Relapse Prevention: Where the Rubber Meets the Road in Recovery

Series Two: Blog Twenty-Nine

The Sailor: by Geof Hewitt

In my movie the boat goes under

And he alone survives the night in the cold ocean,

Swimming he hopes in a shoreward direction.

Daylight and he’s still afloat, pawing the water

And doesn’t yet know he’s only fifty feet from shore.

He goes under for what will be the last time

But only a few feet down scrapes the bottom.

He’s suddenly a changed man and half hops, half swims

The remaining distance, hauls himself waterlogged

Partway up the beach before collapsing into sleep.

As he dreams the tide comes in

And rolls him back to sea.

The reality of relapse is ongoing in addiction recovery. As someone has said, “the struggle is part of the story”. The excitement of breakthrough frequently gives way to relapse. Falling asleep and allowing the tide of craving for addiction to overcome is commonplace. Between 40 to 60 percent of people who’ve been treated for addiction or alcoholism relapse within a year, according to a 2014 study in the Journal of the American Medical Association(JAMA). While relapse is most common during the first year of recovery, people with years of sobriety can resume self-destructive drug use or drinking. For example, in 2014, Academy Award-winning actor Philip Seymour Hoffman was found dead with a syringe in his arm in his New York apartment. Hoffman, 46, died of acute mixed-drug intoxication after injecting himself with a concoction of heroin, cocaine, amphetamine and benzodiazepines, authorities said. The previous year, the actor told TMZ he’d been sober for 23 years but had relapsed.

This blog is dedicated to addressing relapse prevention. The focus will not only be how to stop the bleed of relapse but how to manage the damage—even make meaningfulness from the relapse itself.

I have personally experienced going to a meeting and gaining a sense of grounding and gaining clarity about sobriety from addiction, only to act out before I returned home from the meeting. How do you not beat the hell out of yourself for that? Why would you want to make meaningfulness from that kind of weak-kneed disgusting behavior? The answers will be housed within the principles and positions shared in this blog.

Assess your willingness to do whatever it takes to stop acting out:

 Every day of each week I work with addicts, I listen to addicts tell me they have either lapsed or relapsed into addictive behavior. Lapsing is about delving into high-risk behaviors that are short of relapse but edging toward going over the cliff.  Many times addicts will tell me they are bewildered why they acted out, almost as if it happens out of the blue.  As we discuss their behavior, I will review which part of their program broke down that led to the destructive behavior. The reasons always revolve around exposure to the rewarding substance or process, vulnerability, and exposure to addictive behavior cues or triggers and environmental stressors. After we untangle the story of relapse, I will ask on a scale of 1 to 10 how would you rate your burning desire to do whatever it takes to experience recovery and growth? Inevitably, this is where the rubber meets the road. Addicts who live in chronic relapse or give up totally, score themselves very low on this question.

Recovery is not rocket science. The hardest part about relapse is taking yourself by the nap of the neck and do the next right thing toward recovery and doing it again and again until you force a new neuropathway in your brain that forges a new behavior when triggered. There are many recovery skills to be utilized and it begins with a burning desire to do whatever it takes.

Do a lapse autopsy:

 A lapse autopsy is a step-by-step walk through the relapse behavior? It requires honesty with yourself and those you are accountable to. You must uncover your mistaken beliefs which triggered your addictive slide. You must unearth the environmental influences that fueled the activated mistaken beliefs (struggles at work, home, etc.).  You must walk through your mind and recognize ways that you anticipated rejection, victim postured (woe-is-me attitude), hid behind masks so that no one would see your struggle, emotionally isolated, fantasized, cruised for the opportunity and groomed yourself and others with thoughts and deceptions in order to actually act out. You must then identify ways that you misplace the responsibility to circumstance or other’s behavior that cause you to act out and ways that you distanced yourself from the destructive behavior to avoid taking responsibility for the act out. Each of these phases of acting out can fall into place like a game of dominoes. The difference is that it can transpire with the speed of a snap of your fingers. Slowing down the process during a lapse autopsy can help you not only identify each phase in your build-up behavior but create an effective intervention from destructive to intimacy-abling behavior.

Get Honest with yourself:

 Disrobing relapse requires deep honesty, which is one of the most difficult challenges required in recovery. To look at the truth that you avoided requires strength. You must face the reality you avoided in order to address relapse. Honesty in relapse requires amends and restitution. It is not enough to intellectually recognize a behavior mistake. You must make amends and restitution to yourself and others. You will only be able to consistently do this by living in consultation and accountability. Are you willing and committed to live this way with your community of support?

Be willing to do something different:

 Crazy living is doing the same thing that doesn’t work over and over again, thinking this time will be different. Relapse requires doing something different. It is often suggested that with chronic relapse that an addict will benefit doing 90 meetings in 90 days. Possibly true, but not if you do the meetings the same way you did them during relapse. What happens for many is that they just practice the same habits in recovery that failed to prevent relapse. There’s nothing wrong with going to the golf range to improve your swing but if you practice the wrong mechanics then you are just reinforcing mistakes. With meetings and doing things different, change proposes that you be radical which means to get at the root cause. Going to meetings will only help if you choose to not hide in the numbers of attendees, radically lead by telling on yourself about one thing you don’t want others to know about you and not leaving the meeting until you get one thing that will help you remain sober and serene in life.

Cultivate a good attitude:

 As mentioned before, there are many skills and resources for recovery. Many are expensive and some are not. None will make a difference when an addict shows up with a bad attitude. Your attitude toward recovery is your greatest stock in trade. Resistance, defensiveness and judgmentalism will not stop unless you shift your attitude from a closed heart to an open heart and spirit. A good attitude gets you in the ball park and on the field of recovery. It’s primary to beginning. In and of itself it won’t establish sobriety but you will never maintain sobriety without it. Without a good attitude an addict will take excellent tools for recovery and misuse and will take helpful resources (financial, treatment facilities, etc) and waste them. People who love the addicts in their families and communities must accept that if an addict wants to act out he not only will but has the right to do so. Until the addict embraces an attitude of wanting to stop you will waste your dollars and resources. It is important to respect an addict who wants to live in addiction by letting them go and establish your own boundaries of self-care.

Cultivate Velvet Steel:

 I have said this many times that no one ever beat themselves up to a better place. In the presence of relapse failure, you must practice being gentle which is not about giving yourself a pass or excuse for acting out. Sometimes you must be steel (firm) with yourself to simply stop beating yourself up. Addicts tend to be velvet (gentle) with themselves about behaviors they need to be steel (tough) about and steel (tough) on themselves when they need to be velvet (gentle) with themselves. Velvet steel is an art form that must be practiced. It would be helpful to work with a mature sponsor and complete an apprenticeship with h/her around this skill set.

Create a sweet spot in recovery and dwell there:

 People who play racquetball talk about establishing a sweet spot on the court. This is the ideal location on the floor that renders a vantage point to return the opponent’s ball. The sweet spot helps a player play the game from a position of strength and not weakness. Addicts in recovery also create a sweet spot that helps them operate from strength and not weakness. The sweet spot in recovery includes both program and mindset. A sweet spot is established by engaging an active 12-step program with a commitment to live in consultation and accountability. From this sweet spot or vantage point, an addict is encouraged to cultivate a mindset that detaches from shame that comes with lapse or relapse behavior. This mindset is created through conditioning and training. An addict builds up his sweet spot by refusing to personalize relapse behavior. She learns to direct the shame to the behavior and away from her sense of self. As a result of this reframe, the sweet spot strengthens and the addict is able to more quickly return to center and move forward. Dwelling in the sweet spot of recovery is the place that boosts recovery resilience.

Many addicts fail to create or strengthen their recovery sweet spot so necessary to relapse prevention. As a result, just as the waterlogged sailor who drags himself from the treacherous ocean and falls asleep on shore only to be washed out to sea again, so too can the addict in recovery be washed back to the sea of addiction without a sweet spot. 

When an addict in recovery fans the fire of burning desire with a good attitude, commits to serious relapse introspection, becomes desperate to do something different, practices the art of firmness with gentleness and creates a sweet spot in recovery, h/she will learn to fail forward when faced with lapse or relapse behavior.