What is Organized Recreational Therapy and How does it apply to Substance Abuse?
Organized Recreational Therapy is a treatment tool for substance abuse that focuses on the recovering addict’s adaptation back into society. A majority of the drugs that are abused tend to cause the user to become introverted or distant from others that do not abuse the drug. When someone is addicted to drugs or alcohol, they tend to focus on making connections with those who are into the same things that they are.
Relationships with family and friends tend to diminish and as the addiction becomes the main focus of the person’s life. Their personality, hobbies, likes and dislikes become irrelevant compared to the anxiety and hunger to obtain more of the drug. This is where Organized Recreational Therapy plays an important part in the recovering addict’s treatment.
Organized Recreational Therapy focuses on:
- Helping the addict express feelings and communicate with their peers.
- Reprogramming the brain to release mood elevators during enjoyable activities.
- Help introduce the person to a social environment that is not influenced by drug use.
- Helps the person reconnect with themselves and develop hobbies, likes and dislikes.
Depending on the length of the addiction, the drug that a user is abusing has the tendency to ‘rewire’ the brain to obtain that drug above all else. The enjoyment of anything else tends to not be as exciting or as enjoyable as the drug the person is addicted to. One of the goals of drug treatment is to expose the addict to activities without the drug. Organized Recreational Therapy focuses on reconnecting the addict with themselves, others and the fun-loving child that exists within. These recreational activities can range from painting and drawing to BBQs or picnics.
Addicted Brain
When someone becomes addicted to a drug, they are addicted to the chemicals the drug supply the brain. The most common chemicals are dopamine, serotonin, and norepinephrine. These are mood elevators or ‘happy chemicals’ that the body naturally produces in small quantities. When someone does drugs they put a large amount of these mood elevators into the body, almost 10 times the normal amount the body actually makes. The euphoria of opiates, the rush of meth, the excitement in ecstasy; these drugs dump ‘happy chemicals’ in the body and because the brain does not waste resources making them itself, adapts to drug.
With continuous use of the drug, the brain develops a dependency for the drug and the chemicals it dumps in the system. The brain ‘learns’ that this activity, above all else, is the most rewarding activity and ‘rewires’ the brain to achieve the drug if at all possible. So normal hobbies that people enjoy become less rewarding to the body/brain, so the brain will refocus the person to go for the substance that gives the biggest reward.
Once the body detoxes from the drug, the brain has to be ‘reprogrammed’ to start making ‘happy chemicals’ again and to release those ‘happy chemicals’ during activities that actually bring joy or happy to the person.
When someone becomes addicted to a drug, they are addicted to the chemicals the drug supply the brain. The most common chemicals are dopamine, serotonin, and norepinephrine. These are mood elevators or ‘happy chemicals’ that the body naturally produces in small quantities. When someone does drugs they put a large amount of these mood elevators into the body, almost 10 times the normal amount the body actually makes.
Phase One: Day 1 to 45
When an addict is enrolled in an inpatient program they tend to spend their days waiting for group meetings and therapy sessions. They are given phase one privileges that limit their social involvement in group activities. Phase one focuses on activities like drawing, writing, constructing masks and other activities that help them express themselves without provoking anger of frustration. Since the body is not used to making their own ‘happy chemicals’ and releasing these chemicals, anger becomes one of the more easier emotions to convey. Anger, self-loathing, depression; these emotions will be easier to express in the absence of serotonin, dopamine, and norepinephrine. For the first 45 days the behavior and progress are monitored and through Organized Recreation Activities the therapist is able to get feedback about the addict’s progress.
Drug addiction can be introduced to someone’s life in the early developmental stages like 14 years of age. At 14 a person is still developing their identity, hobbies, and interests. If an addiction becomes the main focus, the brain has less time to develop a personality and more time focusing on obtaining the drug. Having Organized Recreational Therapy focuses the brain back to developing that personality.
Cards and Board Games:
These activities can easily be used to pass the time, however, in rehab these games are used to develop skills, social acceptable behaviors, problem solving, and chemical regulation in the body. For example games like monopoly, spades or gin rummy help the addict manage resources, make decisions based on resources available and develop skills and a desire to win. In the thrall of addiction, your mind is focused on obtaining drugs with two emotions the anxiety of not having drugs and the hunger to do whatever is needed to obtain that drug.
Drawing or Art:
These activities are very important. Many addicts going through rehab have suggested that they ‘get stuck in their head’. Which means that with all of the time they have waiting for meetings, their mind tends to dwell on what they have done, their cravings, their faults. This can cause relapse, and that is very dangerous for the brain when so much effort is focused on getting the addict away from the idea of taking drugs to pass the time or as a form of pleasure. Coloring mandalas (intricate designs), poetry, unfiltered writing, and journal writing are activities that help the addict get out of their head and stimulate the brain for healthier activities.
God Box:
Not all treatment centers practice the God Box within their group sessions, however, the concept of the God Box is usually introduced within the first 45 days of recovery. As the addict is becoming more focused on their life and the direction it is heading and less on the obtaining of the drug the God Box can be introduced. The God Box concept has the addict write down aspects of themselves that they would want to give up or what they give over to God. Often times these slips of paper entail the selfish thoughts and regrets they have accumulated due to their drug lifestyle. This then focuses their mind on the future, what they want for their lives and how achieving sobriety will get them closer away from what they don’t like about themselves or what they gave to God.
Music Therapy:
While music has been known to have therapeutic properties for centuries, music therapy is quickly becoming a legitimate evidenced-based practice. Studies have shown significant reduction in negative psychological, emotional, and even physiological symptoms in patients who experience music therapy. It generally takes form in two different venues: active music therapy and receptive music therapy. Within active music therapy, the therapist and the patient collaborate to either create or play pieces of music, generally as a way of expressing oneself, or coping with stress by placing attention into an activity that stimulates all parts of the brain. On the other side of the spectrum, receptive music therapy consists of the client passively listening to a piece of music, and mediating on how the music affects the individual’s psychological and emotional state. Within the context of substance abuse treatment, music therapy can be beneficial in the areas of emotional regulation, cognitive activity, and stress management.
Phase Two: 45 + days
Phase Two activities focus on the social aspect that needs to be developed. Having a strong bond with those working the program increases the success rate, but also illustrates appropriate behavior. Their life was once get drug from dealer, do drug, obtain more drugs, do more drugs. The brain rewards the individual in getting what they need and then the drug is consumed. Often times these drugs sedate the person or puts them in a state of mind that is unaware of those around them.
This phase also puts the recovering addict into situations where ‘happy chemicals’ should be released on a regular basis; again focusing on getting the brain back to a healthy level of regulation. For example, being in a group and communicating something to the group that makes them laugh provides a boost of ‘happy chemical’ rewarding the addict for causing joy or happy for others and not just self-satisfying joy that drugs can provide.
Physical Activities:
Physical activities like going to the gym and jogging is also used to help regulate proper brain function as well as focus on other things besides their cravings. Staying busy while in treatment and recovery is very important. Dwelling on the negative thoughts that addiction has on the brain can cause relapse and hinder progress. Keeping busy and social helps the person’s progress in recovery. Staying active releases dopamine and adrenaline in the body at appropriate times, regulates healthy brain function.
Sports or Group Activities:
Bowling, volleyball, baseball are group activities that encourages the brain to take action. During these activities those ‘happy chemicals’ play an important role. The fact that the addict is enjoying themselves while doing these activities is due to the brain supplying those ‘happy chemical’. The fact that the addict wants to win or be involved, ‘reprograms’ the brain to release chemical in the body for those type of activities that they are enjoying. These activities build teamwork skills, something that maybe was never important enough for the brain to develop.
Sharing the Message:
After treatment and during recovery the recovering addict may decide to go to hospitals or institutions and share the message of sobriety. For those still enslaved to their addiction, putting an end to their pursuit of obtaining drugs is a frightening thought as that has been their life for x amount of years. Those who are in recovery have found spiritual enlightenment in their sobriety and wish to share this message with those still suffering. Those who are following a 12-step program decide to do this towards the end of their steps. This is never forced upon someone who is recovering, this activity is based purely on the desire to educate others about a better life they can live without the drugs. Sharing their own experience, strength and hope is just as beneficial to the person who is sharing as it is to the people who are listening.
A Deeper Understanding: Addiction as a Three Part Disease
Spiritual Malady
When someone is diagnosed with the disease of alcoholism or addiction their spirituality is also affected. The person becomes so absorbed in their ego that they are focused on themselves and how to make themselves happy. They lack a moral compass in the decisions they make in pursuit of what makes them happy. Their satisfaction becomes the main focus in life and with addiction, drugs and alcohol are their only solution. Lying/stealing/manipulating to obtain what they need, lack of remorse for their decisions, and the violations against another to achieve their own happiness is irrelevant. If you have ever been around anyone who is addicted to drugs and/or alcohol you may hear them talk about feeling different. This different feeling is sometimes associated with a hole that they fill with drugs or alcohol.
With that belief system, negative feelings of remorse and shame will accumulate, driving the need for their addicted substance to unhealthy levels. This is when their drug becomes the crutch against those feelings of regret. Doing drugs alleviates those feelings, bringing about a false sense of ease and comfort.
How Does Treatment Address the Spiritual Malady?
Working the 12-steps helps break through their ego and sparks a shift in perspective in the addicts mind, brings a spiritual awakening that allows them to see a different perspective at which they are not the center. Integrating altruism into their lives helps those individuals continue the work of a selfless commitment instead of the selfish lifestyle they have grown accustom to.
Mental Obsession
Mental obsession can be defined as recurring thoughts or ideas that do not respond to ration or reason. Mental obsession is a unique form of insanity, and one that can manifest quite randomly and for no apparent reason. The obsession can lie dormant in an addict or alcohol until the most opportune situation where it will rear its demonic head. The mental obsession can manifest in two different ways, randomly or deliberately. When someone deliberately succumbs to the obsession, they are justifying it. When the mental obsession hits randomly, that is the very nature of the problem. Spontaneously going insane for no reason at all is why addicts and alcoholics have trouble staying clean and sober.
The obsessing also shows itself when random thoughts hit you, you seem to suddenly forget everything you know about your history with addiction. The fact that you cannot use normally, all the people you will hurt or lose, all the trouble you will get into, and the suffering that the drugs or alcohol have put you through. Irrational thoughts can quickly seem rational. We suddenly believe we can handle it this time, or this time is going to be different.
How Does Treatment Address Mental Obsession?
Educating the person about the 3 parts of this disease helps because they learn to identify that those feelings will not be solved by taking more drugs but can be alleviated through the concepts of the 12-step program. The 12-step program focuses on addressing those feelings and channeling a spiritual awakening to combat those feelings.
Physical Allergy
Having a physical allergy to their substance that they abuse is one of the harder parts of addiction to explain and can best be explain as the disease of more. When an addict has a physical allergy to a substance it is an abnormal reaction. Where someone who is not addicted to alcohol may have one glass of wine with dinner and be perfectly fine with that amount they consume. Someone who has a physical allergy to alcohol will not think about the one glass of wine but the others that are ‘needed’. They ‘need’ more as just one is not good enough. The thought of just one is never in their mind but the importance of they need more of it.
This disease of more is why a recovering addict cannot just settle with one as one will equal five to them. A normal amount that one will consume is never acceptable to one with a physical allergy to their substance, but how to, where to, can they obtain more becomes that force that drives their addiction to unhealthy measures.
How Does Treatment Address Physical Allergy?
The solution is in education and practicing and maintaining sobriety. In treatment the addict is educated about the 3 parts of disease, this education helps them identify if they have a physical allergy. Will just one drink, one toke, one bump ever be good enough for that person, if the answer is no then they must abstain from the drug period. They are taught that moderation is not the key for them and they cannot moderate their intake. The solution lies in being completely abstinent from the substance and doing so is the basis for practicing the 12 steps.
References:
Center for Substance Abuse Treatment. Treatment of Adolescents with Substance Use Disorders. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1999. (Treatment Improvement Protocol (TIP) Series, No. 32.) Chapter 4—Twelve-Step-Based Programs. Available from: http://www.ncbi.nlm.nih.gov/books/NBK64351/
Neukrug, E. (2011). Counseling theory and practice. Australia: Brooks/Cole, Cengage Learning.
