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relapse stages

I’ve been working with adults in recovery and in active addiction for many years. Going from recovery to relapse is process that could take days, weeks, months. The process is generally not paying attention, getting overwhelmed, ignoring your own thoughts/feelings and the input from others, and decided at some level of consciousness to use again. Below is one of the hand outs I use with relapse prevention groups.

Step 1: Getting Stuck In Recovery
Many of us decide that alcohol or drugs is a problem, stop using, and put together some kind of a recovery plan to help us stay sober. Initially we do fine. At some point, however, we hit a problem that we are unwilling or unable to deal with. We stop dead in our tracks. We are stuck in recovery and don’t know what to do.
Step 2: Denying That We're Stuck
Instead of recognizing that we're stuck and asking for help, we use denial to convince ourselves that everything is OK. Denial makes it seem like the problem is gone, but it really isn't. The problem is still there. It just goes under ground where we can’t see it. At some level we know that the problem is there, but we keep investing time and energy in denying it. This results in a buildup of pain and stress.
Step 3: Using Other Compulsions
To cope with this pain and stress, we begin to use other compulsive behaviors We can start overworking, over-eating, dieting, or over-exercising. We can get involved in addictive relationships. These behaviors make us feel good in the short run by distracting us from our problems. But since they do nothing to solve the problem, the stress and pain comes back. We feel good now, but we hurt latter. This is a hallmark of all addictive behaviors.
Step 4: Experiencing A Trigger Event
Then something happens. It's usually not a big thing. Its something we could normally handle without getting upset. But this time something snaps inside. One person described it this way: "It feels like a trigger fires off in my gut and I go out of control."
Step 5: Becoming Dysfunctional On The Inside:
When the trigger goes off, our stress jumps up, and our emotions take control of of our minds. To stay sober we have to keep intellect over emotion. We have to remember who we are (an addicted person), what we can’t do (use alcohol or drugs), and what we must do (stayed focused upon working a recovery program). When emotion gets control of the intellect we abandon everything we know, and start trying to feel good now at all costs.
Relapse almost always grows from the inside out. The trigger event makes our pain so severe that we can't function normally. We have difficulty thinking clearly. We swing between emotional overreaction and emotional numbness. We can't remember things. It's impossible to sleep restfully and we get clumsy and start having accidents.
Step 6: Becoming Dysfunctional On The Outside:
At first this internal dysfunction comes and goes. It's annoying, but it's not a real problem so we learn how to ignore it. On some level, we know something is wrong so we keep it a secret. Eventually we get so bad that the problems on the inside create problems on the outside. We start making mistakes at work, creating problems with our friends, families, and coworkers. We start neglecting our recovery programs. And things keep getting worse.
Step 7: Losing Control:
We handle each problem as it comes along but look at the the growing pattern of problems. We never really solve anything, we just put a band-aides on the deep gushing cuts, put first-aide cream on seriously infected wounds, and tell ourselves the problem is solved. Then we look the other way and try to forget about the problems by getting involved in compulsive activities that will somehow magically fix us.
This approach works for awhile, but eventually things start getting out of control. As soon as we solve one problem, two new ones pop up to replace it. Life becomes one problem after another in an apparently endless sequence of crisis. One person put it like this: "I feel like I'm standing chest deep in a swimming pool trying to hold three beach balls underwater at once. I get the first one down, then the second, but as I reach for the third, the first one pops back up again."
We finally recognize that we're out of control. We get scared and angry. "I'm sober! I'm not using! I'm working a program! Yet I'm out of control. If this is what sobriety is like - who needs it?"
Step 8: Using Addictive Thinking
Now we go back to using addictive thinking. We begin thinking along these lines: " Sobriety is bad for me, look at how miserable I am. Sober people don’t understand me. Look at how critical they are. Maybe things would get better if I could talk to some of my old friends. I don’t plan to drink or use drugs, I just want to get away from things for awhile and have a little fun. People who supported my drinking and drugging were my friends. They knew how to have a good time. These new people who want me to stay sober are my enemies. Maybe I was never addicted in the first place. Maybe my problems were caused by something else. I just need to get away from it all for awhile! Then I'll be able to figure it all out."
Step 9: Going Back To Addictive People, Places, And Things
Now we start going back to addictive people (our old friends), addictive places (our old hangouts), and addictive things (mind polluting compulsive activities). We convince ourselves that we're not going to drink or use drugs. We just want to relax.
Step 10: Using Addictive Substances:
Eventually things get so bad that we come to believe that we only have three choices - collapse, suicide, or self-medication. We can collapse physically or emotionally from the stress of all our problems. We can end it all by committing suicide. Or we medicate the pain with alcohol or drugs. If these were your only three choices, which one sounds like the best way out?
Step 11: Losing Control Over Use
Once addicted people start using alcohol or drugs, they tend follow one of two paths. Some have a short term and low consequence relapse. They recognize that they are in serious trouble, see that they are losing control, and manage to reach out for help and get back into recovery. Others start to use alcohol or drugs and feel such extreme shame and guilt that they refuse to seek help. They eventually develop progressive health and life problems and either get back into recovery, commit suicide, or die from medical complications, accidents, or drug-related violence























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