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Memory Motivation and Maintenance

March 1, 2006
by George DuWors, MSW, LCSW
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The addict must remember past suffering without being consumed by guilt

The two desperate men who founded AA in 1935, both chronic relapsers, later defined memory as one of the most powerful barriers to lasting abstinence. Several years after launching the program and their own lasting recoveries, they published Alcoholics Anonymous. In words that would be both pedantic and clinical, were they not so poignant, “Dr. Bob” and “Bill W.” spelled out the problem this way: “We are unable, at certain times, to bring into consciousness with sufficient force the memory of the suffering and humiliation of even a week or a month ago.”2

Why do we forget pain? Because remembering it hurts! Forgetting the facts of one's own experience paves the way for a decision based on desire, not reality. Picture an alcoholic/addict making the decision to quit. He has just cheated on a beloved wife, loaded. He missed his son's baseball championship, drunk. It would have been worse if he had showed up at the game drunk. The book Motivational Interviewing defines “motivation” as the difference between where you are and where you want to be.5 Most addicts/alcoholics deciding to quit are suffering considerably from just such a gap.

The gap is important, but so is the suffering. An objective condition, no matter how dramatic, does not “motivate” until the person in it experiences the negative emotion that makes that particular state intolerable. It is the distressing inner emotion that motivates—it provides the energy to do the work that will make the “change.”

Feelings of guilt (over what I have done), shame (at who I think I am), and fear (of what will happen and who will see) motivate a typical decision to abstain. They also motivate something else—forgetting. What else can you do if the shame and guilt are so appalling you can barely stand to share your own skin with the other being who lives in there: your conscience? If you don't forget—rapidly, thoroughly—how can you not live in a perpetual state of shame and guilt? On the other hand, if you cannot change the humiliating facts, you can do the next best thing—forget them.

Case examples

Two recurring clinical experiences brought this home for me as a psychotherapist working with addictions. Years ago, I was trained to begin each succeeding psychotherapy session by asking the client what he/she remembered from the previous session. The first time a cli-ent genuinely forgot a dramatic breakthrough, I was stunned. How could he? Had I not seen his eyes grow wide with realization, heard his tremulous voice, and watched his hot tears only a week ago? My mentor showed me that by revisiting this breakthrough, we could actually exploit this memory loss. We used it to deepen the realization that had so nearly been lost. This process is not unique to working with alcoholics/addicts.

The second clinical experience, repeated hundreds of times, is specific to alcoholism. While working in an inpatient chemical dependency program, I was developing skill with dreams. This particular program required all patients to be on disulfiram (Antabuse), a drug that causes extreme nausea if the patient consumes alcohol. The goal was to prevent the behavior for which the patients needed help, so that we would not be forced to stop helping them (It seemed like a good idea at the time.) I might wish I had a dollar for every time I heard this dream: “I was already drinking. Suddenly, I remembered I was on Antabuse. Panicking, I woke up.”

A dream, the humble theory went, is “an unwanted message from the unconscious.” It took us a long time to notice in this case that the dream always began after the patients had started drinking; only then do they remember how much hurt is about to descend upon them. No wonder the dream so often woke them up. Here's the way it folds out:

In other words, the alcoholic's old defense of forgetting won't work when he takes Antabuse. His window of opportunity to enjoy even the first drink has been boarded up. The unconscious itself seems to be warning the conscious mind to “wake up,” the defining effect of a nightmare. “Waking up” is, of course, also a common description of enlightenment.

These examples should illuminate one of the primary dilemmas of the newly sober alcoholic/addict: how to keep the memory of the suffering caused by alcohol/drugs alive, without being doomed to a life of shame, guilt, and fear. Unless something changes, to remember is agony—to forget is fatal.

AA and memory

A quick review of AA's structure reveals an interlocking system of practices: daily meditation about still being in recovery and remembering to use tools, to attend regular meetings to share the story of how disaster follows use, and to work with newcomers who are visible reminders of what really happens. This mnemonic system was designed by those who knew they would forget, for those who know they will forget.

Not so obvious, even to those in recovery, is how directly the 12 Steps themselves confront the dilemma of alcoholic memory. Surely, the “powerlessness” of Step 1 includes the pathetic inability to remember, much less learn from, experience. Step 3 “surrenders” all wills, including the will to remember and the will to forget. Step 4 launches a direct attack on shame and guilt with a “searching and fearless moral inventory.” After writing down the worst, sharing it (Step 5), praying about it (6 and 7), and facing the victims to “make amends” (8 and 9), most who have worked these steps report profound relief.