Relapse prevention

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The importance of relapse prevention in addiction recovery

A relapse is not a random occurrence or event – it is a process that a person goes through during a period of abstinence before a relapse occurs.

Some of the symptoms associated with substance misuse relapse include:

  • Intense or uncomfortable emotions (H.A.L.T – Hungry, angry, lonely, tired)
  • Post-acute withdrawal symptoms (poor sleep, anxiety, mood swings, agitation)
  • Personal relationship and intimacy problems (increased levels of stress if things go wrong)
  • Isolating from others
  • Negative self-care (poor sleeping and eating habits and poor stress management)
  • Nostalgia over people (including addicts that the person once used with)
  • Nostalgia about places (such as where the addict used)
  • Intense withdrawal symptoms (nausea, exhaustion and anxiety)

Relapse Prevention

Since preventing relapse takes a cognitive-behavioural approach – the objective when it comes to relapse prevention is to identify intensely high-risk situations which often involve:

  • Substance abuse
  • Obesity
  • Depression
  • Obsessive-Compulsive Behaviour

Relapse means that a person goes back to using again after a period of sobriety.

According to the National Institute on Drug Abuse, 40 – 60% of people are likely to relapse after a period of sobriety.

One of the aims of preventing relapse is to create a new understanding of what triggers a person to want to use again and helps them to understand the kind of environments, people and situations that motivate and encourage them to use.

Everything and anything can act as a trigger for someone, and a former addict will likely come up with plenty of excuses for wanting to drink or to start drugs again.

Getting clean is one element to recovery. The other is staying that way – both are not easy processes. As a result, an addict may begin an internal bargaining process.

They may tell themselves that one drink won’t do any harm, or that indulging in porn today, won’t happen tomorrow. These are the kinds of bargaining statements that often lead a person to begin the stages of relapse.

How to stop relapsing

One of the first keys of relapse prevention is to recognize the stages of relapse:

  • Emotional Relapse: This is the phase where a person may not be thinking about using. However, the behaviours and thoughts that occur during this phase are gearing the person towards relapse. These include a person suppressing their emotions. The person may even be isolating themselves. This stage often involves feelings of anxiety and anger.
  • Mental Relapse: During this stage, a person may become nostalgic about their former life as an addict. They may reminisce about the good old days of using these may involve the people and places that were associated with the addiction. In this phase, an individual will see their former life as an addict through rose-tinted specs. Essentially, they are planning to start using again.
  • Physical Relapse: It is in this stage that the person has started using again. It may start with one pill, one drink, one bet, and then, eventually, lapse back into regular use.

Several ways that an individual can stop relapsing include:

  • Reminding themselves of the reasons they quit in the first place
  • Seeking help from counsellors, support groups and 12 step programs including Narcotics Anonymous and Alcoholics Anonymous (A.A.)
  • Distraction techniques – this may involve talking to a trusted friend, going for a walk, meeting someone for coffee or watching a favourite film
  • Reward strategies such as having a relaxing massage or booking a day trip for each recovery gain
  • Consistent self-care which involves getting enough sleep, eating a balanced diet and following a daily exercise plan
  • Understanding triggers – this is a crucial element to stopping relapse as the person comes to recognize what led them to abuse substances and identify healthier ways of coping for the future

Relapse prevention plan

the road to recovery teens and adolescents

Recovering from addiction is rarely a smooth process. Therefore, addicts in recovery need to recognize just how tough recovery can be.

Alcoholics who relapse, for example, may punish themselves when they start drinking again. Although this self-loathing can only make things worse and continue the cycle of addiction.

Therefore the process of relapse prevention should begin with self-forgiveness. Once a person recognizes just how common it is for addicts in recovery to relapse, they set themselves on the path to long-term abstinence.

Recovering from addiction must have a tailored treatment plan. In this case, a relapse prevention model of some kind.

So far, we have established the three stages of relapse (emotional, mental and physical) and identified several ways that an addict can prevent themselves from relapsing in the future.

Let us look at some other helpful ways that a person can prevent themselves from a future relapse:

Lapse vs relapse

There is a marked difference between someone lapsing and someone having a full return to previous addicted behaviours.

Lapsing is considered a slip, something that happens in the spur of the moment. A lapse is a temporary blip, but one that does not compromise or prevent full recovery.

A relapse is a complete return to past behaviours, thoughts and addictions.

Knowing the difference between the two can be extremely helpful for addicts in recovery as this often limits the amount of guilt whenever a lapse takes place.

Mindfulness-based relapse prevention

G. Alan Marlett, PhD, coined the term urge surfing which he developed as a mindful practice to help curb the urges, cravings and impulses that are associated with addiction.

Marlett teaches those with addictions to view their urges like waves at the ocean’s edge, the waves follow a natural progression, then peak in intensity, before crashing and receding.

The aim is to bring about conscious awareness in addiction recovery, allowing individuals to observe their cravings and urges, accept them, be present, and ride them out as opposed to resisting them.

The duration of cravings usually lasts around 10-20 minutes before dissipating.

Urge surfing offers addicts in recovery the opportunity to observe their cravings without judgement and without becoming too attached or trying to repress them.

If a person can practice observing their urges for this short duration, the urges will eventually pass. Surfing an urge involves becoming consciously aware of any thoughts, emotions and physical sensations that might be attached to a craving.

By visualizing the urge as a wave whilst focusing on breathing, each breath becomes deeper and slower.

Intentional breathing such as exhaling and inhaling through the abdomen can help individuals to be fully present with their cravings and ride them like waves as they rise, peak and eventually subside.

Relapse programs

12-step programs are helpful when it comes to preventing relapse – many of the strategies often involved in relapse prevention programs include:

  • Deep breathing and meditation
  • Group therapy
  • Exercise routines
  • Rehab aftercare

Other beneficial therapies for addicts in recovery involve:

If you think you might be showing signs of relapse, it might be time to contact a specialist who can help you get back on track. Contact the team at Tikvah Lake today and find out how we can help you through this process.

setting boundaries

Setting boundaries while you’re in recovery

Setting boundaries while you’re in recovery

An addiction – whether it be to drugs, alcohol, gambling, sex, virtually anything – is a challenging road to navigate.

Even when you’re in recovery, your addiction is likely to take a toll on you, your friends, and your family members. In other words, the people you’ll be relying on the most while in recovery are also the people with whom your relationship will likely require some mending.

But mending these relationships is hard work. Addiction is known to fuel many fear-based behavioural patterns, like control and resentment.

During recovery, it’s of paramount importance that you take the time to set healthy boundaries within your support system to keep your interactions and communications civil and stress-free.

On the tail end of a challenging addiction, it’s extremely likely that you’ll pursue the approval of those closest to you in everything you do.

Keeping your interactions comfortable, then, can have many positive effects for everyone involved, and it can even decrease the likelihood of backsliding.

Why is boundary setting important for recovery?

A personal boundary can be defined as a physical, emotional, or mental limit that people set for themselves in order to safeguard their overall well-being.

They can help you feel balanced and in control of yourself. As such, the importance of setting boundaries clearly and honestly is very important in helping you recover smoothly.

Boundaries can…

Encourage self-esteem

With every boundary you set for yourself, you are reminding yourself of your own importance.

Throughout the course of your addiction, you’re likely to come to judge yourself too harshly and come to think of yourself as worthless. For every boundary you set, you are regaining your worth.

Encourage confidence

Setting boundaries involves putting yourself out there. It takes emotional vulnerability and clear communication.

You’ll find that setting a well-defined, healthy limit with someone you love will increase your self-assurance.

Provide good mental well-being

When setting boundaries, you’re given a sense of responsibility and self-awareness.

Not only can it help you feel proud, but it can help you develop healthier channels of communication and cultivate compassion, too.

Help deals with resentment

If you fail to set healthy boundaries, you are essentially giving others permission for their actions toward you.

An inability to confront and verbalize anger leads to resentment, and residual resentment leads you to return to the coping mechanism with which you’re most familiar – your addiction.

What boundaries should you set?

The boundaries you set should be based on your needs – not anyone else’s. Therefore, some of these may apply to you, while some may not:

Physical boundaries

Even around your family members and close friends, you may be uncomfortable with physical contact – even something as benign as a hug or a handshake.

This is perfectly normal, so if you feel uncomfortable being touched, let them know!

Emotional boundaries

Ensure that you are managing your own emotions for yourself, not to please others.

If you take responsibility for the moods and feelings of others, you’ll be unable to distinguish between your own emotions and those of your friends/family.

Mental boundaries

Your thoughts and opinions are worth hearing! Assign value to them (and to yourself) by making it clear that your opinions should be heard.

Conversely, make sure you’re keeping an open mind while hearing the thoughts of others, too.

Sexual boundaries

Say no when you feel uncomfortable. Nobody but you are in control of your sexual boundaries.

Material boundaries

If you’re asked to loan people things that you aren’t comfortable lending out – money, cars, clothes, anything – maintain clear limits with your friends and family in a way that’s assertive and steady.

How to set boundaries through your recovery

People have different communication styles. Many value direct, honest feedback, while others prefer a more tactful approach.

It’s important when communicating your boundaries to adopt an approach that covers all bases. In other words – be firm and direct; don’t be overzealous and rude.

Words matter, especially when communicating boundaries. After all, you’re telling somebody you love that you don’t find their behaviour acceptable. The best way to be respectful is to:

  • Stick to the facts;
  • Avoid assumptions;
  • Use ‘I’ statements; and
  • Focus on your experiences, not the other person’s.

For example, say ‘I find it uncomfortable when you pat me on the shoulder like that,’ followed by ‘I’d prefer a handshake or a high-five from now on.’

Remember, the purpose of setting boundaries is to let someone know that you aren’t okay with their behaviour.

They might still react defensively, but if you’re setting a healthy boundary from a place of self-care in a respectful manner, you’ll be able to acknowledge their reaction without feeling like it’s your job to fix it.

Just out of rehab and stuck at home? Here are a few at-home techniques to avoid relapsing

Just out of rehab and stuck at home? Here are a few at-home techniques to avoid relapse

With so much uncertainty in our lives because of the current COVID-19 pandemic, it’s easy to feel isolated and unsure of what do. For those working on their recovery journey outside of rehab and trying to avoid relapse, these feelings – coupled with boredom, agitation, or anxiety – can make for an environment and mental state that promotes risky behavior and relapse.

To reduce the chance of this happening, here are seven tips to help you avoid relapsing while remaining socially distant.

1. Stay aware of how you’re feeling, emotionally and physically

Physical and mental self-care are more important than ever with the strains of the COVID-19 pandemic. Knowing the common signs of relapse and being able to identify your own triggers are crucial in staying sober.

Mood swings, poor nutrition, and fantasizing about substance use can all be potential precursors to relapse. Addressing these feelings and taking preventative measures to deal with them will lead to greater emotional and physical wellness, as well as decrease your chance of using.

2. Make use of your free time to avoid relapse

Boredom and detachment are major culprits in relapse. They make the pull of substance use that much stronger. If you find yourself with a lot of free time on your hands, it’s important to keep yourself occupied to avoid falling back into old behaviours and risk relapsing.

Practicing a favourite hobby or investing time into a new one are great ways to enjoy yourself and feel productive. Exercising and creative outlets like writing, painting, or playing an instrument are great ways to distract oneself while keeping one’s mind and body engaged.

3. Incorporate holistic wellness practices into your daily life

Holistic activities such as yoga, meditation, and breathing work can help to center yourself and bring much needed balance during all this uncertainty.

Spend time on building out a proper nutrition plan to ensure you’re eating well, too, and make space in both your schedule and your home that is dedicated to exercise. Even spending a short time each day on holistic wellness practices can make a great difference in one’s physical wellbeing and mental outlook, as well as the cravings that are brought on by restlessness and apprehension.

4. Don’t be hard on yourself if cravings arise

Cravings are an unfortunate and almost universal part of recovery and rehabilitation. Getting down on yourself for feeling them is not only unproductive but dangerous.

Indeed, feeling guilty or ashamed for cravings can wind up leading to an unhealthy emotional state that makes it hard to avoid relapse. Accepting that cravings will occur and learning how to manage and move beyond them, however, is an incredibly valuable step in your recovery journey, and in turn it helps reduce your desire to use.

5. Maintain communication with loved ones and those you trust

Even if you can’t go out and see them, it’s important to connect with the people in your life who mean the most to you. Make a list of emergency contacts whom you can reach out to if you’re suffering from cravings, or notice symptoms of emotional relapse such as anxiety, poor sleeping patterns, and mood swings.

Be it family, a sponsor, or support group members, having positive individuals to talk to during this period of isolation will provide much needed encouragement and help to keep you accountable on your recovery journey.

6. Identify your enablers and avoid high-risk scenarios

Especially during times of uncertainty and loneliness, the desire to see old friends who still abuse drugs and alcohol can be strong.

Avoiding these enablers and the high-risk scenarios they present is hugely important to staying sober and to help you avoid relapse. Instead, if you feel overly secluded and in need of personal connection, reach out to supportive and positive forces in your life, such as sober friends and family members, sponsors, or counsellors.

Know that it’s okay to ask for help

No matter the circumstance, it is important to remember that it’s always okay to ask for help. Recovery is a process, not a single event, and your path to sobriety will, at times, be complicated and difficult.

If you ever feel stuck in a situation you can’t deal with alone, or need help navigating negative thoughts or severe cravings, reach out to those you trust or seek the advice of a treatment specialist.

Relapse prevention and aftercare programs exist to help those who are struggling with life out of rehab and encourage you to make positive steps on your recovery journey. Knowing when to ask for help is a sign of strength, not weakness, and can make the difference in staying, and keeping, sober.

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