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Pros and Cons of Relapse Prevention

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Friends, today’s topic is something that quite a few recoverers may not know about.  Relapse Prevention is a while school of thought developed by addiction counselors and therapists and other professionals.  As the name implies, this approach explicitly labels the component of the process in which the recovered alcoholic could possibly hit a relapse.

A report by Larimer, et al. discusses the Marlatt Cognitive-Behavioral Model.  First, this model aims to identify high-risk situations, such as conflicts, negative emotional states, being around other drinkers, etc.  From there, the model looks for coping mechanisms, such as self-talk, leaving the situation, seeking the help of a professional, etc.  The goal of relapse prevention is to take a recovering alcoholic and put her or him through a course of therapy that is meant to

  • increase self-efficacy
  • eliminate myths regarding alcohol’s effects
  • manage lapses
  • restructure client’s perception of the relapse process

So, now that we know about this process, we can take a look at some of the pros and cons of it, see it at work, and get a sense of how likely it is to be successful under what circumstances.

When a person enters a relapse prevention program, he or she probably participates in a support group, and very well meets with a therapist.  Naturally, at the beginning of the program, the person is given instructions to follow.  As you can see, then, it’s an outpatient program, similar to AA, that is largely a matter of putting into play the suggestions you get.  To succeed with such a program, the recoverer has to be savvy, committed, and disciplined.

Anticipate

One of the guiding mechanisms of relapse prevention is anticipating and recognizing stressors.  Changes that occur, foreseen or not, are good examples.  If you don’t make a special effort, it would be easy enough to go into these unsuspecting, not putting your guard up.

But when you do into any change in your job situation or marriage setup, be ready.  Be ready upon breaking up with anyone, moving (even if you’re excited about where you’re moving and what you’ll be doing there), health issues.

The idea is that these changes slowly eat away on our resolve.  Our comfort and security diminished and threatened, we fall back on either security blankets or on pre-existing traits of our personalities.  This is when we’ll either start to drink or have increased thoughts about alcohol.

Willpower

Willpower, we know, is absolutely essential to all components of recovery.  What it means to relapse prevention per se is having the discipline to do what needs to be done when you have warning signs such as cravings, pining away for drink, etc.  Here is where some of the main courses of action are getting a hold of your AA sponsor or a similar person you may be linked with in a relapse prevention program.  You may contact the facilitator of the program or in some way incapacitate yourself as far as your ability to drink is concerned.

The problem for a lot of people is pride, stubbornness, some things like this that add up to not having the discipline to do what needs to be done.  It’s not easy to call a sponsor or to make “a big deal” of the issue.  People want, instead, to be able to just blow past the problems.  This does work from time to time, but any instance of it not working is a pretty huge problem for a recoverer.

Connecting Everything

The ideas behind relapse prevention programs do a nice job of giving the recoverer a checklist.  They can serve their purpose under the right circumstance.  However, the idea is to get into a situation in which you just don’t need it.  In this way, the various concepts I’ve discussed throughout this blog all work together.  For example, to be good at anticipating warning signs, the recoverer needs to have a relatively solid sense of himself, a knack for listening to his signs, and the discipline to listen to these signals.  All of these things indicate really doing your homework and having grown emotionally.

Confidence

It’s hard to know when a feeling of despair, coupled with some yearning for drink is something to get over and when it’s something that cries out for immediate action.  It’s a tough call to make.  However, I do know that there are times when I’ve felt a gentle nagging and I understood that I had the skills to push through it.  I was confident in my abilities, and I did push through.  That might sound like being a daredevil or exercising poor judgment, yet, until you can do things on your own, you’ll always be in trouble.

I think that something that’s very helpful here comes from my post, 5 Things I Learned in Recovery from a couple of months ago.  In this post, I discussed the idea of not allowing yourself to slide too far, understanding that a bad day is just a bad day.  In this way, one wouldn’t need any kind of intervention, since the temptation would never grow very strong.  Here’s what I wrote:

During those days, I wonder why I’ve been off the rails.  I beat myself up an awful lot and consider myself a failure.  I think about it the next day and the next, and I live in a little reality in which it seems like I’ve screwed up and my recovery is over.  The problem with this kind of thinking is that it gets a person into a place of trying to change the way you’re doing things and also losing confidence.

Confidence and faith in yourself are really your best assets, and they’re absolutely essential.  You can’t get bogged down in bad days that scare you.  At first, they will be scary, sure.  That’s only human.  But what I learned before too long was that bad days are just bad days.  They can be caused by all sorts of things, but most importantly, they can be overcome very easily.

Emotional Sobriety

Again, needing some sort of intervention means not developing the kind of emotional sobriety you need to be successful.  That’s fine, but it means that the goal has to be to develop that emotional sobriety.  Use the interventions as necessary, but by all means, spend your time on emotional sobriety.  I wrote a post a few weeks ago in which I discussed all the little checklist items you have to be able to fulfill along the way.  I won’t bore you with the list, but here’s what immediately follows in the post:

It was all about planning my entire life around sobriety.  And not doing drugs. Self-esteem was necessary for sobriety.  Managing anger was important for sobriety.  All of it was important to facilitate my literal sobriety, but it all made up emotional sobriety.

The thing is, you’re not getting sober so you can be your old self, just a sober version.  I mean, there’s a difference, of course.  But the idea is not to have the same old personality problems and same hangups you had while drinking.

I agree with myself.  All of these concepts are tangled up together, and all you can do is attack sobriety in the form of little increments day by day by day.  Break it down into hundreds of little activities.

In a lot of ways, all of us are our own therapist, and we all design  little plans for ourselves.  That’s not necessarily to say that there’s anything wrong with therapies, plans, interventions, just that because so much effort and self-discipline have to go into all that you do, you end up being the architect of your own success or failure.

Photo Credit S Limbért on Flickr