Chapter
1. Introduction to the Stages of Recovery:
An Interview with Barbara Whitfield, RT, CMT
and
Charles L. Whitfield, MD
© 2004 Charles and Barbara Whitfield
In this chapter Barbara Whitfield interviews Charles Whitfield about
the origins of his ideas and work using these recovery plans. He shows how
doing so can be personally empowering, and then discusses the role of using
spirituality in the process of healing.
[Ed. Remember that since these are interviews, these will require a
different kind of editing]
Origins
Barbara Whitfield: Even today (in 2003), books on conventional
medicine, psychiatry and psychology don’t mention stages of recovery
from any illness or problem. How did you discover these stages? And, how useful
are they?
Charles Whitfield: I came upon them when I watched, over time, how my
patients recovered. I discovered them slowly, over a 12-year span from about
1973 through 1985. At first I observed people with alcoholism and other drug
dependence as they were recovering. I noticed a number of things about them, including
how effective early intervention and treatment could be, but at the same time,
how commonly they relapsed. Many could stay abstinent from drugs and alcohol
for a long time, only to relapse months or years later. I asked myself, “why?”
Most of their relapses usually turned out to be due to a low participation
in a recovery program, or to their unhealed painful effects of trauma—or
both. I began to see how this early struggle for a successful abstinence from
alcohol and other drugs was only the beginning of healing for many of them.
In the mid 1980s I saw that identifying and expressing their pain that
was left over from childhood and later trauma helped a lot of these people. It
freed them from most of their stored toxic energy enough so that their relapses
lessened or stopped, and they started to feel and function better. So here were
the first two of the stages of recovery, Stages One and Two, unfolding in my
patients. These included getting an early recovery started and stabilized
(Stage One), and then if they chose, working at a deeper level of healing on
the almost universal finding of having bothersome effects of childhood and
other trauma (Stage Two). I outline these in Table 1, which reads from the
bottom-up.
Table 1. Recovery and Duration According to Stages
|
Recovery Stage |
Condition |
Focus of
Recovery |
Approximate Duration |
|
3 |
Human/Spiritual
|
Spirituality |
Ongoing |
|
2 |
Past trauma recovery program |
Trauma-specific
|
3-5+ years
|
|
1 |
Basic, Early Recovery from Stage 0 disorder |
Basic illness full
recovery program |
Months to 3 or more
years |
|
0 |
Active illness |
Usually none
|
Indefinite |
BW: Did these observations change the way you practiced as a physician?
CW: Yes, it did. Because I saw that this stage-oriented approach worked
well for many of my patients, I told others about using this kind of approach
as an option among their healing choices too. And among those who used it, most
of them got better. So this approach in stages was and is empowering. It gives
the individual more personal power. It also names and breaks down the
various parts of the recovery process, so that it is not so imposing or
overwhelming.
The first stage was to stabilize their illness, in these earlier cases
alcoholism or other chemical dependence. Then if they had a history of
childhood trauma – which it turns out most of them did -- and if they wanted to
heal from the effects of that trauma, they could do some deeper healing work
around that.
This sequence was not new. Some clinicians had used it already, even
though it was not clearly described in the clinical textbooks or journals. But
what I did that was new was to refine and describe the structure of the core
issues and the recovery tasks within each of these two stages. I
then wrote it all out in a reader friendly format so that my patients would now
have a clearer way to see and understand their recovery tasks and process.
Personal Power
BW: Did you do anything else that was different?
CW: I did. One thing that I’ve always found most helpful with patients
was to involve them as much as possible in the process of planning their
treatment. I knew that using a formal treatment plan and process was a
State requirement for any licensed addiction treatment facility. But it was the
clinician who had to write the treatment plan, not the patient. I
thought that that limitation took away some of the patient’s personal power and
may make it less likely for them to own it and follow its actions.
So I simply added a clear explanation of how to write one’s own
recovery plan. This used the same format as formal treatment planning,
which I had simplified for them in these guides. I added that to the
reader-friendly educational material that I had already outlined in writing for
them. I’ve refined it over the years, and that tested and proven version for
each of the recovery stages is what the reader now has in this book. Using such
an individualized recovery plan is empowering for the person. It gives them
more personal power and motivation for their recovery.
BW: How about core recovery issues? Does addressing them help?
CW: They do. They help in all 3 of these Stages. I list and discuss
them in each of the guidelines. Naming and then working through each of them as
they come up for us gives us a great healing advantage. Doing that gives us
still more personal power.
Spirituality
BW: In recovery from addiction we know that spirituality is an
important component. It helps the whole process work better. How did you
incorporate it into all this as a third stage, i.e. as Stage Three?
CW: By the late 1980s I had written the first draft of My Recovery
Plan for Stages One and Two. I had also already been talking about
spirituality regularly with my patients. We knew that there was really not a
separate stage that separated spirituality from the first two stages.
Spirituality was important and useful all the way – throughout
the entire recovery process.
But I noticed that many of my patients had a hard time with the
spiritual stuff. For various reasons, a lot of them had been hurt by some of
their experiences with organized religion. That, combined with their having
been abused by their parents and sometimes their teachers, had often left them
with a big issue of not being able to trust authority figures. It is no wonder
that they then had a hard time knowing and trusting perhaps our ultimate
authority – God.
I also saw that a lot of my patients did eventually find a
nourishing spirituality with and from their Higher Power or God, after
they were well-progressed in their Stage Two work. I believe that the main
reason for this is that by then they now know their real self, which I also
call the Child Within, so much better that they can now experientially connect
to God more easily. Our false self can’t know God authentically.
After finishing this Stage Two work, more of them had a kind of hunger
for the spiritual. They wanted more spiritual nourishment. Because of this, I
wrote out a third and final component of My Recovery Plan and called it
“For Stage Three.” I did that even though I knew that the whole journey was and
is spiritual. Even in Stage Zero, when we have not yet started recovery, we are
still spiritual seekers, although we may not know that yet, as Carl Jung
implied when he wrote to AA co-founder Bill Wilson in the 1930s.
On our life’s journey we are in one way or another asking ourselves
those perennial questions: Who am I? What am I doing here? and Where
am I going? A related question is How can I get any peace?
BW: With the importance and usefulness of AA in Stage One work, how do
AA’s Twelve Steps fit into this whole process?
CW: They are clearly useful from the start. And they continue to be
psychologically and spiritually nourishing throughout recovery Stages One and
Two. So they fit in appropriately and practically. That is why I have included
and emphasized them in the structure of these first two Stage plans in this
book. Because of their importance, I have also included the entire transcript
of the interview that we did on the Twelve Steps in this book as well (as
Chapters 5 through 9.
BW: What about Stage Two recovery? How does it fit in here? Can you say
more about that?
CW: Yes. Stage Two fits in as a crucial part of the whole process of
recovery. I also include an interview that I did with Dr. Lorna Hecker in 1999,
in which I describe some of the important features of Stage Two recovery work,
in Chapter 3.
BW: Which chapter is the most important for the reader to look at
first? Should they start with one of these three interviews? Or should they
read the material in each recovery plan first?
CW: I don’t think it matters where a person starts. Reading any one of
these first prepares us for reading another. I do recommend that a person focus
on the section that addresses their particular sequence in their own recovery
right now. For example, if you are just beginning recovery from any illness
now, then I suggest that you focus your reading on the Stage One material. If
you have finished most of your Stage One work—i.e., your original illness or
problem is well stabilized for at least a few months, or preferably a year or
more (unless you’ve been relapsing), then you might consider looking at the
Stage Two material. The questions and answers on the Twelve Steps (Chapters
5-9) can be read almost anytime during any of the recovery stages.
BW: What about using this stage-oriented approach to healing from other
illnesses? Are addictions the only ones where they are useful?
CW: After using them with patients --who had various problems and
illnesses -- for over 15 years now, I believe that these stages are mostly
generic in their application. They are useful in healing from depression, anxiety
problems, and most of the other psychological disorders. They can also be
useful in helping to heal from some physical illness, if childhood trauma is in
the history and/or if the person is a spiritual seeker.
BW: So if someone has migraine headaches and is being treated by their
physician in a Stage One fashion, Stage Two work could address their pain on a
deeper level if they had a history of trauma. Is that right?
CW: Yes. I describe some of the documented links between physical
illness and childhood trauma in The Truth about Mental Illness.
BW: Thank you for answering these questions for us.
CW: You are welcome. And thank you for asking them. I hope they will
help all who are seeking better ways to heal.