By: Marilyn L. Davis
“If you can quit for a day, you can quit for a lifetime.” ― Benjamin Alire Sáenz,
Relapse: Learning the Lessons
People who have relapsed can learn something from the experience. But, for the rest of us, those lessons are best learned from a distance. We can learn from watching what others go through when they relapse. This is a better alternative than learning first-hand.
I have clients who talk about relapsing as if it just occurred. Yet, when these same people consider the thoughts, feelings, and attitudes that were going on with them a few days or weeks before the relapse, they can often see that there were warning signs that they were heading back to their use.
Relapses can occur because people stop doing something, like letting up on daily recovery maintenance, or they might not have anticipated that an activity would prompt this relapse. We all know that there will be situations, people, feelings, and thoughts that result in thinking about using. Unfortunately, some people get overwhelmed and say, “To hell with it.”
There are alternatives to relapse. When we take the initiative to study and find more alternatives to relapse and use these resources, we are less likely to relapse.
Understanding Relapse Triggers
Relapses do not just happen. There are some subtle and some not so subtle clues that we are heading back to use. An easy way to see if you’re heading towards a relapse, ask yourself:
- What activates my desire to use?
- Are there situations I should avoid?
- What thoughts and attitudes prompt me to think about returning to active addiction?
- Do I let my negative feelings govern my actions?
Learning relapse triggers will help us be able to spot them, and make other choices than to use. There are predictable triggers for all people. We can learn the common ones, and dig deeper and find our personal triggers. Learning our personal triggers is important to our long-term recovery. There is no cure for addiction. Our addiction does not go away, but with proactive choices, we can lessen our chances of a relapse.
With this knowledge, we can help make sure that a relapse doesn’t “just happen.”
Four Aspects of all People
Because relapses have such a devastating effect on the person, it is important to look at four basic aspects of a person’s life. Each aspect has triggers, but they also all have tested, proven ways to help us not sabotage our recovery. All people have four aspects: emotional, mental, physical, and behavioral.
Emotional Triggers Leading to Relapse
Emotions are often numbed or ignored in our addiction. We avoided them, didn’t acknowledge them, or used to mask them, but they are still a part of our make-up.
Imagine that our feelings in active addiction were held in check like a jack-in-the-box. Without drugs or alcohol to numb them, they come flooding back in recovery. When they pop up in early recovery, they often seem inappropriate for the situation.
These emotions are confusing, overwhelming, and frightening. There are some predictable feelings that resurface in early recovery. Some of the more problematic ones are:
But, it’s any emotion that causes thoughts about using.
Learning to deal with our emotions is a key element in long-term recovery. Writing about our feelings, or talking with trusted friends can release them without harming us or others.
Not releasing them may help us justify returning to active use.
Mental Triggers Leading to Relapse
Mental traps for a relapse are the addicted thinking. In our recovery, it’s often necessary to change our thinking patterns and perceptions.
There are usually five problematic traps or some variation on these. We should explore our mental traps that set us up for a rationalized or justified relapse.
- Denial or ambivalence about the severity of our problem
- Fantasizing about using (especially a type of alcohol or drugs we have never used)
- Figuring out ways to control our use
- Glamorizing our past use: Thinking about all we’re missing
- Playing “What If” games about our use that do not end in a negative outcome
A safe way to deal with problem thinking is to talk about those thoughts to others. Let them help us decide if our ideas about a situation show good judgment.
For instance, I had about five months in recovery and decided it was a good idea to go to a Grateful Dead concert in Atlanta. I talked about this in a meeting. Everyone cautioned me that this was not a good idea. I justified this decision with “I’m spiritually fit and think I can handle seeing others use. I’m just there for the music.”
While it sounded good and logical, the reality was different. Surrounded by people using, I was uncomfortable and scared, so we left. So much for riding that train. I got off at the nearest stop and didn’t relapse, but could appreciate the danger, after the fact.
It’s often the case, that we don’t pay attention to others, thinking that we have all the answers. I should have listened. Seeing others use looked invitational. I’m fortunate that my friend was with me to help keep me from returning to use.
Physical Triggers Leading to Relapse
Pain is the number one physical reason that people relapse. Many things cause physical pain in our recovery. Some of the predictable ones are:
- Post-acute withdrawal symptoms that include pain during the physical healing process
- Accidents or Injuries
- Ongoing chronic health issues
There are safe alternatives to narcotics and opiates for pain. Let your doctor or healthcare provider know that you’re in recovery. Ask if there are medications that won’t set up cravings.
I carry a “high-risk acknowledgment” in my purse and have it as part of ICE (in case of emergency) on a phone app. I want doctors or ER people to understand that I’m an addict. This is especially important to me if I’m not able to talk to them. I hope that this means that ER staff will factor this into any decisions about medications.
Behavioral Triggers Leading to Relapse
Behaviors are actions that we do and do not do. So what are the risky behaviors versus safe behaviors?
- Not going to recovery support meetings vs. Enough meetings to reinforce recovery
- Going around using friends vs. Establishing a social network of recovering people
- Dating someone who still uses vs. Putting the relationship on hold to save ourselves
- Discontinuing recovery routines vs. Daily maintenance to support our recovery.
- Not having a plan for stress vs. Learning techniques to reduce stress and anxiety
- Being close-minded to suggestions vs. Listening to more knowledgeable people about recovery
Even with our focus on recovery, there will be unavoidable triggers. There are people and situations that prompt us to think about using.
Unavoidable Triggers and Relapse Prompting Encounters
There will be times that we focus on our recovery and are doing everything we can to support our recovery. Then a chance encounter or a thought of using will happen. It might be:
- Hearing a song on the radio
- Running into an old using friend at a store
- Watching an innocent movie that ends up reminding us of our use
We should always pay attention if our activities prompt thoughts of using. Each of us in recovery needs to be aware of the Red Flag Warnings Leading to Relapse:
- Argumentative about Solutions
- Defensiveness when questioned
- Discontinuing meetings
- Irregular eating or sleeping habits
- Irritation at others, leading to resentments
- Letting up on recovery disciples
- Loss of constructive goals and planning
- Unwilling to change
- Not having a support system
- Resistance to directions
Relapse Prevention Knowledge is Available to Us
As you can see, there are many components to a relapse. Most of these are predictable. That also means that people have come up with safe, effective alternatives to relapse.
Most people are more than willing to share what works for them. The methods for not relapsing are as varied as the people who use them. For instance, going fishing and isolated from all temptations may not work for you. But it works for others. Be open to their solutions, and you may find that some of them will work for you.
Do not hesitate to ask people for suggestions to prevent a relapse.
When You Don’t Relapse: Be Joyful
When we do not use after one of these triggers, we begin to have a personal history that we can have a trigger, not use, and keep our focus on recovery.