is not possible to stress enough that relapse for the alcoholic/addict is a life
and death question. Any relapse is a gamble with death. One or two drinks or
drugs inevitably leads back to massive drinking/using within a short period.
People who relapse can often die from accidents, overdose, suicide or medical
problems. For example, if you have a damaged liver, your liver will return
automatically -and not gradually- to the level of damage it was at when you were
drinking. Some people are lucky to halt the relapse quickly (a lapse), but any (re)lapse
is a mortal danger, which at the very least causes psychological pain and at
worst can lead to a path from which there is no return. Having
said that, we have to face the reality that relapse is an ever-present threat
and part of the general recovery process for the majority of us. Many alcoholics
and addicts experience one or more relapses before achieving a lasting sobriety.
A minority manage to have none at all. The best policy is learn from those who
have never relapsed,
AS WELL AS those who have relapsed, about how to guard against and avoid a
relapse. Having no relapse is the best scenario for all of us and while
accepting the reality of its potential we should not use the fact that it may
happen as an excuse for actually having a relapse or not trying desperately to
avoid one. The first relapse or the next relapse may be your last !
Once we have detoxed our bodies and got sober, the key issue in our minds is
STAYING SOBER. But, in order to do this, we need to understand and accept that
we are alcoholics/addicts and can NEVER drink or use again. However, we also
need to realise that years of chemical dependency and learned habitual
behaviours have programmed our bodies and minds to react instinctively to
emotions, feelings and situations by drinking/using. Many people who relapse say
that when they took the first drinks/drugs, it seemed that they were on ę
automatic pilot Ľ, as though they were in a film and couldnít even seem to
watch themselves disinterestedly from outside as they walked in the bar, opened
the bottle or reached for the joint/needle.
There is a truth in this. We have trained ourselves, often for years and
decades, to reach automatically for the drink/drug as THE means of finding
pleasure and relief from the troubles of everyday life. Other non-alcoholic
people find other ways of dealing with these issues, but we know no different
than drinking or drugging. When we relapse we are rerunning the alcoholic film,
playing out our addict part and then, only once the act is done, reality returns
with a hard thud in terms of the painful consequences of intoxication and
In order to stay sober we have to untrain ourselves, deprogram ourselves, so
that recoiling from temptation and not taking that drink/drug becomes an
automatic response to the life-threatening consequences which drinking/using
means. We have to first pinpoint the dangerous triggers and stimulants which can
provoke the temptation to drink/use, in order to immediately avoid them at any
cost. Then, gradually, we have to learn new coping strategies and methods to
deal with everyday life on a sober basis.
One might classify at least 3 main avenues
down which the road of relapse can arrive. These are :
feelings and emotions, which overwhelm us and can lead to drinking/using ;
situations, places and people which can trigger drinking/using ;
Unhealthy patterns of behaviour and habits which can lead to drinking/using.
There are no hard divisions between the three and, in practice, all three of
these tend to overlap, but the direction you come from may tend to lie more in
one of these areas than another.
1) External Situations, Places and People
We all found our own particular situations, places and social relationships in
which we habitually drank or used. These can be bars, parties, dinners,
after-work socialising, sport events, isolation at home, concerts, clubs etc. It
can be the company of certain people - drinking buddies, colleagues, partner or,
alternatively, being lonely at a bar stool or in front of the TV at home.
Certain music, even smells and foods can be associated with drinking/using.
These situations are associated with strong negative and positive emotions of
pleasure and relief . Physical memory circuits have been established in the
brain, which light up automatically when you find yourself in such circumstances
and trigger the behavioural response circuits of drinking/using. They may do so
consciously, or they may work deep down in the subconscious or unconscious and
creep up on you unexpectedly - often when it is too late.
2) Internal Feelings and Emotions
These can be bad emotions and feelings, like anger, sadness, grief, jealousy,
hate, loneliness, boredom and depression, from which we search for relief
through alcohol/drugs. On the other hand, they can surprisingly also be good
feelings like jubilation, euphoria, happiness, exaggerated self-confidence,
etc., which are linked to celebration and reward, and which can equally lead us
to drinking without thinking. Both negative and positive feelings and emotions
can be equally dangerous to our sobriety, if left unrecognised.
Of course, it is not so easy to avoid emotions and feelings. One cannot cancel
depression, not turn up for anger, avoid feeling sad, etc. Therefore, one needs
to explore what are the most dangerous emotions which you may associate with
drinking. Then to realise that these are SEPARATE ISSUES from drinking/using and
which are part of ę the human condition Ľ, which everybody faces (alcoholic or
non-alcoholic) and which non-dependent people do not use as an excuse for
drinking or turn to bingeing for relief. Having recognised these emotions as
separate issues from your Sobriety Priority, you need to find ways for dealing
with and expressing these emotions and feelings in a SOBER healthy way
3) Unhealthy Patterns of Behavior and Habits
When we first get sober, we often feel like a fish out of water. We donít know
what to do with ourselves or our time. If we donít begin to plan and structure
a new way of life, then we are at risk of falling back into old patterns and
routines. This could be visiting the same bars, restaurants, clubs, staying at
home feeling isolated, depressed and lonely, hanging out with old drinking/using
friends, etc. Initially, we may not drink or use, while doing these things. We
take a Coke or coffee, but, nevertheless, we are essentially acting like an
alcohol/addict, a dry drunk/addict, where just the substance has been
Of course, it is a good thing to drink non-alcoholic beverages and it is not
always possible to avoid places where alcohol or drugs are being used. Staying
sober then is a great achievement and one cannot and should not cut oneself from
life and live like a hermetic shaman (unless that is your route). The
difference, however, is the degree to which you put yourself habitually in
places, situations and gatherings which you previously drank/used and/or similar
circumstances. Furthermore, you may not realise yourself, but by being in these
situations, you are fermenting habitual modes of thought, feelings and emotions
which you had when you were drinking/using. By encouraging
the growth of such addictive behaviours and thoughts, you are then only one step
away from the act of drinking and using itself. By getting back into the old
habits and patterns you are only rehearsing your role before actually going on
Of course, addicted or not, human beings are creatures of habit who tend to fall
back on old routines and habits, especially in times of difficulty or stress.
The alcoholic/addict is not only the ultimate creature of habit, but is also
chemically dependent on a substance and physically drawn to it. Our tendency to
fall back on old patterns and habits is, therefore, ten times stronger than the
average person. The chemical dependency is like some implanted magnet which is
attracted to a bottle or drug. Acting in behaviours previously associated with
drinking or using draws us more and more closely into the ę magnetic field Ľ
of active addiction. If one keeps moving in these circles of addictive
behaviours, it is only a matter time before one connects and gets stuck again.
In the earlier period and in times of difficulty, it is, therefore, essential to
break away from old habits and behaviours as much as possible. Firstly, spend a
many of your evenings as possible in recovery meetings. This is especially so a
we donít often notice what is happening and recognise warning sign in our
thoughts or behaviours. Others, however, may be able to recognise this and warn
us and forewarned is forearmed !
Make a list of place, people and situations to avoid and prepare excuses to not
go. Donít give in to pressure from others to be somewhere you shouldnít be.
If you canít say the truth, say you are ill. Indeed, remember you are ill. You
are recovering from a life-threatening illness ! Your life comes first ! Your
priority is Sobriety. Draw up a day plan - hour by hour. Think of new, SAFE,
places and people. Go swimming, cinema, get videos, go to the library, start a
hobby, join a club, etc. And do things you like. Sobriety is not a penance.
Reward yourself with fun for having saved your own life and having a second
chance. Build a new life.
Building a new life is not an easy thing. We often have to deal with the left
over problems from our past and we suffer mood swings, up and downs, depression,
etc., in the course of sobriety. But then so do non-alcoholic people. Like them,
however, we, NOW, do not drink/use whatever the situation. By remaining sober, a
new sober and rewarding life will gradually emerge. But that doesnít mean it
will be without all the problems and tragedies, as well as great moments and
good times that the rest of humanity faces. Thatís sober life, and thatís
With time and practice, you will find you are able to subdue and, to a degree,
deactivate those old knee-jerk alcoholic/using reactions. The longer one is
sober, then the more these mental associations and neurological pathways become
dormant. New more healthy associations linked to sober life take their place and
become more automatic. We learn how to deal with negative and positive emotions
without reaching for the bottle/drug. We grow in self-confidence and value
through our accumulated ability to deal with the world on its terms and not that
dictated by the drink or drug. We learn to establish more healthy patterns of
behaviour, based on a new life style, habits, new places, friends and
activities. Life becomes richer and more worth living. You grow and develop more
sides to yourself and your place in society and life at large.
However, dormant associations never totally die. The ę sleeping vampire Ľ can
always potentially be reawakened under
certain circumstances and conditions. Therefore, we must never be complacent.
However long our sobriety we must always be on guard for lifeís unexpected
challenges and the need to arm ourselves against possible relapse. Below
you will find some suggestions which may help you. You may also wish to read
books and take therapy as an adjunct to recovery. Above all use your SOS group
to talk about your problems and to find practical help and support from others
in recovery who face similar problems.
SIGNS ! ! !
changes in thoughts, feelings and attitudes.
changes in behaviors and activities.
a combination of the two above.
you may be aware of these signs and other times not. It is difficult for anyone,
alcoholic/addict or not, to be constantly objective about oneself and ones
behaviour. Often it takes another person to spot the changes which are taking
place and you must be prepared to listen and question yourself about others
observations. If you are not, then it is also another clear indication that you
may be in relapse mode. It can indicate that you are still in Denial, even
though you are not drinking or using and that you havenít really come to
acknowledge and accept that you are an alcoholic/addict, who can never drink
Relapses can sometimes occur spontaneously, where the limbic system hijacks the
brain in a particular situation. This is rare, however, and even if the relapse
appears to be spontaneous, it is usually preceded by the building up of a hidden
relapse mode and a growth of factors, which were not readily identifiable. Most
relapses build up gradually over weeks or months before actual drinking/drugging
takes place. Signs may show up hours, days or weeks before.
Furthermore, while there are characteristics similar to all relapsing alcoholics
and addicts, each person will also exhibit particular signs unique to them as
Although one doesnít not want to become neurotically obsessive about any
change in ones behaviours, thoughts or feelings leading to relapse (if you do
become neurotic about it, then it is probably a sign of relapse), nevertheless,
it is important that we become attentive to our moods, thoughts and behaviours
while in recovery. Thinking them through and discussing them out with others
will help you to gain a more balanced view of the processes and potential
dangers, as well as innocuous problems.
∑ who do you spend time with ?
∑ where do you go or feel like going ?
∑ how has you feelings, moods, emotions changed recently ?
∑ how have your behaviours changed in the last period ?
∑ what are the differences in your thoughts and attitudes recently ?
Be prepared to listen to others who have avoided relapse and those who have
Identify common points with yourself and also try to see if there are any other
features particular to yourself and your history.
Emotions and Feelings : below are some the more common emotions which
Good Emotional States !
It is often forgotten that excessive emotional highs can be a threat to ones
sobriety. It is possible that when one is very
happy or exuberant over an event or celebrating a success, that our association
of alcohol/drugs with such a feelings and situations can overwhelm us and lead
us back to taking that first drink or drug in the relapse process. We have
associated drinking/using with reward and pleasure and we must make sure we are
not taken by surprise in positive situations also. Be warned that holidays are
especially dangerous times, like Xmas, birthdays and summer vacations.
Sudden Urges and Cravings -
these can seem to arise like a thunderbolt from a clear blue sky. When
everything appears to be going well in sobriety, you are suddenly confronted by
a sudden urge or craving for alcohol/drugs. Then you have to ę close the gap Ľ
and make the emotional/feeling connection that alcohol/drugs = pain. Practice
this as part of your relapse prevention programme. Simulate an imaginary relapse
situation and then rekindle a really painful physical and psychological
consequence of drinking/using in your past. Remember also, that the more you put
yourself in behaviours, situations and thought patterns linked to your past
addictive behaviour, the more likely are these thunderbolts to become a storm !
a Relapse Prevention Action Plan !
- Have a general plan - phone fellow recovers, get to a meeting, etc
- Make a list of situations in which you
have drunk/drugged in the past.
- Make a list of the places, people
and things associated with your addictive behaviour.
- Make a list of the internal feelings
associated with drinking/using - depression, euphoria, anger, stress,
loneliness, success, etc.
- Identify which of these factors are
present recently and at the moment and note them as warning signs.
- List the specific warning signs which
you have identified and prioritise them hierarchically.
- Work out a series of alternative ways
(not just one) which you can use to deal with each warning sign, e.g., going to
the cinema, instead of a bar, changing your phone nį, exercising away anger,
crying instead of suppressing sadness, etc. Experiment to see what works best.
Some will work sometimes and others will work other times.
- Let yourself have a relapse fantasy -
identify where and when does it occur, who is there, how it happen, what are the
feeling and emotions present and how it ends.
- Are you having drinking dreams when you
sleep - what happens ?
- Practice ę closing the gap Ľ - think
of the times when you were drinking and pick the worst, most painful memories of
the consequences. Re-feel the hangover, dehydration, vomiting, etc., Re-kindle
the emotions of self-hate, shame, hopelessness. Hammer home the fact that
drinking/using equals pain not pleasure or relief. Repeat this exercise, donít
just wait until you feel an urge or a craving.
- Realise that everything passes and that
this feeling, mood or compulsion will disappear. Tell yourself that you do not
have to act upon it, that you have choices as a human being and are not a slave
to a chemical. You will be stronger as a result. Realise that millions of people
face the same moods, feelings and negative thoughts, but donít drink or drug
their way out of them.
- Donít just think, talk or write the
plan - PUT IT INTO ACTION !
Recovery doesnít float down on a cloud, you have to take concrete actions and
steps to realise it. Rehearse strategies one at a time. See yourself walking
past the local bar and going to the cinema. Pick an alternative substitute and
do it. Feel sad and then make yourself cry. Get angry about something and then
- If you find you have barriers to
actually implementing your plan, go back and ask yourself the $50,000 question
of why you created it in the first place. Remind yourself that alcoholics and
addicts look for the easy way out, the quick fix, as easy a taking that drink or
drug. Remember that there is no quick recovery solution ! You donít get
something worth having for nothing, especially when it is a second chance at
life ! ! ! You have to make some effort. If you are creating barriers to your
plan, then it may reflect that you are still in Denial. At the same time donít
make the task too difficult. Donít decide to lay on a bed of nails if you are
caught by an urge to drink/drug. Find alternatives which are pleasurable and
rewarding in some way, if possible. If you are having problems with your plan,
it could mean that your plan is too ambitious, difficult or inadequate. So
analyse what the barriers are and discuss it with others in your group or
- Discuss your plan with others.
the Plan into Action !
means working on things like changing your behaviours, starting healthier
patterns, working on attitudes, thoughts and coping mechanisms. Give yourself
multiple options for the lists of high risk factors you have identified. Test
them out hypothetically and practically, when need be. Donít worry about the
options not being perfect immediately or only being partly effective or not at
all. You have to experiment, eliminate and improve some methods. It is an
ongoing process, which will also change a you do in sobriety. Keep it as simple
as possible, but identifying and focusing on your key risk factors. Donít try
to build up a huge list of responses to every possible variant in life. Above
all, remember that a plan is not an intellectual exercise. You need to ę walk
the walk Ľ. Its about actively working on and changing your behaviours,
thoughts and emotional responses. Often one begins by changing behaviour as a
first step to changing ones thoughts and feelings.
The points above are rational guidelines for dealing with risks associated with
relapse. Arming ourselves as powerfully as possible with rational and practical
methods of dealing with relapse prevention is vital. However, as human beings we
not only work with the rational brain but also with our emotional brain. We can
all remember instances frequently in our active addictive years, when our
rational reasoning was overwhelmed by our emotional brain playing on our
Remember that we are still chemically dependent, but we have only suppressed
that dependency by abstaining. The emotional brain remains strongly connected to
that dependency through years of training in response and coping mechanisms. It
has the capacity to overpower the best and most rational of all plans in certain
situations. Therefore, we not only have to strengthen our rational responses,
but also the emotional or limbic part of our minds. We, therefore, also have to
have an ę emotional Ľ relapse plan in conjunction with our rational defenses.
When you first went sober, your decision should have been based not only upon a
rational decision not to continue and a rational acknowledgement and acceptance
of the fact that you are an alcoholic/addict, but also on an enormously powerful
emotional cry to rid oneself once and for all of the monster of addiction. It is
this response, an emotional explosion driving your desire to quit which you must
practice reliving each time you face
dangerous situations in sobriety. You must provoke a gut desire not to drink and
provoke within you an emotional outburst against returning to your addiction.
You must shudder at the thought of drinking/using again by momentarily reliving
the sensations, feelings, emotional and physical pain suffered in active
addiction and hammer home the point repeatedly to your emotional/limbic brain
that alcohol/drugs = pain, not pleasure/relief. Make it psychologically and
physically clear to yourself that the consequences of relapsing will be far
worse than the problems and pain you are temporarily facing now. Having done
that you must then fuse it with a rational response from your plan, like getting
out of that bar immediately, phoning some for help, jumping on your bike to
ride. This will get you out of danger. And each time you succeed in doing this,
you will powerfully influence fundamental changes in your thought and
behavioural patterns, retraining your mind in healthier patterns and laying
strong foundations and pillars of support for your long term sobriety.
you must know that however bad the situation is or how you feel, there is NO
excuse good enough for returning to drink/drugs. Although you are an addict and
always will be, by going sober, you are now part of the human community which is
not actively dependent on mind-altering substances to get through life. Like the
majority of people, you do not turn to drink/drugs in order to cope or
misguidedly solve problems and pains. Like them you have to learn other coping
methods and also ones specific for your addictive background. For
non-alcoholic/addicted people using drink or drugs is simply not an issue or an
option which they consider when faced with lifeís ups and downs. For you it
must also become a SEPARATE ISSUE.
Other non-alcoholic/addicted people have an
unconscious ę sobriety priority Ľ, knowing that it will cause more pain, bring
no relief, only cause further problems and undermine their ability to deal with
their predicament. The recovering alcoholic/addict is different however, in that
we have a CONSCIOUS ę Sobriety Priority Ľ which says to us that problems and
pain are separate issues from drinking/using. They are no longer linked to the
automatic response of alcohol/drugs. We do not drink/drug, no matter what !
Instead, like the majority of others, we can now face life on its own terms and
respond to its viscitudes under our own resources. No pain, no gain is
unfortunately true. But it helps us to strengthen ourselves and grow as sober
persons. At the same time, however, it not only gives us the power to overcome
pain and suffering, it also brings us the ability to appreciate and enjoy the
positive and beautiful things which are part of life, of sober life, which all
other people enjoy, and which were robbed from us by intoxication. Now by
staying sober, we will also reap the benefits of really living - crying,
hurting, yes, but also loving, laughing, having real fun, pleasure and joy.
not use the article
to start a discussion in your group?