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Controversies in the Addiction Field: Change Versus Acceptance

A. Tom Horvath, Ph.D., ABPP, Kaushik Misra, Ph.D., Amy K. Epner, Ph.D., and Galen Morgan Cooper, Ph.D. , edited by C. E. Zupanick, Psy.D.

Individuals in recovery encounter a conflict that is evident throughout life:  changing things versus accepting them.  Each person must find a way to resolve these conflicting agendas.  We must be able to change things.  We also must not change things (to accept things as they are).  Some things need to be changed.  Some things need to be accepted.  There is no single "right" way.  There is only the right way for each person, in each particular set of circumstances.  Moreover, the "right" way may change throughout the course of someone's life.  People clash with each other over this. Each person mistakenly believing their way is THE right way.  Instead, both ways could be right.  Or, both ways could be wrong.   There are many healing paths to recovery.  As long as the path results in healing, it is the "right way" for that person. 

clock with time for change on itLet's examine this change vs. acceptance dialectic a bit further. Obviously, people in recovery must make some changes or the addiction problem will remain the same. Similarly, a person in recovery must be willing to accept some things. Perhaps they need to accept the obvious fact there is a problem. Perhaps they need to accept suggestions from other people about how to solve the problem. Each of the four models of personal responsibility varies in terms of this tension between acceptance and change.

For people with an external locus of control, recovery is strongly oriented toward acceptance. Nonetheless, change is still required. For instance, for the person who likes the enlightenment model (responsible for causing the problem but not for solving it), attending AA meetings to achieve recovery makes sense. In meetings, one can learn about the true nature of alcoholism. One becomes enlightened as they learn, taking the first drink caused the problem. Therefore, the solution is to abstain from taking that first drink. But, since this is not easy to do, the solution rests upon a higher power to provide this ability. One also learns about character defects that contributed to the establishment of drinking problems. Acceptance and change are both required to gain recovery. One's responsibility is to attend the meetings, and follow other aspects of the AA program.

Another model that reflects an external locus of control is the medical model. If you gravitate toward the medical model (not responsible for causing or solving the problem), you accept you have an addiction problem and recognize you must find suitable experts to help you solve your addiction. You will need to accept the advice and suggestions of the experts if you wish to recover. You must also change your behavior in the manner they suggest. Once again, change and acceptance are both required. However, each model suggests a different balance between change and acceptance.

For people with an internal locus of control, recovery is strongly oriented toward change. Nonetheless, acceptance is still required. For example, the compensatory model proposes you are not responsible for causing the problem but you are responsible for solving it. Although you are trying to make the needed changes in your life, you still need to accept there are some things you cannot change. If there is a history of drinking problems in your family, you might need to accept your genetics place you at risk. In short, alcohol is very appealing and tempting. You need to accept this reality while changing your response to this appealing and tempting substance.

The moral model is another model with an internal locus of control. You are responsible for creating and solving the problem. This requires you to make significant change. You will learn from your mistakes and take corrective action. You may experience substantial guilt about having allowed the problem to develop. Although the guilt might become excessive, a small amount of guilt can serve to motivate people to change their behavior.

The Serenity Prayer, written by Reinhold Niebuhr, provides an excellent way to summarize the issues of change versus acceptance. 12-step groups, such as Alcoholics Anonymous, nearly always recite this prayer:

God, grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference.

For individuals leaning toward an internal locus of control, recovery will be more about "courage to change the things I can." Conversely, for individuals leaning toward an external locus of control, recovery will be more about "serenity to accept the things I cannot change." Whether we have an addiction or not we must all find a balance between active growth (courage to change) and passive rest (serenity to accept).

Some people find the Serenity Prayer does not reflect their religious and spiritual beliefs. An alternative wording might be the following affirmation:

I possess the courage to change the things I can, the serenity to accept the things I cannot, and the wisdom to know the difference.

Our wisdom constantly evolves as we gain life experience. This experience helps us to find the right balance of change and acceptance. It's quite natural to notice the similarities between our own problems and the problems of others. However, we must also recognize even when situations seem similar they may not be. No two situations are identical. No two people are the same. Each person must find their own balance serenity (acceptance) and courage (change). Perhaps the most important part of the serenity prayer is the part that implores God to impart the wisdom needed to achieve this balance. Whether or not God imparts this wisdom, we all must find it. The wisdom to find a balance between change and acceptance seems crucial.

The different approaches people use to solve complex and troubling problems, such as addiction, do not need to become a source of conflict or debate. We understand these differences as each person's unique way of balancing change and acceptance to bring about the solution they desire.