The Difference Between Internal and External Rock Bottom


(Substance Abuse Program Director Lisa Richberg, LMHC and Clinical Director Melissa McLain, PhD)

Thank you to our team contributors, Director of our Substance Abuse Program Lisa Richberg, LMHC and Clinical Director Melissa McLain, PhD for their insight into the difference between internal and external rock bottom for the second post in our four-part series on the treatment of both co-occurring and eating disorders at Oliver-Pyatt Centers. 

The phrase “rock bottom” is often used loosely, in both the eating disorder and substance abuse treatment communities, to mean that someone has reached the lowest point in their disorder. Often times, this is the point at which the individual decides to give recovery a chance. Rock bottom is often associated with difficult life events – relationships ending, accidents, financial losses, academic failures; and is commonly sited as lowest points in a persons’ life. However, in exploring this experience with our clients, we have discovered it is not so much the external “rock bottom” events, but rather the internal emotional lows that matter most. It often seems to be that only by reaching her own internal “rock bottom” a person may be willing to risk attempting a different way of living. Rather than hinging on a major life event to trigger the need for change, this internal shift can take place long before, or after, a devastating event has occurred. This moment is often described as being immensely liberating. Recently, one of our patients shared her own experience: 

For me, my external bottom was when my materialistic life fell apart. I was asked to leave school, lost my spot on the softball team, totaled a car, lost most of my friends, spent all my money, and the list goes on. My external bottoms were extremely overwhelming, all consuming, and life ruining. You would think this would be enough to get me to recover, right? The reality was all of the inner turmoil was still very much alive inside of me. I still had unresolved insecurities, traumas, and chaos, which it is assumed an external recovery could fix. I was wrong… After many relapses, I hit a different kind of bottom. This was a bottom that was foreign and uncomfortable, and I wasnt sure how to navigate it. For the first time I truly wanted to stop my eating disordered behaviors for myself, and not do it just for materialistic things or other people

Exploring this idea can help an individual take time to do a personal inventory to assess where she is, and allow her to ask herself questions such as, “Have I had enough?” “Have I reached my own rock bottom?”  Then she can reflect on what she truly wants for her future, and seek the help needed to make that a reality.  

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