Relapse is a process that occurs over time, in the context of significant decisions. Many people who relapse say that drinking or using was the furthest thing from their mind just before they consumed the chemical. In reality, most of the time, relapse was in process some time before the chemical was ingested. The relapse process involves a return to old thinking, old feelings, and old behavior.
When someone is addicted, consumption of their mood altering drug of choice is almost automatic. It is a deeply ingrained and somewhat unconscious action. It has become "first nature".
The behavior of addiction is like driving your car on a familiar superhighway. You have driven the route many, many times before. The road is smooth, flat, and straight. Your mind wanders. You think about what happened at work, what you're going to fix for dinner, and a conversation that you had earlier in the day. You are not focusing on maneuvering your car down the highway. It seems to just take you.
You don't get up in the morning and remind yourself to smoke pot before you go to work. You just do it. You don't have to remind yourself to stop at the convenience store on the way home to pick up the six pack. Your car seems to know the way. Many of the things you do are part of your routine and not conscious decisions about how to behave.
When you make a decision to get clean and sober, it is like taking a small unpaved utility road off that superhighway. You have to pay close attention to not fall in the potholes, to avoid the big tree roots, and to watch out for deer in the path. In short, you have to pay close attention to what you are doing to keep going down the road. You make conscious decisions about how fast or slowly you are going or about the slight turns in maneuvering your vehicle. You are self-conscious.
You have to be pretty self-conscious to make good recovery decisions each day. You have to consciously identify and deal with your feelings and your thoughts so that your behavior is recovery-appropriate. As you deal with what life serves up everyday, one day at a time, and remain abstinent, it gets easier and easier. The utility road gets smoother and smoother as you travel it, and recovery becomes second nature. After awhile the need for hyper-vigilance decreases.
In early recovery however, the need for hyper-vigilance about your every decision is appropriate. Seemingly unimportant decisions can have major influence over whether you relapse. To prevent relapse it is crucial to scrutinize your patterns of use and identify your vulnerabilities. To identify your specific vulnerabilities, ask yourself these questions, then make a plan to reduce or manage your vulnerabilities, This will help reduce your risk: 1. What drugs did you use?
2. Where did you get it/them?
3. When did you purchase it/them?
4. When did you use?
5. Who did you use with?
6. What activities are associated with use?
Answering these questions gives you a great deal of information to assist you in maintaining abstinence in early recovery.
Let's say that you drank beer alone, purchasing it at a convenience store on the way home from work, and began to drink after dinner while watching tv. Reducing your vulnerability to relapse from this pattern could include these simple cue avoidance techniques:
a. getting the alcohol out of the house,
b. taking a different route home so that you don't see the convenience store where you used to buy it,
c. something else to do after dinner that does not involve television.
Cues are those visual, environmental, and emotional reminders of your chemical use. In this example, you are replacing relapse cues with different cues. You are making conscious choices that can have direct bearing on whether you will relapse. As you do that more and more frequently, your pro-recovery choices become less and less self-conscious and more "natural" to you. At the beginning of recovery, each one of these conscious choices feel weird, "unnatural", or forced. In early recovery, there is an axiom that say "if it feels right, don't do it". You are learning a whole new way of life - with new thinking, new feelings, and new behavior.
Cue avoidance and replacement are helpful, but a recovering person needs a lot more abstinence techniques than this. A recovering person needs an arsenal of abstinence tools to maintain sobriety and prevent relapse. Techniques are need to manage triggers or cues that cannot be avoided. Additional information about relapse prevention by managing cues and triggers can be found on my website in the Addiction/MentalHealth category of articles. My new ebook, "Understanding Cross Addiction to Prevent Relapse" can be purchased by clicking here http://www.peggyferguson.com/ServicesProvided.en.html
My website is a work in progress with additional educational/informational opportunities being added frequently. There are numerous articles on this topic and others, an "Ask Peggy" column, a Links page with additional resources, a newsletter, and a Recommended Readings page.
To visit my website, ask me a question, or sign up for my newsletter go to http://www.peggyferguson.com
Dr. Peggy L. Ferguson, Ph.D., LADC, LMFT, Licensed Alcohol/Drug Counselor, Licensed Marital/Family Therapist, Author, Trainer, Consultant, Private Practice Professional providing counseling and consultation services in Stillwater, Oklahoma.
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