Understanding Relapse
By Terence T. Gorski
Relapse is more than just using alcohol or drugs. It is the progressive process of becoming so dysfunctional in recovery that self-medication with alcohol or drugs seems like a reasonable choice.
The relapse process is like knocking over a line of dominoes. The first domino hits the second, which hits the third, and soon a progressive chain reaction has started. The sequence of problems that lead from stable sobriety to relapse are similar to those dominoes, with two differences. First, each domino in the line (i.e. each problem that brings us closer to substance use) gets a little bit bigger and heavier until the last domino, or problem, in the sequence is 10,000 pounds. As this 10,000 pound domino begins to fall on us, it is too heavy for us to handle alone. The second difference is that the problems circle around behind us. So when the last domino or problem falls, it hits us from behind when we're not looking.
So here we are, moving along in recovery. We encounter one small problem. No big deal! Then we encounter another problem. Soon a chain reaction begins. The first problems are so small that we can easily convince ourselves they’re no big deal. We look the other way and start doing other things. All of a sudden a huge problem falls on us and causes serious pain and injury. We need to make the pain go away and we reach for old reliable - the magical substances that always helped us with our pain in the past. We've now started drinking and drugging.
The answer to avoiding relapse is to learn how not to tip over the first domino, and take care of the little problems in life. Another part of the answer is to develop an emergency plan for stopping the chain reaction quickly, before the dominoes start getting so big and heavy that they become unmanageable.
The Relapse Process
The progression of problems that lead to relapse is called the relapse process. Each individual problem in the sequence is called a relapse warning sign. The entire sequence of problems is called a relapse warning sign list. The situations that we put ourselves in that cause or complicate the problems are called high risk situations.
Other Outcomes Of The Relapse Process
Some relapse prone people don't drink. They may say "I'd rather be dead than drunk" and they either attempt or commit suicide. Others just hang in there until they have a stress collapse, develop a stress related illness, or have a nervous breakdown. Still others use half measures to temporarily pull themselves together for a little while only to have the problems come back later. This is called partial recovery and many people stay in it for years. They never get really well, but they never get drunk either. As a matter of fact ignoring the early warning signs makes us more likely to relapse.
But there is hope. There is a method called Relapse Prevention that can teach us to recognize early warning signs of relapse and stop them before we use alcohol and drugs, or collapse.
Terence Gorski is president and founder of the CENAPS Corporation, a training and consulting company specializing in the recovery and relapse prevention. He will be holding both professional training and a recovery workshop at Life Works on Relapse Prevention at Life Works Duke Street.
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