Relapse Mode--A Slow Motion Train Wreck of Emotional Self-Destruction
Recovery from alcohol/drug addiction is a precious gift. Continuous, long-term sobriety is a miracle. I've been at this "sobriety thing" a little over 20 1/2 years. In that time, I've seen lots and lots of people relapse. Most of my loved ones in recovery have relapsed. Many of them died, the rest either got sober again or live in the hell of continuous relapse or exist in active addiction as the walking dead (can't live, can't die). There are a lot of people who walk into the rooms of recovery who aren't really alcoholics or addicts...you know, got a little tipsy and got pulled over in the new BMW. I'm speaking to the ones who are real alcoholics/addicts--the ones like me.
Relapse isn't an event, it's a process. There are three basic stages of relapse: emotional relapse, mental relapse and physical relapse. Broken down, there are 11 stages:
Step 1: Unhealthy emotions
Recovery is not as important as it once was. We hit a problem that we are unwilling and/or unable to cope with emotionally. We return to insane, addictive thinking. We know there's a problem but can't identify what it is because we cannot identify our emotions and lack ways of processing them.
Step 2: Denial
We don't need help from others in the fellowship. Everything is OK. There's no problem. Suuuure. We start processing our thoughts the same way we did when we were doing drugs. We convinced ourselves everything was OK then, we do it now. "I'm not on drugs so everything is fine". We discard our tools (like openly and honestly sharing our feelings) and don't use recovery to get us back on track. The result is, we begin to distance ourselves from our support system, the quality of our recovery deteriorates and we become increasingly more confused and angry. At this stage, our focus moves from outward to inward.
Step 3: Compulsive behaviors
Why use recovery to cope with problems when we have food, workaholism, overeating, over-dieting or overexercising? I'm sure NONE of us in recovery have ever used sex or addictive relationships to deny our feelings, right? We know we don't want to drink or use again but are not using the tools of recovery to solve our problems. We may become overbearing in friendships or recovery, in an effort to feel like we're still "strong" and have done something worthwhile.
**A sure sign of emotional relapse is acting differently on the outside from what we feel on the inside. Honesty is one simple criterion that will help us maintain our recovery. In abandoning recovery and using compulsivity to cope, we are doing what comes naturally to us, in effect. using drugs to solve our problems. Seeking the "orgasm that rocked New York" may feel good, but it won't get rid of the stress. We feel good now, we hurt later. This is the hallmark of all addictive behavior.
Step 4: Triggers
Something happens to trigger us. It doesn't have to be big, just something that's an old trigger. If we're solid in our recovery, we use recovery tools to handle them. If we aren't...see step 5.
Step 5: Interior chaos
We get triggered, then erratic emotions take control of our thinking. Our mental patterns become insane and distorted again. When emotion takes control of intellect, we abandon everything we know and start trying to feel good at all costs. Relapse almost always grows from the inside out. It isn't the trigger, it's the way we react to it. At this stage, we have probably abandoned our recovery support system. It's not our external problems that make us drink or use again, it's our inability to cope with our emotions and distorted thinking.
Step 6: Exterior turmoil
We can stay in a state of mental relapse for some time, convinced there are no problems. We haven't picked up drugs or booze so we convince ourselves there's nothing to worry about, yet by this point we know there's something wrong with our state of mind. We keep it a secret out of pride and shame. We start having arguments with family members and co-workers. We become bitter towards the fellowship. Our problems accumulate and we have rejected those who can help us.
Step 7: Loss of control
As we try to handle each problem on our own, they overwhelm us and we finally give up.
As soon as we solve a problem, 2 more pop up. Live becomes a series of crises. We never really solve anything, putting band-aids on deep, gushing cuts, using compulsive activity for relief. Finally, we recognize we're out of control. "If this is recovery, who needs it?"
Step 8: Addictive thinking
Now our addict defense mechanisms come back in full force. Our disease convinces us that recovery isn't working and it's not what we want. We feel miserable and feel no one in the fellowship can understand or help. "I just want to get away and have a little fun" often leads to old friends. Our obsession is returning as we start to fantasize about drinking/using. We may start to think people at meetings are against us, don't understand us, or maybe I'm not an addict after all. We may think that outside issues in our lives like marriage, job or zip code were the problem, not the drug. We might think that some kinds of drugs are bad but we can have control of others.
Step 9: High-risk situations
By this step our emotional state is in such turmoil and our thinking is so distorted that we disregard all our emotional tools and suggestions. We put ourselves in high-risk situations, convinced we're not going to use. Our insanity has reached a point that we find it perfectly justifiable doing things that will bring about the triggers (of which we have no mental defense) to drink/use.
Step 10: RELAPSE
Having returned to our old ways of thinking, feeling, attitudes and behaving, we have a physical relapse. Collapse, commit suicide or use, that's our choice.
Step 11: Aftermath of relapse
At this point, we either follow 1 of 2 paths: have a low consequence relapse and reach out for help OR remain in active addiction. Some are stuck in such guilt and shame that they cannot reach out for help. Most of us on the second path develop progressive health and life problems and commit suicide, or die from drug related medical complications, accidents or violence.
Some thoughts on relapse:
Long-term sobriety depends on helping others. In relapse mode, we think only of what we can "get" from recovery, not what we can give.
If the AA Promises haven't come true, there's still work to be done. Half measures availed us nothing.
By the time someone is in full-on relapse mode, they probably won't listen even if you try to tell them. If you do try, prepare to bleed. In their cups, the relapsemoder is like dealing with a defiant teenager.
Even a novice knows what a "dry drunk" looks like. This is relapse mode (or spiritual sickness).
One factor in relapse that is seldom discussed is when a person is dual diagnosis and decides to stop taking their medication/cease treating their mental disorder. This is a relapse in itself, a relapse to insanity. I'm waiting for the day someone I know with a serious organic brain disorder is able to "go off my meds" and live a carefree life, but I've never seen it happen. I wrote 2 previous blogs on this subject.
Sometimes people will suddenly decide to abandon recovery for born-again religion (which many of us have already tried and it didn't get or keep us sober). Others will meet a person who tells them they don't need "those meetings" and the recovering individual will make that person their higher power. We might start doing things that "block us from the sunlight of the spirit" as my old friend James used to say. He died of this disease after a protracted bout of relapse mode and was one of the people I respected the most (in recovery and life in general).
I am by no means the poster boy for recovery. I have experienced relapse mode. Fortunately, I have never had the experience of relapse. Whenever I meet someone who has come back from one, I listen to them, hoping to avoid doing what they did. I hear a common thread, and it looks like the 11 steps above. At 10 years of sobriety, I believed I'd outgrown AA. The resulting insanity took me as far as step 7. I hope I never get any bright ideas like that again.
On my best days, I think about how I can help another person stay sober. I'm a friend among friends, a worker among workers. I'm completely free and usefully whole.
Relapse isn't an event, it's a process. There are three basic stages of relapse: emotional relapse, mental relapse and physical relapse. Broken down, there are 11 stages:
Step 1: Unhealthy emotions
Recovery is not as important as it once was. We hit a problem that we are unwilling and/or unable to cope with emotionally. We return to insane, addictive thinking. We know there's a problem but can't identify what it is because we cannot identify our emotions and lack ways of processing them.
Step 2: Denial
We don't need help from others in the fellowship. Everything is OK. There's no problem. Suuuure. We start processing our thoughts the same way we did when we were doing drugs. We convinced ourselves everything was OK then, we do it now. "I'm not on drugs so everything is fine". We discard our tools (like openly and honestly sharing our feelings) and don't use recovery to get us back on track. The result is, we begin to distance ourselves from our support system, the quality of our recovery deteriorates and we become increasingly more confused and angry. At this stage, our focus moves from outward to inward.
Step 3: Compulsive behaviors
Why use recovery to cope with problems when we have food, workaholism, overeating, over-dieting or overexercising? I'm sure NONE of us in recovery have ever used sex or addictive relationships to deny our feelings, right? We know we don't want to drink or use again but are not using the tools of recovery to solve our problems. We may become overbearing in friendships or recovery, in an effort to feel like we're still "strong" and have done something worthwhile.
**A sure sign of emotional relapse is acting differently on the outside from what we feel on the inside. Honesty is one simple criterion that will help us maintain our recovery. In abandoning recovery and using compulsivity to cope, we are doing what comes naturally to us, in effect. using drugs to solve our problems. Seeking the "orgasm that rocked New York" may feel good, but it won't get rid of the stress. We feel good now, we hurt later. This is the hallmark of all addictive behavior.
Step 4: Triggers
Something happens to trigger us. It doesn't have to be big, just something that's an old trigger. If we're solid in our recovery, we use recovery tools to handle them. If we aren't...see step 5.
Step 5: Interior chaos
We get triggered, then erratic emotions take control of our thinking. Our mental patterns become insane and distorted again. When emotion takes control of intellect, we abandon everything we know and start trying to feel good at all costs. Relapse almost always grows from the inside out. It isn't the trigger, it's the way we react to it. At this stage, we have probably abandoned our recovery support system. It's not our external problems that make us drink or use again, it's our inability to cope with our emotions and distorted thinking.
Step 6: Exterior turmoil
We can stay in a state of mental relapse for some time, convinced there are no problems. We haven't picked up drugs or booze so we convince ourselves there's nothing to worry about, yet by this point we know there's something wrong with our state of mind. We keep it a secret out of pride and shame. We start having arguments with family members and co-workers. We become bitter towards the fellowship. Our problems accumulate and we have rejected those who can help us.
Step 7: Loss of control
As we try to handle each problem on our own, they overwhelm us and we finally give up.
As soon as we solve a problem, 2 more pop up. Live becomes a series of crises. We never really solve anything, putting band-aids on deep, gushing cuts, using compulsive activity for relief. Finally, we recognize we're out of control. "If this is recovery, who needs it?"
Step 8: Addictive thinking
Now our addict defense mechanisms come back in full force. Our disease convinces us that recovery isn't working and it's not what we want. We feel miserable and feel no one in the fellowship can understand or help. "I just want to get away and have a little fun" often leads to old friends. Our obsession is returning as we start to fantasize about drinking/using. We may start to think people at meetings are against us, don't understand us, or maybe I'm not an addict after all. We may think that outside issues in our lives like marriage, job or zip code were the problem, not the drug. We might think that some kinds of drugs are bad but we can have control of others.
Step 9: High-risk situations
By this step our emotional state is in such turmoil and our thinking is so distorted that we disregard all our emotional tools and suggestions. We put ourselves in high-risk situations, convinced we're not going to use. Our insanity has reached a point that we find it perfectly justifiable doing things that will bring about the triggers (of which we have no mental defense) to drink/use.
Step 10: RELAPSE
Having returned to our old ways of thinking, feeling, attitudes and behaving, we have a physical relapse. Collapse, commit suicide or use, that's our choice.
Step 11: Aftermath of relapse
At this point, we either follow 1 of 2 paths: have a low consequence relapse and reach out for help OR remain in active addiction. Some are stuck in such guilt and shame that they cannot reach out for help. Most of us on the second path develop progressive health and life problems and commit suicide, or die from drug related medical complications, accidents or violence.
Some thoughts on relapse:
Long-term sobriety depends on helping others. In relapse mode, we think only of what we can "get" from recovery, not what we can give.
If the AA Promises haven't come true, there's still work to be done. Half measures availed us nothing.
By the time someone is in full-on relapse mode, they probably won't listen even if you try to tell them. If you do try, prepare to bleed. In their cups, the relapsemoder is like dealing with a defiant teenager.
Even a novice knows what a "dry drunk" looks like. This is relapse mode (or spiritual sickness).
One factor in relapse that is seldom discussed is when a person is dual diagnosis and decides to stop taking their medication/cease treating their mental disorder. This is a relapse in itself, a relapse to insanity. I'm waiting for the day someone I know with a serious organic brain disorder is able to "go off my meds" and live a carefree life, but I've never seen it happen. I wrote 2 previous blogs on this subject.
Sometimes people will suddenly decide to abandon recovery for born-again religion (which many of us have already tried and it didn't get or keep us sober). Others will meet a person who tells them they don't need "those meetings" and the recovering individual will make that person their higher power. We might start doing things that "block us from the sunlight of the spirit" as my old friend James used to say. He died of this disease after a protracted bout of relapse mode and was one of the people I respected the most (in recovery and life in general).
I am by no means the poster boy for recovery. I have experienced relapse mode. Fortunately, I have never had the experience of relapse. Whenever I meet someone who has come back from one, I listen to them, hoping to avoid doing what they did. I hear a common thread, and it looks like the 11 steps above. At 10 years of sobriety, I believed I'd outgrown AA. The resulting insanity took me as far as step 7. I hope I never get any bright ideas like that again.
On my best days, I think about how I can help another person stay sober. I'm a friend among friends, a worker among workers. I'm completely free and usefully whole.
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