Integrating the Tools of Relapse Prevention by Terence T. Gorski

Terence T. Gorski
Relapse Prevention and Addiction Expert

For the purpose of this article I want to think about the causes of relapse in a very simple way. Although there are many causes of relapse, sometimes it is helpful to isolate the most important and place the others aside. So let’s look at the three leading causes of relapse – denial, high risk situation, and self-defeating behavior. Let’s start with denial.

Denial as a Cause of Relapse

Many people relapse because of Denial which is the tendency to deal with problems that can cause us to use alcohol or other drugs through the processes of ignoring, minimizing, rationalizing, or blaming. When we ignore a problem we pretend that it doesn’t exist. We deliberately refuse to recognize and to honor what is going on inside of us and around us. When we minimize we mislead ourselves into believing the problem is so small and insignificant that it isn’t worth dealing with. When we rationalize we find good reasons for having the problem and believe that these good reasons will protect us from the damage of our addiction and of relapse. When we blame our problems on other people we can convince ourselves that since the problem isn’t our fault there is no way it can lead us into a relapse .

It is important to know that relapse can occur both during our active addiction and during our recovery. During active addiction our denial convinces us that it’s OK to keep using alcohol and other drugs and we don’t need to start a recovery program. During recovery denial prevents us from recognizing the problems and situations that could cause us so much pain and problems in recovery that using alcohol and drugs to deal with the pain seems like a good idea. Denial, especially rationalization, can keep us from doing the things we really need to do to get well. As a result we build a recovery program that doesn’t meet our real needs in recovery, we experience pain and problems in spite of our recovery program, and then we start believing recovery doesn’t work which gives us the excuse we need to go back to using alcohol and other drugs.

Recognizing and managing denial is a complicated process and that’s why I developed a concise and easy to use workbook, The Denial Management Counseling “ Workbook to help recovering people and their families to understand, recognize and manage denial. The techniques in this workbook can be applied to any repeating self-defeating pattern of behavior. There is also a professional guide that gives a lot of in-depth information that can help make using the workbook more effective.

High Risk Situations as a Cause of Relapse

Once we have learned to manage our denial and see the reality of our addiction, the problems caused by our addiction and what we need to do to recover, the second leading cause of relapse rears its ugly head – High Risk Situations. A high risk situation is anything we experience that makes us want to start using alcohol and other drugs. Most addicts in early recovery have a life that is filled with high risk situations. Just about everybody they know uses alcohol or other drugs. Almost everywhere they go they see reminders of how good it used to be to drink and drug. Worst of all, in early recovery we feel deprived of the one thing that used to allow us to feel better about ourselves, cope with our problems, and have what we believed was the good life.

These high risk situations have become such a common part of our lives that we often don’t see them as what they really are – land mines that can blow up our sobriety and throw us back into the fires of addiction. We usually don’t deliberately put ourselves into a high risk situation. We hit a trigger that activates a habit. Let me explain.

A trigger can be something we see, hear, feel, touch taste or think about that reminds us of the good times we used to have when drinking and drugging. This trigger event activates our euphoric recall and we say to ourselves: “remember how good it used to be when I was drinking and using drugs!” Then we look at our sober life and lock onto to all of our pain and problems while blocking out any of the benefits of recovery. Then we start awfulizing sobriety by saying to ourselves: “Look at how boring, awful and terrible it is to be sober and not be able to have the good life of someone who can drink and use drugs.” Then we use magical thinking and start fantasizing how wonderful it would be to start drinking and drugging again. This activates an automatic pattern of alcohol and drug seeking behavior. This drug seeking behavior draws us into situations were we encounter more reminders of “our good life as an addict.” The drug seeking behavior also takes us away from people, places and things that support our sobriety and help us keep our thinking straight and leads us deeper and deeper into the addictive drinking and drug culture. As a result we surround ourselves with people, places and things that lead us back into denial, feed our delusion that drinking and drugging will make my life better, and eventually put us face to face with our drug of choice.

Remember, getting into a high risk situations is something that most addicts do automatically and unconsciously. In other words we don’t have to think about it or plan it. It just happens. The trigger goes off, the addictive thinking starts, and a series of old habits take control and lead us away from recovery and puts us around people places and things that tell us its stupid to stay sober, its fun to drink and use drugs, and make it easy for us to get started again.

It takes work to identify and learn how to change the addictive alcohol and drug seeking behaviors that lead us into these high risk situations. This is why I developed a The Relapse Prevention Counseling Workbook, which is a step by step guide to identifying and learning how to avoid and manage high risk situations that activate craving and make us want to start using alcohol and other drugs again.

Self-defeating Behavior as a Cause of Relapse

Self-defeating behaviors are things that we do that fail to get us what we need and want and end up causing us unnecessary pain and problems. Self-defeating behaviors have nothing directly to do with drinking or drugging. They do however, cause us so much pain and problems and such a sense of helplessness and hopeless that we come to believe that drinking and drugging is the only way to manage the pain and solve the problems.

When we have serious problems we are at risk of relapse. When we start trying to solve the problems and things keep getting worse, our relapse risk goes up. When the pain and problems get really bad and we start to believe that there is no way top solve them, we are vulnerable to denial and the creation of high risk situations that will justify relapsing back into the use of alcohol and other drugs.

Once again, we don’t consciously start using self-defeating behaviors. We’re in the habit of doing so. Many of us learn these self-defeating behaviors as infants and children in our family of origin. We were taught by our parents or primary care givers that “this is the right way to deal with problem!” We may even have been taught that it is the only way and if we try to solve the problem in another way something awful will happen.

We need to a system for identify and change these patterns of self-defeating behavior. This is why I developed the Relapse Prevention Therapy Workbook which describes ways of identifying and changing these self-defeating behaviors and lifestyle patterns.

So we have three major problems that can cause relapse – denial, high risk situations, and self-defeating behavior and lifestyle patterns.

We also have three workbooks (Denial Management, Relapse Prevention Counseling – Managing High Risk Situations, and Relapse prevention Therapy – Managing Personality and Lifestyle Problems). Each of these workbooks has related self-help material that can make a difference in your recovery and in your life. I hope they can make a positive difference for you and the people you love and care about.

Best Wishes in Your Journey of Recovery

About the Author

Terence T. Gorski is a pioneer in the development of Relapse Prevention Therapy, who has achieved international acclaim for his work. He is considered a leader and authority in the addiction, behavioral health, social services, and correctional industries for his work in recovery and relapse prevention.


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