Tuesday, April 10, 2012

The Pink Cloud

In AA and NA, people talk about the "pink cloud" - that period of time in early recovery when everything feels and seems good. The physical withdrawal has passed, so people begin to feel healthier, and more clear headed. They're not having many cravings, and become confident in their recovery. The losses that may have motivated them to recover have started to turn around - they can see positive changes in their relationships, life circumstances, and perhaps even opportunities. Recovery seems like a cake walk, especially when compared with the throes of a serious addiction. People may conclude that they have beaten the addiction, and become overconfident in their recoveries.

Unfortunately, the pink cloud invariably bursts. Life stops improving at the same rate it had been, or may even seem to be getting worse. The reality of the recovery process, with all of its related difficulties and discomforts, comes crashing down on the person. He or she realizes that life is still hard, and that recovery is a long-term commitment. People feel discouraged, and sometimes even resentful. Cravings increase, and the risk of relapse is high.

Although the idea of the pink cloud comes from substance abuse recovery, which is a unique physiological process, I think that the phenomenon is also psychological, and applies to recovery from a wide range of problematic behaviors. It is therefore something worth thinking about, whatever type of change we're helping clients to make.

Specifically, I think the pink cloud relates back to costs and benefits - of both recovery, and the problem behavior (i.e., the good ol' decisional balance). People usually become committed to recovery when the costs of the behavior, and benefits of recovery, outweigh the benefits of the behavior and costs of recovery. When they first change the behavior, this balance shifts. They experience relief from the costs of the behavior, along with the benefits of recovery (improvement in how they feel, relationships with others, and functioning in various life domains). Recovery seems clearly better and easier than continuing with the problem behavior.

However, after some time in recovery, the balance shifts again. Life doesn't continue to improve at the same rate it did initially, and the difficulty of change becomes more evident. The costs of change, in what the person has to give up to achieve it, as well as the discomfort of the process, are at the forefront. At the same time, the costs of the problem behavior feel more remote, and the person may begin to miss whatever benefits they derived from the behavior, leading to more urges to return to it. The pink cloud is gone.

The good news is that, if people can persist in their change efforts, they ultimately move into a balanced and stable part of the process. They don't return to the illusion that recovery is easy, but they regain their confidence and commitment, recognizing that recovery really is better than the alternative. This shift is a natural result of the costs of change lessening, and the benefits of change increasing.

Knowing that the pink cloud is a common part of the change process, which can - but doesn't have to - lead to relapse, what can we do to help our clients ride out the "storm?"

1) Educate them about the pink cloud and its aftermath, so that they know what to expect and can be prepared for the "crash."

2) Encourage them to persist in change efforts: highlight the benefits of change, and costs of the problem behavior, while assuring them that their current discomfort won't last forever.

3) When they first make a decision to change, consider asking them to write a letter to their future selves about what motivated them to make that decision. Then, have them read this letter when their motivation lessens, or they begin to glorify the "good old days" of the problem behavior.

4) Normalize slips as an expected part of recovery, and encourage clients to resume change efforts ASAP rather than letting a slip become a full relapse.

5) Keep track of the positive changes that have resulted from behavior change, and call attention to them when people begin to get discouraged.

6) ...what other strategies might you use?

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