The concept of an addict’s guilt may seem foreign and contradictory to a loved one. During active addiction, people lie, lose their jobs and bankrupt themselves or their families seemingly without a second thought (though they often do feel guilt but then use more drugs to bury those feelings).

When an addict gets sober, the guilt hits hard.

Healthy vs. Unhealthy Guilt

Guilt arises when a person feels that they have violated their morals or principles or fallen short of their personal expectations, resulting in harm to self or others. Although unpleasant, some degree of guilt in early recovery is a good sign. In fact, in some cases a lack of guilt can be a symptom of mental illness. If you’ve lied, put other people in danger, or committed crimes or other acts you’re not proud of, it’s healthy and natural to feel guilty.

In order to effectively manage guilt, you have to identify the type of guilt you’re up against. When guilt is a catalyst for a positive change in behavior, it is healthy guilt. Guilt can lead to empathy, or the consideration of how one’s actions affect other people, a skill that is critical for long-term addiction recovery. It also encourages people to hold themselves accountable for their actions and make amends for the harm they caused, which helps to ensure they don’t make the same mistakes again.

In just about any self-help support group meeting around the world, you will find people who have been through unimaginable pain standing tall and fearlessly sharing their stories. Despite devastating personal losses, lifelong health problems and broken relationships, they are not consumed with shame. In fact, many seem strangely at peace with their past.

This is the freedom of recovery without regret.

Because addicts tell lies and make repeated mistakes, regret commonly becomes an obstacle to recovery. Left to fester, regrets not only make it difficult to learn from the past and move forward but they can also take valuable time and attention away from recovery, increasing the risk of relapse.

Though painful, regret can be an important part of the healing process. In treatment, we see regret as a sign of readiness to change. As addicts become increasingly aware of the negative consequences of their drug use, regret is a natural response. In its healthiest form, regret drives the addict to ask, “What can I do differently right now to right the wrongs of the past and make better decisions in the future?”

Women don’t want to admit it. Their families often turn a blind eye. Yet drug and alcohol addictions that were once considered a man’s problem now affect an estimated 2.7 million women.

Women have different reasons than men for using drugs and tend to become addicted faster and after using smaller amounts of drugs than their male counterparts. They also have different reasons for relapsing. Here are the top five challenges that pose a threat to women in recovery:

#1 Getting into Romantic Relationships Too Soon

Romantic relationships in the early stages are one of the most significant threats to recovery. If (or more likely, when) they go awry, the loss can send recovering addicts into an emotional spiral. Until their new coping mechanisms are securely in place, it is not unusual for relapse to follow every time a relationship goes wrong.

For many of us, daily life is about “going through the motions.” How often do you drive from point A to point B without remembering how you got there?

Are you able to focus on one activity at a time or are you a multi-tasker who juggles five things at once?

Modern life is not always conducive to staying in the present moment, but as we are learning in the addiction field, the practice of mindfulness can bring greater joy into daily life and also help recovering addicts guard against relapse.

Increasingly, the field is embracing Eastern practices, including mindfulness meditation, as an adjunct to traditional addiction treatments.

In the past two decades, mindfulness has been incorporated into a variety of therapies, including:

• Dialectical Behavior Therapy (DBT)

• Mindfulness-Based Cognitive Therapy (MBCT)

• Acceptance and Commitment Therapy (ACT)

• Mindfulness-Based Stress Reduction Program (MBSR)

• Mindfulness-Based Relapse Prevention (MBRP)

What does an addict who has lost everything in their pursuit of drugs and alcohol have in common with the person who has it all – a great job, a loving family and an immaculate home? Although they may appear to come from opposite worlds, perfectionism can be at the root of both great successes and great struggles.

Although paradoxical, where there is addiction there is often perfectionism. Underneath the addiction may be a person whose unrealistic expectations have caused them to give up on their goals and “check out” through drug and alcohol use. Of course, not all addicts are perfectionists, but it is often black-or-white thinking that drives the unhealthy thought and behavior patterns behind a number of addictions and mental health disorders.

Here are some of the ways perfectionism and addiction are linked:

Early recovery is a confusing time, not only because returning to “normal” life outside rehab can be jarring but also because the brain takes time to heal from the cognitive impairments caused by prolonged drug use. With the aid of neuroimaging, we can see the physical changes that take place in the brain as a result of addiction, and we know that in most cases, it can repair itself over time.

Many recovering addicts, frustrated by difficulties remembering things, concentrating for more than a few minutes, understanding abstract concepts and solving problems, ask, “I stopped using drugs – why do I still feel so confused?”

One year, five years, 10-plus years into recovery, it is not unusual to hear of someone relapsing. What happens? There are endless possibilities but a common explanation is, “I quit going to meetings.” So why do people stop going to meetings (whether AA/NA, SMART Recovery, LifeRing or some other form of group support)? And are they destined for relapse as a result?

Here are some of the most common reasons people give up on meetings:

#1: I don’t need them anymore.

Complacency leads many recovering addicts off course. When the program starts working and the recovering addict begins to feel better, they think they got what they needed to get out of meetings. Rather than wanting more of a good thing, they stop working their recovery program.

There are so many tragic stories in the field of addiction, and no shortage of onlookers who are drawn to the shock and awe of addicts’ war stories. It’s easy to lose sight of the brighter side of the story: Treatment works and people do recover.

This was the message of a survey released last week by The Partnership at Drugfree.org and The New York State Office of Alcoholism and Substance Abuse Services (OASAS), which found that more than 23 million people (10% of adults) in the U.S. have recovered from drug and alcohol problems.

This is a part of the story that is not told enough. If told more often, perhaps we would see more addicts moving beyond the shame and stigma of addiction, getting help, and sharing their success stories. Just as importantly, it would remind the 23 million Americans who have yet to find recovery that there is hope.

Why Hope Matters

Hope matters in addiction recovery because put simply, without hope nothing changes. Few people set goals or pursue them if there is no hope of achieving them. Few people embark on a difficult task if there is no hope of completing it, or at least reaching important milestones along the way. Those who cannot envision a future that is brighter than the present may fall further into drug use, depression or worse, give up on life altogether.

I remember driving past a church one evening with a colleague. A large group of people stood out front, shrouded in an impressive cloud of cigarette smoke. “AA meeting,” my colleague remarked. He didn’t actually know this for a fact, but this is one of those iconic images of recovering alcoholics: coffee cup clutched in one hand, cigarette in the other.

Treatment programs don’t usually address nicotine addiction; they say it is just too much to take on in the early weeks or months of recovery. It is probably the most common cross-addiction. People who quit smoking years ago will start up within days of quitting drinking, looking for something to make them feel better.

Recovery from addiction can feel like a game of whac-a-mole™, that classic carnival game where you mallet a mole as it pops up from its hidey hole, only to have one pop up from another hole. Whack away; there is always another mole taunting you from another hole.

Cross-addictions are nothing new, but the fact that treatment centers are now addressing them during the first 30 days of recovery is.

Anyone who has managed to avoid addiction (whether to drugs, work, sex, food, or some other substance or behavior) is fortunate indeed. But those who have not may not be as unlucky as they think.

In drug rehab, addicts learn life lessons and skills that many people don’t learn until much later in life, if ever. As a result, I believe people in addiction recovery often lead happier, more meaningful lives than the general population (with noted exceptions for those who continue with diseased thinking and behaviors regardless of what they learned in drug rehab).

Here are some of the possible reasons for this turnaround:

#1 Recovering addicts are grateful to be alive.

Gratitude is a recurring theme in 12-Step recovery. Early on, addicts are advised to simplify their lives, making their recovery their primary focus. This clears space for the things that matter most – personal growth, health and family – and drives many to make long-needed changes in their careers, relationships and lifestyle.