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. 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 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 don’t 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 here’s 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
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. Don’t 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 “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 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 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 after-care for a year. I mean,
eventually he might get drunk again, like a year from now,
if he doesn’t keep going to after-care or continue
to get help somewhere, but not now, for God’s sake.
If this is what after-care is all about, the next two years
are really going to 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.”
What? You have to be kidding!
She wasn’t. John had lasted until Saturday night.
He went to a party and got drunk.
Unbelievable.
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
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. They can’t. Never
happens. Others tried to keep from drinking, but don’t
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, “To hell with it.” 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 didn’t 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 didn’t 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?
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 is still drinking. 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. 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
– 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, never making
exceptions, 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 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, 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. If I carry it trough 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 to shall
pass,” seems simplistic. It is, but it’s true.
When I’m hit with a craving, 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, I can’t 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 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 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 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?” He shrugged. “Tell you
what .I’ll answer the question for you. Normally,
I wouldn’t. You have to decide that for yourself.
But, Jonathan, 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, Jonathan. 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.
Keeping gratitude in the forefront
of our consciousness provides another defense for relapse.
I’ve heard many recovering alcoholics talk about how
grateful they were that they were alcoholics. That’s
because life’s 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 they’ve had to learn to deal with
life on life’s 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 they’ve done the night before because they
don’t 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.
Gratitude’s more that, though. It’s an antidote
to depression and anxiety. It’s easy to focus on what’s
wrong. It takes some effort to notice what’s right.
The former drags us down. The latter pulls us up. Here’s
the prescription I’ve been given by those who have
been successful in avoiding relapse: Whether you’re
an alcoholic or not, put this book down right now. Get a
piece of paper and start making a list. A gratitude list.
Don’t 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 isn’t.
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 you’ll 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 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.
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