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It 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 withdrawal.

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 :

1) internal feelings and emotions, which overwhelm us and can lead to drinking/using ;

2) external situations, places and people which can trigger drinking/using ;

3) 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 temporarily displaced.

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 stage.

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 just life. 

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.

 

WARNING SIGNS ! ! !

1) changes in thoughts, feelings and attitudes.
2) changes in behaviors and activities.
3) a combination of the two above.

Sometimes 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 again.

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 individuals.
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.

Ask yourself

∑ 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 experienced it. 

Identify common points with yourself and also try to see if there are any other features particular to yourself and your history.

 

General Relapse Factors
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 !

Create 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 go exercise.


- 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 individually.

- Discuss your plan with others.

Putting the Plan into Action ! This 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 chemical dependency.

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.

Finally, 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.



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