by Tom Horvath, Ph.D., ABPP
There are multiple ways to experience any well-developed approach to addiction recovery, whether that approach is, for instance, SMART Recovery, a 12-step group or Stanton Peele’s PERFECT Program. In this article I present my observations about experiences in SMART Recovery. I acknowledge the foundation established for this article by The Varieties of Religious Experience: A Study in Human Nature by William James, and The Varieties of Recovery Experience: A Primer for Addiction Treatment Professionals and Recovery Advocates, by William White and Ernest Kurtz.
This article is written to help celebrate SMART Recovery’s 20th anniversary, and the annual conference last month in Washington, DC, celebrating that anniversary. The highlights of that conference, which included receiving a message from President Obama, delivered in person by “Drug Czar” Michael Botticelli, Acting Director and the Director Nominee of the Office of National Drug Control Policy, Executive Office of the President, are presented in a companion article, Celebrating 20 Years: What’s Next for SMART Recovery?
SMART Recovery® (Self Management And Recovery Training) is an international non-profit that offers free, self-empowering, science-based mutual help (support) groups and related services for individuals desiring to abstain or considering abstinence from any substance or activity. Unless announced as closed, meetings are open to the public. There are approximately 1300 meetings worldwide.
Let’s consider how someone might view the fundamental contribution of SMART Recovery to his or her recovery process, across several possibilities. These possibilities are not mutually exclusive. An individual might experience more than one aspect of SMART as crucial. What is crucial may also change over time. The purpose here is to reduce the risk that we will perceive someone as not experiencing SMART Recovery “the right way.” Rather, we can support that individual in SMART, regardless of her or his specific emphasis. There are as many roads to recovery as there are individuals.
1) The SMART Recovery Tools. Over the last 15 years SMART has evolved a rich set of “tools” for recovery. Currently, this primary list is:
Stages of Change: At present, what are you motivated to do?
Change Plan Worksheet: Change is not magic. It requires thinking ahead, and then actually changing your behavior (in small steps if necessary).
CBA (Cost/benefit Analysis): Are the benefits of your addictive behavior (whether it is a substance or activity) worth the costs?
ABC: If something upsets you, you can change how you think about it (the “B” in ABC)
A = Activating event (whatever happened, in the world or in your head)
B = your Belief, thoughts about, interpretation about what happened
C = the emotional or behavioral Consequence, not of A, but of B
ABC for urges: Urges (sometimes called cravings): 1) are time-limited (they go away, often soon); 2) don’t harm you (even though they are irritating and uncomfortable); and 3) cannot force you to engage in addictive behavior. Whatever you are seeing in your head (or telling yourself) needs to be tested against these 3 fundamental facts about urges.
DISARM (Destructive Images and Self-talk Awareness and Refusal Method): You can imagine the urge as something or someone attacking you in some way, and see yourself fighting back.
Hierarchy of Values: Are you living consistently with your values, or what you say are your values?
Brainstorming: Do you need fresh ideas about a problem or belief you have?
Role playing and rehearsing: Do you have an upcoming conversation that may be difficult? Could you benefit from practicing your part in advance?
USA (Unconditional Self-Acceptance): Do you accept that you have as much right to be in the world as anyone else? Do you treat yourself as well as you treat those you care about (or as well as you treat strangers)?
The Tools may be the most popular aspect of SMART. They suggest actions someone can take, and appeal to those wanting a self-empowering approach to recovery. These Tools keep evolving, and there are many additional secondary tools in use throughout the organization. For specific individuals, one or a few tools may be primary. The ABC and CBA seem to be most popular overall.
2) The 4-Point Program®: “We support 1) Building and maintaining motivation; 2) Coping with urges; 3) Managing thoughts, feelings and behaviors; and 4) Living a balanced life.”
The Tools are intended to fit under one or more of these Points. For many individuals the Points themselves provide the overview of the changes needed, and further detail about how to accomplish them can be provided by the individual.
3) The SMART slogan: “Discover the Power of Choice”
At an even higher level of abstraction, the slogan implies the Points and the Tools. Especially in later recovery, the Power of Choice may be the summary of an individual’s SMART Recovery experience.
4) Meeting and online discussions about Tools: The previous possibilities do not require meeting attendance or interaction with others online. The information about Tools, Points, and slogan can be gained by reading the SMART Recovery Handbook (available for purchase at the website; now in seven additional languages), reading the SMART Recovery website (at no charge), or obtaining a paid subscription to Overcoming Addictions, SMART’s evidence-based web app (available at the website), and completing its exercises.
However, for many, the Tools and other aspects of SMART Recovery only become fully alive through hearing stories about how other participants have applied them. In addition to face-to-face meetings, SMART also offers online meetings, a 24/7 chat and a Message Board with hundreds of participants each day.
One of the recent developments in SMART, designed to emphasize contributions from each participant, is the “round-the-circle” exercise. The meeting facilitator might say: “Let us do a ‘round-the-circle’ exercise based on the Cost-Benefit Analysis (CBA). Let’s start to my right. Say pass if you wish. Otherwise, tell us the biggest benefit you got from your addictive behavior (when it was good), and now the biggest benefit you get from abstaining from it. After we go around the circle we can discuss what we heard.” There are many variations of each Tool that can be used for these exercises, keeping the meetings fresh and bringing out different aspects of the Tools.
5) Sharing hope and support in meetings and online. For some, SMART is more about discussion, with the Tools as a minor backdrop. What is important is knowing I can tell my story and be accepted, that I get encouragement for my struggles, that people care about me and my progress, and that people care about me even when I’m not making progress. The meetings and the website become a “home” for me, a place of fellowship with other individuals pursuing a self-empowering approach to recovery.
6) The relationships that develop outside of the meetings and the website. Although the outside social aspect of SMART is relatively small, it is a growing aspect of SMART Recovery. Particularly in later recovery, friendships established in SMART may continue indefinitely, based in part on a common approach to recovery and a common language of recovery.
7) The website and the 24/7 access provided to like-minded individuals. Particularly in early recovery, knowing that there are dozens of people online at any time day or night (in large part because of the participation of UK and Australian participants) provides a sense of support that for some works better than having only one individual (such as a sponsor in a 12-step fellowship) to reach out to. Access to the website is now easy to accomplish from any smartphone.
In conclusion, just as there is no right way to recover from addiction, there is no right way to do SMART Recovery. I hope that the above ideas have illustrated the variability of recovery in SMART, and the richness of the experience it can offer.