The challenge of relapse
Relapse is a characteristic of the disease of addiction and therefore if it should happen, it is no reason to feel especially negative. The event may be disappointing, just as it would be disappointing to suffer a relapse after treatment for cancer for example. However, the best response is always to face the challenge and perhaps seek further treatment. At Castle Craig Hospital we see the reality of relapse and are always glad to advise on the best way for a person to deal with the situation. The way that relapse is addressed depends very much on individual circumstances, but the event should always be taken seriously.
The residential treatment programme at Castle Craig gives considerable attention to causes and prevention. Our Relapse Prevention Course goes into considerable detail on the practical aspects such as triggers to relapse, dangerous situations, and techniques for coping with cravings as well as specific events such as weddings or parties, using role-play. Anyone leaving treatment here takes with them a Continuing Care Plan which contains their planned responses to potential relapse situations that they have identified. Yet people may still relapse.
Recognize the danger
Fully recognizing the danger of relapse, even for the well-prepared, is a prudent first step. It can take different forms, from the isolated incident to the full-blown reversion to active addiction; from the ‘slip’ to the ‘crash landing’.
A phenomenon of recovery that quite a few people who have been through rehab seem to experience, is the unconscious need for one final test of their ability to control their addictive behavior. It’s as of they need one more ‘convincer’ that they can’t. The act of taking another drink in this way, another drug, or returning to compulsive behavior such as gambling, can be demoralizing but often this ‘convincer’ turns out to be the last shout of a person’s denial. if it is simply a single event, it can be treated as a slip rather than a full-blown relapse.
That is not to say it can be ignored – far from it. The person concerned must get to a meeting as soon as possible and talk about their slip openly with other fellowship members and with their sponsor. Provided that the person maintains honesty and openness in dealing with the matter while fully embracing the fellowship relevant to their addiction, that would be a sufficient response in most cases for this type of relapse. If a further ‘slip’ or recurrence of return to active addiction occurs, then more drastic measures in the form of more intensive treatment (probably some form of counseling therapy) will be needed. If the person who has relapsed has been through rehab before relapsing, they should certainly review their aftercare arrangements at the time of their discharge together with their subsequent commitment to continuing care and attendance at self-help fellowship meetings.
The more serious type of relapse needs a different approach. This is where a recovering person reverts to their active addiction and does not stop at a single episode. This means that their attitude, thinking, and behavior have all reverted to their addictive mode and therefore drastic measures are required. Where a person has perhaps not fully committed to the changes that are necessary for sobriety or perhaps has not fully dealt with underlying issues such as childhood trauma, then this sort of relapse is more likely. Further work needs to be done which may take the form of professional input – perhaps counseling using a variety of therapies. This may be difficult to arrange while living at home and if a person has recently been in rehab, it may very well be a wise course of action to return for a boost. It may not necessarily mean a long stay, but it will reset a person’s attitude of mind to make them once again orientated towards recovery.
An opportunity to learn
The great benefit of relapsing is that we can learn a great deal from it. We have in effect, created our own very personal case study that if examined thoroughly, will pinpoint exactly where, when, and how we went wrong. We can examine our thoughts feelings and actions before the event and see how we could have done things differently. In short, relapse is a unique opportunity to finally get things right once and for all.
The shock of relapse
Relapse can happen out of the blue and be a shock. For many people, relapse is a process that may have started several days or even weeks before a person returns to their addictive habits.
The main point is to address the relapse as soon as it happens and make sure that steps are taken to restore the right conditions for recovery to continue. A lot of people who have relapsed find that their ability to block self-defeating behavior has evaporated. Thus, most choices they make throughout the day become based either on fear or the easier softer way. Sometimes at the same time. The effect is that often they simply do nothing, being simply too frightened and too unmotivated.
Three sensible choices
Here are three sensible and immediate choices that they can make if a relapse should occur:
- Stop the behavior
- Seek support
- Explore why and how it happened and plan the best way to prevent future re-occurrence
All these, of course, can be best achieved by going to a Twelve Step meeting – preferably several meetings – and talking to your sponsor and like-minded people. But more may be required.
Some difficult questions
To determine whether you need to go back to rehab, you might start by asking yourself some difficult questions very honestly:
- Was this truly an isolated incident?
- Had I been planning this for some time, perhaps subconsciously?
- Have I been seeking the company of unsuitable people (e.g.: who are drinking or using)?
- Have I been thinking about addictive behavior a lot?
- Have I been making choices on the basis of what I want rather than what is good for my recovery?
- Do I honestly want to stay clean and sober?
- Where did I go wrong in my continuing care plan?
- Am I prepared to go to any lengths to achieve sobriety?
Addiction can produce denial in some people that makes self-honesty hard, so you may be better off discussing these questions with your sponsor or at least a person in long-term recovery.
The decision – ‘half measures availed us nothing’
Depending on your answers, if you determine that this really was an isolated incident and you’re committed to conscientiously following your continuing care plan from now on, then you may not need to go back to residential rehab. However, if you are doubtful or concerned about some answers, then you should seriously consider a return to rehab if possible.
The benefits of returning to rehab
The benefits of a return, even for a short time, will be to reinforce within you the basic truths and requirements of successful recovery:
- Asking for help
- No compromise
Successful sobriety requires us to build our lives around our recovery, not the other way round. Mature people when faced with a challenge, might ask themselves three vital questions:
- What is the reality of my situation?
- Where do I want to be in a year’s time?
- What steps do I need to take to achieve this?
If we can answer these questions without fear, self-seeking, or self-deception, then the answer should be clear. In many cases, it will indicate the advisability of a return to rehab. A long stint may not be needed but we need to be able to feel that on discharge, the idea of taking a drink or some other addictive behavior is a bad one, because we have truly discovered other choices that work better. Whether you need help with drugs or alcohol, contact Castle Craig to start or restart your recovery.