Episode 278: About Relapse

Although relapse is often a source of shame, it needn’t be. As we learn on this episode, there are ways to understand such stumbles as part of the larger process that is recovery. This livestream conversation features co-hosts John Sheldon and Mary C., who together explore the healing opportunities available to us when we respond to, reflect on and ideally avert relapse altogether. They are sharing personal experiences as well as fascinating highlights from an article, “Relapse Prevention and the Five Rules of Recovery.”

John and Mary cover the emotional, mental and physical circumstances commonly associated with relapse as well as useful strategies for identifying these pitfalls before tumbling into them. We also look at the biggest risks to sobriety (lack of self-care is at the top of the list) and some of the most toxic reactions to relapse (pride, which breeds silence and self-loathing).

It’s a free exchange of ideas, including candid and thought-provoking comments from viewers on a range of topics. You’ll come away with a deeper perspective on what it means to relapse and the tools available to manage through even the most challenging of times. The most important takeaway: Remember that the quickest way to recover from a relapse is to confront the reality. No denial, no hiding — and no fear of judgment, at least not among those who understand that it’s all part of your recovery.

If you would like to watch the video of this conversation on YouTube, click here. And you can read in its entirety the  2015 Yale Journal of Biology and Medicine article about the stages of relapse discussed on this episode here.

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Key Takeaways

  • Mary C. Shares the story of her relapse 11 years ago, when she lit up a joint that led to a brief break from what is now 27 years of sobriety. Lessons learned.
  • Sobriety dates can be a strong incentive to remaining sober — until they aren’t. Mary shares her perspective on the counterproductive pride associated with wanting to keep her sobriety date. She was out of integrity and justifying lies.
  • John recognizes that recovery is a process of change and that a relapse doesn’t have to hammer us or negate all our time in recovery.
  • You can’t really go back to where you were before a relapse, but you can move forward with meaning and deeper understanding.
  • Secrets Are a Sickness: Shame does not serve us, even in the wake of relapse.
  • Is relapse part of recovery? There are varying philosophies about whether it’s an inevitable part of the process.
  • John shares some of the ideas offered up by Steven M. Melemis in his Yale Journal of Biology and Medicine article, “Relapse Prevention and the Five Rules of Recovery,” according to which there are four main ideas:
    • Relapse is a gradual process with distinct stages (and the earlier the stage we disrupt, the better our odds of success).
    • Recovery is a process of personal growth with developmental milestones, each of which has its own risks for relapse.
    • The main tools for relapse prevention are cognitive therapy and body relaxation, which change negative thinking and encourage healthy coping skills.
    • Most relapses can be explained in terms of a few basic rules and learning about those rules can help people focus on what’s important.
  • John reflects on a series of events that created for him a scenario rife with risk for relapse. It was a situation that occurred gradually and then with a sudden triggering (that he wrestled with in isolation). Reaching out to his sponsor was what ultimately freed him from the obsession.
  • Five Recommended Rules of Recovery:
    • Change your life.
    • Be completely honest.
    • Ask for help.
    • Practice self-care.
    • And don’t bend the rules.
  • Mary reflects on the ways in which relapse started in her body, which was holding tension and required self-care, including meditation and mind-body connection.
  • Negative self-talk can be a fast-track into a spiral that we can interrupt with self-care — as well as fun activities that are more than avoidance of the present moment.
  • About the silence-based practice of Vipassana meditation centered on breath that some in recovery use to stay connected with their bodies.
  • Self-care can run the gamut:
    • A book club.
    • A mani-pedi.
    • A massage.
    • All kinds of things — whatever we find works for us!
  • Stages of relapse identified by Steve M. Melemis in his article “Relapse Prevention and the Five Rules of Recovery:”
    • Emotional: Individuals aren’t thinking about using. They remember their last relapse and don’t want to repeat it, but their emotions and behaviors are setting them up for relapse down the road. It’s unconscious, steeped in denial and often associated with a lack of self-care. Signs for being at risk of Emotional Relapse:
      • Bottling up emotions.
      • Not going to meetings.
      • Going to meetings but not sharing.
      • Focusing on other people’s problems or how they impact others.
      • Poor eating and sleeping habits.
      • The process can begin weeks before reaching an inflection point.
      • Ask yourself: Are you in a state of HALT?
    • Mental: A state of mental war within, pitting the desire to use against the desire to obtain. Cognitive resistance diminishes and the need for escape increases over time. Signs for being at risk of Mental Relapse:
      • Cravings for drugs or alcohol.
      • Thinking about people, places or things associated with past use.
      • Minimizing consequences of past use — or glamorizing it.
      • Thinking of schemes to better control using.
      • Looking for relapse opportunities.
      • Planning a relapse scenario.
      • To Note: Occasional thoughts or cravings are NOT a big deal.
    • Physical: Occurs when an individual has started using again. Lapses that are minimized because they appear to be isolated can predispose a full relapse. It’s critical to look at it honestly and ask the hard questions.
    • Be Aware: Even when we’re in recovery, addictions tend to go elsewhere. Keep an eye out for compulsive behaviors that are unhealthy, even if in ways that differ from using.
    • A shout-out for LaDawn and her lively “Did It For Real” videos at this link.
    • Mary’s Bottom Line Thought: Relapse is a part of recovery — which is not to offer a free pass. But if you find yourself in that situation, be honest and seek help. Don’t keep it a secret. Claiming the truth will release the burden.

      Key Quotes

“The amount of shame and guilt … just keeps the relapse going longer.” (Mary)

“For me it really wasn’t about the substance. It was about being dishonest.” (Mary)

“I understand (relapse) and I understand how people hide it … If a person that relapses can actually see the warning signs and learn a lesson from it, then that’s the takeaway. Not just what you did but what you learned.” (Mary)

“If you’re going to deal with (relapse) you have to be honest about it. And if you’re honest with yourself then it’s easier to be honest with other people about it as well.” (John)

“There shouldn’t be any shame attached to this. It’s natural to feel it, I suppose, but hopefully not to dwell in that feeling for too long because it’s really not productive.” (John)

“There are actually stages that we go through (in relapse) and the earlier that you can recognize some of your thinking or patterns – the earlier you can catch it – the better.” (John)

“There’s a real difference between being selfish and practicing self-care.” (John)

“How I’m breathing and how tense my body is also a reflection of what’s going on in my mind.” (Mary)

“The way we use to blow it out when we were drinking is different than blowing it out when we’re sober. I can have just as much fun as I ever had, minus the guilt and shame.” (Mary)

“If we can get the lesson in the relapse, then it wasn’t worthless.” (Mary)

“It takes courage to be a sober person in this world.” (Mary)

“I welcome people that relapse and would be happy to talk to you all day long about it, because it’s not something you can shut down with guilt or shame.” (Mary)

“Relapse is a part of recovery and it’s okay. That doesn’t mean you have a free pass. It just means that if you have relapsed and are ashamed, just talk to somebody. Don’t keep it a secret. Reach out and tell someone. That will release the burden and the weight of it all.” (Mary)

Further Resources

“Relapse Prevention and the Five Rules of Recovery,” by Steven M. Melemis
Information about the practice of Vipassana meditation
About Relapse with John and Mary: Full Beyond Belief YouTube Livestream
Check out LaDawnDidItForReal, a great collection of YouTube videos!

Follow Beyond Belief Sobriety


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