Understanding the Stages of Relapse
In truth, relapse is a process, not just an event. Because of this, relapse can be broken down and understood through a series of stages. Often, relapse begins weeks or potentially even months before the physical act of ingesting a drug and/or alcohol. This process is broken down into three stages, starting with emotional relapse.
In this stage, one has not yet begun thinking about relapsing, but their behavior, emotions, and overall mood reflect a person who will likely relapse. The signs of emotional relapse include restlessness, irritability, dissatisfaction, anxiety, anger, defensiveness, mood swings, isolation, and poor eating and sleeping habits. Emotions and behaviors like these typically lead one to the next stage, mental relapse.
This stage represents the chaos that occurs in one’s mind leading up to relapse. This is the back and forth in the brain, the part of you that wants to use it again, and the part that insists you can’t.
It can be an occasional, not-so-serious thought in the early parts of mental relapse, but it quickly progresses into definite thoughts about using.
Some signs of mental relapse include: thinking about people, places, or things you associate with using, romanticizing the past, lying, fanaticizing about using, and planning a relapse. Once a plan is made, or the urge becomes too overwhelming, mental relapse leads one into the last stage, physical relapse.
As the thoughts and fantasies of relapse grow stronger during the mental stage, an intervention needs to occur. Without intervention or even self-prevention, physical relapse is likely.
It often begins with driving to a dealer or a liquor store and ends with ingesting the substance they swore off. The physical act of relapsing completes the relapse process, but it does not end one’s recovery process. It only resets recovery.
How to Develop a Relapse Prevention Plan
STEP 1: IDENTIFY YOUR TRIGGERS
Generally, the best way to prevent a relapse under any circumstance, including unemployment, is to create a relapse prevention plan. There are multiple ways to do this, largely because each plan needs to be tailored to the individual.
However, there are some tried and true ways to prevent relapse more effectively than others. One of the first and most vital parts of creating a substance abuse relapse prevention plan is identifying one’s triggers.
A person must pay attention to the situations, people, thoughts, feelings, or places that make them feel like using again. These feelings should not be denied or avoided. One must confront and take note of them.
Without knowing one’s triggers, one cannot properly prepare themselves. This process takes self-awareness and mindfulness. However, if it seems risky, one should consult with a friend, sponsor, counselor, or loved one to help them identify their triggers.
STEP 2: AVOID OR COPE WITH TRIGGERS
Once one has identified their trigger, one can then make plans to avoid or cope with triggers. This means one has to be honest with oneself. If a potentially high-risk situation, such as a party with drugs and/or alcohol, one needs to learn to acknowledge this risk and react responsibly.
Avoiding situations with triggers or potential triggers can make relapse prevention much easier; however, it is impossible to avoid all triggers all the time. While avoiding can be the most beneficial, it is also important to have coping mechanisms.
Coping mechanisms can take various forms, which are usually unique to the person, but some of the most common are other habits or practices. For example, when triggered, a person may instead choose to exercise, meditate, read, write, or play an instrument.
Replacing a negative hobby like substance abuse with a healthy one is an effective means of coping with addiction. It also serves as one of the most effective ways to prevent relapse.
Create and Lean on a Support Network
While it is possible to prevent relapse on your own, having a support network can make prevention even more effective. By creating a support network, one can have people to talk to or lean on when struggling with emotions or thoughts of relapse.
The people in one’s support network should be those one trusts and wants the best for them. However, a common trigger for those in recovery is around people who use, so ideally, the people in one’s support network should not be those that use drugs and/or alcohol or encourage it.
This could have the opposite effect one intends when creating a support network and trying to avoid relapse. So always be sure that those who make up the support network are those without substance use disorder or recovery.
Once one has built a support network, one can use it to maintain recovery. This network can often work better than anticipated. Individuals in the network may be able to recognize potential triggers that one might miss or overlook.
They can also provide much-needed encouragement, support, or even distraction when triggered or in crisis. How they do this is largely up to them, but typically, they are trying to help you be helpful.
At the very least, it can be a distraction. Most urges for relapse come in waves and usually subside within 15-30 minutes so distraction can be enough in some cases.
However, you should build a support network with your specific needs in mind. If a person likes to go bowling to cope, then they should find a good, supportive, and sober bowling partner to go to when needed.
The Five Rules of Recovery
Ultimately, to avoid a relapse during any difficult or life-changing circumstance, one should not only understand the stages of relapse but create a plan and lean on their support network.
To adequately prepare, you should also know the Five Rules of Recovery. These were published in the Yale Journal of Biology and Medicine and were created by author Steven Melemis after 30 years of treating patients with substance use disorder, which is the medical diagnosis for addiction. The rules are as follows:
- Change your Life – Recovery is not just about not using. It requires one to create a new life where it is easier not to use. If one does not change, one is more likely to fall back into addictive behavior.
- Be Honest – Addiction usually requires lying. Lying about taking or getting the substance or substances, lying to hide it, and/or lying to avoid consequences. Honesty is necessary for confronting one’s addictive behavior. Without confronting the source or sources of addiction, recovery is not possible.
- Ask for Help – Recovery requires help. Although many feel they should take control and recover independently, studies have proven that asking for help and leaning on others can improve lasting recovery.
- Self-Care – Individuals in recovery are typically too hard on themselves. However, the body and the mind need self-care. To reinforce new, healthier habits and behaviors, one needs to reward themselves. If one deprives themselves of little rewards, they may begin to see nothing as rewarding, and the emotional stage of relapse may begin as they seek the sense of reward they once felt with substance abuse.
- Don’t Attempt to Bend the Rules – The purpose of these rules is to aid in recovery. Creating loopholes or exceptions can create or lead to negative impacts on one’s recovery.
Relapse is Not Failure
Overall, recovery is an ongoing process. Relapses can occur, but they do not define you. You are more than just your mistakes. Recovery requires you to put in the effort every single day; this includes doing what you can to prevent relapse every day.
At the same time, circumstances like unemployment can make recovery more difficult, and effective strategies for preventing a relapse. First, try to understand the stages of relapse so that you can avoid them.
Next, identify your triggers and find coping strategies for those triggers. But, if those fail under pressure, lean on your support network. Loved ones, sponsors, and counselors will do everything they can to help you make it through another day sober. Just keep the recovery rules in mind and stick to them and your relapse prevention plan as close as possible.