The first six months of abstaining from an addiction are the most difficult. During these six months, most of the typical temptations, triggers, and challenges will occur at some point. If someone can successfully cope with these problems and maintain abstinence, then some stability will be established and recovery will begin to get easier. Therefore, be prepared to endure. Recovery will not happen overnight. How can a person prepare for successful recovery?
As with any battle, it is essential to know as much as possible about one's enemy — in this case, relapse.
What are the most common causes of relapse?
Continually berating oneself for having an addiction.
Preoccupation with the past, including the pleasures associated with one's addiction.
Hanging on to guilt and shame over the addiction.
Persistent blaming of oneself or others for the problems caused by addiction.
Overconfidence with one's initial abstinence.
Self-centeredness and self-pity related to the addiction.
Negative thinking or the fear of trusting any successes.
Sampling of the addictive substance or behavior. This may happen inadvertently, such as tasting food cooked in alcohol.
How common is it for a recovering addict to relapse?
The National Institute on Drug Abuse (NIDA) states that the relapse rates for recovering addicts (40 to 60 percent) are similar to those for individuals managing chronic diseases such as diabetes (30 to 50 percent), hypertension (50 to 70 percent), and asthma (50 to 70 percent). Ninety percent of recovering addicts will have a brief period of relapse. The majority of these brief relapses occur within the first month of recovery.
The common denominator of these causes of relapse is having one foot in the addictive past. Successful recovery requires a forward focus. One must deal with the past, acknowledging and taking responsibility for wrongs done to others out of one's addictions, making amends if possible, and managing the consequences of addictions as positively as one can.
Old, dysfunctional thought patterns and behaviors must be transformed into ones that are true, productive, and healthy. Once those things are accomplished, it's time to move on. Recovery is a word associated with the future, not the past.
One activity that many have found helpful in being prepared is the “what if” exercise. This exercise works best with someone who knows the recovering addict well and who will be willing to role-play responses. All possible scenarios that might set off a slip or relapse are brought up for discussion. The recovering addict then brainstorms how he might handle each situation to avoid relapse. Here are some examples:
What if an old friend the addict used with calls and wants to get together?
What if the alcoholic finds a hidden bottle of vodka that she missed when she was cleaning her house of alcohol?
What if a friend invites the pornography addict to an “R-rated” movie with sexually explicit scenes?
What if a food addict is invited to a birthday party where his favorite cake is being served?
What if a gambling addict is invited to participate in a Vegas-style fundraiser?
What if a nicotine addict is invited to a family function where everyone else is smoking and she knows she'll be offered a cigarette to be sociable?
Brain-imaging studies have demonstrated the struggle to avoid relapse. Visual cues as short as 33 milliseconds that are related to one's substance abuse can activate the dopamine reward circuit. This process begins before conscious awareness. Once this occurs, the decision-making functions of the brain's frontal lobe become less effective. The result is greater difficulty in resisting the urge to relapse.
With potential responses already in mind and practiced, it's much easier to handle these tempting and difficult situations.
Another suggestion is to always have a “plan of escape.” When it seems impossible to avoid problematic situations, maybe because of family obligations or work requirements, have a logical, but honest, rationale for needing to leave the scene if the temptations become too strong. Take a separate means of transportation, if necessary, so that dependence on another person for a ride will not be a hindrance to leaving a stressful situation. This is no reason to feel guilty; protecting one's recovery is saving one's life.
Since there may be times when triggers and temptations are unavoidable, another strategy to manage these times is to condition oneself to have a different response to the temptation. Professional therapeutic help may be required to accomplish this. Desensitization, relaxation training, distractions, and positive self-talk are all methods one can use to retrain the response to an addictive cue.
Adolescents are at particularly high risk for addiction relapse. This is partly due to their developmental stage in life. The immature brains of adolescents are often disposed to poor decision-making and lack of impulse control. Adolescents with the additional risk factors of learning disabilities, dysfunctional family systems, and/or a dual diagnosis need extra help in maintaining recovery.
For example, learning relaxation training in order to get in a relaxed state prior to encountering an addictive cue can help one replace feelings of excitement with feelings of calm and indifference. A person addicted to pornography will need to learn the skill of distraction if he's ever to go to the beach again on vacation. He will need to learn to refocus his attention to the sea life, to learning scuba diving, and to the wonderful taste of fresh lobster. Although this may seem too difficult, it most definitely can be accomplished with help from a professional.
Learning the art of positive self-talk is an essential skill for a recovering addict. Saying to oneself, “I can focus much better on the conversation with a glass of iced tea than with a martini” or “I am more than able to use my creativity to come up with new outfits from my own closet. I don't need to spend more to look good” are just two examples of positive self-talk. It's a good idea to develop a list of positive self-talk statements to have handy whenever recovery is threatened. Reviewing these statements daily is also a great preventative measure to avoid slips and relapse.