A Relapse Prevention Plan: The Tools of Recovery
by Steven M. Melemis, Ph.D., M.D.
The Stages of Relapse
Relapse
is a process, it's not an event. In order to
understand relapse prevention you have to understand the stages of relapse.
Relapse starts weeks or even months before the event of physical relapse. In
this page you will learn how to use specific relapse prevention techniques for
each stage of relapse. There are three stages of relapse.
- Emotional
relapse
- Mental
relapse
- Physical
relapse
1. Emotional Relapse
In
emotional relapse, you're not thinking about using. But
your emotions and behaviors are setting you up for a possible relapse in the
future.
The signs
of emotional relapse are:
- Anxiety
- Intolerance
- Anger
- Defensiveness
- Mood
swings
- Isolation
- Not
asking for help
- Not
going to
meetings
- Poor
eating habits
- Poor
sleep habits
The signs
of emotional relapse are also the symptoms of post-acute withdrawal. If
you understand post-acute withdrawal it's easier to
avoid relapse, because the early stage of relapse is easiest to pull back from.
In the later stages the pull of relapse gets stronger and the sequence of
events moves faster.
Early
Relapse Prevention
Relapse
prevention at this stage means recognizing that you're in emotional relapse and
changing your behavior. Recognize that you're isolating and remind yourself to
ask for help. Recognize that you're anxious and practice relaxation techniques.
Recognize that your sleep and eating habits are slipping and practice
self-care.
If you
don't change your behavior at this stage and you live too long in the stage of
emotional relapse you'll become exhausted, and when you're exhausted you will
want to escape, which will move you into mental relapse.
Practice
self-care. The most important thing you can do to prevent relapse at
this stage is take better care of yourself. Think about why you use. You use
drugs or alcohol to escape, relax, or reward yourself. Therefore you relapse
when you don't take care of yourself and create situations that are mentally
and emotionally draining that make you want to escape. For example, if you don't take care of
yourself and eat poorly or have poor sleep habits, you'll feel exhausted and
want to escape. If you don't let go of your resentments and fears through some
form of relaxation, they will build to the point where you'll feel
uncomfortable in your own skin. If you don't ask for help, you'll feel
isolated. If any of those situations continues for too long, you will begin to
think about using. But if you practice self-care, you can avoid those feelings
from growing and avoid relapse. (Reference: www.AddictionsAndRecovery.org)
2.
Mental Relapse
In mental
relapse there's a war going on in your mind. Part of you wants to
use, but part of you doesn't. In the early phase of mental relapse you're just
idly thinking about using. But in the later phase you're definitely thinking about
using.
The signs
of mental relapse are:
- Thinking
about people, places, and things you used with
- Glamorizing
your past use
- Lying
- Hanging
out with old using friends
- Fantasizing
about using
- Thinking
about relapsing
- Planning
your relapse around other people's schedules
It gets
harder to make the right choices as the pull of addiction gets stronger.
Techniques
for Dealing with Mental Urges
Play the
tape through. When you think about using, the fantasy is that you'll be
able to control your use this time. You'll just have one drink. But play the
tape through. One drink usually leads to more drinks. You'll wake up the next
day feeling disappointed in yourself. You may not be able to stop the next day,
and you'll get caught in the same vicious cycle. When you play that tape
through to its logical conclusion, using doesn't seem so appealing.
A common
mental urge is that you can get away with using, because no one will know if
you relapse. Perhaps your spouse is away for the weekend, or you're away on a
trip. That's when your addiction will try to convince you that you don't have a
big problem, and that you're really doing your recovery to please your spouse
or your work. Play the tape through. Remind yourself of the negative consequences
you've already suffered, and the potential consequences that lie around the
corner if you relapse again. If you could control your use, you would have done
it by now.
Tell
someone that you're having urges to use. Call a friend, a
support, or someone in recovery. Share with them what you're going through. The
magic of sharing is that the minute you start to talk about what you're
thinking and feeling, your urges begin to disappear. They don't seem quite as
big and you don't feel as alone.
Distract
yourself. When you think about using, do something to occupy yourself.
Call a friend. Go to a meeting. Get up and go for a walk. If you just sit there
with your urge and don't do anything, you're giving your mental relapse room to
grow.
Wait for
30 minutes. Most urges usually last for less than 15 to 30 minutes. When
you're in an urge, it feels like an eternity. But if you can keep yourself busy
and do the things you're supposed to do, it'll quickly be gone.
Do your
recovery one day at a time. Don't think about whether you can stay
abstinent forever. That's a paralyzing thought. It's overwhelming even for
people who've been in recovery for a long time.
One day at a time, means you should match your goals to your emotional
strength. When you feel strong and you're motivated to not use, then tell
yourself that you won't use for the next week or the next month. But when
you're struggling and having lots of urges, and those times will happen often,
tell yourself that you won't use for today or for the next 30 minutes. Do your
recovery in bite-sized chunks and don't sabotage yourself by thinking too far
ahead.
Make
relaxation part of your recovery. Relaxation is an
important part of relapse prevention, because when you're tense you tend to do
what’s familiar and wrong, instead of what's new and right. When you're tense
you tend to repeat the same mistakes you made before. When you're relaxed you
are more open to change.
3.
Physical Relapse
Once you
start thinking about relapse, if you don't use some of the techniques mentioned
above, it doesn't take long to go from there to physical relapse. Driving to
the liquor store. Driving to your dealer.
It's hard to stop the process of relapse at that point. That's not where
you should focus your efforts in recovery. That's achieving abstinence through
brute force. But it is not recovery. If you recognize the early warning
signs of relapse, and understand the symptoms of post-acute withdrawal,
you'll be able to catch yourself before it's too late.
