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Old 09-02-2013, 11:51 AM   #1
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Default Relapse Avoidance and Recovery

Relapse Avoidance and Recovery

Relapse happens. In fact, it happens a lot. Researchers have found that 90% of alcoholics who go through treatment relapse within the first four years of sobriety. Thatís true for drug addicts, too. A million people go on diets and start exercise programs every day and a million people give them up every day. Thatís just the way it is.

So are you doomed to relapse? No, it isnít required. Iíve known a good many alcoholics and addicts who quit drinking and drugging years ago and havenít relapsed yet. I relapsed from alcohol and cigarettes after quitting, but that happened when I was trying to quit on my own. Since I sought and received help, I havenít relapsed. The tools and strategies that I learned from the treatment center and from other alcoholics have worked so far. In fact, the sobriety tools have worked for smoking and for diet and exercise too. The common thread among those who avoid relapse is their commitment to keep working at it. They make sobriety and healthy living their first priority. They donít make excuses. They are committed to a better life and nothing's going to take that away from them.
Unfortunately, though, relapse is a reality for the vast majority of us who are trying to get better. And hereís the great danger: many people who relapse feel so badly about themselves, are so embarrassed, are so depressed about the relapse, that they give up. They donít try again. Or, they go through the misery for many more years before they hit a new bottom sufficiently horrible to motivate them to try again. A lot of them die.
Be Prepared
Donít plan to relapse. Thatís dumb. If you quit drinking, smoking, eating, or slothing with the notion that relapse is normal and acceptable, youíre flat doomed. Instead, learn and practice relapse prevention strategies so you avoid it. You should however, think about what you will do if you do relapse before it happens. I was a Boy Scout for two weeks. I didnít like it much. That was my fault, not the Boy Scouts. But in those two weeks, I latched onto the Boy Scoutsí motto: Be Prepared. You should too. Donít wait until you wake up the morning after a relapse and have no idea what to do next except feel really, really lousy. You should have thought about how youíre going to get back on your program if relapse happens. Donít let embarrassment or regret threaten your life by keeping you in your addiction or other self-destructive behavior.

Early in my sobriety, I witnessed something that demonstrated how tenuous sobriety is. It happened at my first after care meeting at the treatment center. Because I was new to the group, the meeting started with me telling the rest of the group about what brought me into the treatment program. After I finished, the counselor announced that we were going help a fellow member named John get ďframed upĒ for having his driverís license reinstated in the coming week. She explained that John had been in after-care for a year. His driverís license had been suspended more than a year ago because of his drinking. We were going to spend the hour helping John figure out how to avoid getting drunk once he got his license back and was free to drive to the liquor store again if he chose to.

I was amazed, and a little irritated, that we were spending the entire meeting on this. Surely it wasnít necessary. The guy had been without a driverís license for one year because of his alcohol drinking. Heíd gone through treatment and had been in after-care for a year. I mean, eventually he might get drunk again, like a year from now, if he doesnít keep going to after-care or continue to get help somewhere, but not now, for Godís sake. If this is what after-care is all about, the next two years are really going to suck.

A week later, John wasnít in the meeting. When the meeting started, the counselor said, ďI have some bad news. Johnís back in the day program. He went out and got drunk last weekend.Ē

What? You have to be kidding!

She wasnít. John had lasted until Saturday night. He went to a party and got drunk.


But it was true. John taught me the necessity of being on constant guard against relapse. Alcoholics Anonymous founder Bill Wilson called the disease of alcoholism cunning, baffling, and powerful. Thatís so true. So is the desire to eat brownies and sit in the recliner all day. My alcoholism, nicotine addiction, obsession with fattening food, and attraction to sloth are just sitting there waiting, like vultures. They are incredibly patient. Theyíll wait a day, a year, a decade, and more.
Don't Want to Change? Expect Relapse
Over the years, Iíve watched alcoholics and addicts relapse. Some decided that if theyíve been able to keep from drinking or drugging for a while, they must be able to control it. They canít. Never happens. Others tried to keep from drinking, but donít change their lifestyles. They still hang around in bars, keep the same friends, and do the same things. They drink again. Some try to white knuckle it without doing anything to change the way they respond to life. When bad things happen, they have no defense against them. The misery, anxiety, fear, or any other feeling they tried to change by drinking or drugging never goes away. Eventually the continuing misery leads them to say, ďTo hell with it.Ē They drink or drug again.

I relapsed when I was trying to quit drinking by myself. I was looking out a hotel window in Texas, feeling uncomfortable and out-of-place because of being in close quarters with a bunch of strangers, and saw the liquor store. I knew vodka would change those feelings. As I stood and stared at that store, my mind went through the mental gymnastics that led me to go and buy a fifth of vodka. Now I know that I relapsed the nanosecond I saw that liquor store. I didnít really need to go through all that thinking to convince myself it would be OK to drink in Texas. I was doomed the moment I saw the store because I was extremely needy and I had no defense against my desire to use alcohol to feel different. I had no tools to keep from drinking alcohol and had no strategies to help me feel different without alcohol. At that moment, I didnít have a chance. No amount of self-will in the world would have changed the outcome. I knew nothing about what to do to avoid relapse. Relapse was inevitable.

So how do you avoid relapse?
Priority One
The first defense against relapse is to stay centered in the desire to remain healthy by making sobriety and healthy living an absolute priority in our day-to-day lives. Iíve heard alcoholics use this analogy: Before every airline flight, the flight attendants tell passengers what to do if cabin pressure is lost. Oxygen masks will drop from above their heads. Passengers are instructed to put their on masks on first. Even if you have a child gasping for air next to you, put yours on first. You have to take care of yourself first, then care for your children and others after that. If you donít put your mask on first, you will be disabled and will be unable to help anyone else. Same with sobriety. I know a recovering alcoholic who disagreed with putting sobriety first. He put it in third place. God was first and family was second. He was proud of that. He relapsed and is still drinking. Hereís the deal: You canít have God or a family if youíre drunk. Sobriety has to come first. Itís not selfish to put healthy living first. Absent that, you canít be there for others.

Complacency is the friend of relapse. If we ever believe we have our problems licked and quit working at the solutions, weíre doomed. Donít do that. Like diabetics, we are never cured. Instead, we have to manage our conditions to stay healthy. Keep doing the things that helped you to quit in the first place, whatever that is. For me, that means doing all those things outlined in the previous chapters Ė things like living one day at a time, reordering priorities by gaining new perspectives on whatís important in life, living life on lifeís terms, never making exceptions, and the rest.

Become aware of triggers and avoid them. Remember the acronym HALT Ė hungry, angry, lonely, tired. Any of those feelings will often lead to relapse. Stay aware of what youíre feeling and take action when you find yourself on dangerous ground.

Romancing our addictions is a sure road to relapse. Whatever our addiction, there were times when the substance worked for us. Bad things didnít happen every time we drank, smoked, or ate excessively. Not at all. In fact, some of my favorite memories come from times when I was drinking alcohol. Thereís nothing much better than sitting on the condo balcony looking out at the ocean and having a gentle buzz going. Too bad the legacy of that behavior is so very lousy. I loved that first cigarette after coming out of a movie. I remember sitting in my grandmotherís kitchen while she cooked and eating her chocolate fudge cookies with great fondness. Iíve got to keep remembering where all that will lead me when I want to romance those things.
Overcome Cravings
When weíre faced with cravings to drink, drug, eat, or sloth, there are things we can do. We can call a buddy and talk about our obsession. The buddy needs to be somebody who shares our issues because we need someone to commiserate with us and remind us of what works. If you talk to someone who doesnít share your problem, whatever they say will be preaching and lecturing. That seldom works. Alcoholics need to call another alcoholic. Drug addicts need to call another addict. Develop former smokers as the relapse prevention buddy. Same with diet and exercise. If Iím sitting on the couch, deciding not to do my run today, I need to call my exercise buddy so he can remind me what happens if I miss a day. If we wait until the obsession, or fit of laziness, hits us, itís too late to find a buddy. We need to have them set up and ready to call.

We can carry it through to the end. When Iím dying to light that cigarette, I think about where that first puff will take me. Right now, most of the time Iím not thinking about cigarettes, but if I take even a tiny puff, the nicotine will trigger my obsession and Iíll be right back to the misery of nonstop craving. Iíll smoke again. Iíll spend lots of money, stink, and eventually die. If I carry it trough to the end, chances are Iíll decide to let time pass before lighting up and the obsession will leave me.

When eating chocolate chip cookies sound good, I carry it through to the end. I envision myself struggling to put on too tight pants in the morning. I envision myself back on the cardiac cath table, only this time theyíre inserting a stint. I donít want to do that, so I skip the chocolate chip cookie.Play the tape all the way through and the craving will pass.

Speaking of passing, cravings do that. ďThis to shall pass,Ē seems simplistic. It is, but itís true. When Iím hit with a craving, Iíve learned to take a deep breath, and engage in some self-talk. I tell myself that the craving is temporary. There will come a time when I wonít be thinking that life isnít worth living without cigarettes. In fact, that time will come in just a few minutes. Soon Iíll focus on something else and those awful feelings will go away. Iím always right. A few minutes later I realize I had stopped thinking about cigarettes. I am again grateful they donít control my life as they once did.

Actually, everything passes eventually. Often, I remember that I had been really irritated, or depressed, or angry about something not long before Ė maybe last week. I remember that I had a hard time sleeping from thinking about it. But, I canít for the life of me remember what it was I was upset about. No doubt something had happened, but what was it? That happens often enough so that itís legitimate for me to remind myself when I have a craving, or am upset by some event, or worried about some future event, that there will come a time when I wonít even be able to remember what Iím upset about! Thatís what ďThis too shall passĒ really means.
Attitude Adjustment
Our attitudes about life can go a long way toward preventing relapse. Things that seem bad and make me feel bad are triggers. But, way more often than not things that seem bad turn out to good. An alcoholic I know named Jonathan was arrested for DUI one morning while he was on his way to work. I was acquainted with him before that happened, but had no idea he had a problem with alcohol. As he told me about his arrest, his distress was obvious. He was embarrassed, scared, and angry. He hadnít met with his supervisors yet and didnít know if he still had a job or not. By now, Iíd heard the same story a hundred times. I asked, ďDo you think you have a problem with alcohol?Ē He shrugged. ďTell you what .Iíll answer the question for you. Normally, I wouldnít. You have to decide that for yourself. But, Jonathan, this is different. If youíre drinking in the morning before you go to work and you get a DUI, you have a problem. Donít know the extent of it, but you have one.Ē

ďYeah.Ē He paused. ďIím going to an AA meeting tonight.Ē He didnít look happy about that.

ďLet me tell you something, Jonathan. Right now, itís obvious you donít like that much. But, if youíre an alcoholic, and you do what it takes to quit drinking alcohol -- go to A.A., go to treatment or whatever else you finds that works. If you do that and donít drink alcohol anymore, there will come a day when you will be grateful for this D.U.I., whether youíre fired from the job you have now or not.Ē

He looked irritated. ĎYeah, right,Ē he said.

A year later, and still sober, he told me the D.U.I. arrest was the best thing that ever happened to him. If he hadnít been arrested, heíd still be drinking alcohol and still be miserable. Heíd still be embarrassing himself. Heíd still be making all life decisions based on how they affected his ability to drink alcohol. He told me he remembered what Iíd told him the year before and said I was right. When we come to view all lifeís events as learning opportunities, we are less likely to try to change our feelings by drinking, drugging, or eating.
Keeping gratitude in the forefront of our consciousness provides another defense for relapse. Iíve heard many recovering alcoholics talk about how grateful they were that they were alcoholics. Thatís because lifeís gotten so much better in sobriety. Before, life seemed impossible without alcohol. Now, life is massively better without alcohol. More importantly, in order to stay sober theyíve had to learn to deal with life on lifeís terms. They no longer worry about the stuff that used to drive them crazy. They no longer wake up and grab their head in embarrassment when they remember something theyíve done the night before because they donít do those embarrassing things anymore. They no longer wake up, have to figure out where they are, and go looking for their car.

They are grateful.

Gratitudeís more that, though. Itís an antidote to depression and anxiety. Itís easy to focus on whatís wrong. It takes some effort to notice whatís right. The former drags us down. The latter pulls us up. Hereís the prescription Iíve been given by those who have been successful in avoiding relapse: Whether youíre an alcoholic or not, put this book down right now. Get a piece of paper and start making a list. A gratitude list. Donít spend a lot of time wondering if you should be grateful for something or not. Just write it down. Write down a hundred things. Seems impossible? It isnít. Just get started. Put the list in your wallet. When you feel down, angry, hurt, or discouraged, pull out your gratitude list and look at it. Add to it. Tell somebody about something on the list. Do that and youíll feel better. If we feel better, our odds of relapse are greatly diminished.

Most people who quit drinking, smoking, getting fat, and being lazy will relapse. You donít have to, though. Iíve shared a sampling of strategies Iíve used to avoid relapse. There are more. Look for them. If you do relapse despite the efforts you make, donít make that an excuse not to try get better again. I know alcoholics who relapsed multiple times before getting it. Problem is, Iíve know some who relapsed and didnít make it back. They died first. You donít want to do that. If you do relapse, gather yourself quickly, work to recapture the willingness, and try again.
"No matter what you have done up to this moment, you get 24 brand-new hours to spend every single day." --Brian Tracy
AA gives us an opportunity to recreate ourselves, with God's help, one day at a time. --Rufus K.
When you get to the end of your rope, tie a knot and hang on. --Franklin D. Roosevelt
We stay sober and clean together - one day at a time!
God says that each of us is worth loving.
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