This is a complicated question, and there are lots of confounding issues, so let's break it all down.
First of all, although going to rehab and following up with AA meetings is a very traditional path, they two concepts do not always go hand in hand. For example, an alcoholic could attend a religious based treatment program rather than a 12 step based program, and therefore they might follow up with church involvement and community rather than AA meetings.
Second of all is the issue of timing. There is a big difference between talking about someone with 4 days sober versus someone with 4 years sober. As we will see in a moment, timing makes a huge difference when it comes to this particular question.
I think what many people are really saying when they ask these types of questions is: Do I really have to go to rehab and AA meetings in order to get over my drinking or drug problem?
The short answer is yes, you do need to attend those things if you want to change your life.
The long answer is no, you don't necessarily have to go to meetings, or even to rehab, and there are exceptions everywhere. That said, I think that the answer that people really should hear in this case is something more like: If you have struggled even a little with alcoholism or drug addiction, then you should try to be open minded about treatment and AA meetings.
If you are still stuck in active addiction then your denial is keeping you stuck. That denial is clinging to all sorts of excuses as to why you cannot get clean and sober, or why rehab won't work for you, or why you went to AA once and it did not help and it only made you want to drink even more. All of those excuses and arguments are just part of your denial, and at some point you will come to realize that you are stuck in your addiction, you are completely miserable, and you do not know how to live a happy life any longereither with or without alcohol or drugs.
That is the point of surrender, and hopefully when you reach that point you will become willing to ask for help. Now the person who is posing the question Do I really need to go to rehab? is not in a state of what we would call total and complete surrender. If they were in that state then they would say something more along the lines of Please help me, I don't know how to live my life any more, I will do anything you tell me.
That is total surrender. Notice that they are not worried about what may or may not be suggested to them at this pointthey just want help. And the only thing that they know for sure is that they themselves do not have all the answers. They know that someone else has to show them how to live successfully. Their way has failed and led them to misery.
So in order to turn their life around, they need to surrender completely, ask for help, and then do what they are told to do. If they are to be successful at this point, they cannot be arguing about what will and will not help them, they cannot be pointing fingers or blaming others or worrying about where they will get help. They just need to listen and learn and be open about the help that they are going to get.
If you or your loved one is at this point of total surrender, or if they happen to still be stuck in active addiction, then what they need to do is to get help, probably go to treatment, and that will likely involve AA meetings. If the person is arguing against this in any way then that is a major red flag in itself. It is a red flag which is indicating this person is not in a state of total surrender yet. Which ultimately means that they are not truly ready for recovery yet, and therefore they probably have more drinking or drug use to engage in. They have not yet reached a point of misery that forced them to surrender completely.
Now in long term recovery, things are a little bit different. If you are in long term recovery then you have likely already surrendered and gone through some sort of treatment process. You probably have been to some meetings, you may have worked the steps with a sponsor, and maybe you see a therapist or a counselor regularly. You have been clean and sober for several months or a few years in this case, and you no longer have the immediate threat of relapse staring you in the face every single day. Sure, you could still end up relapsing..but that would be a process that unfolds over weeks or months, not over the next hour or two. The threat has changed from one of immediate triggers to one of complacency.
As such, once you are living in long term recovery, you no longer necessarily have to have the same cookie cutter recovery treatment as everyone else does. After a year or two sober your recovery could look completely different from other people in recovery. Sure, the basics might be meetings, therapy, and personal growth, but you no longer have to stick so closely to the recommendations at this point.
For example, there is a program of recovery that is based entirely on meditation, and another one that is based entirely on jogging. These two programs are very different from traditional 12 step programs or even the more common alternative of religious based programs.
But again, going to a meditation style program probably won't work for people who have 3 days sober. That person is still struggling and they need to connect with other alcoholics, they need to go to treatment, and they need to relate to others in early recovery along side of them. You don't get that kind of connection when you are in an exercise based recovery program.
When AA was founded it was revolutionary because it allowed alcoholics to relate to one another and get hope from that process of identifying as alcoholics with each other. This is an important concept in early recovery, but it becomes less critical if you are already well established in your sobriety. So again, some of this is all about timing. In very early recovery, you probably do need treatment, and you probably need a support system, whether that is AA or something else. In long term recovery, your program could look quite different, and you can remain clean and sober based on a lot of different kinds of personal growth.
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