RELAPSE CAN AND DOES HAPPEN.
Relapse is more than just using alcohol or drugs. It is the progressive process of becoming so dysfunctional in recovery that self-medication with alcohol or drugs seems like a reasonable choice.
The relapse process is a lot like knocking over a line of dominoes. The first domino hits the second, which hits the third, and soon a progressive chain reaction has started. The sequence of problems that lead from stable sobriety to relapse are similar to those dominoes. There are two differences. First, each domino in the line (i.e. each problem that brings us closer to substance use) gets a little bit bigger and heavier until the last domino in the sequence is ten feet tall, four feet wide, and a foot thick. As this 10,000 pound domino begins to fall on us, it is too heavy for us to handle alone. The second difference is that the dominoes circle around behind us. So when the last domino falls, it hits us from behind when we’re not looking.
So here we are, moving along in recovery. We tip over one small domino. No big deal! That domino hits the next, and then the next. A chain reactions gets started. The first dominoes are so small that we can easily convince ourselves that it’s no big deal. We look the other way and start doing other things. All of a sudden a huge domino falls on us from behind, crushing us to floor, causing serious pain and injury in the process. We need to make the pain go away and we reach for old reliable – the magically substances that always helped us with out pain in the past. We’ve now started drinking and drugging.
The answer to avoiding relapse is not to take up weight training so you will be strong enough to lift that last domino off of your now crippled body. Part of the answer is to learn how not to tip over the first domino. Another part of the answer is to develop an emergency plan for stopping the chain reaction quickly, before the dominoes start getting so big and heavy that they become unmanageable.
The progression of problems that lead to relapse is called the relapse process. Each individual problem in the sequence is called a relapse warning sign. The entire sequence of problems is called a relapse warning sign list. The situations that we put ourselves in that cause or complicate the problems are caused high risk situations.
It’s important to remember that we don’t start drinking and drugging because of the last problem in the sequence. We start drinking and drugging because the entire sequence of problems got out of control. Let’s look at the steps of this process in more detail.
Step 1: Getting Stuck In Recovery
Step 2: Denying That We’re Stuck
Step 3: Using Other Compulsions
Step 4: Experiencing A Trigger Event
Step 5: Becoming Dysfunctional On The Inside:
Step 6: Becoming Dysfunctional On The Outside:
Step 10: Using Addictive Thinking
Step 11: Going Back To Addictive People, Places, And Things
Step 12: Using Addictive Substances:
Step 13: Loosing Control Over Use
Other Outcomes Of The Relapse Process
Some relapse prone people don’t drink. They may say “I’d rather be dead than drunk” and they either attempt or commit suicide. Others just hang in there until they have a stress collapse, develop a stress related illness, or have a nervous breakdown. Still others use half measures to temporarily pull themselves together for a little while only to have the problems come back later. This is called partial recovery and many people stay in it for years. They never get really well, but they never get drunk either.
What I have just described is called the relapse process and it’s not rare. Most recovering people periodically experience some of these warning signs. About half can stop the process BEFORE they start using substances or collapse from stress. The other half revert to using alcohol or other drugs, collapse from stress related illness, or kill themselves.
It’s not a pretty picture. No wonder we don’t want to think or talk about relapse. It’s depressing. The problem is that refusing to think or talk about it doesn’t stop it from happening. As a matter of fact ignoring the early warning sing makes us more likely to relapse.
But there is hope. There is a method called Relapse Prevention that can teach us to recognize early warning signs of relapse and stop them before we use alcohol and drugs or collapse. That’s what my next article is about. There’s also a process called Relapse Early Intervention that helps us set up an emergency plan to stop relapse quickly should it occur. We’ll cover that in our third article.
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