I’ve always been fascinated with the concept of time. It seemed to be an enemy, as there were so many things that needed completion and only so many hours in the day. On the other hand, I would have to wait for time to pass to move onto the next stage of a journey. It would seldom cooperate with me, moving either too quickly or too slowly. I would track time, attend to it, and be mindful of it as the most precious of resources. I even had a nice watch collection when I was young and built a grandfather clock in high school. Something about the precision and the inevitability of time was deserving of both reverence and a little fear.
I now see time somewhat differently, especially in regards to recovery and healing. The most important asset to anyone’s recovery is time. Through the 12-step community, a standard recognition for efforts in recovery is the receipt of a chip which will indicate length of time sober. We also pay attention to the anticipated length of time a patient will need in residential treatment. I care so much about the concept of time that I will often downplay the extensive groups, therapy, and programming we provide at the Center for Dependency, Addiction and Rehabilitation (CeDAR), instead emphasizing the structured holding center we provide to help them achieve clean and sober time. This process is very trusting in the ability of the brain to flex its fantastic neuroplasticity and adapt to sobriety. Of course, many patients require necessary medical and psychiatric interventions for them to reach stable sobriety, but even with mental illness and medical comorbidity, time is a vital ingredient.
Animal models will demonstrate a similar neurological process to humans as described by the extensive work of George Koob. He showed that mouse models will struggle with anxiety, agitation, and insomnia for the first 3 months of sobriety following a course of addictive substance self-administration. Most human patients with addictive diseases will describe similar phenomenon in early recovery. They will often experience the same triad of symptoms, and many will describe a perpetual sense of ‘not feeling right.’ This gets better, but it takes time. I use some of the animal model comparisons to demonstrate to patients that a natural healing process will take place and to trust in the ability of the brain. Functional neuroimaging studies will show remarkable differences between the 90-day mark and the first day of a person’s sobriety. Although the 12-step community wasn’t ‘imaging’ subjects when they coined the term ’90 meetings in 90 days,’ there is now neuro-biologic evidence supporting what they were promoting.
Time is the most important ingredient in recovery because with it comes possibilities. These are possibilities to build insight, establish new and healthy attachments, and stabilize in a safe way from the grip of an addictive process. There is no short-cut. If you are currently on a road to recovery, any time you have clean and sober is good time.