Addictions - The Pear Model

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This article is reprinted from Challenges.

Author's instruction: "Note about Copyright: This material is copyrighted. Permission is hereby granted for any non-profit use of this material. Please do share with others in recovery (or that need to be!)."

THE PEAR MODEL OF SUBSTANCE ADDICTION RECOVERY
GARY STONE, B.A., L.C.D.C.

Before anyone can consider working a program of recovery, the person must first have made a commitment to the recovery process. The effort placed toward staying in recovery will soon become too great a burden unless you have firmly decided that the old way of life simply will not be acceptable any longer. The following is a brief questionnaire that will help you determine if you have indeed made the necessary preliminary decisions that are essential before you can succeed in recovery:

1. Do you have a genuine desire to improve your life?
2. Do you completely accept that you are an addict?
3. Are you willing to surrender to take whatever action is necessary?
4. Do you recognize that your program must be developed?
5. Do you accept that recovery will require an enormous investment of time and energy?
6. Are you willing to do a complete written plan of recovery?

All six questions require a Yes answer. If on any point you think differently, this model of recovery will be ineffective. An addict who enters and stays with recovery will soon learn that the necessary time and effort are not a burden. Energy spent toward a new life style is worth every ounce of effort and that the rewards are very real.

The P.E.A.R. Model of Recovery
Think about the pear fruit. I remember times as a child when our parents would pick some pears and wrap them in newspaper and save them until Christmas. Then you could eat the pears with a spoon. They were so sweet and juicy. On the other hand, I also remember some pears picked from the tree that were hard, bitter and very difficult to eat.

Recovery is very much that way. Some people seem to fall into recovery and for others it seems as though no amount of effort gives good results. It does take a lot of time and effort for recovery.

Some people who enter treatment after treatment seem to have little or no recovery. This model will help you to GET IN recovery and to STAY IN recovery. A life of substance addiction recovery can indeed be sweet and easy to swallow. This model of recovery will help you to look at some areas that will assist you to have a sweet, successful recovery life.

Overview of the P.E.A.R. Recovery
P.E.A.R. is an acronym meaning Payoffs, Education, Action and Realities. In Payoff we will examine the need for specific rewards. Education will explore some time-tested facts regarding recovery. Action will involve defining what is appropriate and listing some specific criteria for something to be true action. Realities details very real truths for every addict that chooses against recovery.

Payoffs
Most people generally like doing the things that make up their life. However, at times it seems a drudgery to continue. It is during those times that payoffs become important. For example, a person may love their job, but sometimes the only reason they continue is because of the paycheck. The ultimate reason you do things is the personal payoff. Recovery is not different.

The person who is actively drink-ing or drugging often would like to be in recovery. They sometimes sit around and go through a wishful thinking phase. They think that some day things will be better. We must want something before getting it for keeps. This want is real if backed by our knowing that rewards are forthcoming.

Sometimes (more often than we like to think), staying in recovery is a real job and we simply must understand that the payoffs are for real! You realistically look for payoffs in many different areas of your life. Example:

FINANCIAL
- Better control of money.
- Remembering what happens to your money.
- Ability to save for the future.
- Pay off some debts.
FAMILY
- Better relations overall.
- Able to mend some broken fences.
- Participation in family events.
- Reconciliation with spouse and children.
JOB
- Able to keep a job.
- Security for the future.
- Good relationships at work.
- Feeling useful again.
SPIRITUAL
- Better understanding of God.
- Reconciliation with Church.
- Understanding of a higher power.
- Peace with inner self.
HEALTH
- Better overall health.
- Chronic problems get better.
- Personal health needs noticed.
- Feeling good again.
LEGAL
- No more trips to jail!
- No more probation or parole.
- No jumping at sight of police.
- No panic when phone rings.

The above serves as a small sample. The list could and should continue. You should anticipate a payoff in every area of your life. These payoffs should be anticipated with the zeal of a 10-year-old at Christmas!

Simply yearning for a better life will fall into daydreaming. To have payoffs, you must convert your daydreaming into developing a specific program tailor-made for you. When you create your own list, make it personal.

Education
Alcoholism and drug addiction are complex problems that touch every aspect of a person’s life. The recovery process is one that requires a period of education. This is actually often a period of unlearning and re-learning. The recovering person must remove some old tapes and replace them with recovery thinking.

The P.E.A.R. concept is a broad-based approach that allows many different approaches to work together. However, this model does rely on some concept generally accepted as facts. You may be having trouble staying in contented recovery. A review of the following 10 absolutes may uncover a root cause of your trouble. These items are essential facts and any denial of their truth results in problems.

THE ADDICT MUST HAVE A DESIRE TO IMPROVE.
The addict is entering a process of recovery that will not always be easy. They must show a desire to change their lifestyle. This change is often sweeping and deep into their life. The addict can be directed into treatment in a number of ways, but eventually the addict must really desire to change.

THE ADDICT MUST ACCEPT THEIR DIAGNOSIS.
The addict must agree that they have a real diagnosis of addiction. This belief must come from deep within themselves.

THE ADDICT MUST SURRENDER TO THEIR DISEASE.
For the addict to experience recovery, surrender is an absolute. The addict must come to the point of willing to do anything in order to be receptive of the necessary changes in their life.

THE RECOVERING PERSON MUST HAVE A PROGRAM OF RECOVERY.
If you investigate any great event or project, you will discover some specific plans. Most projects entered with poor planning have poor results!

RECOVERY IS NOT AUTOMATIC.
One of the greatest mistakes is to consider a program a treatment. The goal is to train a person to make real changes in their life. The title “training center” is more appropriate. Many patients enter treatment and expect to get something that will fix them. This thinking is dangerous and, unfortunately, very well masked. Recovery requires time and effort.

THE RECOVERY PLAN MUST BE WORKABLE, WRITTEN AND SPECIFIC.
Here’s where most people fall through the cracks. Many patients leave a program with a vague idea of recovery and what they plan to do, but they do not have a written, specific plan. Think of recovery as a tremendous project that requires a plan that is written, workable with the resources available, and specific-- specific items to deal with specific problems.

RELAPSE IS A PROCESS.
A person does not relapse in an instant. Relapse is a process that can be observed, detected and halted before the person loses their recovery. The process of relapse has its very own symptoms. These symptoms must be studied, understood and processed as they occur.

RECOVERY IS A PROCESS.
Just as relapse has specific symptoms, so does recovery. The process (meaning it does not happen quickly) of recovery is also one that can be observed, detected and improved upon. Some people are expecting results too quickly. The process of recovery takes genuine effort and a willingness to go the extra mile.

RECOVERY REQUIRES SPECIFIC TOOLS FOR THE JOB.
Just as you would not go to a dentist for a foot problem, recovery from addiction must contain tools designed specifically to deal with the varied problems of addiction and recovery. These tools can be extremely different from one recovering person to the next, but they must be specific tools that work.

RECOVERY REQUIRES TOTAL ABSTINENCE.
The word “total” means no use of mood-altering chemicals. There is no documented long-term success program that does not involve total abstinence.

The re-education process may involve more than the 10 items above, but these items are the backbone of understanding recovery. When a person tries to enter recovery without the necessary knowledge of the disease, they often relapse. A person interested in long-term recovery has a thirst for recovery knowledge. They will continue to desire more knowledge about themselves and what keeps them in good recovery.

Affirmations

I have a desperate desire to improve. I realize this change will involve all areas of my life.

I fully accept my diagnosis of addiction. This is an absolute reality for me, and I recognize the implications of this disease.

I do surrender to my disease. I understand this means doing whatever is necessary to enter and stay in recovery.

I accept the fact that I must have a program of recovery. I understand that without specific planning, I have no chance for recovery.

I agree that my treatment program is really a training program. I acknowledge the need to see myself as a student. I must keep being trained for what is ahead.

I fully accept that my personal program must be written. I accept this will require a specific and workable plan. I will readily allow others to review my plan.

I realize that relapse is a process. I know this means that I must stay in tune with the symptoms of relapse. I know this also requires action to deal with the symptoms.

I also realize that recovery is a process. I understand this means that my recovery will not be an overnight event. I know this will require time and effort.

I surrender to the fact that recovery requires total abstinence from mood-altering chemicals. I commit to this fact.

The above statements need to be read more than once. You must replace the old tapes with new tapes, and this takes repetition. Before you move on to the Action portion of P.E.A.R., re-study the above affirmations.

Action
A person may desire recovery but the bottom line is that to achieve it will require very specific action.
Some general guidelines about an action plan:

It must be written. This will force a focus on specifics.

It must contain the what, how, when and where to qualify as action.

It must be realistic. Action steps that are not possible are useless.

It must be a support to the payoffs identified in the first element of P.E.A.R.

It must not be so rigid that it has no provision for change nor so flexible that it is constantly being changed.

You need to develop a specific bag of tricks that will assist you in your goal of total recovery. This portion of the P.E.A.R. recovery must be specific. Recovering people relapse when their plan of action becomes unstructured. These items of the plan must be used on a regular basis, not just in time of crisis. Example: A person says they will call their AA sponsor, IF THEY FEEL THE NEED TO TALK TO SOMEONE. By the time they NEED to talk,they probably will not unless they have made a point of talking to their sponsor on a regular basis. These tools of recovery are not useful if only used on a crisis basis. How would you like to have surgery and the surgeon never used the instruments but felt he could if necessary?

The goal is simple: happy recovery. If the recovery process becomes anything less, some changes must be made. Here are some examples of an appropriate action plan:

WHAT
HOW
WHEN
WHERE
Better family togetherness.
Family recreation (voted on by whole family).
Every Friday evening after dinner.
As per family vote.

WHAT
HOW
WHEN
WHERE
Attendance at AA meetings.
In my own car.
Tues, Thurs, Sat, 8 PM
308 Pecan St, Sobercity

The above action plan has details. See the errors in the following:

WHAT
HOW
WHEN
WHERE
Attendance at AA meetings.
Catch a ride.
Three times per week.
Various places.

The difference in the two examples can mean the difference between recovery and relapse. The latter lack enough specific commitment to make the plan real. They allow for loop holes. Addicts and alcoholics will often allow such loop holes to become steps to a relapse.

Realties
Someone once said, “Reality! What a concept!” It seems that reality often hits us in the face. This is especially true for a person entering into and staying in recovery.

Addicts and alcoholics will often continue to use KNOWING THE REALITY OF WHAT IT IS DOING TO THEIR LIFE. That is very true. No single element of recovery can stand a alone A reality check can become a healthy part of a program of recovery. (“If I drink or drug, I can go to jail.”) A healthy fear can create an aversion to the way we had been living.

The person entering recovery must accept some facts regarding their addiction. This acceptance serves as one (of many) elements of the overall program of recovery. If you are working a good program, the reality of jail after drinking can be a part of your total package of recovery. Remember, the P.E.A.R. recovery utilizes a broad network of recovery tools and ideas.

It's a helpful exercise to actually list these facts and look at them periodically. These facts have to be accepted versus just admitted. In addition, the realities need to be very specific for each person who enters into recovery. What may be a reality and a fact for one person may not be for the other. The following is a list of some general realities:

Addiction is a fatal disease. The only positive outcome is active recovery.
Addiction is a progressive disease. This means it will get worse over time.
Returning to controlled use is not possible.
Family systems do not function well in the user’s life.
In over 50 percent of all accidental deaths, the person was using or drinking.

The above examples are real; however, they are no specific to the individual recovering person. Most addicts and alcoholics would look at the above list and say, “Well, I suppose that stuff is true.” The Realities portion of P.E.A.R. require the realities to be very specific to the individual person. For example:

The last time I drank alcohol, my liver went into failure and I almost died.
My last relapse occurred after a period of two years in recovery and the results were worse than ever before.
Sarah and the kids will not tolerate any more of my using.
If I am late to work, I will be fired.
My drinking history proves that I cannot ever control my drinking.

You can see how the above examples are very specific. Be careful to list only personally true realities. For most people, their list of realities will be the opposite of their list of payoffs in the first portion of the P.E.A.R. recovery.

P.E.A.R. Working Together

Examine the way the areas work together. A person first becomes interested in recovery and begins to look forward to the rewards. This leads the person to get some specific education regarding addiction and recovery. Then a specific plan responds to the desire for specific payoffs. This plan is based on the training received to deal with recovery. Lastly, listed realities help the person continue to recognize the seriousness of this disease.

If an area of P.E.A.R. is neglected, problems will result. To illustrate this fact, look at the results of a person attempting recovery lacking one or more of the elements of P.E.A.R.:

E.A.R. This person does not have a grasp of the Payoffs from working a long-term recovery plan. The results:
• When the going gets rough, they relapse.
• They have no staying power that comes from looking forward to some rewards.
• This person simply does not accept that recovery is worth the effort.
P.--A.R. This person lacks adequate Education regarding addiction and recovery. The results:** They want recovery, but do not know how to achieve contented recovery.
• The action taken is often inappropriate and not effective.
• They mistakenly believe that recovery is mostly common sense.
P.E.-- R. This person has very little but frustration in trying to enter and stay in recovery. They look forward to payoffs and they understand that they can do it on their own. They recognize that specific plans of action are good for those who need them. This person needs to stop thinking and start doing. The results when Action is lacking:
• Frustration from entering one treatment center after another.
• Waiting for the magic wand that will fix them.
• Rigid denial that they must make some real changes in their total life.
P.E.A.-- This person has lost sight of Realities brought about by their substance abuse. The results:
• Long periods of recovery, followed by relapse.
• Slow degeneration of their program.
• They soon forget how bad it really was during the using days.

Some Closing Thoughts

The P.E.A.R. recovery will result in contented recovery. You must make a decision about your life. If you are tired of the old way of life and are willing to put forth some real time and effort, the rewards of recovery await. This model is a system of putting recovery into a working package. Recovery is never a “work it and forget it” affair. In order for recovery to be continuous and joyful, a program must be in place at all times.

Points to Remember:

The addict can be directed into treatment in a number of different ways, but eventually the addict must really desire to change.
The person who is actively drinking or drugging often would like to be in recovery. They sometimes sit around and go through a wishful thinking phase. They think that some day things will be better. We must want something before getting it for keeps.