addict can be confronted with the truth. The addict can come to accept the truthful insight of self-harm. But even in acknowledging this truth, and earnestly desiring to get better, is pulled down by the force of habit. Why? The question facing every addict is – do you really want to get better? Shame and guilt are quickly left behind when faced with the next temptation. Fortitude is enhanced when the behaviour and desire to change is confessed and shared with another. Living Sober requires a change in belief and practice. I was reminded of this when I watched two movies recently. The first was The Sound of Metal (2019), an award-winning movie in which Riz Ahmed plays a drummer and heroin addict who suffers irrecoverable hearing loss. He experiences emotional turmoil in response to his deafness and is booked into rehab to avoid relapse. While there he is told that rehab can’t treat his hearing loss but can help with his coping. He needs to reach acceptance. The second movie I watched was Smashed (2012). This is about a young couple living a hedonistic lifestyle. The character played by Mary Elizabeth Winstead spirals out of control. When she leaves rehab, she is surrounded by the same former temptations, people in her life and so on. She comes to realise that her recovery is at risk unless she makes fundamental changes to her life. The point of these stories is that recovery is at risk without a fundamental change in attitude to life. Abstinence is tough enough when viewed through the lens of an imposition. The first lesson is to let go of attachments and be more accepting of self and others. Fundamentally there is a need to be comfortable in one’s own skin – to be able to sit still. The second fundamental lesson is about the challenges we face when living sober. Others don't get it – they are not living in your shoes. You may need to move on. It’s a life commitment – not necessarily as the seemingly impossible task of “for life” but in terms of how you live your life. This is not about forgoing pleasure and wearing a hair shirt. It’s about a reorientation of life. Living Sober is more than just not drinking – it’s about finding a new sense of hope and purpose in life, new practises, and new sources of enjoyment in a community that shares your outlook on life. Some people talk about the “gift of sobriety” – accept the gift and the transformation it brings on your path to recovery. The OAD Clinic offers a number of programmes – including alcohol detoxification– that can help you fight your alcohol addiction, no matter what stage you are at with your recovery. Begin your journey to quitting alcohol and living sober with The OAD Clinic, supporting you every step of the way.

Alcoholics can’t stop at just the one drink. Whatever the good intentions, one drink is followed by another until oblivion is reached. It doesn’t always necessarily occur at the first instance of drinking. But relapse is typically associated with a swift return to bingeing, at least it was in my case and in the experience of other alcoholics I’ve come to know. It is very important to distinguish between what Aristotle called “intemperance” and “incontinence”, as discussed elsewhere in these blog writings. In brief, the former involves a deliberate intention to go out and get drunk for the “pleasure”, whereas the latter entails a compulsive act against one’s better judgment. Both are likely to be harmful in the long-run but it is this sense of compulsion which characterises what we understand as addiction. This “loss of control” is exhibited not only in regard to substances such as alcohol and drugs, of course. Other forms of compulsive behaviour are widely observed. These include eating, shopping, cleaning, gambling, sex, or yanking on the car door to make sure it’s locked before walking away, for example. Some of these are more harmful, perhaps, than others. These are telling us something both about “attachment” and “absence”. Attachment is a pattern of behaviour that gives rise to habit, which then becomes necessity. This involves various motivating factors and “rewards”. At the same time, however, this behaviour is telling us about absence of something. We might understand this as filling a gap – “I drink to lose my inhibition” or, perhaps, “I get to feel more fully myself after a drink”. One is telling us something about why we get drunk. The other is hinting at how we might reorient our intentions and habits through recovery treatment. Augustine uses the term “inordinate desire” rather than incontinence. He talks about the formation of habit. He says that we don’t use our will as some kind of independent judge when we make choices. Instead, our will is tied-up with the desires embodied in our acts. Our reasoning becomes caught up with our passions and these serve bodily desire. This, then, reveals itself in habit, attachment and, ultimately, enslavement to inordinate desire. Augustine says that wrongly directed desire is at root of the problem. This relates, in the first instance, to the sense of clinging or attachment. Augustine discussed this in the context of overwhelming attachment to worldly goods as opposed to the spiritual. He says that we ought not to blame the things in themselves. Rather, it is how we use them as a result of our misdirected desire which is the problem. He says: “The very same things are used in different ways by different people; some use them badly and others use them well. Someone who uses them badly clings to them and becomes entangled with them….Since this is the case, you must realise that we should not find fault with silver and gold because of the greedy, or food because of gluttons, or wine because of drunkards, or womanly beauty because of fornicators and adulterers, and so on…”, (On Free Choice of the Will, Hackett Publishing Company, 1993, p.26). A similar view is contained in the teachings of Buddhists, who express the view that suffering results from craving. The latter, in turn, comes from false perceptions of the self in relation to others and the world around us. This gives rise to wrongly directed desire and attachment. The Path to recovery - the end to the cycle of suffering - involves a reorientation of our thought and practice. In modern addiction theory, the model of inordinate desire translates into “excessive appetite”, a term used in the work of Jim Orford. He starts, as with Augustine, by recognising that the concept of addiction should be very broadly applied across a range of behaviours and not only to common forms of substance abuse. The common factor exhibited is lack of self-control, often against our better reasoning. The features which give rise to this lack of self-control are various. They include socio-cultural factors – the desire to fit in with the culture and be liked (all too prevalent in social media), reward mechanisms – the sense of well-being reinforced by feedback mechanisms in the brain, and the comfort factor from self-medicating to block out suffering. Cues which trigger memories of pleasure feed the habit. I have no direct experience of these various other areas of addiction or expertise to share. But I’m interested in common features that might shed insights into alcoholism and alcohol treatment. Excessive or uncontrolled appetite is associated with feelings of guilt and shame. This, in turn, leads to hiding away and isolation. As an alcoholic in recovery, I recognise these feelings and responses. But these other forms of “skewed consumption” are not directly mind-altering, at least as far as I’m aware. Eating the whole chocolate cake doesn’t lead to blackouts or cognitive impairment, albeit there may be negative consequences for both physical and mental health. We lose freedom when we are attached to the worldly. This is the sense in which we become trapped and experience suffering. This is recognised in Stoic philosophy. Its modern interpretation in Cognitive Behavioural Therapy (CBT) is that we need to downplay the weight we give to the things and events that we cannot control. What should we do in response to the suffering that results from “excessive appetite” or “inordinate desire”? We need to work with alcoholics and other sufferers from substance use disorders to redirect desire and build up good habits in practical behaviour. This is about the proper exercise of freedom, which is character-building and person-forming. Let go of the past, don’t worry overly about the future – however hard this may be in practice – re-examine your motivation and ask what gives you lasting enjoyment in life.

Since ancient times, trauma has been one of the most frequently used words in medicine. It is Greek in origin, meaning ‘physical wound'. Today, traumatology is the branch of medicine that studies and deals with physical injuries. However, from the late XIX century, Freud extended its meaning to include not just physical but also psychological wounds emerging from what he called a traumatic event. During and after WWI, the term ‘mental trauma’ was widely used to describe the psychological scars left in those returning from the front. Soon, doctors and psychologists learned that many people suffered a similar cluster of mental and physical symptoms despite having never been on a battlefield. A wider concept of trauma was born. Trauma played a central role in psychoanalysis. Freud thought the symptoms seen in patients were the consequences of mental mechanisms trying to keep the memories of those traumatic events away from the conscious mind. In his view, the aim of psychological trauma treatment was to dig deep in the patient’s mind, bring the traumatic events to the surface and confront them. The principle of reality would prevail and the conflict would be resolved. It was a simple and logical idea that fitted perfectly well with the psychoanalytic theory. However, it didn’t take long to realise that trauma was a lot more complex and that pushing patients to recall painful events from the past only brought more suffering. Instead of relief, patients feel intense anxiety remembering the event that resulted in psychological trauma. Upsetting memories and flashbacks and the overwhelming feeling of helplessness would be repeatedly triggered by unrelated circumstances. Many people lose interest in daily life and feel emotionally numb and detached from others. Anxiety, panic attacks and depression persist long after the events. It is not unusual to turn to alcohol or drugs in an attempt to control the overwhelming feelings. Insomnia resulting from excessive anxiety and depression, and total or partial amnesia of the traumatic events are very common. This results in a certain level of impairment of cognitive functions. The symptoms usually manifest soon after the events but in some cases, they can take weeks to emerge slowly, in a pervasive way. Patients report having good days when the symptoms almost disappear, and bad days when all of a sudden they return, stopping them from living a normal life. Today, this symptomatic constellation is known as post-traumatic stress disorder (PTSD). Over time a mixture of despair, anger and hopelessness leaves persistent scars in people. Depending on the predominant symptoms they showed during the first psychiatric assessment, patients can be diagnosed with borderline personalities, bipolar disorders, alcohol or drug misuse disorders, or post-traumatic stress disorder. Treatment PTSD is one of the most incapacitating anxiety disorders; it is not suitable for a single line of treatment. Sometimes anxiety or depression can be the main reason people seek treatment. Over the years I have seen many patients treated for alcohol or drug dependence when the underlying condition was PTSD. In those cases, removing the addiction could result in severe depression or anxiety, because addiction was the only defense they could put up to control the overwhelming feelings, very difficult to express in words. There are a variety of therapeutic interventions to help people with PTSD. Individual and/or family therapy are the foundations of any therapeutic approach. Most patients also need medication to help them sleep and control anxiety or depression. Cognitive behavioural therapy (CBT) has been proven beneficial for minor symptoms of PTSD. Eye movement desensitisation and reprocessing (EMDR) is a new neuropsychological technique that is known to benefit patients as well. Dr Oscar D'Agnone, MD, MRCPsych. Medical Director

This time of year is especially tough for alcoholics. We need to talk about the particular problems posed and the strategies that we can form in response. It’s also a time of spiritual significance, at least to many, and we should reflect on what part this can play in recovery. As we approach year-end, it’s also a time for taking stock more generally. On the latter, I’ve learned some lessons over the past nearly two years since volunteering as a mentor. It’s worth first sharing these to see whether they might provide some insights. As said many times, I’m not a therapist or a medical practitioner. Instead, I’m an alcoholic in recovery who’s “been there and done that”, wanting to share my experience and help others. This has worked well in some cases but in others it has not. On many occasions, sufferers at the start of treatment will express an interest in talking, take part in two or three conversations, and then disappear. What is going on here? I've worried a lot about why some people might not want to talk to me. Is it that they believe we have nothing in common? This is a view expressed by some when they encounter others in support groups for the first time and then fail to return. Do alcoholics all have to dress and sound the same? Of course not! We all have our own backgrounds but it’s naïve to believe we have nothing in common when we all share the devastation in our lives caused by alcohol. Is my approach too intellectual? It doesn’t have to be. Let's not talk about the intellectual stuff, at least not in the first instance. I didn’t find it very intellectual being taken to hospital, entering therapy, or suffering panic attacks, so there are plenty of other alcohol-related topics to discuss. But in my experience many of those emerging from darkness into light are open to discussing new meaningful changes in their lives. My observation is that there are two things going on here. The first is that those who walk away and don’t want to engage are often in denial. When I go to fellowship meetings, I often hear that the sticking point of a 12-step programme is acknowledging the hurt caused to others and apologising. But it’s more fundamental than that. Too often, sufferers will not take the first step of genuinely admitting and confessing to others loss of control. The second is that it’s “the nature of the beast”. Alcoholics and others suffering from addictive disorders are so turned inward on themselves that they are simply not ready to engage. This was true in my own case. It wasn’t that I was in denial. Rather, in the early days it took real concentrated and exhausting effort to get well and I wasn’t ready to engage properly with anybody not directly involved in my treatment. That came later and helped to sustain my recovery over the longer-term. The other major thing I’ve been doing over the past two years is writing blogs. For the most part, these have been about issues that have been burning inside me for years. Are they too heavy? Sometimes, perhaps, I don't know. I discussed this with a friend who has struggled most of his life with addictions. His comment was, “well, addiction is a heavy subject”. I get disappointed if they're not read by many but that’s a bit daft. As somebody else said to me, if they're read by just one person and it helps then isn't that enough? The major purpose of the blogs is to strike a chord. They are a way of opening a conversation. In that respect, they’ve been working as intended. I've had some gratifying responses from some surprising people. There are plenty more to come. Yes, some will be heavy, or at any rate will include references to philosophy and spirituality. That’s important because we are trying to explore pathways to recovery. But I acknowledge the well-known saying - Keep It Simple, Stupid! So now we are approaching the festive season. As said, this is a very difficult time of the year for alcoholics (and others) for several reasons: First, it’s supposed to be a time for families and loved ones to come together but what if you are from a broken background or there is not one special person in your life? You surely then feel the isolation even more intensely. Second, it’s a time to be happy, at least outwardly, but often the expression of happiness is a mask. It’s not a happy time of the year for me because it marks the anniversary of when my brother died. I’ve hated the secular festivities ever since despite the religious significance of the season for me. No doubt, that played a part in my drinking to excess. Third, there is pressure to take partying to the extreme. We all have our own memories. The City was a wild place at this time of year – perhaps it still is but I wouldn’t know. I once went to the party of a former employer in the early evening then onto the party of my then current employer, before confessing to a senior manager at the end of the night that I had a serious drinking problem! Let's figure out the strategy here. If you’re feeling lonely then reach out to somebody less fortunate than yourself or pick up the courage to ask for help. Otherwise, let everybody else get on with it while you focus on something else you’d really like to do for a few days. Read a book, watch movies, or go for some long walks. Be kind to yourself. Give yourself some credit for what you’ve achieved so far, despite the inevitable setbacks, and make a plan to continue your recovery in the New Year. Most importantly, focus on avoiding the first alcoholic drink if and when you go out. You can drink something non-alcoholic but admittedly it’s not much fun if you feel that you’re cast as the “party pooper”. So, be prepared for the questions and don’t allow yourself to feel pressured. Tell people that you feel much fitter and healthier without alcohol. If necessary, stay away from the temptation altogether. I try to avoid works’ parties. Can alcoholics enjoy this time of year? Why not?! People of all faiths, and none, celebrate the seasonal festivals - not always with alcohol! I celebrate the blessing of my sobriety, the gift of wisdom, the feeling of being wide awake and the joy of life with all of its ups and downs. Fundamentally, this time of year is about loving and giving. Focus on the gift of your recovery and remember – you are not alone. Just reach out and somebody will be there for you.

Some people ask me - "how did you manage to cope and be a success in your career?" or "how did you manage to carry on with your work while your drinking was out of control and a cause of suffering in your life?" These are good questions, of course, and I’m not sure that I can give an altogether convincing answer. Perhaps it was the case, thankfully, that my own personal rock bottom was not as deep as that experienced by some. But the question also betrays a fundamental misunderstanding. Just because we see, sadly, alcoholics lying in shop doorways and on park benches, homeless, these circumstances are not what define "alcohol use disorder". After all, we know that doctors, lawyers, teachers, actors and professional sports people - yes, sportspeople - are alcoholics. We used to call these “functioning alcoholics”. Alcoholism does not discriminate by gender, social class or profession. What define “alcohol use disorder” are things like - loss of control, bingeing, blackouts, craving, tolerance and withdrawal symptoms. You don't have to be drinking 24 hours per day to tick these boxes. Functioning alcoholics of course suffer from a major impairment, and the downward slide will continue if left unchecked, but it is possible to lead what looks at least outwardly like a normal life. I was only ever seen drunk at work when it was an accepted part of City culture - it still is in some areas – or at social functions. Later, almost all of my heavy drinking was done alone and outside of normal working hours. Often it was planned beforehand. But I didn't always take a drink intending to get drunk. It just happened. It became regular and got worse. The danger of this misunderstanding or lack of perception is that it can deny somebody from receiving help. It's like saying – “you are fine - you’re coping, you have a job, you hold a responsible position, you don’t really have a serious drinking problem”. But this is wrong. I've talked before in these blogs about the identity of an alcoholic. If you are judgmental about denying the label, then how on earth is the sufferer to achieve Step One? Why or how would a sufferer confess to a problem if they sensed they were to be doubted or asked to justify why they feel the need to ask for help? He or she would be more likely to stay in denial. There is an old saying, “If it walks like a duck, swims like a duck and quacks like a duck, then it's probably a duck”. If somebody keeps repeating loss of control binge drinking, it causes self-harm, and is destructive to others around them then they are alcoholic. It doesn't help to say – “you go to work every day, you’re getting along well – you’re fine”. In a related vein, I often use the self-descriptive term “alcoholic in recovery”. I say that because the opinion expressed by some is – “if you haven't touched a drink for 20 years then you can't possibly be an alcoholic now”. In other words, you are "recovered" not "in recovery". Fair enough, possibly, but I choose not to describe myself in that way for good reason, based on my own personal experience and what I have seen in others. I choose to use the term as a reminder. It's not a badge of honour. Neither is it a ball and chain. Instead, it's a reminder that I'm still on a life journey and I'm very aware of what I did and its consequences, and the danger of slipping back. Am I "recovered"? I've really no idea. I don't have any intention of putting it to the test. That's because I tested it many times in the past and failed. I was dry for five years and then resumed the pattern all over again, despite brief hospitalisation and intensive psychotherapy. Also, I've heard many stories of those who were sober for longer than me, started drinking again, and died. I don't want to try it out. No thanks! Tony Adams, the former Arsenal and England football captain tells the story of how his co-founder of the Sporting Chance clinic, Peter Kay, relapsed after sharing almost 20 years of being sober and subsequently died at the age of 52. Adams says, “The death certificate would say that he had died of a heart attack, but I know that he, as many alcoholics and addicts do, without it being the formal cause, died of the disease of addiction”. Sober, Simon and Shuster, 2017, p.193 It doesn’t have to be this way. The late actor Robin Williams was interviewed about his addictions. He related a story about how he was sober for twenty years but then relapsed on location in Alaska in 2003. He said, "I was in a small town where it's not the edge of the world, but you can see it from there, and then I thought: drinking. I just thought, hey, maybe drinking will help. Because I felt alone and afraid. It was that thing of working so much, and going f--k, maybe that will help. And it was the worst thing in the world." What did he feel like when he had his first drink? "You feel warm and kind of wonderful. And then the next thing you know, it's a problem, and you're isolated." - Guardian, Monday Sep 20, 2010 Over and over again, we hear the same stories. Some do manage a return to controlled “social” drinking. Good luck to them! The fundamental point here is that we are all of us facing tests throughout our lives. We are tested in education and in our work lives. We are tested in our ability to build relationships and families. Some tests are moral or spiritual in nature. We make promises to people and then we let them down. We make commitments to clean, purposeful living and then we don’t abide by them. We are all less than perfect and make mistakes. We need to acknowledge the slip-ups, learn from the experience, and move forward with a renewed sense of purpose and commitment. Focus on your recovery, enjoy the present moment, don’t torment yourself with the past, and don’t overly stress about what the future may or may not hold – don’t keep wondering “what if?”

When I stepped into semi-retirement, I wanted to do something useful and with purpose. I said to somebody that I wanted to stop being an academic. I’ve been a (semi-) academic all of my life. I wanted to get my head out of books and get my hands dirty, so to speak. As an alcoholic in recovery, I wanted to help others undergoing alcohol treatment. I started reading books about addiction – not for the first time. I investigated getting another set of certificates in psychotherapy and counselling. But then I stopped. It seemed to me that I already had sufficient “qualifications”. I’ve studied psychology and philosophy most of my adult life. I have a doctorate in philosophical theology. My special interest is personhood – what makes a human person. Above all else, “I’ve been there and done that”, as we say. I’ve looked over the precipice and become locked into a cycle of destructive behaviour. I’ve lost my footing and fallen into despair. I’ve been helped along the path to recovery and I’ve climbed out on the other side. What would some more “certificates” prove? Am I not interested in the academic study of addiction? Yes, of course I am! I’ve been reading indirectly about the subject for most of my adult life. I want to understand what people have been studying on a formal basis. I can’t go around generalising from my own personal experience. But I’m not fundamentally interested in arcane philosophical debates when it comes to offering help. Actually, what I want to do as a mentor is to be ready to offer support when it’s asked for. I can do this through listening, relating my own experience, and making practical suggestions for things to do as life choices. I want to do more than “talk the talk”. I want to “walk the walk”. The alcoholic doesn’t really care about the details of the academic debate. He or she just wants to get better. The relentless search for knowledge or self-understanding can become destructive. That is because it becomes a vicious cycle from which we can never completely escape. We are not satisfied that we have found the “truth” and our scepticism prevents us from acting. Tony Hancock was a famous British alcoholic and comedian who committed suicide at the age of 44. In The Life and Death of Tony Hancock, Clive Goodwin observes that he was often surrounded by books, obsessed with a thirst for knowledge. He carried a set of encyclopaedias with him everywhere and “would arrive at rehearsals carrying a copy of Kant’s Critique of Pure Reason or Spinoza’s Ethics” (see p. 210) but it didn’t help his melancholy. Many great thinkers have cautioned against the pursuit of speculative knowledge. In his letters to Lucilius in the first century, the Roman Stoic Seneca cautions, “You must linger among a limited number of master thinkers, and digest their works, if you would derive ideas which shall win firm hold in your mind. Everywhere means nowhere”, and “since you cannot read all the books which you may possess, it is enough to possess only as many books as you can read” (Letters From A Stoic, Dover Publications 2016, p.2). In a different but somewhat related vein, Martin Luther, the sixteenth century Reformer, commented that what makes a good theologian is “not understanding, reading or speculating” (Weimar Collection 5.176, pp 32-33) – in other words, what matters is commitment and not having your head stuck in books. The Danish philosopher Soren Kierkegaard contrasts the life of what he calls the aesthetical and the ethical. He says, in effect, that if we go up the path of philosophical speculation then we end up in a relentless circular movement, never actually making decisions, trapped in a kind of paralysis or being carried along with the flow. This is a form of stasis often associated with melancholy. Instead, true freedom is ethical – when we make an internal commitment, decide for something, and make choices about how and what to do with our lives. That is how we become someone. This process of self-actualisation is ekstasis. The literal meaning is that we “stand outside” of ourselves, relating to other people and the rest of the external world as we grow as human persons. In his Journal of 1843, Kierkegaard famously said, “Life can only be understood backwards, but it must be lived forwards”. In other words, we can analyse as much as we like, or don’t like for that matter, but ultimately we have to make choices at every moment as life progresses forward. The truth is not presented to us in textbooks. The latter are providing us with the tools. These are the tools to build a body of knowledge, to allow us to analyse. But the spiritual quest is the “path” – it’s about how we find meaning and purpose in our lives and about the practical choices that we make through being in the world – Practical Wisdom. We can easily relate this to the problem of addiction and recovery. The addict remains tied to the past and becomes increasingly melancholic. Life is perceived as meaningless. The addict is trapped in his or her world. The movement in recovery needs to be outward. It needs to be a movement that involves active choice on a pathway to freedom and openness. Sometimes we need to throw the books away and get our hands dirty with practical wisdom. As Shakespeare says through Hamlet – “there are more things in heaven and on earth, Horatio, than are dreamt of in your philosophy”. We need to lift our heads and look forward on a journey of discovery on the path to recovery and freedom!

In an earlier blog from last year, called Be Still – Mindfulness in Lockdown, we talked about how lockdown was an opportunity to stop racing around and burdening ourselves with often self-imposed pressure to stay busy. Alcoholics and others suffering from addiction are not very comfortable sitting still. In this blog, we consider meditation in a bit more detail. Meditation is a practise to train and discipline the mind. It may prove helpful to some people in recovery. Some people have asked me, “do you meditate”? I'm almost surprised by the question. That's because I’ve always regarded meditation as playing an important role in my overall physical and mental health. I find it easy to meditate. It's a part of living and breathing whether regarded as a spiritual practice or not. As usual, I preface my remarks by saying that I’m not a certified meditation therapist. I’m just an alcoholic in recovery, wanting to share my experience with those who might find it helpful. I was first taught meditation techniques while undergoing psychotherapy. I suffered excruciating panic attacks because of my abuse of alcohol. When I entered treatment, one of the first things I was taught was how to cope with the panic attacks rather than to tackle any deep-seated issues to do with drinking. This was “one step at a time”, as we say. The first lesson was how to breathe deeply and properly. It's a better way of coping with a panic attack then sticking your head in a paper bag! Fellow sufferers will know what I mean by reference to the latter. There was a time when I wouldn’t leave the house without a paper bag in my pocket. From memory, it was never used but it was there as reassurance. I was taught to breathe in deeply through the nose while pushing out my diaphragm (pushing out the belly, basically). This seems a bit like a strange coordination but I was told to watch the body of a baby when it’s sleeping deeply. It’s a natural rhythm of deep relaxed breathing. Hold the breath briefly then breathe out again slowly through the mouth while feeling the stomach move inward. The purpose here, of course, is to avoid the short gasping associated with panic attacks. In my first full-blown panic attack this led to hyperventilation and tetany – contraction and cramping of the muscles, including around the mouth and throat, frighteningly, with an experience of pins and needles. I felt my hands turn into claws. The second lesson was to learn muscle relaxation techniques These involved clenching and then relaxing muscles, starting from the feet, moving up from the legs to the middle body, the shoulders and then to the mouth, the eyes and so on. This was done against the background of soothing music. The choice of music was optional. I chose the sound of waves breaking on the seashore. This practise was carried out for about 30 minutes per day, while lying flat on my back with pillow support under the lower back and knees. It was a discipline. Now I can recollect and apply the technique almost anywhere and at any time – in the office, on the train, sat in the garden, on the beach, or wherever. What does this have to do with meditation? Relaxation and calming of both body and mind is part of the preparation for meditation. In the first instance, meditation is about ridding the mind of externals. It's about emptying and calming the mind. When I started the aim, of course, was to rid my mind of running away with itself in panic attacks. Sessions were finished with a sensation of floating. Quite commonly, practitioners will fall asleep but awaken refreshed. Later, with more practise, meditation is used to train and focus the mind. Again, the objective is to let go of all other distractions and to focus on the problem or task at hand. Sports people and Special Forces use meditation techniques as a way to prepare. This is to empty the mind of distractions, stay calm, lose fear, and focus in preparation. Subsequently, I studied Buddhism as an undergraduate and learned a bit more about what was going on when we use meditation as a spiritual practise. Buddhists believe that, at risk of oversimplifying, suffering results from craving because of attachment to false notions about the self and the world around us. Meditation is about training the mind. Let's examine some common misconceptions about meditation. First, you don't have to sit in the lotus position staring at the wall. Second, you don't have to do it for hours on end, although Zen meditation does this. Third, you don't have to learn chanting, although this may be helpful to provide focus and rid the mind of external distractions. Fourth, it doesn't have to be religious. Some people consider meditation to be like prayer. But as already said it doesn't have to be religious. Even here, there is a fundamental misunderstanding, in my humble opinion. I've often said to people that prayer is about listening, not asking. People seem surprised by this. I don't know why. Fundamentally, both meditation and prayer are about letting go of self-concern and self-will – what theologians call kenosis or self-emptying. There is, of course, a difference between meditation to calm and empty the mind of all but the present moment and a training of the rational mind. The famous Stoic Emperor Marcus Aurelius wrote his Meditations as a series of rational arguments rather than spiritual practise. Training the mind to think through situations in a calm rational manner is a technique used in Cognitive Behavioural Therapy (CBT). How does all of this apply to recovery from addiction? It's about learning methods to cope and aid recovery. It's about giving up attachments to false ways of thinking about the world and others around us. It's about giving up on things we can't control. It's about losing fears, resentment and other emotional responses to stress. It's about anticipating and coping with triggers to relapse. Sit quietly, breathe deeply, close your eyes and focus on your recovery.