Relapse Prevention

WARNING SIGNS ! ! !

1) changes in thoughts, feelings and attitudes.
2) changes in behaviors and activities.
3) a combination of the two above.

Sometimes you may be aware of these signs and other times not. It is difficult for anyone, alcoholic/addict or not, to be constantly objective about oneself and ones behaviour. Often it takes another person to spot the changes which are taking place and you must be prepared to listen and question yourself about others observations. If you are not, then it is also another clear indication that you may be in relapse mode. It can indicate that you are still in Denial, even though you are not drinking or using and that you haven’t really come to acknowledge and accept that you are an alcoholic/addict, who can never drink again.
Relapses can sometimes occur spontaneously, where the limbic system hijacks the brain in a particular situation. This is rare, however, and even if the relapse appears to be spontaneous, it is usually preceded by the building up of a hidden relapse mode and a growth of factors, which were not readily identifiable. Most relapses build up gradually over weeks or months before actual drinking/drugging takes place. Signs may show up hours, days or weeks before.
Furthermore, while there are characteristics similar to all relapsing alcoholics and addicts, each person will also exhibit particular signs unique to them as individuals.
Although one doesn’t not want to become neurotically obsessive about any change in ones behaviours, thoughts or feelings leading to relapse (if you do become neurotic about it, then it is probably a sign of relapse), nevertheless, it is important that we become attentive to our moods, thoughts and behaviours while in recovery. Thinking them through and discussing them out with others will help you to gain a more balanced view of the processes and potential dangers, as well as innocuous problems.

Ask yourself

· who do you spend time with ?
· where do you go or feel like going ?
· how has you feelings, moods, emotions changed recently ?
· how have your behaviours changed in the last period ?
· what are the differences in your thoughts and attitudes recently ?

Be prepared to listen to others who have avoided relapse and those who have experienced it.
Identify common points with yourself and also try to see if there are any other features particular to yourself and your history.

General Relapse Factors
Emotions and Feelings : below are some the more common emotions which cause dangers for the recovering alcoholic / addict. There are many more and others which may be more relevant to you -
Anger/Hate, Anxiety /Panic, Guilt and Shame, Depression, Sadness, Grief, Loneliness

Good Emotional States !
It is often forgotten that excessive emotional highs can be a threat to ones sobriety. It is possible that when one is very happy or exuberant over an event or celebrating a success, that our association of alcohol/drugs with such a feelings and situations can overwhelm us and lead us back to taking that first drink or drug in the relapse process. We have associated drinking/using with reward and pleasure and we must make sure we are not taken by surprise in positive situations also. Be warned that holidays are especially dangerous times, like Xmas, birthdays and summer vacations.
Sudden Urges and Cravings - these can seem to arise like a thunderbolt from a clear blue sky. When everything appears to be going well in sobriety, you are suddenly confronted by a sudden urge or craving for alcohol/drugs. Then you have to « close the gap » and make the emotional/feeling connection that alcohol/drugs = pain. Practice this as part of your relapse prevention programme. Simulate an imaginary relapse situation and then rekindle a really painful physical and psychological consequence of drinking/using in your past. Remember also, that the more you put yourself in behaviours, situations and thought patterns linked to your past addictive behaviour, the more likely are these thunderbolts to become a storm !

Create a Relapse Prevention Action Plan !
- Have a general plan - phone fellow recovers, get to a meeting, etc
- Make a list of situations in which you have drunk/drugged in the past.
- Make a list of the places, people and things associated with your addictive behaviour.
- Make a list of the internal feelings associated with drinking/using - depression, euphoria, anger, stress, loneliness, success, etc.
- Identify which of these factors are present recently and at the moment and note them as warning signs.
- List the specific warning signs which you have identified and prioritise them hierarchically.
- Work out a series of alternative ways (not just one) which you can use to deal with each warning sign, e.g., going to the cinema, instead of a bar, changing your phone n°, exercising away anger, crying instead of suppressing sadness, etc. Experiment to see what works best. Some will work sometimes and others will work other times.
- Let yourself have a relapse fantasy - identify where and when does it occur, who is there, how it happen, what are the feeling and emotions present and how it ends.
- Are you having drinking dreams when you sleep - what happens ?
- Practice « closing the gap » - think of the times when you were drinking and pick the worst, most painful memories of the consequences. Re-feel the hangover, dehydration, vomiting, etc., Re-kindle the emotions of self-hate, shame, hopelessness. Hammer home the fact that drinking/using equals pain not pleasure or relief. Repeat this exercise, don’t just wait until you feel an urge or a craving.
- Realise that everything passes and that this feeling, mood or compulsion will disappear. Tell yourself that you do not have to act upon it, that you have choices as a human being and are not a slave to a chemical. You will be stronger as a result. Realise that millions of people face the same moods, feelings and negative thoughts, but don’t drink or drug their way out of them.
- Don’t just think, talk or write the plan - PUT IT INTO ACTION ! Recovery doesn’t float down on a cloud, you have to take concrete actions and steps to realise it. Rehearse strategies one at a time. See yourself walking past the local bar and going to the cinema. Pick an alternative substitute and do it. Feel sad and then make yourself cry. Get angry about something and then go exercise.
- If you find you have barriers to actually implementing your plan, go back and ask yourself the $50,000 question of why you created it in the first place. Remind yourself that alcoholics and addicts look for the easy way out, the quick fix, as easy a taking that drink or drug. Remember that there is no quick recovery solution ! You don’t get something worth having for nothing, especially when it is a second chance at life ! ! ! You have to make some effort. If you are creating barriers to your plan, then it may reflect that you are still in Denial. At the same time don’t make the task too difficult. Don’t decide to lay on a bed of nails if you are caught by an urge to drink/drug. Find alternatives which are pleasurable and rewarding in some way, if possible. If you are having problems with your plan, it could mean that your plan is too ambitious, difficult or inadequate. So analyse what the barriers are and discuss it with others in your group or individually.
- Discuss your plan with others.

Putting the Plan into Action ! This means working on things like changing your behaviours, starting healthier patterns, working on attitudes, thoughts and coping mechanisms. Give yourself multiple options for the lists of high risk factors you have identified. Test them out hypothetically and practically, when need be. Don’t worry about the options not being perfect immediately or only being partly effective or not at all. You have to experiment, eliminate and improve some methods. It is an ongoing process, which will also change a you do in sobriety. Keep it as simple as possible, but identifying and focusing on your key risk factors. Don’t try to build up a huge list of responses to every possible variant in life. Above all, remember that a plan is not an intellectual exercise. You need to « walk the walk ». Its about actively working on and changing your behaviours, thoughts and emotional responses. Often one begins by changing behaviour as a first step to changing ones thoughts and feelings.
The points above are rational guidelines for dealing with risks associated with relapse. Arming ourselves as powerfully as possible with rational and practical methods of dealing with relapse prevention is vital. However, as human beings we not only work with the rational brain but also with our emotional brain. We can all remember instances frequently in our active addictive years, when our rational reasoning was overwhelmed by our emotional brain playing on our chemical dependency.
Remember that we are still chemically dependent, but we have only suppressed that dependency by abstaining. The emotional brain remains strongly connected to that dependency through years of training in response and coping mechanisms. It has the capacity to overpower the best and most rational of all plans in certain situations. Therefore, we not only have to strengthen our rational responses, but also the emotional or limbic part of our minds. We, therefore, also have to have an « emotional » relapse plan in conjunction with our rational defenses.
When you first went sober, your decision should have been based not only upon a rational decision not to continue and a rational acknowledgement and acceptance of the fact that you are an alcoholic/addict, but also on an enormously powerful emotional cry to rid oneself once and for all of the monster of addiction. It is this response, an emotional explosion driving your desire to quit which you must practice reliving each time you face dangerous situations in sobriety. You must provoke a gut desire not to drink and provoke within you an emotional outburst against returning to your addiction. You must shudder at the thought of drinking/using again by momentarily reliving the sensations, feelings, emotional and physical pain suffered in active addiction and hammer home the point repeatedly to your emotional/limbic brain that alcohol/drugs = pain, not pleasure/relief. Make it psychologically and physically clear to yourself that the consequences of relapsing will be far worse than the problems and pain you are temporarily facing now. Having done that you must then fuse it with a rational response from your plan, like getting out of that bar immediately, phoning some for help, jumping on your bike to ride. This will get you out of danger. And each time you succeed in doing this, you will powerfully influence fundamental changes in your thought and behavioural patterns, retraining your mind in healthier patterns and laying strong foundations and pillars of support for your long term sobriety.

Finally, you must know that however bad the situation is or how you feel, there is NO excuse good enough for returning to drink/drugs. Although you are an addict and always will be, by going sober, you are now part of the human community which is not actively dependent on mind-altering substances to get through life. Like the majority of people, you do not turn to drink/drugs in order to cope or misguidedly solve problems and pains. Like them you have to learn other coping methods and also ones specific for your addictive background. For non-alcoholic/addicted people using drink or drugs is simply not an issue or an option which they consider when faced with life’s ups and downs. For you it must also become a SEPARATE ISSUE. Other non-alcoholic/addicted people have an unconscious « sobriety priority », knowing that it will cause more pain, bring no relief, only cause further problems and undermine their ability to deal with their predicament. The recovering alcoholic/addict is different however, in that we have a CONSCIOUS « Sobriety Priority » which says to us that problems and pain are separate issues from drinking/using. They are no longer linked to the automatic response of alcohol/drugs. We do not drink/drug, no matter what ! Instead, like the majority of others, we can now face life on its own terms and respond to its viscitudes under our own resources. No pain, no gain is unfortunately true. But it helps us to strengthen ourselves and grow as sober persons. At the same time, however, it not only gives us the power to overcome pain and suffering, it also brings us the ability to appreciate and enjoy the positive and beautiful things which are part of life, of sober life, which all other people enjoy, and which were robbed from us by intoxication. Now by staying sober, we will also reap the benefits of really living - crying, hurting, yes, but also loving, laughing, having real fun, pleasure and joy.

To learn more about the « Sobriety Priority » go now to Sobriety Priority
To begin working immediately on your emotional response and limbic system go now to Urges & Cravings