| 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. That’s true for drug addicts, too. Mark Twain was reputed to have said, “Quitting smoking’s easy. I’ve done it thousands of times.” A million people go on diets and start exercise programs every day and a million people give them up every day. That’s just the way it is.
So are you doomed to relapse?
No, it isn’t required. I’ve known a good many alcoholics and addicts who quit drinking and drugging years ago and haven’t 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 haven’t 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 my weight management and exercise too.
Unfortunately, though, relapse is a reality for the vast majority of us who are trying to get better. And here’s the great danger: many people who relapse feel so bad about themselves, are so embarrassed, are so depressed about the relapse that they give up. They don’t 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.
Don’t plan to relapse. That’s dumb. If you quit drinking, smoking, eating, or slothing with the notion that relapse is normal and acceptable, you’re 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 didn’t like it much. That was my fault, not the Boy Scouts. But in those two weeks, I latched onto the Boy Scouts’ motto: Be Prepared. You should too. Don’t 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 you’re going to get back on your program if relapse happens.
First, don’t let embarrassment or regret threaten your life by keeping you in your addiction or other self-destructive behavior. Get back in the saddle. I’ve seen lots of relapsed alcoholics come back in and all were welcomed back among the ranks of recovery with opened arms.
Early in my sobriety, I witnessed something that demonstrated how tenuous sobriety is. It happened at my first aftercare 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 I’ll call John get “framed up” for having his driver’s license reinstated in the coming week. She explained that John had been in after-care for a year. His driver’s license had been suspended more than a year before that day because of his drinking. We were going to spend the hour helping him 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 wasn’t necessary. The guy had been without a driver’s license for one year because of his alcohol drinking. He’d gone through treatment and had been in aftercare for a year. I mean, eventually he might get drunk again, like a year from now, if he doesn’t keep going to aftercare or continue to get help somewhere, but not now, for God’s sake. If this was what aftercare was all about, the next two years would really suck.
A week later, John wasn’t in the meeting. When the meeting started, the counselor said, “I have some bad news. John’s back in the day program. He went out and got drunk last weekend.”
You must be kidding!
She wasn’t. 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. That’s 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. They’ll wait a day, a year, a decade, and more.
Over the years, I’ve watched a good many alcoholics and addicts relapse. Some decided that if they’ve been able to keep from drinking or drugging for a while, they must be able to control it. So far, none of them could. Not one.
Others tried to keep from drinking, but didn’t change their lifestyles. They still hung around in bars and kept the same friends. They drank again. Some tried to white knuckle it without doing anything to change the way they respond to life. When bad things happened, they had no defense against them. The misery, anxiety, fear, or any other feeling they tried to change by drinking or drugging never went away. Eventually the continuing misery led them to say, “To hell with it.” They drank or did drugs again.
So how do you avoid relapse?
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. I’ve 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 don’t 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 now’s he’d dead. Here’s the deal: You can’t have God or a family if you’re drunk. Sobriety has to come first. It’s not selfish to put healthy living first. Absent that, you can’t 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, we’re doomed. Don’t do that. Like diabetics, we are never cured and that’s true if we’re alcoholics, drug addicts, nicotine addicts, or food addicts. Instead, we have to manage our conditions to stay healthy. Keep doing the things that helped us to quit in the first place, whatever that is. For me, that means doing all those things outlined above – things like living one day at a time, reordering priorities by gaining new perspectives on what’s important in life, living life on life’s terms, making gratitude lists, helping others, and the rest.
Become aware of triggers and avoid them. Remember the acronym HALT – hungry, angry, lonely, tired. Any of those feelings will often lead to relapse. Stay aware of what you’re 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 didn’t 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. There’s 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 grandmother’s kitchen while she cooked and eating her chocolate fudge cookies with great fondness.
I’ve got to keep remembering where all that will lead me when I want to romance those things.
When we’re 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 doesn’t 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 I’m sitting on the couch, deciding not to do my run today, I can 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, it’s 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 I’m dying to light that cigarette, I think about where that first puff will take me. Right now, most of the time I’m not thinking about cigarettes, but if I take even a tiny puff, the nicotine will trigger my obsession and I’ll be right back to the misery of nonstop craving. I’ll smoke again. I’ll spend lots of money, stink, and eventually die because of it. If I carry it through to the end, chances are I’ll 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 they’re inserting a stint. I don’t 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. “This too shall pass,” seems simplistic. It is, but it’s true. When I’m hit with a craving, I feel awful and have no doubt I’ll feel terrible forever. I’ll never enjoy life again. I’ve 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 won’t be thinking that life isn’t worth living without cigarettes. In fact, that time will come in just a few minutes. Soon I’ll focus on something else and those awful feelings will go away. I’m always right. A few minutes later, I realize I had stopped thinking about cigarettes. I am again grateful they don’t 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 – maybe last week. I remember that I had a hard time sleeping from thinking about it. But, for the life of me, I can’t remember what it was I was upset about. No doubt something had happened, but what was it? That happens often enough so that it’s 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 won’t even be able to remember what I’m upset about! That’s what “This too shall pass” really means.
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 who I’ll call Peter 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 hadn’t met with his supervisors yet and didn’t know if he still had a job or not. By now, I’d heard the same story a hundred times. I asked, “Do you think you have a problem with alcohol?”
“Tell you what—I’ll answer the question for you. Normally, I wouldn’t. You have to decide that for yourself. But, Peter, this is different. If you’re drinking in the morning before you go to work and you get a DUI, you have a problem. Don’t know the extent of it, but you have one.”
“Yeah.” He paused. “I’m going to an AA meeting tonight.” He didn’t look happy about that.
“Let me tell you something, Peter. Right now, it’s obvious you don’t like that much. But, if you’re 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 don’t drink alcohol anymore, there will come a day when you will be grateful for this D.U.I., whether you’re fired from the job you have now or not.”
He looked irritated. ‘Yeah, right,” 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 hadn’t been arrested, he’d still be drinking alcohol and still be miserable. He’d still be embarrassing himself. He’d still be making all life decisions based on how they affected his ability to drink alcohol. He told me he remembered what I’d told him the year before and said I was right.
When we come to view all life’s events as learning opportunities, we are less likely to try to change our feelings by drinking, drugging, or eating.
Most people who quit drinking, smoking, getting fat, and being lazy will relapse. You don’t have to, though. I’ve shared a sampling of strategies I’ve used to avoid relapse. There are more. Look for them.
If you do relapse despite the efforts you make, don’t make that an excuse not to try get better again. I know alcoholics who relapsed multiple times before getting it. Problem is, I’ve know some who relapsed and didn’t make it back. They died first. You don’t want to do that.
If you do relapse, gather yourself quickly, work to recapture the willingness, and try again.