Is Relapse Part Of Recovery?

As a substance abuse counselor I am asked this question all the time. Because I am not in recovery myself, my answer comes from years of counseling alcoholics/addicts and processing their answers along with my own professional insight.

So, with that said...is relapse part of recovery? Yes and no depending on whom you are talking to. If one has relapsed, learned from their "slip" and embraced a stronger, more formidable recovery, then the answer is "yes". However, if one continues to relapse because they have not tethered a confident and secure change in their lifestyle, then relapse just becomes an excuse for buying more time before committing to sobriety. Hence, the answer is "no".

I have befriended many alcoholics/addicts and a number of them have embraced their clean and sober lifestyle from the day they committed to it. However, the majority have had some hiccups along the way.

For the alcoholic/addict that is working a recovery program there can be four main dispositions that present formidable challenges which can trigger relapse. Relapse is an individual preface, and depending on the personality of the recovering alcoholic/addict, their relapse triggers might be different from others. The four that I discuss here represent the broadest of relapses and represent "Kryptonite" to anyone in recovery no matter how long or how strong their program is.

Expectations
Resentment
Boredom
Fear

Expectations:
Expectations that either fall short or are unfulfilled can open the flood gates to relapse. Expectations can be unrealistic, and the alcoholic/addict can get swept up with what they think is a fast or easy recovery, which develops into a honeymoon period reflecting a happy work environment and fairy tale relationships. When events or people don't turn out to be what the alcoholic/addict "expected", they don't know how to deal with their frustration or disappointment; hence they turn to the only way they know to comfort themselves; getting high or intoxicated.

Relapse is common when the alcoholic/addict has not had enough recovery under their belt through 12-step meetings, sponsorship, counseling or their own personal determination to rely on an arsenal of "tools" to ward off the relapse demon. With an addictive personality, the pendulum swings so far in either direction that there is no middle ground of normalcy. Life to them is often black or white. The highs are too high, and they represent a false state of contentment. Eventually, those highs can't stay so lofty, and the alcoholic/addict needs to learn to work with, understand and accept expectations that may fall short of their intended mark.

Conversely, the lows can get so low that the alcoholic/addict doesn't know how to crawl out of the hole, dust themselves off and move on. They are very hard on themselves and don't trust that it will be "okay" if they are patient and take their time to re-group; hence they often resort to their addiction. Taking away the pain of reality with alcohol or drugs is the only thing that the alcoholic/addict has known for quite some time. It has for years been a "Pavlovian" response to stressful or difficult life situations. As the alcoholic/addict matured, they might never have learned how to "roll with the punches". In lieu of these experiences, the alcoholic/addict escaped to their addiction and therefore stunted their emotional growth.

As the recovery process gets underway, the alcoholic/addict realizes what they missed through all the years of substance abuse, but often doesn't have the patience to wade through the discomfort of this new emotion and therefore retreats (or relapses) to their safe haven of addiction. Their expectations of falling right in step with the rest of society can fall short as they have not literally clocked in the life hours as others have because they were intoxicated or high as others dealt with relationships, careers and family.

Resentments:
When the alcoholic/addict harbors resentment toward a person or place, (whether a current resentment or one from 20 years ago) the resentment can be so overwhelming that in order to stop the internal anger or frustration, the alcoholic/addict needs to self-medicate in the hopes of turning off the "noise".

In order for recovery to be strong and for relapse to no longer be an option, these resentments must be dealt with through 12-step meetings, sponsorship and counseling. If not resolved, these resentments feed upon the alcoholic/addicts inner turmoil until busting free in the form of relapse or reckless actions. As a counselor working in a rehabilitation recovery program, all too often I have heard my clients share that because they were resentful towards a girlfriend, family member or institution they thought "who gives a f***" and went out and used or drank.

To the "normie" these resentments may cause a pimple or two, and usually our actions and emotions stay in check and we work through them and move on. The residual effect may produce some discomfort or even anger, but the outcome is rarely as detrimental as it is for the alcoholic/addict. The "pity-pot" to the alcoholic/addict is a handy way of keeping their resentment alive. "Oh, woe is me, no one understands me, I'm doing the best I can, but I guess it's not good enough, etc..." The alcoholic/addict can find great comfort on their "pity-pot" and if enough pity is spent on the pot, then lo and behold, they have found their right to drink or use. They believe their own press which tells them that they are no good or a failure, and the only thing that will dull the pain or make it go away is alcohol or drugs.

There is nothing you can do as the family member or friend to help the alcoholic/addict deal with their resentment. Remember, some of their resentment might be about you for something you did or did not do yesterday or years earlier. These resentments need to be worked through with a sponsor from a 12-step recovery program who has dealt with their own resentments and a professional counselor.

Boredom:
I believe the statement goes..."An idle mind is the devils play ground". This is true for both the "normie" and the alcoholic/addict. Often boredom can be a contributing factor in the world of addiction. However, many "normies" find themselves eating too much, gambling, shopping to excess, etc...because of boredom. Various addictions and their degrees of severity impact everyone's life differently.

Routine and concrete scheduling is a life-saver for the alcoholic/addict. Knowing where one has to be and when; being accountable to someone or something else provides a safe framework for the newly recovering alcoholic/addict to live with and depend upon.

Fear:
Is the fear imagined or real? Most fear that anyone experiences (whether you are an alcoholic/addict) or not, is imagined. Basically, it is fear of the unknown - of distrusting an outcome and not feeling in control of what may or may not happen. People can be gripped with fear and it can cripple their ability to make important changes in their life. Although they may be very aware that their current lifestyle is unacceptable, overwhelming fear of changing what they have known for so many years keeps them from taking steps toward a better life.

I heard a woman share about her fear of getting clean and sober. She stated that she was afraid of not knowing who she would be once she embraced an alcohol-free life; after all, she had grown very accustomed to her alcoholic self and was anxious about a new identity. After years of sobriety, she professed that she liked and respected herself more now than she ever could have imagined.

Getting beyond fear requires a lot of strength and trusting in a belief that a "higher power" will take care of you. It does not matter if one practices a formal religion or not. I believe that as long as there is some kind of spiritual belief then self-confidence and faith will grow and with that, our fears start to dissipate.

If I can be of service to you or your family, please e-mail me at [e-mail] or go to http://familyrecoverysolutions.com/free_one_hour_session.html

 

 

Comments

[Taiyu Robertson]

Anyone can get sober. Perhaps the simplest way is to simply hit a cop. A month or so later when you're released from jail, you'll be sober. Notwithstanding the terror those contemplating abstinence experience, stopping drinking is probably the easiest part of recovery.

The difficulty is staying sober. That's why relapse is so common, that's why AA and it's progeny exist, why treatment programs exist, and ultimately, why this blog exists.

And while I'm not an AA thumper by any stretch of the imagination, I believe it's hard not to give the program its due, for recognizing the near absolute necessity for fundamental change in the addict/alcoholic's inner reality if long term sobriety is to occur. In that endeavor, and while I suppose it's fair to critique the god talk, the religious overtones, the cultish-ness the program sometimes fosters, and the oftentimes ridiculous resistance to changing itself to fit the truths of addiction in the 21st century, a far more fruitful perspective might be to simply look below AAs language and patterns, and try to understand the underlying principles it communicates: That alcoholism renders it's sufferers incompetent, dangerous, and doomed, that sobriety AND a good life is possible, and that in order to attain that, one must turn inward and address himself or herself at a fundamental level and on an ongoing basis.

[soonerdru]

Really wonderful post. I'm going to re-print it for my clients.

[Taiyu Robertson]

thank you

[bikerdude]

Right on the money, Tayiu....

[bikerdude]

Relapse is part of the addiction cycle. Relapse aborts recovery and the addict has to start again.
Addiction is an Obsessive Compulsive Disease. The compulsion part takes over once the addict begins using. If the system is clean and the addict doesn't use again then the compulsion goes away. The mental obsession is the hard part. Even thought the addict is clean, his drug of choice is all he thinks about. During the course of the addiction, the addict eventually comes to a moment of clarity and says with firm conviction "never again". Unless he/she finds the tools to fight off the mental obsession, he/she will use again. The 12 step programs offer the tools that permit an addict to stay stopped. I relate addiction to any of the diseases, such as diabetes that are uncurable, but treatable./

[stargazer13]

6 billion ways to look at it

to thy own heart be true !!

[Grada3784]

23 years sober and not had a slip. My sponsor just celebrated 28 years - no slips. Another sponsor died of AIDS at 21 years sober - no slips, even with doctors repeatedly cutting pieces out of him.

At a year I was shaky and I was told that I didn't have to pick up a drink. I listened and I didn't and I haven't. I won't, certainly not now, and God willing and me willing, not ever, but certainly not yet.

Slips are not mandatory; they happen and can be learned from or died from, but they are not mandatory.

[bikerdude]

Right on Grada....Your comments indicate a 12 step program. To me, they are necessary when the obsession tried to take over. Long term sobriety is contingent upon spiritual fitness, patience and a willingness to do whatever it takes to not pick up that drug of choice. I have a famous friend who has over 25 years of sobriety without any program. We all call his condition "stark raving sober". Not a lick of spirituality or patience in that dude....

[SpinDown08]

It's increasingly clear to me that that some programs such as AA start off on the wrong foot by breaking a person down to label themselves as "an alcoholic". They may give positive reinforcement to such a claim, but still it caries with it a stigma that makes one feel different form others.

How about getting up and saying "Hi, I'm Bob, and I'm a human being." What does that actually mean? It means you recognize that you are a part of your environment. You are included in this experience. There is no other goal for someone that to balance with their environment. If this were the focus, rather than sentencing a person who drinks too much to a life of sobriety, then we could have significant chnages in our behaviors.

I'm presently working on this subject, researching how science, behavior modification, and a kind of methodical scheduling of alcohol intake can bring person back to being a responsible drinker. wish me luck.

[bikerdude]

You are not correct. We ARE different. We have an Obsessive Compulsive Disorder that differentiates us from "normal drinkers". There are over 62 pages in the BB of AA that talk about the nature of our problem. It is powerlessness over taking that first drink. We cannot drink in safety. The prupose of calling us what we are is to begin the process of understanding our dilemma.
Once I start treating an addict, I step away from talking about their deficits and get them to focus on their assets...."Why are you still alive after all you have done? What are the special things in your life that have enabled you to survive up until now? It is a process.

[soonerdru]

Methodical scheduling of alcohol intake? You clearly don't understand what a true alcoholic is.

[JayMonaco]

Thank you for being a reasonable person.

[Giada]

I'm more prone to follow the Stanton Peele approach, CBT, maturing out, Harm Reduction, SMART, SOS. I've been with a group for several years that openly discusses use of the words, "alcoholic, addict," and are in agreement these have a demeaning and negative value.

Current studies show those who choose they're own path have higher rates of success, whether the plan is abstinence or moderation.

Mistakes are part of the process.

[bikerdude]

I understand what you are saying but you fly in the face of scientific research and the success of the 12 step programs. I wish you were right but you are trying to "tune" a mental disorder. I don't think being called an alcoholic is any more demeaning than being called a diabetic. Both diseases are incurable but treatable.

[UncleBubba]

My sobriety date is June 6, 1992 and I've not had a relapse during that time. The question of whether or not relapse is required is a pointless argument. The only thing I would say for sure is that it's helpful to explain to newcomers that relapse is not a requirement.

I was an active AA member for years and was a Big Book thumper for most of that time. Following the directions saved my life even though I don't believe in a God that sits on high, as did many, not all, of the original members of AA. Belief in a higher power is not about groveling, it's simply an act of humility. Interestingly, the 9th step explicitly states that "we stand on our feet; we don't crawl before anyone."

Despite my appreciation of AA, I don't attend meetings anymore. A lot of worry has been associated with that decision, as well as a lot of thought about AA's strengths and weaknesses. I try to keep my opinions to myself so the only thing I'll add, and perhaps some of you old timers can address this, is a question: why are there so few old timers in the rooms? Is it because they picked up again? Or is it because AA no longer offered the "medicine" they needed for their on-going recovery? I have my opinion. Just curious what others might think.

[boomerangst]

With 24 years of comfortable sobriety as a result of the fellowship and principles of AA, I find myself wanting to defend AA and that's pretty funny! Because AA doesn't need any defense. AA is alive and well and helping people who want a daily reprieve from the compulsion to drink.
AA NEVER takes credit for anything ever because AA has no opinions and has no need to take credit for anything. Lots of people have a difficult time with AA's organization (or lack of it).
Instead of AA changing to suit this crazy mixed up world (modern ain't always better), maybe the world could change to the principles of the 12 steps (hope, love, compassion, acceptance, helping others, etc).
I'm sooo glad I did not let my intellectual self-sufficiency get in the way of surrendering to a power greater than myself and listening to those who had what I wanted (sobriety). I thank my concept of God everyday that I am sober and happy, joyous, and free. There's room in AA for all kinds of higher powers and all types of belief. The bottom line is SOBRIETY.
Remember, the only requirment for membership in AA is a desire to stop drinking.

[hippie4ever]

No, she didn't advocate only for the 12-Step but also for those "who own personal determination to rely on an arsenal of "tools" to ward off the relapse demon." SMART is such a discipline to combat alcoholism­/addiction by teaching resistance strategies, and to identify false beliefs that lead to relapses.

I agree that AA has done a lot of harm in pushing their "higher power" nonsense and ignoring scientific advances in addiction. Inadvertently they do help many by providing a venue of bad coffee and cigarettes instead of booze. Fellowship is powerful but AA is yet another decrepit institution requiring an infusion of new ideas, yet they stubbornly resist change and progress. Sad, really, and their track record is poor. AA does not help the overwhelming majority of alcoholics.

A few avoid drinking by attending meetings nonstop; this isn't addressing the problem and such a life couldn't be very fulfilling. Mostly people reach a point in their lives where they realize they'll die if they continue on, and then they make the change. Survival instincts kick in, but if one's ever been to a meeting AA will take full credit.

[Ametista]

SMART looks like a good program. I wonder how effective it is.

[Ametista]

Yeah see it says right here:

Respondents with low levels of religiosity were more likely to actively participate in groups with secular programs, such as SOS and SMART Recovery.

[dandypuddin]

One of the best articles I have read on relapse.

[Ametista]

So its the 12-step "I am weak and powerless and pathetic" approach or nothing? These programs are basically designed to make people dependent on a church. Seriously, is that your ONLY answer, because you mentioned the 12-step program multiple times, as if that is all you have to say. Maybe more people would seek help if they didn't have to grovel and pretend some higher power was all that could help them. How about responsibility for yourself? KNOWING that you are the one in control, not a substance and not "god"?

[dandypuddin]

Meetings can take place in churches, but no church going is pushed on anyone. Going to meetings is taking responsibility for oneself.

[tploomis]

You mis-state the the central tenets of the 12 step program. If a person is an addict/alcoholic and is able to stop using through feeling in control, then by all means use that to stop using. But for most addicts, that simply does not work, and the mistaken belief that they are in control of their addiction maintains the addiction. Turning their will over to a higher power after recognizing that they are out of control is a core step in recovery. Groveling and being pathetic, as you put it, are not part of 12 step recovery. Further, the concept of a higher power is far broader than the concept of "God." I am an atheist, but I'm not so egotistical and narcissistic that I think there is no larger power in the universe than myself. You are very good at constructing red herrings and then demolishing them, but unfortunately, the only person defeated in the end is yourself.

[Progressiveama]

These are diseases where the best of thinking gets the person nowhere. There is a lot of ego in trying to control everything around us, plus the addictive diseases. The record is poor for recovery if the person doesn't surrender and ask for help. In admitting that the disease has won, there is a universe of strength to be had. From there, the person has all strength. Really, we don't know what is around the corner, what is to come, or what other people should do. The focus needs to be on the person's self and only that.

[boredwell]

Though I've been sober 23 years, I continue to ride the roller coaster of doubts and fears. I realize that the proverbial ups and downs, those peaks and valleys are Facts of Life. In the early years of my sobriety whenever I would feel tweaked by mundane "stuff" and quick to make a mountain out of a molehills, a walk past the local pub would convince me I was definitely on the right track.

[GoDogGo]

Recovery here doesn't just apply to drink or drug. Try reading the article as it relates to food, sex or any other compulsive behavior. Relapse is a part of any change of behavior. If one is "mindful" and present though, it doesn't have to end the recovery.

[Angel1961]

Exactly, but the problem is, the author refers to those who abuse food, sex and other compulsive behaviors as "normies". I found that offensive. Those people are equally engaged in self-destructive behaviors.

[spilkus]

Yes. Like Ram Das says "My karma is my dharma."

[dwoodsvc]

Sometimes I think of my sobriety in terms of trading one discomfort for another. And someone else said that recovery is different in the long-term vs. the short-term, and I hope that is true. I'm hopeful that the discomfort associated with sobriety will ease over time. I know I have to work to make that happen, but I can't help but ask myself whether I'm better off sober or not. Now that I'm coming up on two years sober, I've been asking myself that a lot lately. I think we forget how bad off we really were, and maybe that's where we get into danger of relapse. Thanks for the article. You make some really great observations.

[UncleBubba]

In response to your question, I can only say that things do get better. Sobriety can be uncomfortable, but in my experience that discomfort is akin to growing pains. The psychic change necessary to be "happy, joyous, and free" takes work, as you said. Work is hard and requires commitment and endurance. I can only speak for myself, but I know for a fact that sobriety is the better choice. Choosing to pick up a drink or a drug, is a death wish. If I were you, with two years and doubting my motivations for staying sober, I'd go to a meeting and talk to my sponsor. If your sponsor doesn't direct you to the steps, get a new sponsor. I'd also suggest you keep talking about how you're feeling with your network of sober friends. Chances are, there's someone else feeling exactly the same way you are. If you open up, you're probably going to help someone else. That's how this thing works. Again, that's just my opinion. I hope you make the choice to stay sober. You deserve it. Best of luck to you.

[sobermike]

thanx for your lucid post.As a counselor & being in recoverey for over 12 years without a relapse,it seems most addicts return to the familiar at some point. I believe that all addictions are of a limbic systerm variety,and unless the sufferer has truly surrendered,relapse is inevitable.