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It is not possible to stress enough that
relapse for the alcoholic/addict is a life and death question. Any
relapse is a gamble with death. One or two drinks or drugs inevitably
leads back to massive drinking/using within a short period. People who
relapse can often die from accidents, overdose, suicide or medical
problems. For example, if you have a damaged liver, your liver will
return automatically -and not gradually- to the level of damage it was
at when you were drinking. Some people are lucky to halt the relapse
quickly (a lapse), but any (re)lapse is a mortal danger, which at the
very least causes psychological pain and at worst can lead to a path
from which there is no return.
Having said that, we have to face the reality that relapse is an
ever-present threat and part of the general recovery process for the
majority of us. Many alcoholics and addicts experience one or more
relapses before achieving a lasting sobriety. A minority manage to have
none at all. The best policy is learn from those who have never
AS WELL AS those who have relapsed, about how to guard against and avoid
a relapse. Having no relapse is the best scenario for all of us and
while accepting the reality of its potential we should not use the fact
that it may happen as an excuse for actually having a relapse or not
trying desperately to avoid one. The first relapse or the next relapse
may be your last !
Once we have detoxed our bodies and got sober, the key issue in our
minds is STAYING SOBER. But, in order to do this, we need to understand
and accept that we are alcoholics/addicts and can NEVER drink or use
again. However, we also need to realise that years of chemical
dependency and learned habitual behaviours have programmed our bodies
and minds to react instinctively to emotions, feelings and situations by
drinking/using. Many people who relapse say that when they took the
first drinks/drugs, it seemed that they were on « automatic pilot », as
though they were in a film and couldn’t even seem to watch themselves
disinterestedly from outside as they walked in the bar, opened the
bottle or reached for the joint/needle.
There is a truth in this. We have trained ourselves, often for years and
decades, to reach automatically for the drink/drug as THE means of
finding pleasure and relief from the troubles of everyday life. Other
non-alcoholic people find other ways of dealing with these issues, but
we know no different than drinking or drugging. When we relapse we are
rerunning the alcoholic film, playing out our addict part and then, only
once the act is done, reality returns with a hard thud in terms of the
painful consequences of intoxication and withdrawal.
In order to stay sober we have to untrain ourselves, deprogram
ourselves, so that recoiling from temptation and not taking that
drink/drug becomes an automatic response to the life-threatening
consequences which drinking/using means. We have to first pinpoint the
dangerous triggers and stimulants which can provoke the temptation to
drink/use, in order to immediately avoid them at any cost. Then,
gradually, we have to learn new coping strategies and methods to deal
with everyday life on a sober basis.
One might classify at least 3 main
avenues down which the
road of relapse can arrive. These are :
internal feelings and emotions, which overwhelm us and can lead to
external situations, places and people which can trigger drinking/using
Unhealthy patterns of behaviour and habits which can lead to
There are no hard divisions between the three and, in practice, all
three of these tend to overlap, but the direction you come from may tend
to lie more in one of these areas than another.
1) External Situations, Places and People
We all found our own particular situations, places and social
relationships in which we habitually drank or used. These can be bars,
parties, dinners, after-work socialising, sport events, isolation at
home, concerts, clubs etc. It can be the company of certain people -
drinking buddies, colleagues, partner or, alternatively, being lonely at
a bar stool or in front of the TV at home. Certain music, even smells
and foods can be associated with drinking/using. These situations are
associated with strong negative and positive emotions of pleasure and
relief . Physical memory circuits have been established in the brain,
which light up automatically when you find yourself in such
circumstances and trigger the behavioural response circuits of
drinking/using. They may do so consciously, or they may work deep down
in the subconscious or unconscious and creep up on you unexpectedly -
often when it is too late.
Therefore, avoiding their activation is obviously the first and best
policy. Recognising and then avoiding places, situations and also people
who might activate these drinking networks in the brain, is the first
step to preventing relapse, especially in early sobriety. Later, once
owns sobriety is more solid, one may be able to handle such situations
without being tempted to drink, however, even then one must always be on
guard and conscious of the dangers. Warning - do not play Russian
roulette and gamble in your early sobriety. Avoid places, give excuses,
cancel appointments - remember sobriety is your N° 1 PRIORITY !
2) Internal Feelings and Emotions
These can be bad emotions and feelings, like anger, sadness, grief,
jealousy, hate, loneliness, boredom and depression, from which we search
for relief through alcohol/drugs. On the other hand, they can
surprisingly also be good feelings like jubilation, euphoria, happiness,
exaggerated self-confidence, etc., which are linked to celebration and
reward, and which can equally lead us to drinking without thinking. Both
negative and positive feelings and emotions can be equally dangerous to
our sobriety, if left unrecognised.
Of course, it is not so easy to avoid emotions and feelings. One cannot
cancel depression, not turn up for anger, avoid feeling sad, etc.
Therefore, one needs to explore what are the most dangerous emotions
which you may associate with drinking. Then to realise that these are
SEPARATE ISSUES from drinking/using and which are part of « the human
condition », which everybody faces (alcoholic or non-alcoholic) and
which non-dependent people do not use as an excuse for drinking or turn
to bingeing for relief. Having recognised these emotions as separate
issues from your Sobriety Priority, you need to find ways for dealing
with and expressing these emotions and feelings in a SOBER healthy way
3) Unhealthy Patterns of Behavior and Habits
When we first get sober, we often feel like a fish out of water. We
don’t know what to do with ourselves or our time. If we don’t begin to
plan and structure a new way of life, then we are at risk of falling
back into old patterns and routines. This could be visiting the same
bars, restaurants, clubs, staying at home feeling isolated, depressed
and lonely, hanging out with old drinking/using friends, etc. Initially,
we may not drink or use, while doing these things. We take a Coke or
coffee, but, nevertheless, we are essentially acting like an
alcohol/addict, a dry drunk/addict, where just the substance has been
Of course, it is a good thing to drink non-alcoholic beverages and it is
not always possible to avoid places where alcohol or drugs are being
used. Staying sober then is a great achievement and one cannot and
should not cut oneself from life and live like a hermetic shaman (unless
that is your route). The difference, however, is the degree to which you
put yourself habitually in places, situations and gatherings which you
previously drank/used and/or similar circumstances. Furthermore, you may
not realise yourself, but by being in these situations, you are
fermenting habitual modes of thought, feelings and emotions which you
had when you were drinking/using. By
the growth of such addictive behaviours and thoughts, you are then only
one step away from the act of drinking and using itself. By getting back
into the old habits and patterns you are only rehearsing your role
before actually going on stage.
Of course, addicted or not, human beings are creatures of habit who tend
to fall back on old routines and habits, especially in times of
difficulty or stress. The alcoholic/addict is not only the ultimate
creature of habit, but is also chemically dependent on a substance and
physically drawn to it. Our tendency to fall back on old patterns and
habits is, therefore, ten times stronger than the average person. The
chemical dependency is like some implanted magnet which is attracted to
a bottle or drug. Acting in behaviours previously associated with
drinking or using draws us more and more closely into the « magnetic
field » of active addiction. If one keeps moving in these circles of
addictive behaviours, it is only a matter time before one connects and
gets stuck again.
In the earlier period and in times of difficulty, it is, therefore,
essential to break away from old habits and behaviours as much as
possible. Firstly, spend a many of your evenings as possible in recovery
meetings. This is especially so a we don’t often notice what is
happening and recognise warning sign in our thoughts or behaviours.
Others, however, may be able to recognise this and warn us and
forewarned is forearmed !
Make a list of place, people and situations to avoid and prepare excuses
to not go. Don’t give in to pressure from others to be somewhere you
shouldn’t be. If you can’t say the truth, say you are ill. Indeed,
remember you are ill. You are recovering from a life-threatening illness
! Your life comes first ! Your priority is Sobriety. Draw up a day plan
- hour by hour. Think of new, SAFE, places and people. Go swimming,
cinema, get videos, go to the library, start a hobby, join a club, etc.
And do things you like. Sobriety is not a penance. Reward yourself with
fun for having saved your own life and having a second chance. Build a
Building a new life is not an easy thing. We often have to deal with the
left over problems from our past and we suffer mood swings, up and
downs, depression, etc., in the course of sobriety. But then so do
non-alcoholic people. Like them, however, we, NOW, do not drink/use
whatever the situation. By remaining sober, a new sober and rewarding
life will gradually emerge. But that doesn’t mean it will be without all
the problems and tragedies, as well as great moments and good times that
the rest of humanity faces. That’s sober life, and that’s just life.
With time and practice, you will find you are able to subdue and, to a
degree, deactivate those old knee-jerk alcoholic/using reactions. The
longer one is sober, then the more these mental associations and
neurological pathways become dormant. New more healthy associations
linked to sober life take their place and become more automatic. We
learn how to deal with negative and positive emotions without reaching
for the bottle/drug. We grow in self-confidence and value through our
accumulated ability to deal with the world on its terms and not that
dictated by the drink or drug. We learn to establish more healthy
patterns of behaviour, based on a new life style, habits, new places,
friends and activities. Life becomes richer and more worth living. You
grow and develop more sides to yourself and your place in society and
life at large.
However, dormant associations never totally die. The « sleeping vampire
» can always potentially be reawakened
certain circumstances and conditions. Therefore, we must never be
complacent. However long our sobriety we must always be on guard for
life’s unexpected challenges and the need to arm ourselves against
possible relapse. Below you will
find some suggestions which may help you. You may also wish to read
books and take therapy as an adjunct to recovery. Above all use your SOS
group to talk about your problems and to find practical help and support
from others in recovery who face similar problems.
SIGNS ! ! !
changes in thoughts, feelings and attitudes.
changes in behaviors and activities.
a combination of the two above.
Sometimes you may be aware of these signs and
other times not. It is difficult for anyone, alcoholic/addict or not, to
be constantly objective about oneself and ones behaviour. Often it takes
another person to spot the changes which are taking place and you must
be prepared to listen and question yourself about others observations.
If you are not, then it is also another clear indication that you may be
in relapse mode. It can indicate that you are still in Denial, even
though you are not drinking or using and that you haven’t really come to
acknowledge and accept that you are an alcoholic/addict, who can never
Relapses can sometimes occur spontaneously, where the limbic system
hijacks the brain in a particular situation. This is rare, however, and
even if the relapse appears to be spontaneous, it is usually preceded by
the building up of a hidden relapse mode and a growth of factors, which
were not readily identifiable. Most relapses build up gradually over
weeks or months before actual drinking/drugging takes place. Signs may
show up hours, days or weeks before.
Furthermore, while there are characteristics similar to all relapsing
alcoholics and addicts, each person will also exhibit particular signs
unique to them as individuals.
Although one doesn’t not want to become neurotically obsessive about any
change in ones behaviours, thoughts or feelings leading to relapse (if
you do become neurotic about it, then it is probably a sign of relapse),
nevertheless, it is important that we become attentive to our moods,
thoughts and behaviours while in recovery. Thinking them through and
discussing them out with others will help you to gain a more balanced
view of the processes and potential dangers, as well as innocuous
· who do you spend time with ?
· where do you go or feel like going ?
· how has you feelings, moods, emotions changed recently ?
· how have your behaviours changed in the last period ?
· what are the differences in your thoughts and attitudes recently ?
Be prepared to listen to others who have avoided relapse and those who
have experienced it.
Identify common points with yourself and also try to see if there are
any other features particular to yourself and your history.
Emotions and Feelings : below are some the more common
emotions which cause dangers for the recovering alcoholic / addict.
There are many more and others which may be more relevant to you -
Anger/Hate, Anxiety /Panic, Guilt and Shame, Depression, Sadness, Grief,
Good Emotional States !
It is often forgotten that excessive emotional highs can be a threat to
ones sobriety. It is possible that when one is
happy or exuberant over an event or celebrating a success, that our
association of alcohol/drugs with such a feelings and situations can
overwhelm us and lead us back to taking that first drink or drug in the
relapse process. We have associated drinking/using with reward and
pleasure and we must make sure we are not taken by surprise in positive
situations also. Be warned that holidays are especially dangerous times,
like Xmas, birthdays and summer vacations.
Sudden Urges and Cravings
- these can seem to arise like a
thunderbolt from a clear blue sky. When everything appears to be going
well in sobriety, you are suddenly confronted by a sudden urge or
craving for alcohol/drugs. Then you have to « close the gap » and make
the emotional/feeling connection that alcohol/drugs = pain. Practice
this as part of your relapse prevention programme. Simulate an imaginary
relapse situation and then rekindle a really painful physical and
psychological consequence of drinking/using in your past. Remember also,
that the more you put yourself in behaviours, situations and thought
patterns linked to your past addictive behaviour, the more likely are
these thunderbolts to become a storm !
Create a Relapse Prevention Action
- Have a general plan - phone fellow recovers, get to a meeting,
- Make a list of situations in
which you have drunk/drugged in the past.
- Make a list of the places,
people and things associated with your addictive behaviour.
- Make a list of the internal
feelings associated with drinking/using - depression, euphoria, anger,
stress, loneliness, success, etc.
- Identify which of these factors
are present recently and at the moment and note them as warning signs.
- List the specific warning signs
which you have identified and prioritise them hierarchically.
- Work out a series of
alternative ways (not just one) which you can use to deal with each
warning sign, e.g., going to the cinema, instead of a bar, changing your
phone n°, exercising away anger, crying instead of suppressing sadness,
etc. Experiment to see what works best. Some will work sometimes and
others will work other times.
- Let yourself have a relapse
fantasy - identify where and when does it occur, who is there, how it
happen, what are the feeling and emotions present and how it ends.
- Are you having drinking dreams
when you sleep - what happens ?
- Practice « closing the gap » -
think of the times when you were drinking and pick the worst, most
painful memories of the consequences. Re-feel the hangover, dehydration,
vomiting, etc., Re-kindle the emotions of self-hate, shame,
hopelessness. Hammer home the fact that drinking/using equals pain not
pleasure or relief. Repeat this exercise, don’t just wait until you feel
an urge or a craving.
- Realise that everything passes
and that this feeling, mood or compulsion will disappear. Tell yourself
that you do not have to act upon it, that you have choices as a human
being and are not a slave to a chemical. You will be stronger as a
result. Realise that millions of people face the same moods, feelings
and negative thoughts, but don’t drink or drug their way out of them.
- Don’t just think, talk or write
the plan - PUT IT INTO ACTION !
Recovery doesn’t float down on a cloud, you have to take concrete
actions and steps to realise it. Rehearse strategies one at a time. See
yourself walking past the local bar and going to the cinema. Pick an
alternative substitute and do it. Feel sad and then make yourself cry.
Get angry about something and then go exercise.
- If you find you have barriers
to actually implementing your plan, go back and ask yourself the $50,000
question of why you created it in the first place. Remind yourself that
alcoholics and addicts look for the easy way out, the quick fix, as easy
a taking that drink or drug. Remember that there is no quick recovery
solution ! You don’t get something worth having for nothing, especially
when it is a second chance at life ! ! ! You have to make some effort.
If you are creating barriers to your plan, then it may reflect that you
are still in Denial. At the same time don’t make the task too difficult.
Don’t decide to lay on a bed of nails if you are caught by an urge to
drink/drug. Find alternatives which are pleasurable and rewarding in
some way, if possible. If you are having problems with your plan, it
could mean that your plan is too ambitious, difficult or inadequate. So
analyse what the barriers are and discuss it with others in your group
- Discuss your plan with others.
Putting the Plan into Action
means working on things like changing your behaviours, starting
healthier patterns, working on attitudes, thoughts and coping
mechanisms. Give yourself multiple options for the lists of high risk
factors you have identified. Test them out hypothetically and
practically, when need be. Don’t worry about the options not being
perfect immediately or only being partly effective or not at all. You
have to experiment, eliminate and improve some methods. It is an ongoing
process, which will also change a you do in sobriety. Keep it as simple
as possible, but identifying and focusing on your key risk factors.
Don’t try to build up a huge list of responses to every possible variant
in life. Above all, remember that a plan is not an intellectual
exercise. You need to « walk the walk ». Its about actively working on
and changing your behaviours, thoughts and emotional responses. Often
one begins by changing behaviour as a first step to changing ones
thoughts and feelings.
The points above are rational guidelines for dealing with risks
associated with relapse. Arming ourselves as powerfully as possible with
rational and practical methods of dealing with relapse prevention is
vital. However, as human beings we not only work with the rational brain
but also with our emotional brain. We can all remember instances
frequently in our active addictive years, when our rational reasoning
was overwhelmed by our emotional brain playing on our chemical
Remember that we are still chemically dependent, but we have only
suppressed that dependency by abstaining. The emotional brain remains
strongly connected to that dependency through years of training in
response and coping mechanisms. It has the capacity to overpower the
best and most rational of all plans in certain situations. Therefore, we
not only have to strengthen our rational responses, but also the
emotional or limbic part of our minds. We, therefore, also have to have
an « emotional » relapse plan in conjunction with our rational defenses.
When you first went sober, your decision should have been based not only
upon a rational decision not to continue and a rational acknowledgement
and acceptance of the fact that you are an alcoholic/addict, but also on
an enormously powerful emotional cry to rid oneself once and for all of
the monster of addiction. It is this response, an emotional explosion
driving your desire to quit which you must practice reliving each time
dangerous situations in sobriety. You must provoke a gut desire not to
drink and provoke within you an emotional outburst against returning to
your addiction. You must shudder at the thought of drinking/using again
by momentarily reliving the sensations, feelings, emotional and physical
pain suffered in active addiction and hammer home the point repeatedly
to your emotional/limbic brain that alcohol/drugs = pain, not
pleasure/relief. Make it psychologically and physically clear to
yourself that the consequences of relapsing will be far worse than the
problems and pain you are temporarily facing now. Having done that you
must then fuse it with a rational response from your plan, like getting
out of that bar immediately, phoning some for help, jumping on your bike
to ride. This will get you out of danger. And each time you succeed in
doing this, you will powerfully influence fundamental changes in your
thought and behavioural patterns, retraining your mind in healthier
patterns and laying strong foundations and pillars of support for your
long term sobriety.
Finally, you must know that however bad the
situation is or how you feel, there is NO excuse good enough for
returning to drink/drugs. Although you are an addict and always will be,
by going sober, you are now part of the human community which is not
actively dependent on mind-altering substances to get through life. Like
the majority of people, you do not turn to drink/drugs in order to cope
or misguidedly solve problems and pains. Like them you have to learn
other coping methods and also ones specific for your addictive
background. For non-alcoholic/addicted people using drink or drugs is
simply not an issue or an option which they consider when faced with
life’s ups and downs. For you it must also become a SEPARATE ISSUE.
Other non-alcoholic/addicted people have an unconscious « sobriety
priority », knowing that it will cause more pain, bring no relief, only
cause further problems and undermine their ability to deal with their
predicament. The recovering alcoholic/addict is different however, in
that we have a CONSCIOUS « Sobriety Priority » which says to us that
problems and pain are separate issues from drinking/using. They are no
longer linked to the automatic response of alcohol/drugs. We do not
drink/drug, no matter what ! Instead, like the majority of others, we
can now face life on its own terms and respond to its viscitudes under
our own resources. No pain, no gain is unfortunately true. But it helps
us to strengthen ourselves and grow as sober persons. At the same time,
however, it not only gives us the power to overcome pain and suffering,
it also brings us the ability to appreciate and enjoy the positive and
beautiful things which are part of life, of sober life, which all other
people enjoy, and which were robbed from us by intoxication. Now by
staying sober, we will also reap the benefits of really living - crying,
hurting, yes, but also loving, laughing, having real fun, pleasure and
To learn more about the «
Sobriety Priority » go now to
To begin working immediately on your emotional response and limbic
system go now to
Urges & Cravings
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