I spent five years in the nineties as part of research teams studying how to improve drug and alcohol treatment. My job was to manage and clean the data and to do statistical analysis.
In my first job after university, I worked on a team that examined “proximal outcomes” for recovery, both for twelve-step programs and cognitive behavioral therapy. The idea of the investigation was, each modality of treatment program suggests various activities for people to do if they want to get sober – but which of these many activities are actually empirically effective?
What we found is that what correlated with recovery most strongly is authentic interpersonal connections – in other words, the main thing that seemed to get people off of their addictions was sharing themselves honestly with other people who provided an open heart and an accepting ear. Specifically, what helped most was working with a sponsor or therapist and attending twelve-step meetings or therapy groups. What helped less was working the twelve steps, reading the Big Book, doing therapy homework assignments, and/or reading psychology self-help books.
It seems that getting fully mentally healthy is not something that we can do alone. I imagine most people reading this know that honest and loving social connection is a central necessity for our mental vitality.
A few years later, I was part of a research team that examined the efficacy of two different types of six-month treatment programs. In both types of clinics, the clients did similar structured recovery activities during the day. Some of the programs, however, were inpatient/residential, and the others were day-treatment (people went home and slept in their own beds). We were trying to see if expensive in-patient treatment programs could reduce the high costs of overnight stays.
What we found was that, by the end of the six-month program, people in the day-treatment programs had lower rates of sobriety and had had more relapses. We discovered that this was because, every night as they had gone home after treatment activities, they had been exposed to temptation. It had been relatively easy for some of them to get sucked back in as they walked past liquor stores, bumped into their dealers and using buddies, stressed out about rent money, or had agitating fights with their partners, roommates, or parents.
The inpatient treatment folks, in contrast, spent six months in wholly cocooned environments that had supported their sobriety and recovery around the clock, free from temptations. And just about all of them who were able to stay in the program until the end were, as one would expect, still sober then.
What we found, however, is that people who had been through both types of programs had about the same rate of sobriety a year and a half after their clinic visit had ended. This was in part because the residential programs people had a massive drop off of sobriety rates right after the program ended, as they suddenly experienced the temptation of the outside world all at once. In contrast, most of the day-treatment folks who were able to stay sober until they graduated also had a good chance of being sober eighteen months later.
In light of this, when your meditation practice is mature and robust enough for it, I recommend something that my principal meditation teacher Shinzen Young calls “trigger practice”. This involves maintaining a centered and spacious meditative awareness while intentionally putting in front of ourselves something that typically draws a strong and destructive compulsive reaction out of us – a bottle of booze, a pack of cigarettes, a letter from an ex we are trying to get over, a website showing porn, a gambling interface, or upsetting political content, or something like that. The point of this exercise is to slowly but intentionally work to get over the compulsive unconscious pull that this temptation has on us, so that it doesn’t hit us all at once when we are least ready for it.