Why does it take several return trips to treatment facilities before an alcoholic gets clean and sober?
It took me 6 treatment facilities (all volunteer and not a result of legal or medical problems) ranging from 6 week outpatient to 4 weeks to months before I got 4 consecutive years. While in treatment, most of the patients there, were not there for the first time. In 12 step programs there are numerous cases of relapse. So why is the success rate so low?
The success rate is low because that's the nature of the illness or dependence. Recidivism rates are high for alcoholics as well as for people who abuse prescription medications or any substance for that matter. A physical or psychological dependency on any substance is a problem that most people continually have to work at to conquer. The creed of AA is "one day at a time". Often, many stints in treatment are necessary to overcome the addiction. You may have heard the old saying that one has to "hit bottom" before they are amenable to treatment. Some people seek out treatment for these problems before they are actually receptive to the treatment. In other words, they are not psychologically ready for the treatment that they seek. In addition, many people in treatment facilities are there because someone else wants them to be there ( like a family member ). Also, many people with substance abuse problems have additional psychological issues like anxiety, depression, etc. that needs treating in addition to the substance abuse problem.
This is a question that seems to be can be best answered with the narratives of individuals who have endured the process of recovery and still live with it. Part of the reason why recovery is so challenging is because to effectively move away from addiction causes a massive change in thinking and defining one's world and one's self. These are powerful elements and to undertake them requires a fundamental transformation in belief systems. It goes beyond and deeper than "I am going to stop using," and rather seeks to reconfigure one's own sense of self because it carves out a reason as to why addiction happened, how it impacted one's life, and how it will not play a defining role again. Think of it like this: Addiction causes the individual user to lose their own sense of self and autonomy. The life lived within addiction subsumed a life that probably already had something in it where voice was denied. Once one makes the conscious choice to stop the cycle of addiction, they are using their voice for the first time in their lives and advocating a sense of autonomy which did not exist. This is powerful, richly evocative, and brings out subterranean demons and aspects of self which, on first glance, can be quite unappealing. To effectively undergo such a process and then live with it is a challenge.