I heard of SMART Recovery several years ago, and lately I’ve been hearing more and more about the program. Based on what I’ve learned about their philosophy, I have mentioned it to some people who have inquired about non-12-step options, but I figured I ought to go check out a meeting so I can give a less ambiguous recommendation. So here’s my review of a SMART meeting, and a bit of info about their philosophy.
For those who don’t know, SMART is an alternative support group to AA – and it is a real alternative to treatment programs which operate on the disease model of addiction. When I stepped into the meeting I was given a handout with anti-disease messages appearing twice on the first page:
What you believe about addiction is important, and there are many ideas being tossed around about addiction and recovery. You may believe for example, that you have an incurable disease, that you have a genetic defect, that you are powerless, or that after the first drink or use or act you have to lose all control. These beliefs may actually be damaging you.
That right there was a great sign to me. It falls exactly in line with what I believe about addiction – the belief that you have an incurable disease which causes you to be addicted – actually causes you to behave like an addict. There’s more:
We’re not trying to cure an imaginary disease. We’re concerned with changing human behavior.
And that’s what it’s all about. The disease stuff sends you on a wild goose chase, when you should be focusing on changing your behavior. This is why I tell people to stay as far away from treatment and 12-step programs as possible. Reading this first page while waiting for the meeting to start truly was a breath of fresh air for me. Beyond that, the facilitator of the meeting mentioned several times that they do not view addiction as a disease, and that they see people as responsible for their own choices and behavior.
I should also mention here that I returned to check out some 12-step meetings a few years back because an AA friend was trying to convince me that the disease stuff is never really mentioned and it’s only used figuratively etc, and I thought to myself that I hadn’t been to a 12-step meeting in 6-7 years, maybe she’s right, and I’m just remembering it wrong. Nope, she was wrong, I couldn’t even begin to count how many times that disease was mentioned, literally, not figuratively. So on this count, and it’s an important one, SMART is a true alternative to 12-step programs in that they are clear about saying that addiction is not a disease and they will not approach it on those terms. This is important because there are some other programs out there who claim to reject the disease model, but end up using the model under different terms and different ways – such as those who tell you that nutritional factors cause addiction and that you need supplements to quit your addiction. There is none of this in SMART, it truly is an alternative on the disease front. I do however have one nit-picky problem with the fact that the term “relapse” is used in SMART. It’s a word I like to stay away from, because it implies that there is a disease state to relapse into. One person used the term at the meeting, but it was clear to me when he said it that he took responsibility for the act of using. So it seems that the term may be used simply to refer to a freely chosen episode of substance use, rather than the common usage which implies that it’s something which happens uncontrollably. Even so, in a perfect world, if I were running SMART, I would strike the word from their vocabulary because it’s too mixed up with the disease model of addiction.
The meeting kicked off with a quick statement read by the facilitator about SMART’s philosophy and goals, then moved on to a 30 minute open discussion period where attendees were asked to introduce themselves, and speak about what they’re working on changing. Crosstalk was encouraged, and the discussion was great. First of all, no one identified themselves as an addict or alcoholic (a harmful practice of negative self-labeling which turns many people off of 12-step groups for good reason). Second, the discussion was very rational for the most part. These were people discussing how they related to substance use, trying to understand why they chose to do it, and working out how to change their behavior and move on with life. Although this meeting was small (only 5 people in attendance), everyone was really taking responsibility at the level of thought and behavior for their own problems. Not one person talked about how they relapsed because of something ridiculous like their cat died, or their mother asked them to do something, or they walked past a bar and couldn’t resist walking in, or whatever silly things you hear in other support groups. One guy who was trying to quit a crystal meth habit had used 4 days prior to the meeting, and when he discussed it, he didn’t blame anyone or anything other than his own pattern of thought, and he was working to find a way to make a different choice. Again, truly refreshing.
There is no illusion in SMART that you need to wait for god to change your behavior, and the facilitator made clear that spirituality of any kind is an outside issue on which SMART doesn’t really take a stance. The focus is clearly on beliefs, motivation, emotions, and behavior – and how we can modify these to end our substance use problems. Mysticism is “avoided like the plague”, and instead, SMART seems to get you focused on the here and now with things you can directly do to change. I didn’t hear one mention of god in the discussions at the meeting – this is something which would also be a breath of fresh air for someone looking for an alternative to the conventional recovery culture.
After the initial 30 minute discussion period, the facilitator moved on to the decisional balance exercise – a key component in SMART. I was first introduced to this exercise as part of a management training program I went through years back, eventually I saw that it was something used to help people with addictions in some literature from some of my favorite researchers, Mark and Linda Sobell, and I began to use it myself with my coaching clients. The exercise is a cost/benefit analysis. You quite simply look at the costs and benefits of the behavior and measure whether it points you towards quitting. The facilitator drew four quadrants on a whiteboard and began to question the group about the costs and benefits of substance use and enter the answers on the board. The twist on how I’ve usually seen it done, is that this one only focused on the costs and benefits of substance use, and broke them both into subcategories of short and long term costs and benefits – in lieu of sections on the costs and benefits of quitting. This was quite a genius way of doing the exercise because the long-term benefits of substance use section was ultimately left empty. No on could really think of a long-term benefit, and that makes a poignant point about what’s going on in addiction – you’re trading your future for some cheap of-the-moment thrills. I think this point really sunk in with everyone in attendance.
During the decisional balance exercise, there was a lot of discussion and it took up the last hour of the meeting. It felt good, like everyone was really pushing their minds in a positive rational direction. In the recovery culture, thinking is frowned upon. You’re considered arrogant if you believe that you could reason your way to better choices about substance use. When you express any ideas about how to control your own behavior in 12-step forums, you’re often told to “take the cotton out of your ears, and stick it in your mouth.” That was not the case at this meeting. People were encouraged to think, express their honest ideas and feelings, and to build confidence to make their own informed choices about substances use. On this front, SMART is an incredible alternative to the conventional recovery culture.
When the meeting was done, I felt like I could whole-heartedly recommend SMART Recovery to others, and I do. With that said, I have one warning. There is something about all support groups which can be dangerous, and that is that people may use the group as a means to ride the fence and feel like they’re doing something to change, when they really aren’t. People may use the groups as a dose of medicine, or to diffuse responsibility for change on others. This potential exists no matter the philosophical content of the support group. So beware that if you choose to use SMART, you don’t do it in this way. SMART, seems to want people to come get what they need and move on. They’re not looking for lifetime members, and the last thing they want is for people to be dependent on the group. It looks like there may be some safe-walls in place in order to prevent this though. For example, when we did the decisional balance exercise the facilitator was sure to let us know by the end, that we couldn’t rely only on the content of the exercise we did together in the meeting, and reminded us that we have to do our own decisional balance which reflects our own thoughts, beliefs, feelings, and values. This is smart, because it reminds us that we’re individuals making our own choices, and that we can’t depend on the group to make our choices for us. Small touches like this, will go a long way towards effecting individual work to change rather than dependence on the group or attendance at the meetings while spinning your wheels.
I have one other nit-picky problem with SMART, and that is that it is an abstinence only program. At this point, with all the research I’ve seen, and living in the real world where people tell me about how they quit an addiction and moved on to moderate use all the time, I feel it’s unrealistic and wrong for a program to be focused only on abstinence. With that said, SMART doesn’t seem to push abstinence on anyone, they leave it up to the individual to choose, and they say that they’re there to help people with abstinence. Also, I think abstinence is probably the best choice for a lot of people, but I’d just personally like to encourage and support any goal of substance use reduction that people choose, whether it be abstinence or moderation.
Having taken the path I took, through the Jude Thaddeus Program, I wouldn’t choose a support group myself. I liked our approach which is to deal with the problem quickly and move on with life, and support groups seem to naturally stand in the way of that. With that said, there’s no reason you can’t go get what you need in SMART and move on with your life. Many people want the social support of such groups though, so in spite of my concerns about support groups, I recommend SMART to people who want that – it’s a billion times better than any 12-step group.
Here is a link to SMART Recovery’s website, where you can find a meeting in your area. If you’re struggling “in recovery” by conventional methods, I encourage you to pull the trigger on trying something different and go check out SMART. It won’t hurt, and you’ll leave with some important insight into your problems.