The completion of addiction treatment comes with much excitement, anxiety, and anticipation. Walking out the doors of rehab sober, exhilarated, with a new look on life and the thought of what lies ahead in the “real” world causes anxiety and fear to kick in. A relapse means an individual who was once clean of drugs and alcohol “slips” and partakes in drugs and/or alcohol. 

With relapse affecting 40%-60% of recovering individuals, experts continue to improve relapse prevention techniques. Most treatment centers offer a comprehensive relapse prevention therapy program to prepare the client for life after treatment. Continued sobriety is achievable with the successful completion of a well-structured relapse prevention plan.

Relapse Prevention Therapy is a cognitive-behavioral based therapy that identifies thoughts, emotions, and situations that may lead to relapse. The client acquires an understanding of why relapse happens and how to prevent it. The therapist and client will work together to develop the skills needed to keep the client on the path to sobriety. 

Relapse Stages and Warning Signs

There are signs to look for when a relapse is imminent. Relapse does not happen without warning. An old habit may start to appear, or “friends” that are not supportive of a sober lifestyle start hanging out again. Ideally, friends and family will be watching for the signs, and the relapse is noticed early on or even before it happens. An individual who doesn’t have family around may slip back into addiction if they do not acknowledge the signs in time. 

The NCBI outlines four main ideas in relapse prevention. 

1. Relapse is a gradual process with distinct stages.
2. Recovery is a period of growth and development.
3. Relapse prevention requires cognitive therapy and mind relaxation to build coping skills.
4. A few basic rules define relapse:

• Changing your life
• Complete honesty with yourself and others
• Seek help
• Practice self-care
• Do not bend the rules

Stages of Relapse

To prevent relapse first, an individual needs to understand that relapse happens over time. A person may be on the right path for weeks or months before signs of relapse begin. 

Relapse Prevention Therapy teaches the client the signs to look for and the tools needed to change their way before relapse happens. Though some individuals have a hard time seeing the signs for themselves and relapse happens before changes can occur. There are three standard stages of relapse, and they are as follows. 

Emotional Relapse  

In this stage of relapse, the individual isn’t thinking about drugs or alcohol. Thinking about past experiences with relapse comes with a fear of having to get sober again. Denial about emotions and behaviors that are pointing toward relapse is a big part of emotional relapse.

Some signs of emotional relapse are:

• Keeping emotions bottled up

• Self-isolation

• Avoiding meetings

• Not sharing at a meeting.

• Focusing on others problems and 

• Bad eating habits

• Bad sleeping habits

All the signs of relapse start with signs of not focusing on self-care. Self-care is the main focus of Relapse Prevention Therapy. The definition of self-care is different for everyone. For some, it means a hike just them and mother nature, and for others, it may be cooking a healthy meal. 

A simple reminder that you are not taking good care of yourself is the acronym HALT: hungry, angry, lonely, and tired. It is essential for sobriety to enjoy life. Try new foods and go to new places. Filling your time with activities that make you happy and fills your life with joy will drastically reduce the chances of relapse. 

Continuing therapy is vital during this stage because of denial. The therapist will help the client identify and acknowledge the areas that need attention. The therapist will continue encouraging positive behaviors and remind the client of what led to past relapses. It is imperative to be open and honest with your therapist to receive help and encouragement to keep you sober. 

Extended poor self-care is the consequence that transitions emotional relapse to mental relapse. Not taking care of yourself results in a psychological downfall. If an individual does not stop the cycle now, then the path of relapse is inevitable. The longer a person stays in a mental relapse, restlessness, and irritability start. As discontentment with themselves builds, the thoughts of escaping begin, and so do the ideas of using. 

Mental Relapse

In this stage, a war begins—a battle between wanting to use and not wanting to use. The longer a person stays in this mental state, their fight to resist drugs or alcohol weakens. An individual may start to hang out in the same old spots with the same old people ignoring all the tools and techniques learned in Relapse Prevention Therapy.

Some signs of mental relapse include:

• Cravings

• Missing people and places related to the days of addiction

• Downplaying consequences and finding the positives of using

• Lying

• Scheming

• Bargaining

• Finding excuses to use

• Planning a relapse

An essential goal of therapy is teaching clients to avoid high-risk situations. For some, they have a hard time identifying unhealthy conditions. And for some, they think they are stronger than their addiction and knowingly put themselves in harmful situations. It doesn’t matter how long a person has been sober; it is never a safe idea for a person to put themself in a position of having to fight the urge to use.

It is not uncommon for a person in recovery to have thoughts of using, it is healthy as long as the ideas are brief. Some see it as a failure to even think about using drugs or alcohol. On the contrary, not talking about it only leads to relapse. It is impossible to forget life with addiction, and just as memories from those times keep a person sober, thoughts can also be associated with happy times. Using the coping skills learned in therapy, a person can release these thoughts quickly. 

Continuing care with a therapist will help hold a person accountable, and their behaviors monitored. The therapist will watch for signs that brief thoughts are becoming more frequent. 

Physical Relapse

This stage of relapse is the act of using again. Some experts call a one time use a “lapse,” and going back to uncontrolled use is “relapsing.” It doesn’t matter if a person takes one- sip or one-hit versus getting drunk or high, it is still the same. If an individual focuses on the amount consumed in the moment of relapse, then the full effect of the consequence will not be felt. One use can quickly turn into full-blown addiction again if not gotten under control immediately. 

Physical relapse is an act of opportunity. The individual feels it’s ok because they will not get caught. In this stage, addiction is creeping its way back into the thoughts regularly. It tricks the individual into thinking it is ok to partake in unhealthy substances as long as you say “no” first. It is that type of thinking that leads a person to relapse. 

Relapse Prevention and Cognitive Therapy

The primary therapy used in Relapse Prevention Therapy is cognitive therapy. The focus of cognitive therapy is changing negative thoughts and gaining excellent coping skills. It is common for those in recovery to have some of the following ideas:

• Others are the problem, not me

• I need drugs to cope with life

• Occasional use is ok

• It’s not fun being sober

• Staying sober is to much work

• I am only going to fail, so why not use it

• I can keep my relapse a secret.

The negative thoughts of addiction become an all or nothing kind of thinking. Any positive thoughts that try to form are immediately shut down and replaced with negative, harmful ideas. These thoughts can lead to uncontrollable anxiety, stress, and resentment, which can lead to relapse. Relapse Prevention Therapy helps retrain the brain to create positive thoughts and helps the patient break old habits. 

Fear 

A typical negative thought pattern, fear can debilitate a person and keep them in a negative place mentally and physically. All concerns stem from one main fear, and that is the fear of failure. A misconception of recovery is that a person needs to have a superpower or unique willpower. An individual will use past relapses as proof that continued sobriety is impossible for them. The therapist will help the client to see that it is about coping skills and techniques and not willpower. 

Redefining Fun 

An essential part of therapy is redefining fun. Recovery is hard and requires a lot of work, so it is crucial to enjoy sobriety. On a bad day, it can be easy to glamorize the past party life. When those thoughts start, they progress quickly, so it is easier to use, then stay sober. Sobriety is hard.

A person always needs to be aware of the environment they are in, what they are being exposed to. But sobriety is also fun, making memories with family and friends ( and remembering them), experiencing and seeing new things you couldn’t do high or drunk. Life is beautiful, and seeing it through sober eyes can excite people to continue a life of sobriety. 

Learn from Setbacks

A setback can include any action that is a step toward relapse. The way an individual handles setbacks will determine a lot about their recovery journey. Some examples of setbacks include:

• Not asking for help

• Not practicing self-care

• Putting oneself in unhealthy situations

• Not setting healthy boundaries

Setbacks are reasonable in the journey of sobriety. Setbacks are not failures but a lack of tools and techniques needed to overcome the negative forces. Continued therapy is useful in reinforcing these skills and helping to curb the negative thoughts that come with setbacks. 

Become Comfortable with Uncomfortable 

In promoting continued sobriety, it is important to be comfortable feeling uncomfortable. This lesson is important to acknowledge in life for all individuals. Negative feelings and emotions should be viewed as growing experiences. When a person learns to see the negative positively, they become comfortable in every situation. This new-found confidence pairs with increased self- awareness, and promotes continued sobriety.

Relapse Prevention Plan – Dealing with Urges

When people are fighting the urge to use, they will often try to rationalize their decisions. They will quickly think of reasons why it’s ok for them to use. But, the most important thing an individual can do is think it through to the consequence of using drugs and alcohol. If a person takes the time and not make a rash decision, thinking of the hard work thrown out the window and the disappointment felt should be enough to encourage healthy choices. 

An important topic to cover in a relapse prevention plan is what to do when you have urges. If the urge is more than a fleeting urge to use, then it is vital to have a plan in place, so you do not progress to relapse. 

Tell Someone About Your Urges  

Talking about urges takes away their power, and in the process, the urges fade away. All individuals in recovery should have a support person or a sponsor, a close friend, or family member to share their struggle. Your therapist will not be available all hours of the day, so it is good to have a few people you can call and not feel alone.

Find Distractions

Get up and out of the house. Go for a walk, go to a meeting, play with your kids. Find something to do. If you do nothing, the urges will get stronger and can lead to relapse. In your relapse prevention plan, you should have a list of activities to do when you are fighting the urge to use drugs and alcohol again. 

Wait 30 Minutes

Typically urges last 15-30 minutes. So keep busy. And remember, this to shall pass. 

One Day at a Time

Match your short term goals to how you feel that day. If you are feeling confident in your sobriety, set a week-long goal. If it is not the best day for you and you are struggling, then set your goal small. Maybe your goal that day would be to go to a meeting and stay sober. Sobriety is a day-to-day journey. Accepting that decreases the stress a person puts on themselves to improve every day. 

Relax

When a person is relaxed, they are more open and accepting to change. If a person is always stressed and tense, they can not think clearly enough to fight any urges and temptations that may arise. 

Let Ken Seeley Rehab Help After a Relapse 

Choosing to get sober can be a terrifying decision. Admitting you relapsed and need treatment again is full of all kinds of negative thoughts and emotions. What will people think of me? What is wrong with me that I cannot stay sober? But the wonderful and caring staff at Ken Seeley Rehab are waiting with open hearts and with no judgment. Whether it is your first time seeking help or you have tried many times, the expert staff is waiting to guide and support you to success. 

To learn more about Ken Seeley Rehab and the programs we offer, please contact us today. We look forward to helping you or your loved one on the path of sobriety. 

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4553654/

https://dhhr.wv.gov/bhhf/Documents/MAT%202017/M114%20Relapse%20Prevention%20Plan.pdf