Four weeks of rehab is a good start, but can’t reorder the lives of people who have spent decades looking to drugs and alcohol as the solution to their every problem. So rehabs stress that patients’ ties to treatment facilities must continue well beyond discharge. Most recommend continuing care through once-a-week Aftercare sessions and Alumni meetings, group therapy sessions led by a counselor which return you to treatment a couple times a week. These groups are extensions of the rehab’s therapeutic community.
The tenor of these sessions is different than in-patient therapy because rather than living in the safety of a treatment facility, one lives in the world facing all the daunting daily challenges of early sobriety. The issues in Aftercare revolved around early sobriety in our daily lives: the struggle with cravings, working the Steps with a sponsor; trying to find a balance between work, family and sobriety; negotiating a completely different sober relationship with families and friends; how to travel and remain sober; and, of course, relapse.
Though one of my buddies relapsed in mid-treatment (after he switched from in-patient to out-patient at the insistence of his insurance company), he was the only one who did. By contrast, a significant minority of my Aftercare fellows, including me, relapsed at some point during the year-and-a-half I attended. Two died from heroin overdoses the first time each relapsed. Those deaths and relapses where my friends survived were tremendous learning opportunities (for more click on Can Relapse Be A Good Thing?)
The alumni group was a wider circle of experience, including those with long-term sobriety as well as people straight out of treatment. It was a “check-in” meeting, an opportunity for people to report on things that impacted their sobriety that week. Anyone who relapsed was encouraged to admit and talk about it and it wasn’t uncommon for meetings to start with such confessions. Then the floor was open for anyone with a “burning” issue to bring up.
Unlike AA meetings, where “cross-talk,” or commenting directly on what another says, is uncool, the alumni meetings encouraged such feedback. It was supposed to be done tactfully, though this was often ignored in practice, and you weren’t to give guidance so much as cite your experience with a particular problem, like how you’d handled your first sober cocktail party.
The Alumni meeting was a very safe place to discuss the problems of new sobriety, just like what I ultimately found at AA meetings. This was made clear at one of my earliest alumni meetings where the topic was drinking dreams. Still not completely sold on opening up, I didn’t tell anyone that I’d been dreaming about drinking, certain that admitting it could do nothing but harm. Wasn’t the staff knocking me about denial? Wasn’t dreaming of drinking like a normie proof I wasn’t willing? Wouldn’t that mean they’d come after me with even more of a vengeance?
At the Alumni meeting, however, without even saying anything I realized my fears were misplaced. Someone said, “I’ve been having drinking dreams again.” Even before she could finish the sentence, all the grins and guffaws proved the room had an easy familiarity with drinking-and-using dreams. People loved to talk about how weird their dreams were. Some, like me, dreamed they were transformed back into acceptable social drinkers. Others had wild bingeing dreams with rooms full of bottles waiting to be consumed. A few told terrifying tales of dreams where drinking no longer had any medicinal effect, of frantically chasing down one kind of drug after another, searching for one that worked. The crack smokers dreamed of piles of rocks bigger than themselves while heroin addicts dreamed of needles — needles in their body, needles flying through the sky, syringes stabbing syringes.
What I learned from the discussion was my dreams were normal and nothing to worry about. Everyone had them and it didn’t mean you were going to drink, the universal fear. Talking about them defused some of their power. Most importantly, I learned the value of the group and its collective experience. I realized that if I shared how I felt I’d probably find that what I was going through was not only entirely normal, but utterly predictable. And I edged slightly closer to understanding that an Alumni meeting was a safe place, no matter the issue.
Aftercare and the Alumni meetings were crucial because they kept us close to the hospital, our drop-in center for sanity. Both were instrumental in maintaining sobriety for my friends and me.