Coming back from RELAPSE
There’s no getting around it. You slipped. You had a relapse. It’s time to face the facts, pick yourself up, and start back on the road to recovery. The truth is that many recovering addicts have one or more relapses before they finally get it together. This is not an indictment, simply a reality. The problem is, once it’s happened to you, it’s not so easy to face what’s happened. The tendency is to heap blame on yourself, to feel that somehow you should have been able to avoid a relapse. That’s counter-productive.
Here’s a more constructive way to face yourself after relapse.
Respond to relapse immediately
First of all, you need to act immediately. After your relapse, you can’t delay for several days or weeks. That will just compound the problem and prolong your relapse – maybe even make it worse. It’s also a mistake to think to yourself, “Oh, this is it. I’m going downhill and there’s nothing I can do about it.” That’s just not true. In fact, only you can take the steps to resume your recovery. Recognize that you slipped and double your efforts to overcome your cravings or urges. You don’t have to have all the answers right now. What’s most important is your desire to move past your slip-up and forward with your recovery.
Deal with your depression
Addiction is considered a biopsychosocial disease. What this means is that there are biological, psychological and social or environmental factors that contribute to the development of addiction. In a relapse, some or all of these factors come into play, making recovery more difficult for the addict. In fact, they can be much more difficult than simply treating a medical condition.
Depression is very common among alcoholics, particularly women, both during treatment and in recovery. After a relapse, then, it’s even more important to deal with the crushing depression that can derail recovery. A psychologist or recovery counselor can help you sort out the psychosocial problems that may have contributed to your relapse. Attending 12 step or self-help groups is also beneficial in working through feelings of depression. Be prepared to work on this for a while, however, as depression doesn’t just magically disappear. Dealing with depression by talking about your issues with a counselor and interacting with others who have been in the same situation is a constructive way to get a handle on depression. Look at it this way. Depression won’t go away on its own. Often, the addict who’s relapsed doesn’t even know where to begin to work it out. Get professional help and seek the support of others.
Prepare to make major changes
During treatment for addiction, you most likely worked out a game plan, a list of goals, and worked on effective coping skills. Once you entered the recovery stage, you may have become a bit overconfident in your ability to resist urges and cravings. You may have thought that you could have just one drink, or do a little bit of drugs, or gamble a set amount, or indulge your addiction in some small way. Even if you didn’t delude yourself that you could handle your urges by going slower, reducing your consumption or addictive behavior, you may have let your guard down. Perhaps this was an instance of you falling back in with friends you used to drink or do drugs with, or go gambling with, or whatever. It may be that you didn’t purge your surroundings of any temptations, which now serve as triggers.
Whatever you were doing, however, it’s obvious to you now that it didn’t work out quite like you planned. If it had, you wouldn’t have relapsed. You’ll need to make some major changes in your life now.
Some of the changes you should plan to make include making a list of the people, places and things that are dangerous to you. These are the situations that remind you or prompt the need to drink, do drugs, gamble, or engage in compulsive sexual activity, overeating, overwork or other addictive behavior. Next to each, start writing down ways that you can deal with these situations as they arise. This is your plan of attack, how you will navigate your way through the minefield of obstacles that are a threat to your sobriety.
Again, don’t worry that your list isn’t comprehensive, or that you don’t have a solution to deal with the problem. Just put down everything that occurs to you. Every time you think of a new issue or problem, write it down. Similarly, as potential coping strategies or solutions come to you, or you hear them from your counselor or your 12 step sponsor or self-help group members, write it down alongside the appropriate issue. You will be building on your plan, and that’s a constructive and proactive way to approach your recovery.
Learn how to combat social pressures
For the recovering addict, particularly the alcoholic in recovery, the social pressures to drink can be enormous. It’s almost impossible to completely insulate yourself against the presence of drinking as a social activity. Drinking is portrayed as fun and socially acceptable in advertisements for liquor, beer and wine. You’re bombarded by characters that drink in movies and on television programs — and not all of them drink responsibly.
For some recovering alcoholics, just the sight of someone raising a glass in a bar or at a party is enough to send them into a desperate craving to imbibe. For others, it’s the sound of the ice cubes in the glass, or the smell of the saloon. And, yes, alcoholics recognize that smell. To them, it symbolizes the good times, the camaraderie, and the excitement, the loss of inhibition, the drowning of sorrows. They never think about the mess alcoholism caused in their lives — not at that moment. It takes discipline and a plan to remember these things when you’re confronted with the temptation.
The same social pressures can negatively affect other recovering addicts as well. How do you respond to the TV ads promoting the Lottery — “You can’t win if you don’t play.” Or the guys in the office betting on the sports pool and urging you to get in on the action. What about the trigger of the starting bell on the sports report of the horse races?
Effectively combating social pressures to indulge in addictive behavior isn’t easy. For the alcoholic, drug user, gambler, etc., it’s critical to remember that you can’t just go back to the behavior. You need to learn how to extricate yourself from tricky situations, how to say no and mean it. Alcohol and drug use, to recovering addicts, presents more than just psychological problems in relapse. Serious health consequences can occur. It’s better to have a plan you can put into action than give in to social pressure.
Build a better support system
Another common reason why addicts relapse is that they don’t have an adequate support system in place. Without a support system, addicts are at greater risk for relapse. Those who are homeless, lack a job, or have no caring family members to assist fall into this category, but any recovering addict without sufficient support is also at risk. For those at the bottom of the ladder in terms of self-sufficiency, however, there’s still hope to come back from relapse. It’s just a little harder to accomplish. Admittedly, the odds are somewhat stacked against them, but 12 step sponsors and group members may offer resources and advice on getting back on track. Some groups have job counseling or training seminars, or can point the addict in the direction to resources that can provide assistance.
For many recovering addicts who’ve had a relapse, the only way they are able to make it through the difficult times is with the support of their fellow self-help group members and their sponsor. Lacking a family, or having a family that’s disowned them, these individuals can benefit from the kind of extended family that 12 step groups provide. This fellowship demands nothing in return except a genuine willingness to get better and to someday help others in a similar fashion. And it doesn’t cost a penny. When you are at a stage in your recovery where you are stronger, you can give back by helping others on their path.
Get body and mind back on track
The first year of recovery is the toughest to get through. It takes a long time for your body and your mind to rid itself of the effects of drugs, alcohol, and other addictive behavior. The rush of adrenalin, the “high” you felt during your addictive behavior, still leaves residual traces imprinted in your brain and your nervous system.
Physiological and psychological damage takes a long time to repair. This includes cognitive impairment, memory loss, confusion, emotional distress and other symptoms. Getting your body and mind back on track takes hard work and time. After a relapse, you need to build up your physical and mental strength through proper nutrition, adequate sleep, exercise, medical check-ups, counseling and attendance at 12 step or self-help group meetings.
Eliminate boredom and loneliness
Along with having a plan of action to avoid people, places and things that cause you to want to resume your addictive behavior, you also need to be alert to two other potential concerns for another relapse. These are boredom and loneliness. When you’ve had a relapse, especially during early recovery when your coping skills may not be strong enough, you’ve got a lot of hours on your hands. When you were using or engaging in your addictive behavior, you took up a lot of time. Now that you have made the effort to be clean and sober, but had a misstep, you’re facing a lot of empty time — hours that you don’t know what to do with. What happens is that boredom and loneliness step in to fill the void.
There is a solution, and it’s a fairly straightforward one. You need to cram your schedule with activities and interactions that are more helpful to your recovery. One of the best ways to do this is to attend more 12 step meetings. Immerse yourself in them. Attend them more frequently than once or twice a week. Some recovering addicts who’ve relapsed find it helpful to go to meetings twice a day. Pick several groups and attend them all. Do whatever it takes to find the support you need. Talk with your sponsor. Do things with your group members. Participate in workshops and seminars. Listen to others at the meetings and lend your support as well. Reaching out can benefit you by taking you outside your own concerns as well as helping the other person in need.
Replace addictive behaviors with healthy ones
Okay, so you know you have some negative behavior that you need to replace. How do you find the ones that will be most beneficial? Let’s face it. You’re probably not the best one to decide what’s most appropriate and could use some help.
Addiction recovery experts recommend two solutions:
- Develop a good relationship with your sponsor.
- Attend self-help or 12 step group meetings more frequently.
Both of these strategies will help you confront the feelings of self-pity, complacency and dishonesty you felt before and after your relapse. Use the Alcoholics Anonymous acronym of “HALT” as a reminder of what you need to do. Avoid allowing yourself to get hungry, angry, lonely or tired.
- Make sure you eat regular and nutritious meals (plenty of fresh fruits and vegetables, fiber, whole-grains).
- Exercise regularly. This doesn’t mean that you have to join a gym. You can go for a 30-minute walk four times a week, go swimming, bicycling, or work out at home with hand weights and exercise bands. The point is to do regular exercise to a point where your body feels the effects of the workout. This helps your body and your mind by producing endorphins that make you feel good.
- Get enough rest. While you are in recovery, especially after a relapse, you should aim for 7-8 hours of sleep a night. Don’t read in bed or watch TV. Make your sleeping environment conducive to sleep. Try to go to bed and get up at the same time every day. This sets a natural rhythm for your body. If you toss and turn, get up and go in another room until you feel sleepy. Then, go back to bed.
- If you’re feeling lonely or blue, go to a meeting or call someone you trust and talk. You don’t necessarily have to talk about your problems. Just talk. And listen. The act of engaging in conversation with another will take your mind off your feelings for a while — and this may be all it takes to lift your mood.
Healthy behaviors — like regular exercise, socializing with non-using individuals, attending meetings, and others — will become easier to develop over time. Be patient. It does take time.
Let go of guilt, shame and resentment
While recovering addicts are in the early stages of recovery, it’s common for them to experience feelings of guilt, shame and resentment. After a relapse, however, these feelings can become so intense they’re almost unbearable. They don’t have to be. Recognize that it’s normal to feel guilty that you weren’t able to keep up with your recovery, shame that you’ve let others – and you – down, maybe even a little (or a lot) of resentment toward others that they didn’t support you during your time of crisis.
Then, get past it. You need to acknowledge the feelings, yes, but it’s even more important that you let them go. This is easier said than done, of course, and probably means you need help doing so. Seek the assistance of your counselor, if you still have one as part of your aftercare recovery treatment program. If not, look for counseling that’s a pay-as-you-go or sliding scale fee. Utilize any federal, state or local resources to get the ongoing counseling therapy you need. Besides individual counseling, group counseling sessions can also prove beneficial.
Remember that guilt, shame and resentment are strongly associated with the stigma of being an addict. Left unattended to, they will interfere with your ability to heal. You deserve the right to your own redemption, to being clean and sober again and to live a happy and productive life.
Learn from Your Relapse
So you’ve had a relapse. That doesn’t spell the end of the world. Even if you’ve had multiple relapses, it doesn’t mean that you are beyond help. You just need to get better support systems or help to deal with another major crisis that has temporarily derailed you. The point is that you don’t give up.
Take a detailed look at what happened to prompt your relapse. Prior to your slip-up, what strategies or coping mechanisms seemed to work the best for you? List those and see how you can incorporate more of them into your behavior now. Next, look at the circumstances surrounding your relapse. What immediately happened? Is there something that you could have done to prevent it? Write down your thoughts and discuss them with your counselor, your sponsor and/or your fellow group members.
By learning from your relapse you will be building your defense arsenal to be better able to cope with threatening situations in the future.
List your triggers
While we’ve mentioned triggers before, it may be helpful here to have you list those separately. What specific activities, sights, sounds, or people, places or things raise your relapse threat level to severe? What triggers cause you to relapse?
Now, develop new plans for two or three of the major triggers – the ones most likely to cause a relapse. You will need to avoid these triggers for a while or until you find new ways to cope with them.
Tips to help in recovery
Here are some final tips to help in your recovery.
- Stay focused on your recovery. Don’t try to concentrate on another major goal while you’re coming back from a relapse. You need time to get yourself together, time to get stronger.
- Make sure you recognize your incremental achievements. Reward for achieving a goal of one week of sobriety, or one month without gambling, for example, is a great way of recognizing your achievements and spurring you on to your next goal.
- Get support and help often. Keep in close contact with those who are most helpful to you. This may be your family members, close friends or co-workers. It should definitely include your 12 step group sponsor and other group members with whom you share similarities or friendship.
- Change your routine. Switch the way you drive to work, the order in which you do your exercises, the variety of cuisines you eat or prepare. This keeps things from getting stale and creates an aura of excitement, of something different, something new each day to look forward to.
- Don’t see your relapse as failure. Never give up on your goal of recovery.
- Relapse is a brief return to addictive behavior. It doesn’t mean that you’re destined to fail if you’ve had a relapse. You may need to go back into treatment and/or intensive counseling so you can get back on the road to recovery.
- Get support immediately from a person or group that you trust.
- Make yourself wait at least 2 hours before acting on a craving or urge. This is often long enough for the urge/craving to dissipate.