In addiction recovery, the concept of “people, places, and things” is pivotal for maintaining sobriety and achieving long-term success.
“In active addiction, individuals become conditioned to associate certain stimuli (people, places, and things) with the substance and the rewarding effects it produces,” explains ETHOS Treatment Clinician Allyson Andrisani, MS, BSRN. “This conditioning creates triggers that can induce cravings when encountered. For example, a person might have often used drugs when tailgating at games. That person’s brain is now conditioned to associate the sights, smells, and sounds of a stadium parking lot with a reward — the feeling of getting high. Just walking through the lot can produce a powerful craving because, over time, the brain has been trained to expect that reward whenever it’s in that ‘place.’”
Andrisani, who runs small group sessions in Ethos’s Intensive Outpatient Program (IOP) for substance use disorder, helps people in recovery understand and navigate these triggers.
Coping Strategies
Some triggers are easy to avoid, while others must be handled in other ways. “Avoidance alone is not always possible or practical, especially with triggers that are integral to one’s daily life,” says Andrisani. “You can change your commute to bypass a liquor store, delete a dealer’s number, and skip a music festival, but you must establish boundaries and develop coping skills to mitigate conditioning associated with family members, co-workers, places within your home, and other stimuli you can’t steer clear of.”
Adopting new behaviors in previously triggering situations can help rewire the brain and reduce cravings over time.
“If someone routinely drank at the kitchen table, their brain is conditioned to anticipate a reward when they sit down — or even when they walk into the room,” she says. “To disrupt the conditioning, they can change their perspective and the environment by sitting in a different chair, changing the art on the wall, and getting a new table. Another example would be, if you are used to cracking open a beer at 5 p.m., you can go for a daily walk at that time instead.”
Ultimately, the brain will gradually learn that the presence of the trigger does not lead to the expected reward, thereby reducing the emotional response to the trigger and decreasing the craving over time.
The Power of Group Therapy
Developing strategies to handle interactions with unavoidable people is an important part of early recovery. “In our group therapy sessions, we talk a lot about ways to cope with people who may not understand what you’re going through or who don’t support the positive changes you are making in your life.”
Working in a group setting — in addition to one-on-one therapy — can be a crucial part of successful recovery. Group therapy offers peer support, shared experiences, and mutual encouragement, which can be more effective than individual therapy alone.
“There’s a sort of magic that happens in group settings,” says Andrisani. “People who are going through this journey at the same time can teach each other and learn from each other. They get positive reinforcement while providing support to others. They are creating a safe place for honest accountability and reaping the benefits of that accountability. This collective experience fosters a sense of community at a time when it’s needed the most.”
A Comprehensive Approach to Recovery
The process of recovery is complex and requires a comprehensive approach. ETHOS’s Intensive Outpatient Program (IOP) for substance use disorder combines individual counseling, and small group and family therapy to maximize the potential for long-term, sustainable recovery. To start or continue your journey to recovery, or to learn more about ETHOS’s substance use disorder program, visit https://www.ethostreatment.com/contact.