In the very beginning of separating yourself from who you had become, a person serving your addiction, this is an excellent admonition. Substance use had become automatic as it had morphed from self-medicating for pleasure, the search to feel normal, or relief from pain, into a survival strategy. Our very survival had become dependent on avoiding the physical and psychological distress of withdrawal. This drive to avoid withdrawal suspended all of the rules we may have lived by. The new rules became “I will do almost anything to get my drug”, the “compulsive drug seeking despite negative consequences” that is used as one of the medical model requirements to define SUD’s as a disease.
Survival Strategy: We have a built in, “hard wired” biological imperative to survive and procreate at all costs. The most primitive biological requirements are; air (3 minutes), water (3-7 days), elimination (5-7 days), sleep (4-5 days before hormone production begins to cease) and food (1-2 months), in that order. These are needs not wants, you will perish if you fail to provide them. The secondary part the “how to meet these needs” become strategies “software” acquired by interaction with the environment we were prisoners in (could you have survived on your own from 0-12 yrs. ?). This “software” is the territory of the biopsychosocial acquisition of “How will I obtain my biological necessities” i.e., strategies. Once addiction takes on the delusion that avoiding withdrawal is a survival strategy, we must develop new software programs to facilitate our new definition of survival .
How do I alter the new software program I created that bypassed my working memory (frontal cortex) and went directly to my amygdala (midbrain limbic system) as a survival strategy. The cue that withdrawal was imminent (I will die without it) or in the near future the new acquisition strategy of ” my drug at all costs” execute the strategies for drug acquisition.
Now that I have detoxed, decided to get and stay clean, how do I accomplish that goal? The spiritual and most common approach has been AA and NA because it is the least expensive, and been around the longest. It is usually associated with non-secular support and the removal of desire by resetting of your moral compass with the assistance of a ‘Higher Power”. If the desire has been removed what are the sequalae of removal that require reminding yourself that it isn’t permanently removed, apparently only put on hold for now? AA aphorism “What do you have left when a drunkard car thief gets sober?” “A sober car thief”. After the initial few months, the cues, internal conflicts, trauma are still there and the internal processes that prompted the need to self-medicate remain. Recovery without resolution of the precursors prompting the need to self medicate is not a cure. Equally important is the fact that the software you created to survive are still part of your skill set that became automatic.
Nothing you have learned is permanently forgotten. To become a non-addict you must replace the “addict thoughts, feelings and behaviors” with non-addict thoughts feelings and behaviors. You and your higher power did not permanently erase your addict skill set. The behaviors, thoughts, and feelings are still available hence the admonition one day at a time.
The Serenity Prayer says it Best: God grant me the serenity to accept the things I can’t change the courage to change the things I can and the wisdom to know the difference.
Change requires substituting new, prosocial behaviors, thoughts and feelings for your drug survival strategies. This requires adult (TA) monitoring of yourself, an assessment to be in the here and now (mindfulness).
“One day at a time” requires constant awareness, mindfulness. One day at a time can become hypervigilance prompted by fear. The part pf your autonomic nervous system is the sympathetic division (SNS), the fight flight, freeze, or fawn part. When it is on constant alert the hormone cortisol is not allowed to return control of the (SNS) over to the rest and digest
It comes down to this will you spend every day in fear or anticipation of success?