Drinking health - harm. Although this phrase sounds beaten, nevertheless, it is true. Imagine the absurdity of the situation, when a person spends money on alcohol, then he spends money to learn not to drink alcohol.

Represents a table of phases of alcoholic recovery according to the organization of "Anonymous Alcoholics" to familiarize yourself with all interested parties for self-control.

1. Phase "Failure" (0 -15) days

PROBLEMS	POSSIBLE SOLUTION	MY DECISION
Medical	Visit to specialist
State of abstinence	Observation of signs
Depression	Physical exercises
Mood swings	Visit to psychotherapist
Sleeping attacks	Determine the time to relax and sleep
2. Phase "honeymoon"(16-45 days)
PROBLEMS	POSSIBLE SOLUTION	MY DECISION
Recycling (workolism)	Planning time
Insomnia, anxiety	Physical exercises
Excessive self-confidence	Obtaining knowledge of illness
Loneliness	AA

3. Phase "Wall" (46-120 days).

This is the hardest phase of sobriety. During this period, the most frequent breakdowns. Most people have this phase from 30 to 60 days from the date of refusal to surfactant. In this phase you can feel discomfort physical and psychological. It is important to distinguish this phase and clearly understand that while preserving the abstinence, poor health will pass, and you will achieve progress in the process of recovery. "Wall" is part of this process and proof that you will feel better.

PROBLEMS	POSSIBLE SOLUTION	MY DECISION
Apathy, depression	Physical exercises
Attempt to return to use	Contact with sponsor
Inability to organize your life	Planning time
Loneliness, Tosca	AA \\ An.
Family difficulties	AA, AN, Al-Anon, al-Atin
Mood swings	Visit to the therapist

"Wall" is characterized by various signs: depression, anxiety, decay of forces, fluctuation of mood, reluctance to bring to the end, a sense of alcohol \\ narcotic hunger, unwillingness to be treated, cessation of treatment, memories of the past, surroundings, rejection of AA \\ AN, Care with Meetings, lack of interest in sobriety, feeling of loneliness, isolation, cessation of exercise, inability to organize time, returning to old habits, sense of hopelessness. No clear thinking. .

4. Phase "Adaptation"(120 – 365 days)

PROBLEMS	POSSIBLE SOLUTION	MY DECISION
Yearning	Intellectual and spiritual development
Dissatisfaction with work	Self-education
Ambiguity of goals in life	Determination of clear goals and clear landmarks
Excessive self-confidence	Group aa \\ en
Difficulties in communication	Aa \\ en, training adaptability
Guilt	Family therapy, 4-5 steps of the AA \\ An

In any phase of stabilization of recovery from time to time, "pitfalls" come across. The collision with them can lead to the return of use. But it is important to understand that none of those people who have already passed the way of recovery, did not escape the clashes with them.

Staying soberly helped them:

• 1. Confidence that these signs should be personally
• 2. Knowledge that these signs are signs of recovery
• 3. Understanding. What is it overcome if there is a desire to overcome

The process of recovery from chemical dependence, as well as any other disease has its stages, stages, tasks.

What is recovery?

Recovery is a consistent life in which there is no need to use psychoactive substances. Sober and cleanliness is something more than the restoration of the destroyed spheres of life. This is a new lifestyle, thinking that contributes to the continuous process of personal growth. The recovery process is a process, it is never committed for anyone in one day, it is a long process passing through certain stages and stages. The evolutionary model of recovery implies growth through movement and change. These are consistent efforts to master new skills and skills. We can get well, starting with simple abstinence and achieve a comfortable sobriety filled with meaning.

The recovery process is based on a number of certain concepts:

• Recovery is a long-term process.
• Recovery requires complete abstinence from psychoactive substances of any character
• There are basic principles that control the recovery process to which the program "12 steps"
• The deeper and more honest we accept and apply these principles, the easier it is to get to us
• Only understanding does not lead to recovery. It is necessary to apply new knowledge in life
• Success in recovery depends on how a person can cope with these challenges that are found on its path without consuming psychoactive substances.

The recovery process passes through a number of stages.

Transitional Stage

At this stage, a person is thinking and begins to realize that he has serious problems associated with the use of substances (drugs, alcohol, etc.). There is awareness that it is impossible to continue.

Stabilization stage

The fact of your illness is recognized, acceptance of responsibility for their recovery, recognition of the need to do something.

• Stage of early recovery

The process of internal changes occurs. At this stage, the dependent learns to feel comfortable in sober life. Physical traction gradually passes. The dependent begins to learn more about the specifics of the nature of the disease, acquires the ability to solve problems without consuming chemicals. This stage ends when a recovering dependent in practice applies what he learned by working under the program "12 steps".

• Stage of medium recovery

At this stage, there is a revaluation of relations in the family, with friends, compensation for damage caused to the "past" life. The step of medium recovery ends when stability and balance appears in the lifestyle.

• Stage of late recovery

solves three important tasks:

1. The definition of problems that arose in adulthood, as a result of education in a dysfunctional family.
2. Getting rid of the complexes that appeared before the chemical addiction developed.

• Stage of maintaining sobriety and purity

This period is accompanied by personal growth, daily work under the recovery program.

Main goals

• Transition stage. Refusal to attempt to control the use.
• Stage stabilization. Restoration of the body from the effects of use.
• Previously recovery. Internal changes in thinking, feelings, actions regarding the use and lifestyle.
• Average recovery. External changes, restoring damage to life caused.
• Later recovery. Overcoming children's complexes, zero and disadvantages.
• Maintain sobriety. Balanced life, personal growth and development.

The stage of recovery from the dependence on T. GORSKI.
Gorsky, using its own experience of clinical observations and therapeutic work with drugs dependent on drugs and alcohol patients, offers the following stages of recovery from addiction based on understanding of motivational readiness to changes. This understanding allows you to more carefully and adequately plan the collaboration of the therapist with a dependent person.
1. Transient (transient) stageit begins when the personality acquires a negative experience of drug addiction and drug use problems. At this time, the dependent person begins to accidentally try to establish control over the use. Attempt
establishing Control either changes in their own
situations related to drug use in any way -
fundamental symptom intraxichesky conflict dependent
person related to personal identity problem.
Drinking drugs loses in this stage the illusory faith in the fact that it is a normal person who can control his behavior and drug intake. This happens as a result of the fact that all attempts to prove to themselves and other opportunities to control drug use are unsuccessful. The main reason for the impossibility
stop the use of drugs in the transient stage -
illusory faith in what exists a path to controlled consumption.
2. Stabilization stabilization.During the stabilization stage, which comes when the dependent person comes to understanding the need to completely and finally stop using drugs and stops him, the patient is experiencing the abstinence and is faced with a number of medical problems that he needs to decide. In the same time, he studies how to cope with the mental state associated with the need to immediately get a drug.
At the same time stabilizes the crisis of motivating the treatment of medical care and recognizing themselves to patients. Patient learning to identify symptoms and manage them. Narcologists often underestimate the need to help the patient in the management of these processes, focusing exclusively on detoxification and drug therapy. The patient feels unable to cope with stress and symptoms of dependence after detoxification, which prevents the recovery process.
The pronounced stress, the inconsistency of psychological and social support and stress-overcoming behavior, peculiar to the patient drug addicts impede the effectiveness of attempts to cope with the symptoms. At this stage, return to drugs in order to remove the Disteres. This period lasts from 6 weeks to 6 months. At this time, the patient must be cope with the symptoms, both with the help of corrective therapy and independently. The main reason

the impossibility of abstinence from drugs during the stabilization period –
weakness of the skills to overcome stress from their condition management.
3. Related period of recovery.The early period of recovery denotes the need to establish a vital style free of drug use. Recompusants should learn to understand the nature of their dependence and the recovery process. During this period, it is necessary to stop all sorts of contacts with persons who use drugs, and begin to build new socio-supporting links necessary for the long-term recovery process. This is usually a very difficult time for patients with addicts, which may never have durable ties with people who are leading life-free life. In this regard, throughout this period, recovering must be included in the therapeutic environment and psychotherapeutic programs of cognitive development and change, as well as emotional and behavioral training. This period lasts from 1 to 2 years. Main
the cause of the breakdown on the length of the early recovery period
is the poverty of social and psychological skills overcoming
life stresses and socio-supporting environment, skills
recovery (overcoming the disease) required for construction
free from life-style drugs.
4. The time of recovery period.During the late period of recovery, the person continues to form changes in the direction of development of drugs free from drugs, an effective life style. In traditional psychotherapy, this process is indicated as self-actualization. This is the process of reassessment of values \u200b\u200band goals that arise in connection with the adaptation to the social environment (family, the environment of peers, cultural, professional life). During this period, you have to revise many values \u200b\u200band goals and form new ones.
Many recovering these processes become most relevant for 3-5 recovery. Patients addicts the experience of such crises may cause a return to drug use. The process of self-affirmation and self-determination can be very painful, since it did not occur in a timely manner in a timely traveler and the logical age dynamics is rudely broken.
Rather, on the contrary, self-deepening behavior, originating the beginning of the psychological processes that occurred in childhood, such as physical, sexual or psychological and social barriers that existed on personal growth or other psychological and social barriers were formed. The main reason for the breakdown in the late period
recovery is the lack of skills to cope with stress
having deep origins in unresolved childhood problems and
adolescence, in the problem-avoiding behavioral style formed
as a result.

5. Presentation
stage.
The supporting stage of the recovery process is personal growth and long-term development. It includes overcoming the problems of late growing and managing everyday life problems. The use of any psychoactive substance, whether it is a drug or alcohol, resumes pathophysiological, pathopsychological and social progression of the disease. The main reason for breaking throughout supporting
the recovery stage is to stop performing supporting
programs and meeting on this background with large life changes.
6.To in recovery. Although some patients successfully overcame the stage of recovery without complications, most people dependent on drugs still face serious problems on this path. Typical error of these people is
"Point laying" in the process of recovery when the patient can decide that it is already healthy. Usually this step is associated with a weak development of premiere-over behavioral behavior, low self-competence, which leads to the termination of the implementation of the recovery program. Risk factors on this path are unexpected clashes with physical, psychological and social problems, reduced development strategies for the search for social support and not the development of a socially supporting network. Without the constant development of specific skills of the prevention of breakdown, work on identifying problems and self-identification (the basis of motivational work) The pressure of stress begins to grow.
The result of the ineffectiveness of overcoming multicomponent and chronic stress addiction is a breakdown.
Conclusion.
Motivational counseling is a work method that can be used only if its principles and the essence are understood.
An important role is played by an understanding counseling as a process.
Of course, technical aspects should also be differentiated. The way the therapist learns to use the method is directed mainly to understanding the relationship between the patient and the therapist and the ability to create a working atmosphere. Lightness, depression and lack of prospects for the future are strong incentives to continue using surfactants. The sense of social insecurity, tested by patients, is difficult to change.
Therefore, many patients suffering from severe dependence, weakly believe in therapy. For the therapist, the patient's dependence is, on the one hand, a trap, and on the other, an interesting task, consisting to change to a certain degree, the own responsibility and determination of the patient in the process in which they enter together.
Many patients during a difficult change process are several times interrupted by therapy. Maintaining faith in the ability to change and especially the preservation of faith in people supports therapists and inspires them in search of a possible solution to the problems of their patients.

If a person who assists consumers to consumers is influenced by public opinion, we will get the situation that it is best to describe how secret assistance to second-rate citizens.
Motivational counseling helps therapists to avoid this attitude towards their patients. A real interest in dependence and to a person suffering from addiction or a risking to be subjected to her, and the corresponding participation gives the addiction to persons a chance for a normal existence.
Colleagues support in this form of work is indispensable. Supervision and team relations are tools to maintain their own motivation and aware of their own relationships and opportunities.
Literature:
1. Austie: Motivational Interviewina. Guide to motivational consulting. Council of Europe, Pompidou Group.
2. GERDNER A. Lectures. 2000 - 2001
3. PROCHASKA J., Diclemente C., & Norcross J. In Search of How People Change:
Applications to addictive behaviors. American Psychologist 47: 1102 - 1114,
1992b.
4. Miller W. R. Motivation Enhancement Therapy: Description of Counseling
Approach. Approaches to Drug Abuse Counseling. Nida. Printed July.
2000. P. 99 - 106.
5. Rollnick S., Mason P., Putler C. Health Behavior Change. A Guide for Practitioners; Churchill Livingston, 1999, 225 p.
6. Tucker J. et al. Environmental Influences ON RELAPSE IN SUBSTANCE USE
Disorders. The International Journal of The Addictions, 25 (7A & 8A) 1017 -
1050, 1990-1991.
7. Wolff K. & Winstok A. Practical Guidelines for Narcology Clinics In The
Russian Federation. Deceptber 2000 - March 2001, 59 p.
Information about authors:
Yalton Vladimir Mikhailovich. [Email Protected]
doctor of Medical Sciences, Professor of the Department of Clinical Psychology
Moscow State Medical and Dental University,
leading Researcher of the Prevention Department of the National Scientific Center
roszdrava anesthesia.
Orphan Natalia Alexandrovna
Professor, Doctor of Medical Sciences, Dean Faculty and Head of the Department
clinical psychology of the Moscow State Medico -
dental University, Head of Prevention Department
National Scientific Center Narcology Roszdrava. [Email Protected]

A simple alone, who has never faced drug addiction, the alcoholism of the idea of \u200b\u200btreating these dependencies may be limited. As a rule, people say that it is necessary to endure, there must be some time for drug addiction, alcoholism is allowed, but unfortunately this is an erroneous opinion. In this article, I will tell you a simple language that there are recovery stages in each of which there are our tasks that need to solve the dependent person to overcome their dependence.

There are consistent stages of recovery. There are 6 of them 6. These are the steps:

Transition
Stabilization
Early recovery
Middle recovery
Later recovery
Support

I will tell you in this article about the first two stages. Because in the rehabilitation center we rely and work on the first two stages of recovery, and after the discharge, a person should work in good by the following tasks.

The first stage This transition to it includes three main tasks for solving:

Recognition of loss of loss of control over the use of alcohol and drugs
Recognition of the inability to control the use because I am dependent
Take commitments to fulfill the program of recovery that implies the help of other people

You might think that it would be like easy things to understand, but I assure you that a dependent person solving such tasks is given with very great difficulty.

Let's wonder these tasks on the shelves. The first task in the process of transition is a recognition of loss of loss of control over the use of alcohol and drugs. Almost all alcoholics and drug addicts come to this understanding through a series of failed attempts to control the substances and obtain painful consequences as a result of a series of disruptions. Man performing correctional psychological work comes to the fact that he recognizes that his own strength is not enough to be controlled. From this step, the recovery of the dependent people begins. And believe me for them is the most difficult.

The second task in the process of the transition is slightly similar, but actually it is about the same. A person solving this task recognizes its inability to consume it, but why he cannot do this, but because he is a dependent person and precisely the disease addiction makes it unable to control its use. For many dependent people, to get a "label" of an alcoholic or drug addict is as difficult experience. But without solving the task of recognizing that he is impossible dependent on any further recovery. Finally, the third task suggests that a person needs to make the obligation to fulfill the program of recovery. In other words, follow the recommendations of specialists and guided by the experience of people who went through this path. Also a rather complicated task for the guys. Because they are not accustomed to ask for help. Their self brought them to that deadlock in which they are now. And in order to find a way out, you need the help of other people. Here are the main tasks that solve the dependent person at the transition stage.

The following stage is called the stabilization of the task, which are included in this stage:

Physical recovery from the cancellation syndrome
Termination of concerns of alcohol, drugs
Learning to solve problems without drinking alcohol and drugs
Development of Hope and Motivation

I propose to disassemble these four tasks. The first task is that a person physically recovered from the state when the substance is canceled. What do I mean here? A person after long-term use of alcohol and drugs will experience a state of hangover or breaking. These are sleepless nights, temperature, can "twist" legs, hands, etc. It is clear that with this state, it is impossible to talk about internal changes and about working with the psychological sphere of a person. The second task and it is quite difficult this cessation of concerns substances. I'll tell you that when there is a cancellation syndrome by the guys even for a long time can dream in a dream as they use drugs or alcohol. Imagine how many substances have penetrated a person. These may be euphoric memories when a person recalls the positive moments of use with simultaneous blocking of negative moments. Sometimes conversations of use can lead to the subsequent use of drugs and alcohol. Therefore, there are tools and techniques in order to stop such memories, cravings, etc.

The third task is to teach a person to solve its problems, psychological, emotional and other characters without resorting to chemicals. Here, for simplicity of understanding, I will give a simple example when a dependent person, feeling dissatisfaction, stress, stress with substances as if solve this problem. Although actually aggravates even more. Alcohol, drugs act as a certain pill or anesthesia if you want. In other words, substances, though short-term, but help solve problems in all life aspects. Another thing is that after each use, a person goes deeper into these problems, but the person of course does not think so. For the period of rehabilitation, we teach a person techniques, tools that will be supported in his life and it will be able to solve problems without drugs and alcohol.

Finally, the fourth task is the development of hope and motivation. A person after full or partially defeat is very difficult to develop motivation and hope that you can live a common life and have fun without drinking. It is sometimes difficult to believe that life will improve at all. Therefore, it is a very painstaking work on creating the motivation of the dependent and help him see the hope of life.

The path of recovery action plan to prevent breakdown. Terens T. Gorski

Sequential stages of recovery.

The developing model of recovery (for brevity will be called its RMV) is based on the following beliefs:

Recovery is a long-term process that is not easy.

Recovery requires complete abstinence from alcohol and other drugs, as well as active efforts to personal growth.

There are fundamental principles that manage this process.

The better we understand these principles, it makes it easier for us to recover.

Understanding in itself will not lead to recovery. A new understanding should express itself in actions.

The actions necessary to achieve full recovery can be clear and accurately described as recovery tasks.

It is normal and naturally - periodically stuck on the road of recovery. That you are stuck or not, is not considered a success or defeat, but the way you cope with difficult places is considered.

To find out what recovery is, it is useful to divide the process at the stage. We will learn six different stages of recovery. I will call them (1) transition, (2) stabilization, (3) early recovery, (4) average recovery, (5) late recovery, and (6) maintenance.

In the first stage of recovery - the transition - we recognize that we have problems with chemicals, but we think that we can solve them if you learn to control the use. This stage ends when we recognize that they lost the ability to control (that we are "powerless" before alcohol and drugs), and that we need to abstain in order to return control over your lives. We still do not know why we have lost control, or how to remain sober; We just know that we cannot continue to be those who we were. In AA, this is called "tired of fatigue."

During the next stage - stabilization - we already know that we have serious problems with alcohol and drugs, and that we need to completely stop using them, but we can not do this yet. During this period, we recover from acute cancellation syndrome (the stage of trembling and embarrassment, which we are experiencing until our bodies are cleaned). And we get better from a delayed, or subacute syndrome abolition of alcohol or drugs (the period lasting from 6 to 18 months, when we feel as if in a mental fog). At this stage, we learn how to "hold from the only glass (or one dose of the drug) day after day."

The third stage - early recovery is the time of internal changes. On it, we learn to feel comfortable in abstinence. Physical traction to the use of substances weakens, and we will learn more about your dependence and how she worked on us. We also learn to overcome the feelings of shame, guilt and remorse. We are able to cope with their problems without applying to substances. Early recovery ends when we are ready to start applying what we learned to correct other areas of your life.

During the average recovery, in the fourth stage, we learn how to correct past damage and find equilibrium in life. We learn that complete recovery means "to apply these principles (the skills of the sober life, which we received during early recovery) in all of our affairs" (in the real world of everyday life). During the period of medium recovery, the priority becomes correction of relations with people. We overestimate our significant relationships, in particular, with family and friends, as well as our career. If we find that unhappy in any of these areas, we accept it and plan to do something about this. In terms of AA, this is called "to block the guilt". We realize that they caused harm to other people. We want to take responsibility and do everything possible to compensate for damage. The average recovery ends when we achieve a balanced and stable life.

During the fifth stage - late recovery - we focus on overcoming obstacles to healthy life, which were formed when we were children, even before our dependence was developed. Many chemically dependent people occur from dysfunctional families. Due to the fact that our parents could not best fulfill their work on education, we could not get the skills necessary to be happy. Later, recovery ends when we complete three things:

first, we recognize our adult problems that are caused by the fact that we have grown in a dysfunctional family;

secondly, we learn how to recover from inadequate pain caused by what we grew in it.

Finally, we learn how to resolve current problems, despite the obstacles caused by how raised us.

The sixth and last stage is maintenance. At this time, chemically dependent people find out that their illness exists at present, and not in the past. (The game of words: Alcohol-ISM, not Alcohol-WASM). We learn that we need constant growth and development of your personality. We realize that we will never be able to eat alcohol and drugs without problems, and that we should be guided daily by the recovery program so that dependent thinking is not returned. We live in such a way to enjoy your travel in life.

Stage of recovery	Main theme
Transition	Let's stop attempting to control alcohol or drugs.
Stabilization	Healing from damage caused by use
Early recovery	Internal changes (change in thoughts, feelings and actions related to alcohol and drug use).
Middle recovery	External changes (correction of violations of life style caused by addiction, and the development of a balanced lifestyle).
Later recovery	Extraction of restrictions of childhood
Maintaining	Balanced life and continuation
	growth and development

Many chemically dependent people ask a question: "What are my actions can lead to a breakdown?" The answer is simple. You do not need to do anything. Stop drinking alcohol and other drugs, but continue to live the life you always lived. Your illness will make the rest. It will include a series of automatic (or familiar) reactions to life, and this life will lead to such pain and discomfort that refund to drink will seem good output.

Recovery - means change. In order to change, we must have goals. It is also useful to have an action plan or step-by-step guide that will show us what and how to do. This book is created in order to be such a guide.

Each of the following chapters is a detailed description of one of the stages of recovery. Do not despair. Remember that recovery is a growth process that takes time. To go through the way from stabilization to maintain, it may be necessary from three to fifteen years, depending on how sick you were when they started to recover how hard and continuously you worked in our way of recovery, and from the type of help you received from others.

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