Relapse

A Relapse

The relapse process is similar knocking over a line of dominoes (the sequence of problems that lead from stable sobriety to relapse).

There are two differences:

Each domino in the line (i.e. each problem that brings us closer to acting-out) gets a little bit bigger and heavier until the last domino in the sequence is large enough to overwhelm us.
The dominoes circle around behind us. So when the last domino falls, it hits us from behind when we're not looking.

We tip over one small domino. No big deal! That domino hits the next, and then the next. A chain reactions gets started. The first dominoes are so small that we can easily convince ourselves that it's no big deal. We look the other way and start doing other things. All of a sudden a huge domino falls on us from behind, crushing us to floor, causing serious pain and injury in the process. We need to make the pain go away and we act-out to medicate the pain.

Solution:

Learn how not to tip over the first domino
Another part of the answer is to develop an emergency plan for stopping the chain reaction quickly, before the dominoes start getting so big and heavy that they become unmanageable

The Relapse Process

http://www.tgorski.com/gorski_articles/understanding_relapse.htm

The progression of problems that lead to relapse is called the relapse process.

Each individual problem in the sequence is called a relapse warning sign.

The entire sequence of problems is called a relapse warning sign list. The situations that we put ourselves in that cause or complicate the problems are caused high risk situations.

Getting Stuck in Recovery

Many of us decide that alcohol or drugs is a problem, stop using, and put together some kind of a recovery plan to help us stay sober. Initially we do fine. At some point, however, we hit a problem that we are unwilling or unable to deal with. We stop dead in our tracks. We are stuck in recovery and don’t know what to do.

Denying that We're Stuck

Instead of recognizing that we're stuck and asking for help, we use denial to convince ourselves that everything is OK. Denial makes it seem like the problem is gone, but it really isn't. The problem is still there. It just goes under ground where we can’t see it. At some level we know that the problem is there, but we keep investing time and energy in denying it. This results in a buildup of pain and stress.

Using Other Compulsions

To cope with this pain and stress, we begin to use other compulsive behaviors We can start overworking, over-eating, dieting, or over-exercising.

These behaviors make us feel good in the short run by distracting us from our problems. But since they do nothing to solve the problem, the stress and pain comes back. We feel good now, but we hurt latter. This is a hallmark of all addictive behaviors.

Experiencing a Trigger Event

Then something happens. It's usually not a big thing. Its something we could normally handle without getting upset. But this time something snaps inside. One person described it this way: "It feels like a trigger fires off in my gut and I go out of control."

Becoming Dysfunctional on the Inside

When the trigger goes off, our stress jumps up, and our emotions take control of of our minds. To stay sober we have to keep intellect over emotion. We have to remember who we are (an addicted person), what we can’t do (act-out sexually), and what we must do (stayed focused upon working a recovery program).

When emotion gets control of the intellect we abandon everything we know, and start trying to feel good now at all costs.

Relapse almost always grows from the inside out. The trigger event makes our pain so severe that we can't function normally. We have difficulty thinking clearly. We swing between emotional overreaction and emotional numbness. We can't remember things. It's impossible to sleep restfully and we get clumsy and start having accidents.

Becoming Dysfunctional on the Outside

At first this internal dysfunction comes and goes. It's annoying, but it's not a real problem so we learn how to ignore it. On some level, we know something is wrong so we keep it a secret. Eventually we get so bad that the problems on the inside create problems on the outside. We start making mistakes at work, creating problems with our friends, families, and coworkers. We start neglecting our recovery programs. And things keep getting worse.

Loosing Control

We handle each problem as it comes along but look at the the growing pattern of problems. We never really solve anything, we just put a band-aides on the deep gushing cuts, put first-aide cream on seriously infected wounds, and tell ourselves the problem is solved. Then we look the other way and try to forget about the problems by getting involved in compulsive activities that will somehow magically fix us.

This approach works for awhile, but eventually things start getting out of control. As soon as we solve one problem, two new ones pop up to replace it. Life becomes one problem after another in an apparently endless sequence of crisis. One person put it like this: "I feel like I'm standing chest deep in a swimming pool trying to hold three beach balls underwater at once. I get the first one down, then the second, but as I reach for the third, the first one pops back up again."

We finally recognize that we're out of control. We get scared and angry. "I'm sober! I'm not acting-out! I'm working a program! Yet I'm out of control. If this is what sobriety is like - who needs it?"

Using Addictive Thinking

Now we go back to using addictive thinking. We begin thinking along these lines: " Sobriety is bad for me, look at how miserable I am. Sober people don’t understand me. Look at how critical they are.

Maybe things would get better if I could talk to some of my old friends. I don’t plan to act-out sexually, I just want to get away from things for awhile and have a little fun. People who supported my acting-out behaviors were my friends. They knew how to have a good time. These new people who want me to stay sober are my enemies. Maybe I was never addicted in the first place. Maybe my problems were caused by something else. I just need to get away from it all for awhile! Then I'll be able to figure it all out."

Going Back To Addictive People, Places, and Things

Now we start going back to addictive people (our old friends), addictive places (our old hangouts), and addictive things (mind polluting compulsive activities). We convince ourselves that we're not going to act-out sexually. We just want to relax.

Acting-out Sexually (Addictive Behavior):

Eventually things get so bad that we come to believe that we only have three choices - collapse, suicide, or self-medication. We can collapse physically or emotionally from the stress of all our problems. We can end it all by committing suicide. Or we medicate the pain by acting-out. If these were your only three choices, which one sounds like the best way out?

At this stage the stress and pain is so bad that it seems reasonable to act-out sexually to make the pain go away.

We're dazed, hurt, and in tremendous pain.

So we reach out for something, anything, that will kill the pain. We start acting-out in the misguided hope it will make our pain go away.

Loosing Control Over Use

Once sex addicts start acting-out, they tend follow one of two paths.

Some have a short term and low consequence relapse. They recognize that they are in serious trouble, see that they are loosing control, and manage to reach out for help and get back into recovery.
Others feel such extreme shame and guilt after acting-out, that they refuse to seek help. They eventually develop progressive health and life problems and either get back into recovery, commit suicide, end up in a mental institution, prison or die from AIDS, accidents, etc.

Major Causes of Relapse

excessive middle circle behaviors
Denial - inability to accept that one is indeed addicted to alcohol and/or drugs and that it is a primary cause of life problems.
Post Acute Withdrawal Syndrome
Dishonesty - the inability to maintain a commitment to rigorous honesty which is the foundation of a life of recovery (e.g. failure to disclose Middle Circle behavior)

What were your feelings prior to acting out?

- work stress

- accountability for poor performance at work

- resentments

- fatigue (up too late)

- dishonesty (did not keep my two beer limit)

- inability to stick to healthy boundaries

- avoiding unpleasant and difficult work

- overwhelmed

- financial stress

- frustration at program

What red flags did you pass up?

- fantasy, obsessive thinking

- middle circle behaviors

- staying up later / sleeping in later

- drinking, overeating

What tools in your recovery did you choose not to use?

- no prayer, no promises to stay sober for just a minute, just an hour, just one day,

- no phone call, no reading

- no prayer

- go to meeting

What have you learned about yourself in this relapse?

Example:

- Need to learn better ways of handing the physical discomfort of withdrawal

What have you learned about your addiction through the relapse?

-my addiction feeds itself by creating unpleasant, seemingly intolerable states (physical and mental) and then the only way out of these states seems to be to to act out.

Fourteen Ways to Avoid a Slip

http://www.sca-recovery.org/lbb/Avoid.html

A slip is the most painful thing that can happen to an SCA member, yet it is the most natural thing in the world for a sexual compulsive to seek instant gratification. Our disease is cunning, baffling and insidious, and is always seeking out new ways to trick us into submission.

Predispositions to a Slip

There is a "predisposition" to a slip that we can't always recognize, though sometimes it can be sensed by others. It might include being irritable, depressed, unconnected. And we slyly work this predisposition up. In fact, when we have a slip, it is almost always because we talk ourselves into it. Therefore, what we need to do is learn to break deep-rooted habit patterns.

Here are some of the times when our defenses may be weak:

When things go badly
When things go well
When we visit our families
When we come back from visiting our families
When we're avoiding making decisions
When we feel overwhelmed by things -- sometimes even the program itself
When we're in a relationship.
When we're not in a relationship.
When our sexual recovery plan isn't working properly for us.
When we're being Secretive, or are involved in anything Abusive (to ourselves or others), or are out of touch with our Feelings, or are feeling Empty (SAFE).
When we're Hungry, Angry, Lonely, Tired (HALT).

Danger Signals to Watch For

Sexual compulsion is a thinking disease and easily gains complete control of our mental processes. It has a way of persuading us that we want to act out even when we don't. Therefore we have to learn to be as alert and cunning as the disease is. Each of the following danger signals will not apply to every member, but we should all be able to identify with some of them:

Compulsive staring
Compulsive watching of TV or movies
Compulsive shopping, eating, doing crossword puzzles, etc.
Cutting off communication and starting to isolate
Letting go of the spiritual side of things
Abandoning ourselves, walking out on ourselves
Cutting down on meetings
Indulging in Stinking Thinking
Letting our self-image slip. We begin to reinforce behavior that will consistently pull us down. We abandon healthy disciplines: we don't shave or brush our teeth, don't do our exercises, don't make our phone calls, don't clean our homes.
Beginning to lie - to ourselves and other people. We have a lot of secrets, including irrelevant, unimportant ones. We don't want to come out of the shadowy world into the real one, so we need to maintain the "unreal" aspect of it in every way we can.
Looking for escapes from various areas of our lives.
Wanting a cigarette or a drink

The Number One Offender

Paraphrasing AA literature, we can say that resentment is the number one offender. It destroys more sexual compulsives than anything else. Because what better way do we know to "get even" than by acting out? It begins to seem a solution, a weapon, a means of revenge. A way to make people see how they've hurt us.

Consciously or unconsciously, we seek out reasons to justify a slip. "Our life is turning sour." "Nobody understands us." "Nothing is going right."

We feel lonely and hurt, and begin wanting to get back at people: the man in the street who bumped into us, our bosses, our lovers, our parents, ourselves. Even God. (After all, God is responsible for our feeling so hurt and disappointed, right? Then God should be hurt and disappointed, too.)

Our anger feels righteous, and we cling to it. Nothing is going to make us give it away. And when we note the beginning symptoms of sexual compulsion, they only make us angrier.

We start blowing up at people. Or else we suppress the anger, imploding instead of exploding. On the outside we may appear quite calm and reasonable while inside we're simmering with pain and resentment.

Instead of finding ways to heal the situations that are causing the distress, we feed on our resentment in a continuing downward spiral. We secretly don't want to mollify the anger, because it does for our compulsion what lighter fluid does for a campfire. Gradually all the good things about our life lose meaning for us, opening wider and wider the path for sexual compulsion to come raging in, unchallenged.

The Start of the Slip

The process begins to intensify. A mysterious force seems to be taking us over, and we become fascinated by it, slowly letting go of healthy disciplines and slipping into an almost hypnotic state. These are some of the "rituals" we may indulge in that subtly undermine our healthy thinking:

We begin to masturbate compulsively.
We go out without underwear.
We wander around inappropriate neighborhoods.
We miss meetings we planned to attend.
We avoid SCA contacts.
The thought of going to a meeting seems threatening: it's the last thing we want to do.
We begin dwelling on past adventures.
We try on our "acting-out" clothes.
We begin brooding over pornography.
We start rationalizing the slip. "I'm getting older." "Married people have sex all the time." "I've had a miserable week."
We don't want to make a phone call. We don't want to give the slip away or have anybody taking it from us.
We're full of denial. We tell ourselves that we're not really sexual compulsives at all: everybody does these things, it's perfectly normal to go out and have a good time.
Or we have thoughts like, "I'm not like all those other people in SCA, they could never understand me and my needs. It's my private thing and I have the right to it."
SCA begins to seem the enemy. "They're all so self-righteous." "It may be good for them but not for me." "They're conning themselves."
We tell ourselves we're only going out to have a look. Or that we'll only act out this one time, tonight, and go back to SCA tomorrow.

All of a sudden we seem to be on automatic drive. Our feet start taking us to places we didn't mean to go. There's still a chance to pull ourselves out of the slip. But that feels like the last thing we want to do.

How to Get Out of a Slip

We have to become willing to tolerate the discomfort of a frustrated impulse -- an incredibly difficult thing to do. Because not acting out is like developing a new muscle. It feels there's something wrong, we're being brainwashed, we're making a terrible mistake.

Ironically, many of us sexual compulsives seem on the surface to be easygoing and flexible people. But when it comes to changing our minds about acting out, it would appear no force on earth can stop us. Here are some practical steps designed to break through the sexual compulsive's "whim of steel."

Pick up the phone. Don't tell yourself people don't want to be bothered: phone calls are one of the ways we all stay sober. SCA is a selfish program, and everything we do in it -- including getting phone calls -- is for our own sobriety. Try calling somebody with a lot of sobriety. In times of danger it's more important than ever to "stick with the winners."
Get to a meeting. Drag the body, even if you don't want to -- especially if you don't want to. Don't talk about it, just do it. Even if you feel you'll die if you don't act out. You need to "bring the body" when the mind doesn't want you to get better. Go to meetings, even when there is something "more important" or more exciting or more fun you want to do. Very subtly your value system will get healed.
Take the First Step. Repeat the words "We admitted we were powerless over sexual compulsion -- that our lives had become unmanageable," until the meaning begins to sink in. If we really accept that we have no power over our compulsion, we will be able to turn it over -- to our Higher Power, to our sponsor, to the program.
Get an interim sponsor. It doesn't have to be a permanent marriage. Tell someone you're in trouble and need help. All you have to do is ask for it.
Read SCA literature. It can tide you over till you're able to make contact with another member. It also deepens your knowledge of the program, and no matter how often you read it, there's always something surprising to learn.
Read over your sexual recovery plan. Remembering our goals helps us lose the craving to go back to the anguish and confusion we are beginning to ease out of.
Postpone the slip. Remind yourself you can have it later but you'll talk to someone first.
Pray. Pray for help from your Higher Power -- as you understand it or don't understand it. Particularly effective is the Serenity Prayer: "God, grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference." In emergency situations some of us use it as a mantra, saying it over and over till the crisis passes.
Break the habit pattern. We can't get sober in a vacuum. We can't simply stop destructive behavior. We have to replace it with healthy new activities. Often we have to be as compulsive for a time about sobriety as we were about acting out. Try taking creative actions you've never taken before. Prove to yourself you're capable of a healthy action by taking it.
90 meetings in 90 days. A sure-fire way to learn the true meaning of "First Things First." Making a meeting every day no matter what is a foolproof way to discipline deep habits of "giving in" and self-indulgence -- habits so deep they seem our true selves rather than the voice of our illness.
Deep breathing. If you feel a panic attack coming on, try taking slow deep breaths until sanity begins to return. Try other healing physical activities like soaking in a hot bath or looking in a mirror and saying "I love you".
Become willing. Open your mind to the possibility of giving up the slip, rather than giving in to it. It will feel that there's no way you can break the power of your own will. There is. But it can only be done by taking a positive action. Willingness is action. Remember: There is hope, there is a future.
Think the slip through. Ask yourself, Will you really get what you want if you go through with this? Don't dwell on how exciting it's going to be, but remind yourself of the misery that inevitably has to follow.
Accept that you are a Sexual Compulsive. Don't blame yourself for wanting a slip. But don't give in to it, either.

Most of us sexual compulsives have a profound fear of commitment of any kind, because the disease in us is so threatened by it. Little by little, by going to meetings and working the program, we accept the idea that "I Am Responsible" -- first for small things like getting chairs arranged or put away. Then for holding office. Then for carrying the message to others. And then -- slowly, subtly, and usually without our knowing how it happened -- we discover that for the first time we are taking responsibility for our own lives.

What to Do If You've Had a Slip

The Responsibility of the Slip. It isn't the end of the world. The slip may have been the very thing we needed to finally let go. But we have to accept responsibility for it. The slip didn't happen to somebody else. It wasn't anybody else's fault. We allowed it to happen because we weren't working our program properly. And now we can change that.

The first thing to recognize is that the disease wants us to feel guilty and miserable. That way we have little choice but to continue acting out -- to numb the pain of our own self-hate. We have to short-circuit the tendency to isolate from the very people who can help us.

When any of us has a slip, we have it for all of us. And when we recover from the slip, we recover for all of us. The way to work our way out of the agony is to share it, to reconnect with the program in as many ways as possible. And deeper than before.

Get to a telephone as quickly as you can and tell somebody what happened. The worst thing you can do is hold it in, and let shame and isolation build up to set you off on another slip.

Get to a meeting. Talk about the slip, knowing that your pain will be shared by people who can help you. Trust the program and the people in it. We've all suffered the pangs of sexual compulsion or we wouldn't be here. We're not in SCA to judge each other, only to help each other get well.

The Lesson of the Slip. Every slip has a painful but priceless lesson to teach us. We need to review our program and review our lives to see what we were doing wrong. Then we have to make sure we don't make the same mistake again. We can ask ourselves questions like:

Do I have a sponsor?
Am I using him or her properly?
Am I working the steps?
Am I connected to the fellowship -- going to meetings, doing service, going out with the group for coffee after meetings?
Do I call people every day?
Is my sexual recovery plan too severe, too vague, too flexible?
Am I moving ahead with my life?
Am I making any effort to integrate sex into my life as a healthy element?

Compulsive sex is a cleverly wrapped package that, when we open it, always turns out to be full of disillusion and pain. By recognizing the tremendous power of the disease in us, we can surrender to the even greater power of SCA's first step. And that can be the beginning of a richer, deeper sobriety than we ever dreamed possible

A habit of turning away from a relapse even before the addictive craving kicks in. Identify your part in the slippery situation and take responsibility for using the program’s tools to address it.