Stress Self-Monitoring and Relapse

April 27, 2012

By Terence T. Gorski
www.relapse.org 

An exciting new development in the treatment of addiction is the integration of stress management into the treatment and recovery process.  Although stress management has been recognized as an important adjunct to addiction treatment for over twenty years, the relationship between acute stress reactions, denial and treatment resistance is now becoming clear.  As stress goes up, so does denial and treatment resistance.  A key to effectively managing denial and treatment resistance is to teach recovering people to recognize their stress levels and use immediate relaxation techniques to lower their stress.

Recovering people are especially vulnerable to stress.  There is a growing body of evidence that many addicted people have brain chemistry imbalances that predispose them to both addiction and difficulty in managing stress.  The regular and heavy use of alcohol and other drugs can cause toxic effects to the brain that create symptoms that cause additional stress and interfere with effective stress management.

Many recovering people have severe problems with Post Acute Withdrawal (PAW).  PAW is caused by brain chemistry imbalances that are related to addiction that disrupt the ability to think clearly, manage feelings and emotions, manage stress, and self-regulate behavior.  PAW is stress sensitive.  As the level of stress goes up, the severity of PAW symptoms increases.  As PAW symptoms get worse, recovering people start losing their ability to effectively manage their stress.  As a result they are locked into chronic states of high stress that cause them to vacillate between emotional numbness and emotional overreaction.

According to the National Institute on Drug Abuse, exposure to stress is one of the most powerful triggers for relapse to substance abuse in addicted individuals, even after long periods of abstinence.  Stress can cause a problem drinker to drink more, and a recovering alcoholic to relapse.

Many counselors are dealing with these stress related problems by using a simple tool called The Stress Thermometer.

The Stress Thermometer

The Stress Thermometer is a self-monitoring tool that teaches people to become aware of their current stress levels, notice increases and decreases in stress during sessions, and encourages the use of immediate relaxation techniques to lower stress as soon a stress levels begin to rise.  The stress thermometer makes the problem of stress an acceptable issue to bring up any time stress levels increase to a point where denial and resistance are activated.

The concept of using a stress thermometer came from thinking about how we use a temperature thermometer to measure our body temperature.  When we take our body temperature we use a thermometer to tell us accurately and objectively what our body temperature is.  When we use a stress thermometer, we use a system for self-monitoring our stress levels that can tell us accurately and objectively how high our stress levels are.

The stress thermometer is divided into four color-coded regions: blue – relaxation, green – functional, yellow – acute stress reaction, and red – trauma reaction.

Relaxation: Stress levels of 1, 2, and 3 are coded blue. Blue is a color that represents a state of relaxation. We are relaxed and attending to the completion of any tasks. Stress Level 1: Relaxed Nearly Asleep; Stress Level 2: Relaxed – Not Focused; and Stress Level 3: Relaxed – Focused

Functional Stress: Stress levels 4, 5 & 6 designate the zone of functional stress. They are coded green because green is a color that represents “go”.  At stress levels 4, 5, and 6 we are experiencing stress levels that are high enough to give us the energy we need to get things done but are not so high that the stress begins to impair our performance.  Stress Level 4: Focused and Active; Stress Level 5: Free Flow With No Effort; and Stress Level 6: Free Flow With Effort.

Acute Stress Reaction: Stress level 7, 8, and 9 are coded yellow. The color yellow represents caution. At stress levels 7, 8, and 9 we are experiencing an acute stress reaction. The word acute means immediate and severe. Our immediate levels of stress have gotten so high that we can’t consistently function normally. We’re in danger. Stress Level 7: Space Out; Stress Level 8: Get Defensive; and Stress Level 9: Overreact.

Traunatic Stress: Level 10 Plus


No Wrong Doors Into Recovery

April 27, 2012


Courage_And_Fear

April 26, 2012

Courage_And_Fear

COURAGE and FEAR

Facing your fear
Doing what’s right in spite of the fear.
Doing what’s right when it goes against the crowd.
Doing what’s right even when you’re alone and no one will ever know if you don’t.

To live when you feel like dying
To stand when you’re afraid you’ll fall
It’s only fear – after all
It’s only fear!

LIVE SOBER – BER RESPONSIBLE – LIVE FREE
www.cenaps.cominfo@cenaps.comwww.relapse.org


Powerful Recovery Tools

April 26, 2012

Powerful Recovery Tools

LIVE SOBER – BE RESPONSIBLE – LIVE FREE
www.cenaps.cominfo@cenaps.comwww.relapse.org


Courage and Fear

April 26, 2012

Courage and Fear

Facing your fear
Doing what’s right in spite of the fear.
Doing what’s right when it goes against the crowd.
Doing what’s right even when you’re alone and no one will ever know if you don’t.

To live when you feel like dying
To stand when you’re afraid you’ll fall
It’s only fear – after all
It’s only fear!

LIVE SOBER – BER RESPONSIBLE – LIVE FREE
http://www.cenaps.cominfo@cenaps.comhttp://www.relapse.org


Starting Recovery With Relapse Prevention (RP)

April 25, 2012

Starting Recovery With Relapse Prevention (RP)
By Terence T. (Terry) GORSKI-CENAPS

April, 2012

 The First Attempt At Recovery – It Doesn’t Have To End In Relapse

 Many people mistakenly believe that relapse is an inevitable part of recovery – but they’re wrong! Relapse can be prevented. It’s as easy adding some special skills to your initial recovery tool kit.

The idea of relapse prevention was controversial and revolutionary in the 1970’s. In 2012, many common relapse prevention tools have proven their value, even for people entering recovery for the first time.

Preventing relapse, of course, has always been a concern to recovering people and those who love them. Over the years, relapse prevention has grown and expanded to include a wide variety of useful recovery tools. Relapse prevention methods have become a widely accepted and effective method. Two mistaken beliefs about relapse prevention, however, persists in the minds of many people. The first is that RP needs to come at the end of initial treatment; and the second is that RP should be reserved only for people who have attempted recovery and returned to addictive use.

This workbook is designed to challenge these mistaken beliefs. It will show how primary recovery skills and relapse prevention skills can be seamlessly brought together. An even better yet, the end product is a quick guide to staying in recovery during the most difficult early days of abstinence. It teaches skills that will help people to start feeling better and improve the quality of their life from the first day. Many people have started start using these exercises during detox and found they really helped.

Most recovering people experience early relapse warning signs and high-risk situations. They don’t know what’s happening or what to do. As a result, they feel powerless and confused. Their stress goes up. They start having craving and using drug seeking behaviors. They get into a spiral of dysfunction and eventually ask themselves the question: “If this is recovery, why bother?” They are so miserable in recovery that addictive use seems like an acceptable choice. This can all happen in the first days of recovery.

This is why so many people benefit from a custom designed package of both primary recovery and relapse prevention that they can use from day one. Many people who get this vital combination, leave  treatment in the first few days. This is tragic, since a focus on primary recovery AND relapse prevention, can help them make it through.

The workbook, Starting Recovery With Relapse Prevention, presents a simple and easy to understand set of organized exercise that teach both primary recovery and relapse prevention methods as a seamlessly organized system. It presents a powerful set of skills that can support people through the critical first days of recovery. It’s not magic – to avoid relapse, people need to do the right things right. This workbook shows them how. The choice of doing it is up to them.

The Language of Recovery

Addiction is a complicated illness with physical, psychological, and social and spiritual symptoms. Conversational English doesn’t have language to adequately describes these symptoms. As a result people don’t understand what is happening to them and start to feel crazy and out of control.  Starting Recovery With Relapse Prevention defines a basic language of recovery. Nothing fancy – just enough to get started without getting confused.

To take charge of the recovery process takes a plan. This workbook integrates a daily planning process into the review and completion of the exercises. It focuses upon making a simple morning plan, starting the first day you are able to, and doing and evening review. This gives people a daily “to do list” that let’s them put first things first. It shows them how to make recovery and relapse prevention the job Job #1. Stephen Covey, in his book The Seven Habits Of Highly Effective People, puts it this way: “The main thing, is keeping the main thing, the main thing.” Staying away from alcohol and other drugs and building basic recovery skills – these are the main things.

Learning About What’s Wrong With You

It is important to understand and recognize the symptoms of addiction. Completing this workbook won’t give anyone a Master’s Degree in Addiction Science, but it will point out, in clear and easy-to-understand language, the main things that people need to know early recovery and provides a quick and easy to use self-assessment check-list.

Managing Stress

Managing stress! It’s not a luxury. It is a necessity! High stress without the abioity to manage it is the number cause of relapse in early As your stress goes up – the newly sober brain shuts down. Learning to manage stress lowers the risk of craving and automatic drug seeking behaviors. Stress management is a critical skill for getting through early recovery. So, Starting Recovery With Relapse Prevention, explains stress, gives a stress self-monitoring tool, and teaches a easy to use science based deep breathing exercise that is so effective it taught to police officers, combat soldiers, and emergency first responders.

Understanding Post Acute Withdrawal

The brain doesn’t instantly bounce back when people break out of their pattern of addiction. The pleasure chemistry of the gets disrupted and brain keep bouncing back-and-forth like a Ping-Pong ball at a world class Ping-Pong tournament. This is a prolonged period of withdrawal is called post Acute Withdrawal (PAW). The workbook explains the symptoms, what causes them, and some guidelines for managing them. Just knowing that these symptoms occur help people to lower their stress by knowing they are experiencing normal symptoms of recovery.

Managing Denial

Denial is a normal and natural process.  It happens automatically and unconsciously when most people are having serious problems. Just as the human body has an immune system to protect it from dangerous physical organisms, the human mind has a mental immune system to protect it from overwhelming pain and problems. That mental immune system is called a psychological defense system. The workbook describes it as a denial system. The workbook gives a quick users guide to denial and some basic steps for recognizing and managing it. This includes a brief denial management check-list

Craving Management:

In early recovery, people can be overwhelmed by powerful urges to use alcohol or other drugs (craving). A three-part model for understanding craving (Setups, Trigger Events, and The Craving Cycle) is presented. The model is simple, yet effective. It takes denial management into the down to the level of recovery skills that can be taught and learned.

High Risk Situation Check List

The last step on the road to addictive use is a high-risk situation. Recovering people put themselves around people, places, and things where they have no recovery support and addictive use is support and encouraged. A High Risk Situation Checklist is provided as well as a simple set of skills for identifying managing them.

Preparing A Foundation for Lon-term Recovery

Starting Recovery With Relapse Prevention then provides a series of skills that prepare people for more in-depth cognitive restructuring as they get through the difficult first weeks and begin moving ahead into building a sober and responsible way of life. The simple two straight-forward skills: recognizing old thoughts, feelings, urges, and actions related to craving, drug-seeking behavior, and addictive use ; and developing new and more effective ways of thinking, feeling, managing urges, and acting in sober and responsible ways.

So, there it is in a nutshell – the core content of my new book: Starting Recovery With Relapse Prevention.  I was once told that the smarter we become, the less time it takes to explain the complicated. To fully grasp a set of knowledge, we need to be able to write it on the back of a stage stamp. This workbook isn’t a postage stamp. Back in 1978 the Relapse Prevention Workbook consisted of over two volumes, over 200 pages each. I think this short and easy to use new workbook is easier to understand and far more effective.

A Quick Summary of Starting Recovery With Relapse Prevention

  • Develop a Morning Plan
  • Do an Evening Review
  • Understanding Addiction and Its Symptoms
  • Recognizing That I’m Addicted
  • Make The Recovery Decision
  • Recognize Stress
  • Lower Stress
  • Recognize and Stop Denial
  • Recognize and Manage Craving
  • Recognize and Manage High Risk Situations
  • Manage Addictive Thoughts, Feelings, Urges, and Actions
  • Build A Foundation for High Quality Recovery

After completing this workbook under the guidance of a properly trained addiction profession, most recovering people feel confident that that they will be able to do what they need to stay recover. Most addiction professional find that this workbook makes their job much easier.

Best Wishes
Terence T. (Terry) Gorski
April, 2012

Gorski Books: www.relapse.org 

Prebublication and Signed Copies: www.cenaps.com

Info on Special Pricing: info@cenaps.com  


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