Former boxing champ Mike Tyson's admission that he's struggled with grief and forgiveness in part of his ongoing alcohol rehab points to two of the four key stressors Every Silver Lining Has a Cloud notes as potential barriers to long-term sobriety. Of course everyone, Alcoholic or non-Alcoholic, faces these stressors. Most handle it swimmingly well, others not so well, masking them with alcohol. When someone with the disease of Alcoholism encounters something so strong it triggers the stress hormone cortisol, relapse is a possibility.
"For those on the outside of the disease, in a way, dealing with a drinking Alcoholic is easier than dealing with a sober one because with a drinking one you know what the problem is. The conversations I had with more than 200 men and women in recovery reveal what the sober Alcoholic’s problems are.
When the Symptoms of Sobriety appear, know they are normal responses to cortisol increase traced to these four things we struggle with in sobriety:
Guilt (Chapter Four)
Shame (Chapter Five)
Forgiveness (Chapter Six)
Grief (Chapter Seven)
When you take away alcohol, you still have problems—problems that non-Alcoholics sometimes use alcohol to relieve, “treat” or cover up. In an Alcoholic, these four cause relapse. They are the cloud to sobriety’s silver lining. They aren’t simply squishy, intangible emotional qualities for Hallmark cards or spiritual books. Science shows they’re states that have a concrete and measurable effect on our biochemistry.
Every Alcoholic has manifestations of these four and needs treatment geared toward these stressors or the treatment fails. No treatment will have lasting success without addressing what causes the Symptoms of Sobriety. To put it another way, it’s well known that high cholesterol levels increase coronary heart disease—heart trouble. Those who have a genetic predisposition for difficulty handling cholesterol frequently can forestall heart trouble with careful eating habits. A person who doesn’t have the problem handling cholesterol doesn’t have the same urgent need to restrict his diet. Eating ice cream or gorging on fries isn’t much of an issue for him but it is for the man who does have the genetic predisposition. And so it goes with Alcoholics who are stuck with a problem handling cortisol. Guilt, shame, forgiveness and grief are a threat to recovery trouble like cholesterol is a threat to heart trouble."
--from Every Silver Lining Has a Cloud: Relapse and the Symptoms of Sobriety, pgs. 33-34