Relapse Prevention

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Recovery from addiction is a lifelong journey, and relapse can be a common but surmountable obstacle along the way. This article discusses proven strategies and tips to prevent relapsing, ensuring a sustained recovery.

What is a relapse?

Relapse means a return to previous patterns of behavior or substance use after a period of improvement or abstinence. It’s important to note that relapse is a common part of the recovery process and doesn’t signify failure. 

Rather, it’s an indication to strengthen and adapt one’s coping skills. Recognizing the signs of a potential relapse and knowing how to respond can significantly improve outcomes and maintain progress in the recovery process.

How does relapse happen?

Relapse is typically not an instantaneous event but a process. Here’s a breakdown of how relapse often occurs:

Emotional relapse

Before the actual act of returning to a substance or behavior, individuals may experience emotional symptoms that set the stage for a possible relapse. These might include:

  • Anxiety or panic attacks
  • Intolerance
  • Anger or mood swings
  • Isolation from loved ones or support networks
  • Not attending support or therapy meetings
  • Neglecting self-care (e.g., poor sleep and eating habits).

Mental relapse 

This stage is marked by an internal conflict in the individual’s mind about returning to the substance or behavior. Some signs include:

  • Reminiscing about past substance use or behaviors
  • Associating with old friends or acquaintances from addiction days
  • Fantasizing or planning a potential relapse
  • Bargaining or justification thoughts (e.g., “I can handle it now,” or “Just one time won’t hurt.”)

Physical relapse

This is where the individual returns to the undesired behavior. It could start with a small slip, which without intervention, might escalate to a full-blown relapse. Factors contributing to this stage include:

  • Stress: This is one of the most common triggers of relapse. Stressful situations, especially those not handled effectively, can lead to cravings and potential relapse.
  • Environment and people: Spending time in places or with people associated with past substance use may often trigger memories and feelings that can make relapse more likely.
  • Complacency: After a period of sobriety, some individuals become overconfident and neglect their recovery strategies, leaving them vulnerable to relapse.
  • Unresolved psychological issues: Past traumas, unresolved conflicts, or untreated mental health disorders like depression or anxiety can contribute to relapse if not addressed.
  • Social isolation: Isolation or lack of a supportive network can make managing cravings or stressors more challenging, increasing the risk of relapse.

It’s essential to recognize that relapse doesn’t happen overnight. It’s often a gradual process where these warning signs build up over time. Being vigilant about these signs and proactively addressing them can prevent a potential relapse. 

How to prevent relapse

Preventing relapse isn’t just about abstaining from a substance or behavior. Many wonder how to stop relapsing, and the answer lies in a comprehensive lifestyle change that includes mental, emotional, and physical well-being. Here are some practical ways to prevent relapse.

  1. Identify and manage triggers

A ‘trigger’ is any event or situation that can spark cravings or a desire to return to substance use. Identifying and understanding your triggers is an essential step in avoiding relapse. Common triggers can include stress, people connected to previous substance use, or negative emotions.

  1. Set clear boundaries

This might involve uncomfortable conversations or distancing oneself from specific environments. Establishing clear boundaries fosters one’s commitment to sobriety.

  1. Develop healthy coping skills

This involves building a repertoire of physical, emotional, and social tools to manage stress, cravings, and other triggers. Techniques such as mindfulness, meditation, exercise, and breathing exercises can be effective.

  1. Develop a strong support system

This might include family members, friends, mentors, therapists, or support group members. Regular check-ins can provide encouragement, reduce feelings of isolation, and offer accountability.

  1. Stay informed 

Continued education about addiction and relapse can further equip you to handle challenges. This might involve reading, attending workshops, or listening to lectures and podcasts on how to stop a relapse.

  1. Practice self-care

Self-care isn’t just about physical well-being; it’s also about taking care of your mental and emotional health. This includes setting time for relaxation, pursuing hobbies, maintaining personal hygiene, and practicing self-compassion.

  1. Stay engaged in treatment

Stick to your treatment plan, even if you’re feeling well. Attend all therapy sessions and follow your healthcare professional’s advice.

  1. Implement an action plan

Having an action plan in place can help you quickly respond if you feel a relapse might occur. This should include a list of people to contact, strategies to manage triggers, and reminders of why you chose recovery.

  1. Reach out when necessary

Reaching out for help isn’t a sign of weakness. If you’re feeling overwhelmed, seek professional help. This might involve a counselor, therapist, or addiction specialist who can provide further guidance and resources.

Tips for preventing relapse

This section discusses proven techniques, exercises, and activities that can help individuals navigate their recovery with confidence and resilience. Here are some helpful tips for avoiding relapse: 

Relapse prevention techniques

Techniques, in this context, refer to specific tools designed to help individuals recognize and manage triggers or situations that could lead to a return to harmful behaviors. These techniques are often the first line of defense against potential relapses. Here’s how to stop a relapse:

  • Mindfulness: Dedicate a few minutes daily to sit quietly, focusing on your breath or immediate surroundings. When your mind wanders to cravings or triggers, gently bring your focus back to the present moment.
  • Cognitive restructuring: Challenge and question your negative thoughts. For instance, if you think, “I can’t handle this without using,” reframe it to, “I have faced challenges and emerged stronger. I can do it again.”
  • Grounding techniques: When overwhelmed, use tactics like the 5-4-3-2-1 method, where you identify five things you can see, four you can touch, three you can hear, two you can smell, and one you can taste.

Relapse prevention exercises

Relapse prevention exercises are structured activities aimed at reinforcing relapse prevention techniques. They offer a more practical, hands-on approach to understanding and managing potential triggers or high-risk situations. Here’s how to prevent a relapse.

  • Daily journaling: Write about your experiences, feelings, and triggers. Reflect on how you managed challenging situations.
  • Role-playing: With a trusted friend or therapist, act out potential high-risk scenarios and practice responses.
  • Trigger analysis: List out potential triggers and draft positive responses or actions for each.
  • Affirmation practice: Start each day with positive affirmations about your strength, resilience, and commitment to recovery.

Relapse prevention activities

Relapse prevention activities involve incorporating healthier habits or hobbies into daily life. They can serve as practical alternatives during vulnerable times. Here are some beneficial activities on how not to relapse:

  • Physical activity: Engage in regular exercise like walking, running, yoga, or any physical activity you enjoy.
  • Hobbies and interests: Pursue a hobby, learn a new skill, or engage in activities you’re passionate about.
  • Volunteer work: Helping others can provide a sense of purpose and a positive distraction. 
  • Attend group support meetings: Attend AA (Alcoholics Anonymous) or NA (Narcotics Anonymous) meetings, local sobriety groups, or therapy group sessions to learn new strategies and meet others on a similar journey.

Relapse prevention: examples

The following real-life scenarios showcase how individuals in recovery can effectively apply relapse prevention techniques to stay on their path of sobriety. 

Unexpected exposure

Tom is cleaning out his room and stumbles upon an old stash of pills. Instead of letting the moment overpower him, he immediately disposes of them safely and calls a friend to talk about his feelings and the discovery.

Recognizing trigger situations

John, a recovering alcoholic, realized that every time he walked past his favorite bar on his way home from work, he felt a strong urge to drink. So, he started taking a different route home to avoid this trigger. By identifying and avoiding this trigger, John decreased his chance of relapse.

Practicing self-care

Sam, a recovering addict, often felt lonely during the weekends, which was a significant relapse trigger for him. To combat this, he started engaging in self-care activities like going for hikes, painting, and reading. 

By filling his time with activities he enjoys, Sam managed to reduce feelings of loneliness and decrease the likelihood of relapse.

Continuing treatment and education

Emily, who has been sober for several months, felt confident about her recovery. However, she continued attending therapy sessions and support group meetings. 

This continual education about her condition and the ongoing support helped her maintain her sobriety.

Relapse prevention in therapy

Therapy plays a pivotal role in helping individuals avoid relapse. It equips them with tools, strategies, and insights that aid in understanding triggers and managing urges. Here’s how therapy supports individuals in relapse prevention:

Cognitive Behavioral Therapy (CBT) and relapse prevention

Cognitive Behavioral Therapy (CBT) is one of the most studied therapies for addiction recovery, and a substantial amount of evidence suggests its effectiveness in relapse prevention. 

  • Process: The process involves Identifying negative thought patterns that lead to cravings or desires to revert to unwanted behaviors and replacing them with healthier, positive thoughts. 
  • Effectiveness: Studies show that CBT can significantly reduce the risk of relapse in individuals recovering from substance use disorders by enhancing their cognitive skills to avoid triggers.

Dialectical Behavior Therapy (DBT) and relapse prevention

DBT is often used to help individuals learn how to keep from relapsing and manage painful emotions and relationship conflict. Here’s how it works:

  • Process: The key elements of DBT in relapse prevention involve skills training in mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. 
  • Effectiveness: Research has shown that DBT can be particularly effective in individuals with borderline personality disorder and substance use disorders, resulting in lower relapse rates than other therapeutic approaches.

Mindfulness-Based Relapse Prevention (MBRP)

Mindfulness-Based Relapse Prevention (MBRP) is a novel treatment approach integrating cognitive-behavioral relapse prevention strategies with mindfulness meditation.

  • Process: Techniques include breath focus, body scanning, and mindful movement, among others.
  • Effectiveness: Several studies suggest that MBRP can help individuals deal with cravings and triggers. The mindfulness strategies in MBRP help individuals stay present and make thoughtful choices rather than acting on impulse.

Overcoming challenges with preventing relapse

Relapse prevention is often not a straightforward process. In this section, we highlight some common obstacles individuals may encounter in the course of preventing relapse and offer practical solutions on how to avoid relapsing.

Managing high-risk situations

High-risk situations, those that provoke intense cravings or old habits, can be a significant challenge. Here are some ways to overcome this challenge:

  • Develop a plan: Create an action plan for anticipated high-risk situations. This could involve removing yourself from the environment, calling a supportive friend, or practicing a coping strategy.
  • Practice: Rehearse your action plan regularly so you’re prepared when a high-risk situation arises.

Coping with stress

Stress is a common trigger for relapse, making its management crucial in the recovery journey. Here are some strategies to manage stress effectively:

  • Relaxation techniques: Incorporate practices like meditation, deep breathing, yoga, or any other activity that relaxes you.
  • Healthy lifestyle: Regular exercise, adequate sleep, and a balanced diet can help manage stress levels.

Fear of relapse

The fear of relapse can be a significant source of anxiety, potentially leading to self-sabotage or paralyzing progress. Here’s how you can navigate this:

  • Normalize fear: Understand that fear is a common part of the recovery process. Talking about your fears with a therapist or support group can help normalize and reduce them.
  • Develop coping mechanisms: Use relaxation techniques, mindfulness, or cognitive-behavioral strategies to manage fear.

Final thoughts

Relapse prevention is a continuous process, and each person’s journey is unique. By developing a support system and adhering to a treatment plan, individuals can maintain their resolve, even in the face of adversity. Remember, it’s not about never falling; it’s about getting back up each time you do.

Author: Editorial Team
NOVEMBER 1, 2022

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