Contemporary Teaching

Relapse Prevention

I am writing this article to add to the existing knowledge about treating relapse. Relapse is returning to an addictive behavior after the person has demonstrated a time away from the addictive behavior. Addiction is characterized by a loss of choice once the addictive behavior has been engaged in. It is said that relapse is a part of addiction recovery. I disagree with that assessment. It does not have to be a part of recovery. This article is about this point in particular.  

A client who has never entered into any type of change experience i.e.: quitting on their own, going to church, Rational Recovery, SMART Recovery, Hypnosis, Counseling, Women for Sobriety, Men for Sobriety, SOS, any of the 12 step programs etc. All of them work depending on the person and how they resonate with the quitting strategy and their willingness to respond to the principals of the program.

I’ve been in the Addiction, Co-dependency, Trauma resolution, Grief/Loss and Life Transition field since 1973. I have seen many people stop one addictive dysfunctional behavior only to replace it with another, recovery completely and never relapse, relapse once or twice and then they get it and relapse countless times and never seem to be able to hold any time together. Observing these behaviors in detox units, hospital based treatment, intensive outpatient programs, and outpatient programs and outpatient one on one therapy sessions has lead me to believe that the reason most return is they are not convinced the behavior or chemical really has that much control over them. Others would rather use the addictive behavior or another one than use the recovery strategies their program teaches. Another major problem seems to revolve around the client’s unwillingness to accept the level of problems they have that are related to their use as an internal motivator to change.

To me, and the existing literature seems to agree, the key is to assist people to manage their anxiety in an effective manner, tell the truth about, your relationship to the addictive behavior and how you feel and grieve your losses which gets rid of life pain and teaches a process for permanent resolution.  Spirituality is important to some so introduce it a way they can accept it and if spirituality is not important then one of the cognitive approaches to recovery may work better than the 12-step or church approach for that client.

I have found that if the client has told the truth about their addictive behavior and wants to be free from the emotional baggage then grief work is in order. Not the Kubler Ross stages we all learned years ago but steps to effectively say goodbye to the pain of the past. I have a homestudy course c4 that addresses this process. If an addict or client can find a way to deal with their pain they usually will do just that but if they do not have an effective pain killer i.e. resolution they are prone to want to return to behavior that will enable them to bury their feelings through relapse. Seen in this light it’s important to remember that the addict of any type is not failing they are succeeding in producing a result consistent with their thinking at the time. The 12 step programs are a good way for he client to get release. The 4the step or inventory step helps the client identify patterns of behavior and steps 5-9 helps clear up the shame or guild they often carry about these actions. Forgiveness and understanding are the result of the first 9 steps and steps 10-12 keep the addict on even keel.

Article written by Michael Yeager B.A., LCDC, C.Ht, RMT,CAS

Clinical Director of Whole Person Healing Center, an outpatient clinic in Houston, Texas.  800-365-5950.  Michael is also Owner of Contemporary Teaching, an internationally approved training company offering Home study courses and live presentations for CEOs.