Some years ago, I was facilitating a psycho-educational group for addicts, and a young man piped up with the question, "I keep hearing about hitting bottom—when do you hit bottom?" An older gentleman, whom I knew to be a frequent flyer (lots of turns in rehab) and whom I also (wrongly) assumed was just there for the ride, was sitting in the back of the room. His chair was tipped back against the windows of the porch and, with a baseball cap snuggled over his eyes he was enjoying the late afternoon sun. He responded in a soft voice, "When you quit diggin', boy."

Everyone's bottom is different, but I've found it often comes when the motivation for avoidance (anxiety, depression, trauma, or fear) is no longer more compelling than the consequences of continuing with the compulsion or addiction that is fed by that avoidance. Only then can you get up from rock bottom and get on the path to recovery from addiction.

Rock bottom is different for everyone

For some, rock bottom comes quickly

For one of my patients, bottom came when, after only a few years of drinking a bit more than he should have been (minimizing here), he got tagged for being intoxicated at work. He had undergone recent back surgery and was in a bit of pain, so he took half a Vicodin and washed it down with a small glass of vodka, to take the edge off the previous night's binge. A few harsh words to a colleague, an unsteady gate and he was asked to blow the whistle (Navy slang for taking a breathalyzer)—instant suspension.

Rather than continuing to dig, he checked himself into rehab, quit drinking and, by virtue of the experience and his own sense of himself, has gained a powerful perspective on his actions and their potential consequences.

Despite what amounts to only a brief respite from drinking, he is fast approaching a state of “past sober.” He is actually grateful for having taken the Vicodin, and even thanked the supervisor who called him on the carpet.

For others, rock bottom takes a long time to reach

For another of my patients, the loss of her husband, her children, a 4-million-dollar home, her Navy security clearances, and estrangement from both her father and her church hasn't even made a dent. She has yet to grasp that living in a $50 a week motel, turning tricks to support her heroin and cocaine habits, and traipsing in and out of rehab every few months is no way for a very bright, very pretty mother of three to be living. For her, the balance of behavior and consequence has yet to shift.

So, what is that balance? Yet another Michael Mantra—the longest distance in the world is from the head to the heart. We know all sorts of things. But it is only when we own that knowledge that we can act upon it. Until the balance of power between the motivation for our behavior and the consequences of our behavior remains with the motivation, we are just going to keep doing what we're doing to self-destruct.

How and why that balance shifts is something of a mystery—hence, the extremity of our examples. Sometimes it’s not such a mystery—and, usually, it involves loss—the loss (or potential loss) of a spouse, a job, or standing in the community. One young man I see, who has no drinking problem, voluntarily quit drinking (and smoking and getting high) after being pulled over with a DUI. For another person that I see, it took getting slapped with divorce papers—the three DUIs and year-and-a-half in jail for the third DUI didn't do it—for her to get sober. Go figure.

We need to own the consequences of our actions before we begin to recover from addiction

The bottom line is this—we need to own the consequences of our actions before we feel compelled to act and get up from rock bottom. Most of us know exactly what we're doing. We recognize that we shouldn't be killing a pint every night, or sneaking off to the casino on our lunch break, or looking at porn on the Internet while our partner is in the shower.

We understand our triggers, the rituals, and the patterns that accompany our various self-destructive behaviors; we can be a witness to all of it. But it is not until we place a value on the consequences of our behavior—a value that is greater than the motivation for that behavior—that we are motivated to make a change.

By the way, the older gentleman?  At the end of that session—and this is why I do this work—he stopped me and said, "You make a lot of sense, son. I think maybe I might put down the shovel this time around." I ran into him a few months ago sitting at the bar of one his favorite haunts in Westport, eating dinner. He was drinking a club soda, and there wasn't a shovel in sight.

© 2008-09 Michael J. Formica, All Rights Reserved