Spirituality & Relapse

January 18, 2015

By Terence T. Gorski
Author, The Books of Terence T. Gorski )
May 6, 2001 (Last Revised: 2015-01-19

Defining Spirituality

There is a relationship between spirituality and relapse. To understand it, we must first define spirituality.

Father Joseph Martin repeated many times that the easiest way to start grappling with the issue of spirituality is to go back to the ancient Greeks who put it this way: human beings have both a physical characteristics that observable directly observable andradite able in the physical world the world, and nonphysical characteristics that cannot be directly seen and measured in the physical world. These nonphysical characteristics of human beings they called spiritual. Let’s dig into this way of thinking a little bit more deeply.

People have both:
– Physical characteristics, determined by the structure and actions of their bodies, and

– Non-physical characteristics, determined by the structure and actions of their minds. These non-physical characteristics are called spiritual and include the ability to perceive, think, feel, act, assign meaning and purpose to life, and gives us the ability to conceptualize and seek out God, or at least the God of our understanding.

I believe in God. My limited human mind cannot fully comprehend of look upon the face of God. Words cannot adequately define God. Yet, I for one keep trying to capture my sense of God in words to share with others.

Human beings beings have the ability to seek after God because we are sentient, in other words we have the ability think and feel, AND we are conscious of the fact that we can do so.

The capacity for self-awareness or sentience gives each of us the ability to be consciousness or aware that we exit as separate beings. This self awareness causes each individual to develop a core personal identity that moves beyond physical existence into a complex world of ideas and images.

This personal consciousness drives people to find meaning and purpose in human existence.

This desire for a sense of individual meaning that transcends the physical has led many recovering people to a search for the spiritual laws which they should follow to live a sober, responsible, and meaningful life.

In essence, people trying to live the spiritual life are striving to find organizing principles of the non-physical dimension of human existence. They are seeking to find the spiritual principles and practices that can give the the ability to live a sober and responsible life in a difficult world.

People on the spiritual quest seem to believe that human existence is ruled by laws, or organizing principles.

The physical world is governed by physical laws.

The non-physical/spiritual world is governed by mental and spiritual laws.

The belief is that finding and then living in accordance with these universal spiritual laws will help them to:

– Find peace and serenity in life.
– Discover a sense of meaning and purpose in their sobriety.
– Find source of courage, strength, and hope that get get them through even the toughest of times.

They also believe that people who violate these universal principles, either through ignorance or intent, will experience inner pain, turmoil, and frustration. They will become disillusioned in recovery and many will relapse to chemical use to medicate the pain.

With that in mind, let’s explore in more depth the characteristics distinctions between mystical and no mystical spirituality.

Mystical & Non-mystical Spirituality

There are two different ways of thinking about human spirituality. Mystical spirituality is based upon the belief that there is a spiritual world inhabited by a Higher Power or God. The meaning and purpose of life, according to mystical spirituality, can only be found through a conscious relationship with this spiritual Higher Power who reveals information not available through our ordinary senses or intelligence. The ultimate goal of mystical spirituality, therefore, is to establish a personal relationship with God, and to seek knowledge of his will and the courage to carry that out.

Non-mystical spirituality recognizes that human beings exist not only in the physical world, but also in a unique world of ideas, thoughts, feelings, and fantasies that transcends physical limitations. In this sense the word spiritual can be used interchangeably with the word psychological. Non-mystical spirituality, like psychology, is directed at learning to effectively use human mental powers to find meaning and purpose in life. The spiritual life is based upon developing these mental and emotional abilities. Non-mystical spirituality, however, believes that human beings can discover basic spiritual truths thorough the use of their senses and intellect. They do not rely upon divine revelation, but look to human reason to find the answers to sobriety.

Mystical and non-mystical spirituality are not mutually exclusive. Many recovering people have a mixed spiritual system. In the mystical sense, they seek to develop a personal relationship with the God of their understanding and pray to discover what God’s will is for them. In a non-mystical sense, they actively work at psychological growth. They believe this mixture of the mystical and non-mystical captures the principle of “turning it over, but doing the leg work”. Mystical spirituality allows them to turn over some aspects of their human experience to the care of a Higher Power. Non-mystical spirituality allows them to “do the leg work” by taking responsibility for personal growth and change.

Relapse & The Extremes of Mystical Spirituality

Extreme and rigid views of spirituality can result in relapse. Many people relapse because they believe that the mystical god of their understanding will somehow magically save them from their problems. They abdicate personal responsibility and expect God to take care of everything. When God doesn’t, they sink into a deep existential depression and say, “Since God won’t fix my life, I might as well get drunk.”

An example of this is the man who turned $60,000 worth of debt incurred from his cocaine addiction over to his higher power. He was absolutely shocked when his higher power turned his debts over to a collection agency.

Another man, who was divorced shortly after getting sober, looked to God to clean up his apartment. He was disappointed when God wouldn’t do it. Upon spiritual reflection the man concluded that since God wouldn’t clean his apartment, it must be God’s will for him to live in the mess. Shortly afterwards he got drunk.

Relapse & The Extremes of Non-mystical Spirituality

Other people relapse because they cannot find a higher power to believe in. Some of these people are overwhelmed with such intense shame and guilt that they can’t believe God or any other higher power is available to them. Others are locked into grandiosity. They see themselves as bigger, strong, and smarter than anyone or anything else in the universe. When they encounter overwhelming problems they feel cut off from all sources of courage strength and hope. They often become disillusioned and relapse to chemical use.

Most people who succeed in recovery have organized their sobriety around a source of meaning and purpose that is greater than themselves. Most practice the mixed system of spirituality described in the serenity prayer. The Serenity Prayer is “God grant me the serenity to accept the things I can, God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference”.

People who live in accordance with these spiritual principles recognize that there are things that they can and must change if they are to stay sober, and they seek the courage to make those changes. They also recognize that there are other things that are beyond their control. They turn these things over to a Higher Power. They have faith that there is someone or something bigger, stronger and more powerful than they that will take care of the things that they can’t manage. As a result, they can comfortably let go of the things that they cannot manage and invest their energies in taking care of things that are within their power.

Recovery & A Balanced Sense Of Spirituality

People who stay sober are able to transform themselves by surrendering their narrow, addictive world view and embracing a broader and more effective sobriety-based world view. This transformation is a spiritual process, though not necessarily a mystical one. It is a consciousness expanding experience that requires a belief that there is someone or something more powerful than I am. It requires a willingness to believe in a seek out that source of power, to ask for help, and ultimately to follow directions.

Recovering people need to find a source of courage and strength that can overcome frustration, transform despair into hope, and motivate them to move ahead in the sober life. Some recovering people find this in a mystical higher power that many call God. Others find it in the mysterious power present in their group conscience. Still others find it in a higher value system that replaces addictive thinking with rationality and reason.

People who maintain sobriety learn that they are responsible for themselves. They internalize the AA principle of “easy does it, but do it.” They realize that they need to identify the next little thing they have to do to stay sober, and do it. In essence, they realize that they are responsible for whether or not they take the next drink or the next drug. They recognize that they must learn how to look within themselves and find the source of courage, strength, and hope needed to stay sober. Ultimately, they are responsible for rebuilding their lives and finding meaning and purpose in sobriety.

The Spiritual Paradox of Recovery

This is the paradox of recovery. We cannot do it alone, but yet we must do it by ourselves. We cannot expect God or a higher power to do what we are able to do for ourselves, but yet we cannot do it for ourselves without somehow touching a source of courage and strength that exceeds our own abilities. And here seems to be the ultimate spiritual principle that allows alcoholics to avoid relapse and move ahead in recovery. It is a philosophy of balance. It is the ability to recognize and affirm the quality of physical existence, to learn how the physical world operates and operate within the limits of its laws and imperatives. It is also the willingness to affirm the world of ideas, thoughts, and images. It is the ability to learn to turn within and find a creative spark of life, a creative spiritual energy that will allow us to go on and find solutions when none seem available. The balance of these two worlds, the world of physical reality, and the world of ideas where the ultimate spiritual reality exists, allow people to forge a strong and powerful sobriety.

An After-Thought

After reading and rereading this article on spirituality I realize that many of the ideas are not as clear and concrete as I would like them to be. At best this must be considered a work in progress.

Considering that I have been drafting and redrafting this description of spirituality for over forty years, I doubt that I will get it right in the few years I have left.

I am just sharing this and hope some parts of it will be helpful to some people who read it.

Spirituality is a complex area and we don’t have a shared language to describe it.

Spirituality is also an experience that cannot be fully conveyed in language.

When we have a spiritual experience we know it, but when we try to explain what we experienced, the words often fail us.

So the above article on spirituality is my failure to adequately convey my experience of the spiritual in words.

The Books of Terence T. Gorski

Spirituality – One Point of View

November 5, 2014

By Terence T. Gorski,

I think of spirituality as the nonphysical aspects of the human being that involve:

– Thinking,
– Feeling,
– Imagining,
– Learning, and
– Remembering,

These nonphysical aspects give us:
– The ability to establish conscious contact with a power greater than ourselves.
– The capacity for self-awareness,
– The ability to make decisions and exercise free will,
– The ability to seek and find a sense of meaning and purpose in life,
– The the ability to embrace, endure, transcend, and find meaning in the pain, problems, and suffering in life
– The capacity to enjoy and find peace in a wide variety of human experience.

With the continuing evolution of thought, there is a large area of overlapping concepts that can be described in both spiritual and psychological language while expressing essentially the same ideas and concepts. The future challenge will be to agree upon a common language to reduce confusion and misunderstanding and facilitate the continued growth of the human mind and spirit that is aligned with higher principles reflecting goodness love, and peace among of of mankind.

The above statement summarizes my best thinking on spirituality at this moment. Please remember that I am but a fallible human being who could be wrong.

Terence T. Gorski
November 4, 2014


July 27, 2014

The Moon, Earth, International Space Station, and Rising Sun

By Terence T. Gorski

We don’t have to fight it. We can transcend it. We can take it in, understand and learn from it. We can mix it with what we already know and move beyond the limits of our previous knowledge, point of view, or frame of reference.

We transcend something when we go beyond, rise above, cut across, or surpass some previous limit or boundary.

The word transcend comes from
Old French transcendre or Latin transcendere, from trans- ‘across’ + scandere ‘climb.’ The origin of the word therefor implies the idea of climbing or moving across something, especially a limitation or an obstacle.

Transcendence takes us beyond the limits of a previous paradigm, belief, or way of thinking. Transcendence in a spiritual sense, transcendence involves moving beyond the limits of ordinary human consciousness usually in an experiential and nonverbal way.

The idea of transcendence implies moving to a higher level or expanding to a wider and more all-encompassing frame of reference.

Transcendence usually results from an active process that unfolds in stages:

Stage 1: Identifying a personally important problem or area of new knowledge or skill. The key seems to be the initial desire or motivation that becomes harnessed in stage 2.

Stage 2: Total absorption in solving the problem, learning the skill, or figuring out how to achieve a desires state of consciousness. This involves reading, studying, discussing, and mentally wrestling with the problem.

Stage 3: Persistent Intense Effort: This process leading to transcendence is usually so intense that it leads to exhaustion and the inability to continue to hold related ideas in consciousness. This results in the person feeling a need to let go and stop trying.

Stage 4: Sudden and Unexpected Insight: The exhaustion is followed by a period of fitful rest. During this period of rest the unconscious mind or higher self integrates the previous disconnected ideas and presents the conscious mind with a spontaneous insight which is often called “The Aha” experience.

Stage 5: Documentation: The insight is often fragile and quickly forgotten unless written down or concretely expressed. In this way the idea of transcendence and creativity are similar because they both emerge from the same process.

Transcendence is an important idea in recovery from addiction, psychotherapy, spiritual development and personal growth. The process of transcendence that leads to a bigger and more useful frame of reference and a different and more useful point of view is essential to all of these processes. Most people find that as they mature they learn how to transcend or use above pain and problems in life in order to find meaning and purpose.

“We don’t have to fight it. We can transcend it.” ~ Transcendence, The Movie http://en.m.wikipedia.org/wiki/Transcendence_(2014_film)p

strong>GORSKI BOOKS: www.relapse.org

Post Acute Withdrawal (PAW): A Comprehensive Guide

December 23, 2013

p-a-wBy: Terence T. Gorski, Author

Excerpted From Staying Sober – A Guide for Relapse Prevention and
Straight Talk About Addiction   

When most people think about alcoholism or drug addiction they think only of the alcohol/drug-based symptoms and forget about the sobriety-based symptoms. Yet it is the sobriety-based symptoms, especially post acute withdrawal, that make sobriety so difficult. The presence of brain dysfunction has been documented in 75-95% of the recovering alcoholics/addicts tested. Recent research indicates that the symptoms of post-acute withdrawal associated with alcohol/drug-related damage to the brain may contribute to many cases of relapse.

Post-acute withdrawal means symptoms that occur after acute withdrawal. 

  • Post means after. 
  • Acute means immediate or severe; short-term
  • Post Acute Withdrawal: Symptoms that occur after acute withdrawal.

Post-acute withdrawal is a group of symptoms of addictive disease that occur as a result of abstinence from addictive chemicals. In the alcoholic/addict these symptoms appear seven to fourteen days into abstinence, after stabilization from the acute withdrawal.

Post-acute withdrawal is a bio-psycho-social syndrome. It results from the combination of damage to the nervous system caused by alcohol or drugs and the psychosocial stress of coping with life without drugs or alcohol.

Recovery causes a great deal of stress. Many chemically dependent people never learn to manage stress without alcohol and drug use. The stress aggravates the brain dysfunction and makes the symptoms worse. The severity of PAW depends upon two things: the severity of the brain dysfunction caused by the addiction and the amount of psychosocial stress experienced in recovery.

The symptoms of PAW typically grow to peak intensity over three to six months after abstinence begins. The damage is usually reversible, meaning the major symptoms go away in time if proper treatment is received. So there is no need to fear. With proper treatment and effective sober living, it is possible to learn to live normally in spite of the impairments. But the adjustment does not occur rapidly. Recovery from the nervous system damage usually required from six to 24 months with the assistance of a healthy recovery program. Recent research is showing that for some recovering people the symptoms of PAW often occur at regular “moon cycle” intervals and without apparent outside stressors. Often those 30, 60, 90, 120, 180, and 1 & 2-year sobriety dates seem to be “triggering” times for PAW symptoms to increase. People recovering from long term opiate and stimulant use often have PAW symptoms for no apparent reason for up to 10 years after they have stopped using their drug of choice. Often PAW symptoms appear to come and go without apparent reason and without any specific pattern. Individuals who intend to have consistent long-term recovery must learn to recognize these symptoms and learn how to manage them.


Excerpted From
Staying Sober – A Guide for Relapse Prevention and
Straight Talk About Addiction

How do you know if you have PAW? The most identifiable characteristic is the inability to solve usually simple problems. There are six major types of PAW symptoms that contribute to this They are the inability to think clearly, memory problems, emotional overreactions and numbness, sleep disturbances, physical coordination problems, and general problems in managing stress. The inability to solve usually simple problems because of any or all of these symptoms leads to diminished self-esteem. A person often feels incompetent, embarrassed, and “not okay” about themselves. Diminished self-esteem and the fear of failure interfere with productive and challenging living. Let’s take a look at some of the PAW symptoms that contribute to the inability to solve usually simple problems.


images1.   Inability to think clearly
2.   Memory problems
3.   Emotional overreactions or numbness
4.   Sleep disturbances
5.   Physical coordination problems
6.   Stress sensitivity

Inability to Think Clearly

There are several thought disorders experienced by a recovering person when PAW is activated. Intelligence is not affected. It is as if the brain is malfunctioning sometimes. Sometimes it works all right. Sometimes is does not.

One of the most common symptoms is the inability to concentratefor more than a few minutes. Impairment of abstract reasoning is another common symptom of post acute withdrawal. An abstraction is an idea or concept that is not concrete, something that you cannot hold in your hand, take a picture of, or put in a box. Concentration is more of a problem when abstract concepts are involved.

Another common symptom is rigid and repetitive thinking. The same thoughts may go around and around in your head and you are unable to break through this circular thinking in order to put thoughts together in an orderly way.

Memory Problems

Short-term memory problems are very common in the recovering person. You may hear something and understand it, but within 20 minutes you forget it. Someone will give an instruction and you know exactly what to do. But you may walk away, and that memory becomes clouded or may disappear completely.

Sometimes during stressful periods it may also be difficult to remember significant events from the past. These memories are not gone; the person may be able to remember them easily at other times. The person realizes that he or she knows but just cannot recall it while experiencing the stress.

For an alcoholic named Jan this created a problem in AA. “I have trouble presenting my story at AA,” she said. “I have trouble remembering events that happened before my drinking days, let alone things that happened while I was drinking. So to put my life in story form is hard for me. I don’t remember all of my story. I do remember that some things occurred, but I get confused about when they happened. Many times I can remember things when I am alone with no pressure that I can’t remember under the stress I feel when I talk at meetings.”

Because of memory problems in recovery, it may be difficult to learn new skills and information. You learn skills by acquiring knowledge and building upon what you have already learned. Memory problems make it difficult to build upon what you have already learned.

Emotional Overreaction or Numbness

Persons with emotional problems in sobriety tend to overreact. When things happen that require two units of emotional reaction, they react with ten. It is like holding the “times” key down on a calculator. You may find yourself becoming angry over what may later seem a trivial matter. You may feel more anxious or excited than you have reason to be. When this overreaction puts more stress on the nervous systems than it can handle, there is an emotional shutdown. If this happens to you, you become emotionally numb, unable to feel anything. And even when you know you should feel something, you do not. You may swing from one mood to another without knowing why.

Sleep Problems

Most recovering people experience sleep problems. Some of them are temporary; some are lifelong. The most common in early recovery is unusual or disturbing dreams. These dreams may interfere with your ability to get the sleep you need. But they become less frequent and less severe as the length of abstinence increases.

Mike was a periodic drinker. Periods of sobriety usually lasted for several months. During the time he was not drinking, he had dreams that severely disrupted his sleep. His wife said, “I never realized the nightmares Mike was having had anything to do with drinking or not drinking. He would frequently jump out of bed, screaming in terror. When I was able to awaken him and calm him, he couldn’t remember what he dreamed, but he remembered being afraid. After a year of sobriety, he seldom had the dreams. Only then did I realize that they were related to his drinking.

Even if you do not experience unusual dreams, you may have difficulty falling asleep or staying asleep. You may experience changes in your sleep patterns; sleeping for long periods at a time or sleeping at different times of the day. Some of these patterns may never return to “normal,” but most people are able to adjust to them without severe difficulty.

Physical Coordination Problems

A very serious PAW problem – though perhaps not as common as the others – is difficulty with physical coordination. Common symptoms are dizziness, trouble with balance, problems with coordination between hand and eye, and slow reflexes. These result in clumsiness and accident proneness. This is how the term “dry drunk” came into being. When alcoholics appeared drunk because of stumbling and clumsiness, but had not been drinking, they were said to be “dry drunk.” They had the appearance of being intoxicated without drinking.

Stress Sensitivity

Difficulty in managing stress is the most confusing and aggravating part of post acute withdrawal. Recovering people are often unable to distinguish between low-stress situations and high-stress situations. They may not recognize low levels of stress, and then overreact when they become aware of the stress they are experiencing. They may feel stressful in situations that ordinarily would not bother them, and in addition, when they react they overreact. They may do things that are completely inappropriate for the situation. So much so that later on they may wonder why they reacted so strongly.

To complicate things further, all of the other symptoms of post acute withdrawal become worse during times of high stress. There is a direct relationship between elevated stress and the severity of PAW. Each intensifies the other. The intensity of PAW creates stress, and stress aggravates PAW and makes it more severe. At times of low stress, the symptoms get better and may even go away. When you are well rested and relaxed, eating properly, and getting along well with people, you will probably appear to be fine. Your thoughts will be clear, your emotions appropriate, and your memory all right. At times of high stress, however, your brain may suddenly shut down. You may begin experiencing thinking problems, inappropriate emotions, and memory problems.

If your thoughts become confused and chaotic or you are unable to concentrate, if you have trouble remembering or solving problems, you may feel you are going crazy. You are not. These symptoms are a normal part of your recovery and are reversible with abstinence and a recovery program. If you do not understand this you may develop shame and guilt which leads to diminished self-esteem and isolation which creates stress and increased PAW. It is a painful cycle that is unnecessary if you understand what is happening. As your body and your mind begin to heal and as you learn ways to reduce the risk of post acute withdrawal symptoms, productive and meaningful living is possible in spite of the very real possibility of recurring symptoms.

Recovery from the damage caused by the addiction requires abstinence. The damage itself interferes with the ability to abstain. This is the paradox of recovery. Use of alcohol or other drugs can temporarily reverse the symptoms of the damage. If alcoholics drink, or drug addicts use, they will think clearly for a little while, be able to have normal feelings and emotions for a little while, feel healthy for a little while. Unfortunately, the disease will eventually trigger a loss of control that will again destroy these functions.

For this reason it is necessary to do everything possible to reduce the symptoms of PAW. It is necessary to understand PAW and to recognize that you are not incompetent and you are not going crazy. Because post acute withdrawal symptoms are stress sensitive, you need to learn about PAW and methods of control when stress levels are low in order to be able to prevent the symptoms or to manage them when they occur.

Here are some stories about some people who experienced post acute withdrawal and how it affected their lives without their being aware of what was happening to them.

Ray is a young, single, recovering alcoholic. He stopped drinking when he was 22 and was very excited about the possibilities that lay ahead of him in his sobriety. After his initial treatment he began restructuring his life around recovery. He was eager to make up for the time he had wasted during his years of drinking. He got a full-time job, enrolled in college, and committed himself to doing some volunteer work.

After a while he began to notice that he was having trouble with his schoolwork. He found himself confused about things that had at one time been easy for him to follow and figure out. He was having trouble taking care of his financial responsibilities, and when people who cared about him tried to help him figure things out, he felt panicky and overwhelmed. Thoughts rushed through his head, and he was unable to put them in order. He says, “When someone in the financial aid office at the college started talking to me about grant money, loan money, interest, and forms that needed to be filled out, I was so confused and overwhelmed that I couldn’t hear what she was saying. Everything was going around in my head at once and I had to get away. I got up and left without filling out the financial aid form.”

In desperation, and out of fear that he would drink, Ray “ran.” Instead of evaluating what things in his life he needed to change and what he needed to hold onto, he gave up everything. He quit his job, dropped out of school, and stopped doing volunteer work. He gave up his apartment and moved in with a relative until he could “get himself together.” These actions created additional problems with which he found it increasingly difficult to cope. Until he went to a counselor and learned some ways to manage his symptoms, Ray thought he was having a nervous breakdown, when in fact what he was experiencing was PAW.


Excerpted From
Staying Sober – A Guide for Relapse Prevention and
Straight Talk About Addiction

Post-acute withdrawal symptoms are not the same in everyone. They vary in how severe they are, how often they occur, and how long they last. Some people experience certain symptoms; some people have other symptoms; some people have none at all.

Over a period of time PAW may get better, it may get worse it may stay the same, or it may come and go. If it gets better with time we call it regenerative. If it gets worse we call it degenerative. If it stays the same we call it stable. And if it comes and goes we call itintermittent.

Regenerative PAW gradually improves over time. The longer a person is sober the less severe the symptoms become. It is easier for people with regenerative PAW to recover because the brain rapidly returns to normal.

Degenerative PAW is the opposite. The symptoms get worse the longer a person is sober. This may happen even when a person is going to AA/NA and/or following some type of recovery program. People with degenerative PAW tend to become relapse prone. Sobriety becomes so painful that they feel they must self-medicate the pain with alcohol or drugs, collapse physically or emotionally, or commit suicide to end the pain.

A person with stable PAW experiences the same level of symptoms for a long period of time into recovery. There may be days when the symptoms are a little better or a little worse, but essentially the symptoms remain unchanged. Most recovering people find this very frustrating because they believe that they should be feeling better the longer they are sober. With sufficient sober time many people learn to manage these symptoms.

With intermittent PAW the symptoms come and go. Initially people with intermittent symptoms will appear to experience a regenerative pattern. In other words, their symptoms rapidly get better. But them they begin to experience periodic PAW episodes that can be quite severe. For some people the episodes get shorter, less severe, and farther apart until they stop altogether. In others they occur periodically throughout life.

These patterns describe people who have not had treatment for PAW and who do not know how to manage or prevent the symptoms. Traditional treatment does not address these symptoms because until recently they were unrecognized. If you know what to do and you are willing to do it, degenerative PAW can be changed into stable, stable into regenerative, and regenerative into intermittent PAW.

The most common pattern of PAW is regenerative and over time it becomes intermittent. It gradually gets better until the symptoms disappear and then it comes and goes. The first step is to bring PAW symptoms into remission. This means bringing them under control so that you are not experiencing them at the present time. Then the goal is to reduce how often they occur, how long the episode lasts, and how bad the symptoms are. You must remember that even when you are not experiencing them there is always the tendency for them to recur. It is necessary to build a resistance against them – an insurance policy that lowers your risk.


The less you do to strengthen yourself against an episode of post-acute withdrawal, the weaker your resistance becomes. It is like a tetanus shot. The longer it has been since you have had one, the more risk there is that you will become seriously ill if you cut yourself on a piece of rusty metal. Conditions that put you in high risk of experiencing post acute withdrawal symptoms are usually lack of care of yourself and lack of attention to your recovery program. If you are going to recover without relapse you need to be aware of stressful situations in your life that can increase your risk of experiencing PAW.

Since you cannot remove yourself from all stressful situations you need to prepare yourself to handle them when they occur. It is not the situation that makes you go to pieces; it is your reaction to the situation.

Because stress triggers and intensifies the symptoms of post acute withdrawal, learning to manage stress can control PAW. You can learn to identify sources of stress and develop skills in decision-making and problem solving to help reduce stress. Proper diet, exercise, regular habits, and positive attitudes all play important parts in controlling PAW. Relaxation can be used as a tool to retrain the brain to function properly and to reduce stress.


If you are experiencing post acute withdrawal symptoms, it is important to bring them under control as soon as possible. Here are some suggestions that may help you be aware of what is going on and help you to interrupt the symptoms before they get out of control.

  • Verbalization: Start talking to people who are not going to accuse, criticize, or minimize. You need to talk about what you are experiencing. It will help you look at your situation more realistically. It will help you bring internal symptoms to your conscious awareness. And it will give you support when you need others to rely upon.
  • Ventilation: Express as much as you can about what you are thinking and feeling even if it seems irrational and unfounded.
  • Reality Testing: Ask someone if you are making sense. Not just what you are saying but your behavior. Your perception of what is going on may be very different from reality.
  • Problem Solving and Goal Setting: What are you going to do right now about what is going on? You can choose to take action that can change things.
  • Backtracking: Think back over what has been happening. Can you identify how the episode started? What could have turned it off sooner? Think of other times that you were experiencing symptoms of PAW. What turned it on? What turned it off? Were there other options that might have worked better or sooner?

Education and Retraining

Learning about addictive disease, recovery, and post acute withdrawal symptoms helps to relieve the anxiety, guilt, and confusion that tend to create the stress that intensify PAW symptoms. As a recovering person, you need information in order to realize what symptoms are normal during recovery.

You also need to learn management skills so that you will know what to do to interrupt and control the stress and the symptoms when they occur. Through retraining you can improve your ability to remember, to concentrate, and to think clearly. Retraining involves practicing certain skills in a safe environment as you build confidence. It includes learning to take things step by step and to handle one thing at a time so you do not feel overwhelmed. It includes writing down what you want to remember and asking questions when you think that need to have something clarified.

Learning about the symptoms of post acute withdrawal, knowing what to expect, and not overreacting to the symptoms increase the ability to function appropriately and effectively.

Self-Protective Behavior

When all is said and done, you are responsible for protecting yourself from anything that threatens your sobriety or anything that triggers post acute withdrawal symptoms. Reducing the stress resulting from and contributing to the symptoms of post acute withdrawal must be of prime consideration for you. You must learn behavior that will protect you from the stress that might put your sobriety in jeopardy. This self-protective behavior is behavior that will enable you to be firm in accepting your own needs and not allowing other people or situations to push you into reactions that are not in the best interest of your sobriety.

In order to protect yourself from unnecessary stress, you must first identify your own stress triggers, those situations that might bring about an overreaction from you. Then learn to change those situations, avoid them, change your reactions, or learn to interrupt them before they get out of control.


The way you eat has a lot to do with the level of stress you experience and your ability to manage the symptoms of post-acute withdrawal. Poor health itself contributes to stress, and malnutrition contributes to poor health. You may be malnourished because of poor eating habits or because your body, damaged by alcohol or drugs, was unable to use the nutrients that you consumed.

Abstinence from alcohol and drugs will bring about some improvement but abstinence alone is not sufficient to rebuild damaged body tissue and maintain good health. New eating habits must be established and practiced regularly and permanently. Your daily diet should contain a balance of vegetables, fruit, carbohydrates, proteins, fats, and dairy products. Ask a nutritionist to help you figure out how many calories you need each day and what quantities of each type of food.


– Three Well-Balanced Meals Daily
Three Nutritious Snacks Daily –
– No Sugar and Caffeine –

Hunger produces stress. Try to plan your eating schedule so that you do not skip meals and so that you can have periodic nutritious snacks. Do not eat candy, donuts, soft drinks, potato chips, or other high calorie, low nutrient foods. You should specifically avoid foods that produce stress such as concentrated sweets and caffeine. Both of these produce the same kind of chemical reaction in your body as being frightened or overly excited. Concentrated sweets such as candy, jelly, syrup, and sugar-sweetened soft drinks will give you a quick “pick-up,” but you will experience a let-down about an hour later accompanied by nervousness and irritability. Remember that your reason for eating a snack is to combat fatigue and nervousness. Have a nutritious snack before you feel hungry to prevent a craving for sweets.

Jayne, a recovering alcoholic, was in the habit of eating a large quantity of ice cream every night. She often talked about the craving for it she felt, and believed that by eating it she was reducing a craving for alcohol. The next morning she always felt sluggish and irritable. Throughout the day her stress increased until it was relieved by the ice cream. When her counselor suggested that she remove the ice cream from her diet she felt she could not get along without it. When she and her counselor examined her diet they found that she ate no breakfast and was not getting adequate nutrition throughout the day. She agreed to try eating a balanced diet and to eliminate the ice cream on a trial basis. She discovered that when she ate a balanced diet and ate regular meals and several nutritious snacks throughout the day her craving for ice cream disappeared and she could easily eliminate it from her life.

Caffeine also causes nervousness and restlessness. It may also interfere with concentration and your ability to sleep. Loss of sleep or irregular sleep causes irritability, depression, and anxiety.


Exercise helps rebuild the body and keep it functioning properly while also reducing stress. Exercise produces chemicals in your brain that make you feel good. These chemicals are nature’s own tranquilizers to relieve pain, anxiety, and tension.

Different types of exercise are helpful for different reasons. Stretching and aerobic exercise will probably be most helpful for your recovery. Stretching exercises help to keep your body limber and to relieve muscle tension. Aerobics are rhythmical and vigorous exercises for the large muscles. Aerobics are intended to raise your heart rate to 75% of its maximum rate and maintain that rate for at least 20-30 minutes.

We recommend regular use of aerobic exercise. Jogging, swimming, jumping rope, and bicycling are common aerobic exercises, or you might want to join an aerobics class. Dancing can also be aerobic, but remember that it must be done vigorously.

Many recovering people will testify to the value of exercise in reducing the intensity of PAW symptoms. After they exercise they feel much better, find it easier to concentrate and remember, and are able to be more productive.

Choose a form of exercise that is fun for you so that you will stick with it. Most doctors and health books will tell you to exercise three or four times a week, but we recommend that recovering people make time for it every day because of its value in reducing stress. Any day that you do not exercise is a day that you are cheating yourself of a way to feel more relaxed, be more productive, and have more energy. Whatever exercise you choose, remember, do not over-do it! If it hurts don’t do it. The old adage “no pain, no gain” is not true for recovering people. Consistency and regularity are the key words for the recovering person.


There are things you can do to readily reduce or escape the stress you feel when you are unable to change a situation or to better cope with the stress of everyday living. Laughing, playing, listening to music, story telling, fantasizing, reading, and massage are some methods of natural stress reduction.

Playing is a necessary form of relaxation that is often neglected. It is difficult to define play because it is not so much what you do as how you do it. We all need time for having fun, laughing, being childlike and free. There are other “diversions” you can use as natural ways of reducing stress. Try a body massage, a bubble bath, a walk by yourself or with a friend.

Deep relaxation is a way of relaxing the body and mind to reduce stress and produce a sense of well-being. Deep relaxation can rebalance the body and reduces the production of stress hormones. What happens when you relax is the opposite of the “fight or flight” reaction. When you relax, your muscles become heavy, your body temperature rises, and your breathing and heart rate slow down. A muscle cannot relax and tense at the same time. It is impossible to maintain tension while physically relaxing. You can learn techniques to allow your body to relax. The distress resulting from thought process impairments, emotional process impairments, memory impairments, and stress sensitivity can be reduced or relieved through proper use of relaxation.

There are a variety of relaxation exercises that you can use. You can get a book that will offer you a selection of exercises or you can purchase tape-recorded exercises. You can close your eyes in a comfortable position and repeat a pleasant word over and over to yourself. Or you can imagine yourself in a soothing environment such as by a quiet lake or in a green meadow. Pick a method that is relaxing to you and use it often. You will find it a helpful aid for reducing stress and creating peace of mind and serenity.


Spirituality can be defined as “an active relationship with a power greater than yourself that gives your life meaning and purpose.” When you work a spiritual program, you consciously, actively attempt to become a part of something bigger, greater, and more powerful than yourself.

Belief in a Higher Power takes you out of the center of your universe and offers peace of mind and serenity by an awareness that there is a power that is not restricted by your weaknesses and limitations. Through spiritual development you can develop new confidence in your own abilities and develop a new sense of hope. It is through a spiritual program that you can reach with hope and a positive attitude toward the future.

In working on your spirituality it is important for you to use the principles of the AA/NA program. AA/NA provides guidelines for “increasing your conscious contact with your higher power.” You do not have to have any one image of your higher power to increase your conscious contact. You do have to be open to the possibility of a Higher Power and be willing to experiment with communicating with that Power. It is important to structure your life in such a way as to spend time alone each day to interact with your Higher Power. It is important to examine your values and look within yourself to determine whether your life is in harmony with those values.

Spiritual discipline is a consciously chosen course of action. Discipline is uncomfortable for many recovering addicts. They have lived lives of immediate gratification, and discipline is the reverse of that. The purpose of spiritual discipline is freedom from the slavery of self-indulgence. Spiritual discipline includes prayer and meditation, spiritual fellowship, and regular inventory of your spiritual growth.

Balanced Living

Balanced living means that there is bio-psycho-social-spiritual harmony in your life. It means that you are healthy physically and psychologically and that you have healthy relationships. It means that you are spiritually whole. It means that you are no longer focused on one aspect of your life. It means you are living responsibly, giving yourself time for your job, your family, your friends as well as time for your own growth and recovery. It means allowing a Higher Power to work in your life. It means wholesome living.

It means having a balance between work and play, between fulfilling your responsibilities to other people and your need for self-fulfillment. It means functioning as nearly as possible at your optimum stress level, maintaining enough stress to keep you functioning in a healthy way and not overloading yourself with stress so that it becomes counterproductive. With balanced living, immediate gratification as a lifestyle is given up in order to attain fulfilling and meaningful living.

Balanced living requires proper health care so that the body is functioning well. Nutrition, rest, and exercise all receive the proper focus in your life to provide energy, manage stress, allow freedom from illness and pain, combat fatigue, and rebuild a damaged body.

Freedom from physical distress allows psychological growth. When you feel good it is easier to think about your attitudes and values and to work on eliminating denial, guilt, and anger. Balanced living requires doing things to develop self-confidence and self-esteem and learning to feel good about yourself.

Balanced living needs a strong social network that nurtures you and encourages a healthy, recovery-oriented lifestyle. A healthy network provides a sense of belonging. It includes relationships in which you feel you are a valuable part. It includes immediate family members, friends, relatives, co-workers, counselors, employers, self-help group members, and sponsors.

Even after a couple of years of sobriety, Walter had times when he found it more difficult than usual to remember things, when he was more irritable and anxious, when he overreacted around his family and friends, when he felt confused and overwhelmed. His wife began to notice that he experienced these symptoms more on Saturday. What was different about Saturday? He usually slept later and had a couple of cups of coffee as soon as he got up, he began going over to visit his AA sponsor as early as possible. Together they drank coffee, ate donuts, smoked their pipes, and talked. Walter stayed until early afternoon, and by the time he got home and had lunch it was usually 1:30 or 2:00 in the afternoon. If one of his kids left a bike in the driveway or his wife was on the phone too long, he found himself overreacting and leaving the house. The rest of the day was totally unproductive because of what became known in his family as his “Saturday Syndrome.”

Walter decided to try some alternate activities to see if there was a change in his reactions. He started drinking orange juice as soon as he woke up instead of coffee. That helped, so he decided to try eating breakfast. That helped even more. He and his sponsor started drinking decaffeinated coffee and he skipped the donuts. He came home early enough to have lunch and to exercise for a while. He then felt like doing something with his family in the afternoon. They were all amazed at the disappearance of the “Saturday Syndrome.” 

A Quick Guide for Managing Post Acute Withdrawal (PAW) 

You can manage Post Acute Withdrawal (PAW) can be. Here is a quick-guide for the steps you need to take.

1. Accurate Information: Explain PAW and have the person do a self-evaluation of PAW and review the results. This will give them words and ideas to explain what they are experiencing. It will also help people to stop feeling crazy, judging themselves for having the symptoms, and being anxious and afraid because they don’t know what is happening.

2. Stress management: relaxation and meditation. PAW is stress sensitive. This means the symptoms get more severe when experience high stress and less sever under low stress levels.

3. Proper Diet: Have an alcohol and drug free diet. Eat a high protein, complex carbohydrate meal plan. The closest diet plan is is a hypoglycemic diet. Ask a nutritionist or look it up the internet. Avoid foods high in sugar and limit your caffeine intake. Supplement with multiple vitamins,Vitamin B-12, and broad spectrum amino acids.

4. Aerobic Exercise: At least twenty minutes per day at least there-days per week in a heart-measured aerobic zone. (Subtract your age from 220. 80% of that number is you minimal training zone. 80% is the max). Too high or too low don’t seem to help much.

5. A Recovery Program: Have a regular schedule of recovery activities that put you in places and around people who support your recovery and where you can honestly talk about yourself without judgment. It is also important to having a sponsor/mentor and therapist trained as an addiction professional.

These practices stabilize brain chemistry. Don’t leave PAW management to chance. Get a plan. Work the plan. If it doesn’t work, get additional help.

Please don’t spread the mistaken belief there is nothing that can be done to lower the severity PAW symptoms. THIS JUST IS NOT TRUE. The brain is plastic. It grows in response to experiences especially when stress in managed well during the experience.


Excerpted From
Staying Sober – A Guide for Relapse Prevention and
Straight Talk About Addiction

Learning To Live Again – A Guide For Recovery From Addiction by Terence T. Gorski 

Gorski Books – Gorski Training/Consultation/Home Studies



Questions About Spirituality In Addiction Treatment

December 4, 2013

I Need help with several questions:

1. Do current program Certification/licensing standards require that addiction professionals complete a spiritual assessment of each patient?

2. Are there standard questions for a usual and customary spiritual assessment?

3. Do master levels professionals receive formal training in comparative religions and the philosophical ideas related to spirituality?

4. Are current addiction and behavioral health Counselors, in you opinion, qualified by their training to do spiritual counseling?

5. Is Atheism, the fundamental belief that there is no God and make reason the guiding force in life really a religion is disguise?

These appear to be issues many people have questions. Please be concrete and descriptive in you answer .

This is a very important initial survey. PASS THE LINKS ON TO YOU FRIENDS!

Thank you.

%d bloggers like this: