The Lessons Of Relapse
Addiction is a chronic, recurrent and terminal illness. Unattended, it will progress! However, recovery is possible and, if you follow the steps of a relapse prevention model, you can live a relapse-free life…for the rest of your life.
I am a recovering sex addict. Some of you may identify as such, others, perhaps, identify as something else- powerless over any one of several other substance or behavioral addictions and perchance, as me, are already living in recovery. Even if you do not identify as an addict however, it is likely that you know someone who is. If any of the above is true for you, know that the following statements regarding addiction(s) are true. May these words ring loud and clear in your mind and motivate you to commit to a life of change and the work that guarantees freedom from compulsivity.
“By studying relapses we can find the factors at play in a slip to an earlier phase of the change process and we can learn to apply these lessons to our renewed efforts at transformation.”
Having arrived (through whatever route) at the realization that something merits change in your life, success in your commitment to a process of change entails accepting that it is your choices (and yours alone) that will dictate the success or failure of your change efforts. An empowered life is a life of conscious choosing and self-responsibility. Nowhere is this approach to living more important for a recovering person than in regards to changing unwanted and undesirable behaviors or habits, both physical and cognitive.
In recovery, you will encounter bumps on the road to sustainable change. Therefore, it is incumbent upon you to learn from these bumps (lapses or relapses)- to dissect each one of them as they occur, seeking the morsels of information that can help you to avoid the future missteps that can threaten your sobriety. The willingness to pursue this learning is one of the ways in which you demonstrate empowerment and self-responsibility.
I wish to share with you today common lessons of relapse that all self-changers can benefit from. These are lesson gleaned from both my experiences and those of other self-changers who, despite their best efforts, found themselves close to engaging in the very behaviors they wished to be abstinent from. I hope these lessons prove valuable to you on your path to freedom from whatever you have decided merits change in your life.
Relapse is recognized by some as part of the process of change. It is itself the endpoint of a separate process, one that results in the loss of abstinence or the return to the unwanted behavior. By understanding this process we can learn how to make abstinence inevitable!
“Change is difficult” is a cliché that encapsulates a simple truth- what we most wish to change about ourselves is also what we most often resist changing. Thus, we all benefit from tools, practices and programs to guide us and support us on our process of change. A common part of this process of change, and one of its most powerful mentors (if we choose to discern the lessons it affords us) is relapse. Relapse is most easily defined (and observed) as a return to an unwanted behavior following a period of abstinence. At a deeper level, however, relapse is actually a return to a previous stage in the process of change. By studying relapses we can find the factors at play in a slip to an earlier phase of the change process and we can learn to apply these lessons to our renewed efforts at transformation.
That we can change is evidence of the fact that we are never helpless over that which we are powerless over. Change is possible; but it is a process- an often laborious and painful progression through a series of stages that, if successfully completed, leads us to the Maintenance of abstinence, or life without the troublesome behavior. This is an experience of life unlike that we previously knew, and it is typically different enough to be preferable to how we lived before. Maintenance is a latter stage of the change process, one in which we live not just abstinent but soberly in the face of life’s challenges. Maintenance is a delicate entity that requires nurturing, protection and care.
The following lessons from relapse can help you nurture, protect and care for your sobriety. They apply to Maintenance and all other stages of your change process (the stages of change will be discussed in a separate edition of this blog).
1. Failure to sustain change often occurs if we go at it alone.
Eschewing much needed support for the trailblazing feeling of control that going solo can give us is dangerous for self-changers. This feeling is a welcomed part of adventurous exploration, but it is one to avoid in a process of self-change. Whether you are overcoming problems with substance abuse, behavioral addictions, dysfunctional relationships or simply trying to achieve weight loss, going solo, absent a hearty and well-informed support structure- a peer network- is a sure recipe for failure. As you dissect a relapse or lapse, look for any evidence (physical or mental) of isolation or growing distance from your support network. You should make efforts to identify and clearly articulate any thoughts that supported your decision(s) to distance yourself from your support network or to not have one in the first place (see SUD’s below).
2. You are unfamiliar with your acting out cycle and with stage-specific interventions that interrupt it.
A significant contribution to the understanding of relapse is the recognition that most acting out behaviors- whether they reach a standard of criminality or not- are played out in a cyclical pattern that links identifiable events to one another until the outcome of the cycle (the behavior we seek to change) is inevitable. Many people can remain sober without any knowledge of their acting-out cycle. For others- particularly for those who have already experienced a relapse- this knowledge can be a game changer.
An acting-out cycle is a pattern or sequence of events that repeat over time and leads to the loss of abstinence. The patterns are linked to one another like links in a bicycle chain and include habits of perceiving, thinking, feeling and, ultimately, behaving.
Many of you are likely thinking right now that you have a sufficient understanding of your triggers to keep you safe and to protect your sobriety, and that there is no need for additional learning or investigations. I used to think so too. I invite you to avoid contempt prior to investigation, to keep an open mind, and to do the work that will allow you to define your particular acting out chain or cycle. I will be leading a workshop on this subject in the very near future (see below). If the concept of cycles is new to you, I can guarantee that you will benefit from participating in the workshop.
3. Seemingly Unimportant Decisions (SUD’s) fuel all lapses.
All lapses or relapses are the result of a combination of choices / decisions that ultimately lead you to break your abstinence.
A Seemingly Unimportant Decision or SUD is a choice that, at the moment made, you are unaware supports your addictive process (or cycle). Typically “minor” or otherwise easy to justify, SUD’s invariably link one risk factor to another and encourage your progression along your cycle toward the eventual outcome of the cycle- you relapse.
SUD’s arise when you are unconscious of (not paying attention to) the thoughts and feelings that accompany the choices you make when encountering challenges to your sobriety. Being “present” includes developing an awareness of the motivations, urges, justifications and rationalizations that support your choices in recovery. Early in your process of change, SUD’s are always recognized for what they are retrospectively, that is, only after you have dissected a lapse or relapse and studied the decisions that got you there. As you mature in your recovery and study the habitual patterns of thinking that emerge once your cycle is activated, you come to recognize the thoughts that lead to faulty choosing before you actually engage in the risky decision(s).
One way of countering SUD’s is to disclose to your sphere of support as many of your thoughts, decisions and plans as possible before embarking on them and to be open to feedback. Early in your recovery it is best to err on the side of disclosing more rather than less. When you dissect a lapse or relapse, you will always find at least one unacknowledged SUD that supported the return of your unwanted behavior.
4. Lacking a Relapse Prevention Plan(RPP) is like having a relapsing plan.
Sustaining change during Maintenance can be quite difficult. The failure to understand what is involved in changing, and the lack of knowledge of the risk factors involved in relapsing, means that you are handicapped in your process of change. It is like waiting to learn how to swim just before your very first swimming competition while expecting to excel at it.
If you are to sustain change- not for a few months, but for years, even a lifetime, it is vital to have worked out a detailed plan (and to occasionally revisit and revise it) based on an understanding of your unique acting-our cycle. The more you feel as if this is currently unnecessary in your life, the more I believe you need consider deepening your understanding of this material.
5. Distress precipitates a return to compulsivity.
Stress is the enemy of abstinence, particularly for self-changers early in their change process. Why is this? Well, consider that addictions represent a strategy that helps you to avoid uncomfortable feelings- feeling of low self-worth or overwhelm, for example. Finding yourself without your numbing salve amidst intense emotions generated by stressful situations will hasten a return to the very behaviors you are trying to change. The importance of stress in promoting your progression along your acting-out cycles becomes apparent as you dissect a lapse or relapse.
An essential element of a Relapse Prevention Plan is the recognition of your unique high-risk stressful situations and high-risk emotional states, and the development of interventions to help you cope with these when they arise. Distressful circumstances may include actual events (a loss of employment, heated argument with your spouse, death of a loved one, a health scare) or feeling states (anxiety, depression, overwhelm). Hunger, anger, loneliness and tiredness, for example, are common stressors most of us learned early in our recovery to address and resolve.
6. Its 12 steps, not an escalator.
This aphorism, often heard in the rooms of 12-step programs of recovery, is a reminder that everything we learn in our process of change, and all of the tools we avail ourselves of, are of little use unless we incorporate them into a plan of action.
Recovery will not come to he who does not get into action, choosing instead to await a better time to get started. If we fall into the trap of thinking about what we are learning but not putting it into action, we run the risk of remaining stuck in denial and ambivalence. There are other mental traps that can keep us stuck in a state of ambivalence and eventually foster a return to unwanted behavior. Recognizing and countering these mental traps is essential if we wish to change our behavior and to maintain our abstinence for the long term. This will be a topic I cover in greater detail during the workshop I have already alluded to. ……………………………………………………..
There are many other lessons relapse can teach us. I have chosen to limit my discussion to the ones listed above for the sake of brevity. I will have more to say on this topic in future editions of this blog. Thankfully, you do not need to relapse in order to acquire the learning that can protect your recovery.
Until then, stay sober my friends…