Relapse is an important topic in alcohol recovery treatment. It’s not inevitable but it can be a serious setback if it happens. It’s important to understand the triggers of relapse and how to move forward from the experience. The lessons can be used more widely in any form of slipping back when coping with difficulties in life.
What do we actually mean by relapse? We don’t mean the occasional lapse – the odd glass of wine here or there. Some will argue that you shouldn’t even do that. But abstinence may not work for everybody. Instead, what we mean by relapse is a collapse back into full-blown loss of control and all that goes with it. What are some of the triggers of relapse?
Happiness – sometimes we drink because we feel good about ourselves and the world. Drinking is often part of celebration, of course, and we enjoy the sense of well-being it brings – at least initially, in moderation. But alcoholics can’t stop and we end up overdoing it. I remember going to a local village charity auction dinner and spending most of the next day lying in the grass with a massive hangover.
Sadness – on the other hand, sometimes we drink because we feel sad and down. We drink for consolation because we believe that it will help our mood. Initially, it’s true, of course and the first few drinks give us a pick-up. But alcohol is a depressive and we end-up in a downward spiral. Just about the only times in life that I’ve cried have been when drunk – usually out of self-pity.
Stress – we’ve been running around all day, we have been multitasking, firefighting, getting bombarded by emails. Having a drink may help us to unwind. I did this enough times but on most days I would go to work the next day feeling nauseous. I’d sit with my head in my hands in a panicky cold sweat, thinking to myself – why do I keep poisoning myself? But I’d be drinking again by lunchtime and certainly in the evening. The cycle would just keep repeating itself.
Trauma – very often, alcoholics seek oblivion. In recovery treatment, we talk about self-medication. But let’s not beat about the bush. We do it to bury something in our past because we want to block it out. It’s not the answer, of course! Actually, we know it’s not the answer but we find it painful to address the underlying causes.
Boredom – we’re restless and unsatisfied. We are not comfortable in our own company. We can’t sit still. We need to be busy. This is different from experiencing sadness, as such. It shows a lack of meaning and purpose. We genuinely don’t know how and where to find enjoyment, possibly because we’ve never tried. We’ve just been swept along in the flow. So we drink because we’re bored, with the idea that we’ll feel better.
Social Circumstances – often we feel pressured to take a drink by friends and colleagues who don’t understand our condition. They don’t understand that even having one drink can put us back on the slippery path to full relapse. We join in to please them and we perhaps think this time it will be different.
Ultimately, we drink to get drunk because that’s what we do. Alcoholics don’t need a reason. It becomes habit and learned behaviour, reinforced by craving.
When relapse occurs, it can be devastating for the addict and others. The interruption to recovery is damaging to self-confidence, especially following a sustained period of sobriety. Sacrifices have been made and it’s been very hard work. The temptation is to fall back into negative ways of thinking about the possibility of getting better. It can be equally devastating for family and others who are close to the alcoholic because they have invested so much time and effort in providing support.
It’s important not to collapse into a sense of hopelessness, however. What can we learn about coping with the experience from relapse? What positive steps can we take to get back on the recovery path?
First, take some time to examine the experience. Be honest and open about it. Discuss and share with others how you feel about it. This could be with care workers, treatment practitioners, or fellow sufferers perhaps at a fellowship meeting. Perhaps write down what you recall about the circumstances leading up to relapse.
Second, try to identify the triggers. If you’ve done it before, probably more than once, what do you recognise from the above list of possible triggers? The list is not meant to be exhaustive. Ask yourself - what were the circumstances leading up to relapse? Was it a particular situation, person, or something said? What was the appeal of having a drink?
Third, comment on your recovery path – what worked for you previously to sustain sobriety? What do you believe did not work for you? Do you have some ideas of your own as to what might work better? Consider what you expected when you resumed drinking. Do some soul-searching with the help of others to guide you through the process.
Fourth, do some contingency planning. Recognise in advance the circumstances that might make you vulnerable – for example, a wedding or other social event, going to watch football with friends, being away on a business trip for a few days or having a few days of holiday on the beach. Picture the circumstances and how you will respond when the drinks are offered. If you’ve built up the habit of refusing and taking non-alcoholic drinks then it will become easier.
Finally, here is what not to do. Don’t hide away from those who are part of your support group. Don’t beat yourself up. Don’t deny it or clam up – we are not going to judge you. The really important thing here is not to collapse into a state of resignation. Look at what had been achieved prior to relapse. Reflect on the benefit you were receiving – the sense of being wide-awake – and focus on getting that back.
I reached a point where the therapy had run out. I was preoccupied with the panic attacks but once they were under control I was lulled into a false sense of security. It wasn't long before lapses turned into an attempt at "controlled drinking" before full-on relapse had taken hold. On reflection, I hadn't appreciated that recovery treatment needs to be ongoing, albeit it might move from medical supervision to relying on some form of more informal support.
Keep in mind, relapse is not inevitable. But be on your guard. Remain aware!