Relapse is usually caused by a combinations of factors. Some possible factors and warning signs might be: * Stopping medications on one’s own or against the advice of medical professionals * Hanging around old drinking haunts and drug using friends – slippery places * Isolating – not attending meetings – not using the telephone for support * Keeping alcohol, drugs, and paraphernalia around the house for any reason * Obsessive thinking about using drugs or drinking
* Failing to follow ones treatment plan – quitting therapy – skipping doctors appointments * Feeling overconfident – that you no longer need support * Relationship difficulties – ongoing serious conflicts – a spouse who still uses * Setting unrealistic goals – perfectionism – being too hard on ourselves * Changes in eating and sleeping patterns, personal hygiene, or energy levels * Feeling overwhelmed – confused – useless – stressed out * Constant boredom – irritability – lack of routine and structure in life * Sudden changes in psychiatric symptoms
* Dwelling on resentments and past hurts – anger – unresolved conflicts * Avoidance – refusing to deal with personal issues and other problems of daily living * Engaging in obsessive behaviors – workaholism – gambling – sexual excess and acting out * Major life changes – loss – grief – trauma – painful emotions – winning the lottery * Ignoring relapse warning signs and triggers
Preventing relapse requires that we develop a plan tailored to maintaining new behavior. The plan involves integrating into our behavior diversion activities, coping skills, and emotional support. Our decision to cope with cravings is aided by knowing: (1) there is a difference between a lapse and a relapse; and (2) continued coping with the craving while maintaining the new behavior will eventually reduce the craving. Coping Skills for Relapse Prevention
These coping skills can make the difference when cravings are intense: * Ask for help from an experienced peer and use relaxation skills to reduce the intensity of the anxiety associated with cravings. * Develop alternative activities, recognize “red flags,” avoid situations of known danger to maintaining new behavior, find alternative ways of dealing with negative emotional states, rehearse responses to predictably difficult events, and use stress management techniques to create options when the pressure is intense. * Reward yourself in a way that does not undermine your self-caring efforts. * Pay attention to diet and exercise to improve mood, reduce mood swings, and provide added strength to deal with stressful circumstances and secondary stress symptoms, including loss ofsleep, eating or elimination problems, sexual difficulties, and breathing irregularities. Steps for Relapse Prevention
There are nine steps in learning to recognize and stop the early warning signs of relapse. Step 1: Stabilization:
Relapse prevention planning probably won't work unless the relapser is sober and in control of themselves. Detoxification and a few good days of sobriety are needed in order to make relapse prevention planning work. Remember that many patients who relapse are toxic. Even though sober they have difficulty thinking clearly, remembering things and managing their feelings and emotions. These symptoms get worse when the person is under high stress or is isolated from people to talk to about the problems of staying sober. In early abstinence go slow and focus on basics. The key question is "What do you need to do to not drink today?" Step 2: Assessment:
The assessment process is designed to identify the recurrent pattern of problems that caused past relapses and resolve the pain associated with those problems. This is accomplished by reconstructing the presenting problems, the life history, the alcohol and drug use history and the recovery relapse history. By...