This two-column series addresses specific considerations in applying the wellness and recovery model to the growing number of older clients seeking treatment for addictive disorders. The previous column highlighted application of nutritional foundations for recovery, fitness and recovery and conquering nicotine addiction. This column focuses on the qualitative aspects of recovery—including life satisfaction and central purpose—as they apply to this growing segment of the treatment population.

Loss and social isolation
Loss and grieving are predominant components in the lives of many older people. Loss associated with aging takes many forms, including: loss of one’s career focus accompanying retirement; loss of one’s central identity as a parent as children leave the home; loss of a sense of youthfulness and vitality enjoyed in earlier years; and loss of one’s spouse or primary partner, other relatives and close friends due to death.  

Loss is recognized by social scientists as a precursor to distress, depression and many forms of illness, and has even been implicated as a factor in premature death (Hafen, et al, 1996). In a study of 42 consecutive patients admitted to the Rochester Memorial Hospital with a wide range of medical problems, Schmale found that 31 patients—approximately 75 percent—developed their disease within one week of the loss of a loved one (Dossey, 1991). Researcher Steven Schleifer based at New York’s Mount Sinai Hospital estimates that 20 percent of all people who die within a year of losing a spouse die as a direct result of the loss (Lynch, 1977).  

Many older persons are also plagued by an acute sense of social isolation. Men, in particular, are often devastated when they retire and relinquish their occupational roles and social supports at work. Likewise older men, more so than women, often encounter severe social isolation following the death of their spouses. Older women often suffer isolation and loss of identity associated with the “empty nest syndrome”; this isolation can be exacerbated if they are geographically distant from their grown children and grandchildren.  

The severe sense of social isolation that characterizes the lives of many older people can trigger excessive drinking and drug use, including overuse of prescribed medications, especially pain medication. At the same time, these problems are often difficult to detect as these persons are cut off from the mainstream as a consequence of their isolation.

In recognition of the loss, grieving and isolation issues confronting many older patients, primary treatment and continuing care programs need to place special emphasis on actively assisting these patients to forge connections with healthy, nurturant social networks that are supportive of ongoing recovery. This is especially true in reference to social engagement that fosters the qualitative aspects of recovery, particularly maintaining a positive outlook on life and living each day to the fullest. Such involvements can include: participation in 12 Step programs or one’s chosen recovery focused support group; structured exercise programs, such as walking, hiking and biking clubs, yoga, etc.; involvement in one’s chosen religious or spiritual community; part-time employment; and sharing life experience with others through mentoring younger people and other volunteer service.
To the extent that treatment and continuing care programs are able to actively assist their patients in breaking the cycle of despair and withdrawal associated with loss and social isolation, these patients will be motivated to anchor themselves in quality sobriety while acquiring valuable coping mechanisms to safeguard against relapse.

Life satisfaction and striving for an integrated life
In the classic text, Relapse Prevention, Marlatt emphasizes the critical link between life satisfaction and reduced likelihood of relapse (Marlatt, 1985).  Unfortunately, many older persons with addictive disorders experience low levels of life satisfaction due to loss, grieving, isolation and a general absence of joy in their lives. Treatment professionals working with this population are challenged to motivate their clients to work through loss issues that are holding them back from pursuing truly fulfilling lives.

In my book, The Wellness-Recovery Connection, and in my trainings, I like to refer to central purpose as the royal road to health and longevity. I have always been fascinated by the fact that throughout history, people who have left their mark on the world have enjoyed life spans far in excess of their contemporaries. I am also convinced that there is a strong link between fulfillment and successful sobriety maintenance. Simply stated, I believe that when we feel good about what we are doing, we are motivated to take care of ourselves, work our recovery programs and fully embrace the joy of recovery!  

All too often, older people succumb to the stereotype of aging as a progressive process of deterioration. They become risk adverse and
create self-imposed barriers that block them from fully pursuing their dreams. To counteract this inertia, counselors need to serve as cheerleaders in encouraging older clients to bolster their self esteem through uncovering—and actively pursuing—their heartfelt dreams.

I firmly believe, for example, in actively encouraging older clients to break free from conventional stereotypes and embark on exciting new careers and ad vocations that reflect their true values and ­aspirations.

Counselors also need to be attuned to profound shifts in our concept of central purpose that can occur as we grow older. For example, when I retired from my day job, I had a burning desire to launch a new career as a self help writer and speaker. While this continues to be an important focus, I find myself increasingly drawn to other areas of life.   These include a passion for hiking in the desert, singing and drumming (I’m a wannabe jazz vocalist), and focusing on deepening the bonds of love and joy in my marriage to Ann. Concurrently, inspired by the breathtaking beauty that surrounds us, Ann has thrown herself into creative photography and creating expressive DVDs.  

Counselors working with older clients should encourage them to pursue fully integrated lives. This entails striving to create that elusive quality of balance in our lives, together with enhanced self esteem and joy in living. We need to actively motivate our clients to embrace long forgotten dreams involving creativity, giving back and other fulfilling pursuits. Among other things, creating an integrated life in our later years involves opening up to a deepening attunement to a sense of calling, together with a profound awareness of the importance of developing mutually nourishing relationships with both our higher power and our fellow travelers on this planet.

In conclusion, applying the wellness model to older patients suffering from addictive disorders poses special challenges and opportunities to treatment professionals. As always, feel free to share these columns with colleagues and clients who may benefit from these thoughts. Until next time—to your health!    

References
Dossey, Larry. (1991). Meaning and Medicine: A Doctor’s Tales of Breakthrough and Healing. New York: Bantam Books.
Hafen, Brent Q. et al. (1996). Mind/Body Health: The Effects of Attitudes, Emotions, and Relationships. Boston: Allyn and Bacon.
Lynch, James J. (1977). The Broken Heart: The Medical Consequences of Loneliness.  New York: Basic Books Inc.
Marlatt, G. Alan & Judith Gordon, eds. (1985). Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors. New York: Guilford Press.
Newport, John. (2004). The Wellness-Recovery Connection: Charting Your Pathway to Optimal Health While Recovering from Alcoholism and Drug Addiction. Deerfield Beach, FL: Health Communications, Inc.

John Newport, PhD, is an addictions specialist, writer and speaker based in Port Townsend, Washington. He is author of The Wellness-Recovery Connection: Charting Your Pathway to Optimal Health  While Recovering  from Alcoholism and Drug Addiction, and is currently completing a Wellness and Recovery Workbook Series in collaboration with the Gorski-CENAPS® Corporation.  For further information on The Wellness-Recovery Connection, visit www.wellnessandrecovery.com. For information on the Wellness and Recovery Workbook Series, visit www.relapse.org.

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