The Early, Mid and End Game

TREATMENT AND CARE

The game of chess has its roots from Eastern India, around the 6th century. It developed into the complex strategy game we know today through European influence in the 1700s and the eventual competition, including that of Grand Masters, in the mid-1800s. Since chess is a game of complete information, each player is able to see everything in play. There are no elements of luck or randomization, and for this reason, many purists consider chess to be the ultimate game in planning and strategy.

For each of our patients at CeDAR, we are working to develop a strong strategy of addiction recovery options for the individual, not unlike a full game of chess. This includes the early, mid and end-game. As a game progresses, just as someone moves further along in recovery, these options become more open and less structured.

The Early Game

Many games of chess start in quite similar ways. There are often a good set of ‘openings’ a player may use. These openings tend to emphasize good development of the game board, such that the person has options in the future. A constrained opening can be exploited by the other player, hence fundamentally sound development is key.

One of the most important ingredients in early recovery is that of structure. Good addiction recovery treatment often is predictable towards the beginning. This involves detoxification from substances, screening for co-occurring disorders such as depression, and safe medication approaches. During the early stages, the person needs to feel safe, start to engage in a process of change and stick to what works. This helps the person have good options in the future, just as with a game of chess.

The Mid-Game

After primary treatment, our clinical team at CeDAR is making recommendations to each patient about next steps in recovery. This may include a sober living option, step-down care or follow-up services. It is during this stage that we are determining what options are the best fit for any individual, as there exist a wide array of addiction recovery services available in many communities.

Attention to detail and avoiding a costly mistake during this stage is key, just as with the mid-game in chess. Many people relapse on drugs or alcohol following primary treatment, hence it is very important for us to approach this stage with sensible caution. A catastrophic move can spell doom for the upcoming months, even if the person had the best of intentions. It is our job as clinicians to help patients appraise risk for relapse and potential problems.

The End-Game

The ultimate goal of long-term recovery is to rebuild a life worth living. This can involve different ingredients for different people, but some of the most common topics include addiction recovery options like connecting with others, self-care, and a balanced lifestyle. Each of these examples requires a person to feel emotionally secure, attached in positive ways to loved ones, and with a good amount of insight and sense of self.

Very often, individual or family therapy can help someone build the awareness and skills to succeed with these concepts. It is important to visualize these goals while appreciating the need for structured sobriety in the early and mid-game. Sadly, repeated relapsing and disengagement from treatment can make the end-game ideas hard to grasp. This is because relapses tend to get in the way of secure attachment, life balance, and self-care. Alternatively, good progress with these goals actually can help prevent relapse. The key is working through things slowly and consistently.

If you or a family member are engaging in treatment, pay attention to where you are in the process. Does it feel more like the early stages in which you are working to stabilize and start your recovery journey on a good footing? Have you moved onto choices of extended care and relapse prevention? Long-term, do you have ideas around relationships in your life and a life worth living? Thinking of these different stages can help you build a strong strategy in your recovery path.

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