There are critical points (developmental opportunities) that arise within the prolonged course of a disorder that constitute doorways of entry into recovery or opportunities to move from one stage of recovery to another. These milestones can mark a shift either toward greater problem severity or the initiation or qualitative strengthening of recovery. When such transitional experiences initiate or deepen recovery, they are nearly always characterized by a synergy of pain and hope.

The awakening of hope that is such a central theme in recovery narratives almost always occurs in the context of relationships and resources beyond the self, and often occurs through encounters with the experience, strength, and hope of others in recovery. Historically, the addiction field believed that recovery initiation was grounded in the experience of pain ("hitting bottom"), but there is growing recognition that the deepest despair incites recovery only in the presence of hope.  In the addiction field, this is sparking a transition from pain-based interventions to hope-based interventions (e.g., the replacement of confrontation with motivational enhancement techniques).