The words hopeless case have been used to describe many individuals who later managed to build a success life in recovery. The reality is that there are very few actual hopeless cases. Even those individuals who have taken their addiction to extremes can still find their way back to a good life in sobriety. The only real hopeless case is the person who has completely given up on themselves, but even these individuals can have a change of heart. It is common for addicts to worry that they might be one of those who can never get better, but this is hardly ever the case.
The term hopeless case has been used to describe a variety of addict archetypes:
* Those who go from one rehab to another but never manage to enter long-term sobriety. This is sometimes referred to as revolving door syndrome. These individuals just seem to find it impossible to remain sober once they have left rehab.
* Some individuals have a dual diagnosis. This refers to a situation when the individual has another mental health condition as well as their addiction. Such people might not have the mental resources to manage sustained sobriety. This is particularly true if only their addiction is being treated.
* Some people have personality disorders that interfere with their ability to build a life in recovery. Those individuals who have a borderline personality or narcissistic personality disorder can really struggle to maintain sobriety.
* In Chapter 5 (How it Works) of the Big Book it warns that there are people who cannot recover from addiction because they are men and women who are constitutionally incapable of being honest with themselves. In order for people to have any chance at recovery, they need to be able to see the reality of their current situation. They must see beyond the denial. If this does not happen, this individual will be unwilling to give up substance abuse. They will blame everything else for their problems rather than the alcohol and drugs. It is also vital that people develop enough honesty in recovery to rebuild their own life.
* Some alcoholics develop a condition known as wet brain or alcoholic dementia. This can severely impair their cognitive functioning so that they are unable to understand the need to stop.
* Low bottom alcoholics can sometimes be considered hopeless cases. They have lost so much that it is difficult to imagine how they can possibly rebuild their life.
* High functioning addicts could be considered hopeless cases. This is because their life never gets bad enough that they are forced to give up their addiction. They are able to create an outward show of normality and high functioning even though they are really struggling internally.
Even those individuals who have been labeled a hopeless case by themselves or other people can still escape their misery. It seems that most people in recovery had been given this label at one time or another. In the preface to the original edition of the Big Book it mentions how most of the first 100 members had an almost hopeless case of alcoholism. Such individuals were able to escape their addiction because:
* The old adage about how a leopard never changes its spots is false. People can and do completely turn their life around. Even those individuals who have hit a low rock bottom will still be able to find their way back to sobriety. The human spirit (or a higher power) allows the individual to do incredible things.
* Up until recent years there were not good rehab options for those individuals dealing with a dual diagnosis. This is now changed and it is possible for such individuals to get both their conditions managed together while in rehab. This greatly increases their chances of finding success in recovery.
* Even those people who are in deep denial about their problems can develop insight. This can occur with the help of an addiction therapist. These days motivational interviewing can help the individual overcome any resistance they might have to recovery. The client is not coerced into getting help, but instead they develop enough insight to see that this is what they want for themselves.
* Just because people have failed in their attempts at recovery in the past does not mean that they are a hopeless cases. There can be many reasons for why an attempt at sobriety fails; it could be that the individual just did not feel ready or that they were using recovery resources that were not appropriate for them. Relapse should always be avoided if at all possible; there is no guarantee that the individual will get another chance at recovery. It does seem that some people do need quite a few attempts at recovery before they finally manage to enter lasting sobriety. If people have failed in one recovery program they may benefit from trying something different.
* One reason why many people relapse is that they have not developed the coping mechanisms for dealing with life in sobriety. Such individuals may benefit from attending a rehab where they could develop these life skills.
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