Relapse Avoidance and Recovery

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Relapse Avoidance and Recovery

Relapse happens. In fact, it happens a lot. Researchers have found that 90% of alcoholics who go through treatment relapse within the first four years of sobriety. That’s true for drug addicts, too. A million people go on diets and start exercise programs every day and a million people give them up every day. That’s just the way it is.

So are you doomed to relapse? No, it isn’t required. I’ve known a good many alcoholics and addicts who quit drinking and drugging years ago and haven’t relapsed yet. I relapsed from alcohol and cigarettes after quitting, but that happened when I was trying to quit on my own. Since I sought and received help, I haven’t relapsed. The tools and strategies that I learned from the treatment center and from other alcoholics have worked so far. In fact, the sobriety tools have worked for smoking and for diet and exercise too. The common thread among those who avoid relapse is their commitment to keep working at it. They make sobriety and healthy living their first priority. They don’t make excuses. They are committed to a better life and nothing's going to take that away from them.
Unfortunately, though, relapse is a reality for the vast majority of us who are trying to get better. And here’s the great danger: many people who relapse feel so badly about themselves, are so embarrassed, are so depressed about the relapse, that they give up. They don’t try again. Or, they go through the misery for many more years before they hit a new bottom sufficiently horrible to motivate them to try again. A lot of them die.
Be Prepared
Don’t plan to relapse. That’s dumb. If you quit drinking, smoking, eating, or slothing with the notion that relapse is normal and acceptable, you’re flat doomed. Instead, learn and practice relapse prevention strategies so you avoid it. You should however, think about what you will do if you do relapse before it happens. I was a Boy Scout for two weeks. I didn’t like it much. That was my fault, not the Boy Scouts. But in those two weeks, I latched onto the Boy Scouts’ motto: Be Prepared. You should too. Don’t wait until you wake up the morning after a relapse and have no idea what to do next except feel really, really lousy. You should have thought about how you’re going to get back on your program if relapse happens. Don’t let embarrassment or regret threaten your life by keeping you in your addiction or other self-destructive behavior.

Early in my sobriety, I witnessed something that demonstrated how tenuous sobriety is. It happened at my first after care meeting at the treatment center. Because I was new to the group, the meeting started with me telling the rest of the group about what brought me into the treatment program. After I finished, the counselor announced that we were going help a fellow member named John get “framed up” for having his driver’s license reinstated in the coming week. She explained that John had been in after-care for a year. His driver’s license had been suspended more than a year ago because of his drinking. We were going to spend the hour helping John figure out how to avoid getting drunk once he got his license back and was free to drive to the liquor store again if he chose to.

I was amazed, and a little irritated, that we were spending the entire meeting on this. Surely it wasn’t necessary. The guy had been without a driver’s license for one year because of his alcohol drinking. He’d gone through treatment and had been in after-care for a year. I mean, eventually he might get drunk again, like a year from now, if he doesn’t keep going to after-care or continue to get help somewhere, but not now, for God’s sake. If this is what after-care is all about, the next two years are really going to suck.

A week later, John wasn’t in the meeting. When the meeting started, the counselor said, “I have some bad news. John’s back in the day program. He went out and got drunk last weekend.”

What? You have to be kidding!

She wasn’t. John had lasted until Saturday night. He went to a party and got drunk.

Unbelievable.

But it was true. John taught me the necessity of being on constant guard against relapse. Alcoholics Anonymous founder Bill Wilson called the disease of alcoholism cunning, baffling, and powerful. That’s so true. So is the desire to eat brownies and sit in the recliner all day. My alcoholism, nicotine addiction, obsession with fattening food, and attraction to sloth are just sitting there waiting, like vultures. They are incredibly patient. They’ll wait a day, a year, a decade, and more.
Don't Want to Change? Expect Relapse
Over the years, I’ve watched alcoholics and addicts relapse. Some decided that if they’ve been able to keep from drinking or drugging for a while, they must be able to control it. They can’t. Never happens. Others tried to keep from drinking, but don’t change their lifestyles. They still hang around in bars, keep the same friends, and do the same things. They drink again. Some try to white knuckle it without doing anything to change the way they respond to life. When bad things happen, they have no defense against them. The misery, anxiety, fear, or any other feeling they tried to change by drinking or drugging never goes away. Eventually the continuing misery leads them to say, “To hell with it.” They drink or drug again.

I relapsed when I was trying to quit drinking by myself. I was looking out a hotel window in Texas, feeling uncomfortable and out-of-place because of being in close quarters with a bunch of strangers, and saw the liquor store. I knew vodka would change those feelings. As I stood and stared at that store, my mind went through the mental gymnastics that led me to go and buy a fifth of vodka. Now I know that I relapsed the nanosecond I saw that liquor store. I didn’t really need to go through all that thinking to convince myself it would be OK to drink in Texas. I was doomed the moment I saw the store because I was extremely needy and I had no defense against my desire to use alcohol to feel different. I had no tools to keep from drinking alcohol and had no strategies to help me feel different without alcohol. At that moment, I didn’t have a chance. No amount of self-will in the world would have changed the outcome. I knew nothing about what to do to avoid relapse. Relapse was inevitable.

So how do you avoid relapse?
Priority One
The first defense against relapse is to stay centered in the desire to remain healthy by making sobriety and healthy living an absolute priority in our day-to-day lives. I’ve heard alcoholics use this analogy: Before every airline flight, the flight attendants tell passengers what to do if cabin pressure is lost. Oxygen masks will drop from above their heads. Passengers are instructed to put their on masks on first. Even if you have a child gasping for air next to you, put yours on first. You have to take care of yourself first, then care for your children and others after that. If you don’t put your mask on first, you will be disabled and will be unable to help anyone else. Same with sobriety. I know a recovering alcoholic who disagreed with putting sobriety first. He put it in third place. God was first and family was second. He was proud of that. He relapsed and is still drinking. Here’s the deal: You can’t have God or a family if you’re drunk. Sobriety has to come first. It’s not selfish to put healthy living first. Absent that, you can’t be there for others.

Complacency is the friend of relapse. If we ever believe we have our problems licked and quit working at the solutions, we’re doomed. Don’t do that. Like diabetics, we are never cured. Instead, we have to manage our conditions to stay healthy. Keep doing the things that helped you to quit in the first place, whatever that is. For me, that means doing all those things outlined in the previous chapters – things like living one day at a time, reordering priorities by gaining new perspectives on what’s important in life, living life on life’s terms, never making exceptions, and the rest.

Become aware of triggers and avoid them. Remember the acronym HALT – hungry, angry, lonely, tired. Any of those feelings will often lead to relapse. Stay aware of what you’re feeling and take action when you find yourself on dangerous ground.

Romancing our addictions is a sure road to relapse. Whatever our addiction, there were times when the substance worked for us. Bad things didn’t happen every time we drank, smoked, or ate excessively. Not at all. In fact, some of my favorite memories come from times when I was drinking alcohol. There’s nothing much better than sitting on the condo balcony looking out at the ocean and having a gentle buzz going. Too bad the legacy of that behavior is so very lousy. I loved that first cigarette after coming out of a movie. I remember sitting in my grandmother’s kitchen while she cooked and eating her chocolate fudge cookies with great fondness. I’ve got to keep remembering where all that will lead me when I want to romance those things.
Overcome Cravings
When we’re faced with cravings to drink, drug, eat, or sloth, there are things we can do. We can call a buddy and talk about our obsession. The buddy needs to be somebody who shares our issues because we need someone to commiserate with us and remind us of what works. If you talk to someone who doesn’t share your problem, whatever they say will be preaching and lecturing. That seldom works. Alcoholics need to call another alcoholic. Drug addicts need to call another addict. Develop former smokers as the relapse prevention buddy. Same with diet and exercise. If I’m sitting on the couch, deciding not to do my run today, I need to call my exercise buddy so he can remind me what happens if I miss a day. If we wait until the obsession, or fit of laziness, hits us, it’s too late to find a buddy. We need to have them set up and ready to call.

We can carry it through to the end. When I’m dying to light that cigarette, I think about where that first puff will take me. Right now, most of the time I’m not thinking about cigarettes, but if I take even a tiny puff, the nicotine will trigger my obsession and I’ll be right back to the misery of nonstop craving. I’ll smoke again. I’ll spend lots of money, stink, and eventually die. If I carry it trough to the end, chances are I’ll decide to let time pass before lighting up and the obsession will leave me.

When eating chocolate chip cookies sound good, I carry it through to the end. I envision myself struggling to put on too tight pants in the morning. I envision myself back on the cardiac cath table, only this time they’re inserting a stint. I don’t want to do that, so I skip the chocolate chip cookie.Play the tape all the way through and the craving will pass.

Speaking of passing, cravings do that. “This to shall pass,” seems simplistic. It is, but it’s true. When I’m hit with a craving, I’ve learned to take a deep breath, and engage in some self-talk. I tell myself that the craving is temporary. There will come a time when I won’t be thinking that life isn’t worth living without cigarettes. In fact, that time will come in just a few minutes. Soon I’ll focus on something else and those awful feelings will go away. I’m always right. A few minutes later I realize I had stopped thinking about cigarettes. I am again grateful they don’t control my life as they once did.

Actually, everything passes eventually. Often, I remember that I had been really irritated, or depressed, or angry about something not long before – maybe last week. I remember that I had a hard time sleeping from thinking about it. But, I can’t for the life of me remember what it was I was upset about. No doubt something had happened, but what was it? That happens often enough so that it’s legitimate for me to remind myself when I have a craving, or am upset by some event, or worried about some future event, that there will come a time when I won’t even be able to remember what I’m upset about! That’s what “This too shall pass” really means.
Attitude Adjustment
Our attitudes about life can go a long way toward preventing relapse. Things that seem bad and make me feel bad are triggers. But, way more often than not things that seem bad turn out to good. An alcoholic I know named Jonathan was arrested for DUI one morning while he was on his way to work. I was acquainted with him before that happened, but had no idea he had a problem with alcohol. As he told me about his arrest, his distress was obvious. He was embarrassed, scared, and angry. He hadn’t met with his supervisors yet and didn’t know if he still had a job or not. By now, I’d heard the same story a hundred times. I asked, “Do you think you have a problem with alcohol?” He shrugged. “Tell you what .I’ll answer the question for you. Normally, I wouldn’t. You have to decide that for yourself. But, Jonathan, this is different. If you’re drinking in the morning before you go to work and you get a DUI, you have a problem. Don’t know the extent of it, but you have one.”

“Yeah.” He paused. “I’m going to an AA meeting tonight.” He didn’t look happy about that.

“Let me tell you something, Jonathan. Right now, it’s obvious you don’t like that much. But, if you’re an alcoholic, and you do what it takes to quit drinking alcohol -- go to A.A., go to treatment or whatever else you finds that works. If you do that and don’t drink alcohol anymore, there will come a day when you will be grateful for this D.U.I., whether you’re fired from the job you have now or not.”

He looked irritated. ‘Yeah, right,” he said.

A year later, and still sober, he told me the D.U.I. arrest was the best thing that ever happened to him. If he hadn’t been arrested, he’d still be drinking alcohol and still be miserable. He’d still be embarrassing himself. He’d still be making all life decisions based on how they affected his ability to drink alcohol. He told me he remembered what I’d told him the year before and said I was right. When we come to view all life’s events as learning opportunities, we are less likely to try to change our feelings by drinking, drugging, or eating.
Gratitude
Keeping gratitude in the forefront of our consciousness provides another defense for relapse. I’ve heard many recovering alcoholics talk about how grateful they were that they were alcoholics. That’s because life’s gotten so much better in sobriety. Before, life seemed impossible without alcohol. Now, life is massively better without alcohol. More importantly, in order to stay sober they’ve had to learn to deal with life on life’s terms. They no longer worry about the stuff that used to drive them crazy. They no longer wake up and grab their head in embarrassment when they remember something they’ve done the night before because they don’t do those embarrassing things anymore. They no longer wake up, have to figure out where they are, and go looking for their car.

They are grateful.

Gratitude’s more that, though. It’s an antidote to depression and anxiety. It’s easy to focus on what’s wrong. It takes some effort to notice what’s right. The former drags us down. The latter pulls us up. Here’s the prescription I’ve been given by those who have been successful in avoiding relapse: Whether you’re an alcoholic or not, put this book down right now. Get a piece of paper and start making a list. A gratitude list. Don’t spend a lot of time wondering if you should be grateful for something or not. Just write it down. Write down a hundred things. Seems impossible? It isn’t. Just get started. Put the list in your wallet. When you feel down, angry, hurt, or discouraged, pull out your gratitude list and look at it. Add to it. Tell somebody about something on the list. Do that and you’ll feel better. If we feel better, our odds of relapse are greatly diminished.

Most people who quit drinking, smoking, getting fat, and being lazy will relapse. You don’t have to, though. I’ve shared a sampling of strategies I’ve used to avoid relapse. There are more. Look for them. If you do relapse despite the efforts you make, don’t make that an excuse not to try get better again. I know alcoholics who relapsed multiple times before getting it. Problem is, I’ve know some who relapsed and didn’t make it back. They died first. You don’t want to do that. If you do relapse, gather yourself quickly, work to recapture the willingness, and try again.

http://www.myreclaimedlife.com/toolsrelapse.htm