An essential part of effective treatment/recovery is relapse prevention.
In order to recognize the warning signs of potential relapse, it is necessary to identify internal and external risk factors in your life and develop a healthy and sustainable plan for managing these consistently and well.
A continuum of care is often the strongest safety net that you can build for the first several years of recovery. This includes support that will be easily available any time of day or evening, is very accessible and meets your specific needs.
We know that addiction is an illness that affects us in our entirety, that is, physically, emotionally, mentally and spiritually.
A detailed plan of how to prevent the person from crossing the boundary (middle circle) into the inner circle behavior.
The person needs to make plans for what to do about "boundary behaviors". We have to treat these middle circle behaviors as if they are as important as inner circle behaviors.
Go through the last few acting out times in detail and identify all the middle circle behaviors that led up to the crossing into the inner circle.
Then, with the sponsor, work out realistic plans for what recovery actions to take after doing each of those behaviors.
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Set-up behaviors: Ways of thinking, managing feelings, and behaving that increase the risk of having a relapse
Trigger Events: Events that activate the physiological brain responses associated with craving.
Thought Triggers: Thought triggers arise out of addictive thinking or an addictive mind set.
Feeling Triggers: experiencing feelings or emotions that were normally medicated by sexual acting-out.
Behavioral Triggers:
Situational Triggers: Situational triggers include any stressful relationships
The Craving Cycle: A series of self reinforcing thoughts and behaviors that continue to activate and intensify the craving response.
Obsession: When the obsession is activated, the person has out-of-control thinking about acting-out. Intrusive thoughts invade their mind and they can't turn them off. The obsession quickly turns into a compulsion.
Compulsion: When compulsion is activated the person begins experiencing an overwhelming urge to act-out even though they consciously know that it is dangerous to do so.
Craving: The obsession and compulsion merge into full blown physical craving. Physical craving is marked by a strong desire to use the drug, rapid heart beat, shortness of breath, perspiration.
Seeking Behavior: In an effort to manage the obsession, compulsion, and physical craving, many sex addicts begin to cruse old neighborhoods, flipping TV channels, objectifying women (middle circle behaviors).
Recovery Program: Develop a structured recovery program that puts you in continuous daily contact with other recovering people.
Know Your Triggers: Identify the things that activate the craving and learn how to cope with those triggers.
Know & Avoid your Set-up Behaviors: Know your set-up behaviors and learn how to avoid or cope with those set-up behaviors. If you don't set yourself up for craving, when you do have a craving they will be less severe and last for a shorter length of time.
Dismantle Euphoric Recall: Carefully examine past pleasant memories about cocaine use and search for the hidden negatives in the experience. Most people find that they had no purely positive experiences while using cocaine. There were always hidden negatives.
Stop Magical Thinking: It is also important to stop magical thinking about future use and to stop awfulizing your current sobriety. This will allow you to deal with the physical set-ups and let you know what to do to stop a craving.
Recognize Craving: Addicts must learn how to recognize a craving while it is happening. Many addicts fail to identify mild cravings as problematic and wait until they are in a full blown, severe craving before taking action.
Accept Craving As Normal: Many people experience a craving, panic, and believe there is something wrong with their recovery or that they are condemned to return to cocaine use. This is not true.
Go Somewhere Else: The craving was probably activated by an environmental trigger, so get out of the setting you're in and get into an environment that supports sobriety.
Talk It Through: If you talk it through, you don't have to act it out. Cocaine addicts need to talk about their cravings as soon as they occur to discharge the urge to use.
Aerobic Exercise: This stimulates brain chemistry and reduces the physiology of craving.
Eat a Healthy Meal: Eat a healthy meals in order to nourish the brain. Consume some lean fish or meat for protein and eat some whole wheat bread or baked, potatoes or brown rice for complex carbohydrates. It also helps to take some vitamins and amino acids to help stabilize brain chemistry imbalances.
Meditation and Relaxation: Cravings are worse when a person is under high stress. The more a person can relax, the lower the intensity of the craving.
Distraction: Divert attention from the craving by engaging in other activities that productively distract the person from their feelings.
Remember Cravings Are Time-limited: Most cravings are time limited to two or three hours. If you can use the previous eight steps to get yourself fatigued enough to fall asleep, most people wake up and the craving is gone.
For most people who relapse, the first step is a subtle return of the core self-defeating beliefs that we learned as children. Something shifts inside of us and we no longer feel a sense of self-worth and self-confidence. We no longer feel worthy of living or having good things in sobriety, or we no longer feel capable of doing what we need to do in order to feel good about ourselves.
When our old, dysfunctional beliefs from childhood are reactivated, we begin to have negative feelings. These feelings seem out of place in our newly found recovery. There is a tendency to repress them. We would rather not think about them, so we try to push them from our minds. As a result the pain get worse and we tend to reactivate our irrational, addictive thinking to cope with the pain.
Our addictive logic tells us we must find something, anything that will make the go away. This urge to blot out the pain awakens the echoes of our addictive past.
We begin to remember how good it was when we could medicate with sexual acting-out.
We exaggerate the positive aspects of those memories while minimizing or denying the negatives. We then begin to awfulize our sobriety. We take all the negatives of being sober and exaggerate them, while blocking out all the positives. Then, we begin using magical thinking - the addictive logic goes like this - "acting-out worked so well for us in the past, and since it is so terrible to be sober today, acting-out will somehow be able to magically fix me in the future."
These irrational thoughts begin to mobilize addictive behaviors. We begin looking for something, anything that will make the pain go away.
Since our sober friends are beginning to confront us by telling us that we are in trouble and we need help, we seek out "more supportive friends." We want friends who won't confront us with the fact that we're backsliding into old behaviors. This means we begin surrounding ourselves with two types of people - codependents who won't challenge our self-defeating behavior, and people who are still actively addicted.
Relapse prevention is both proactive and reactive. As a proactive strategy, relapse prevention teaches us the importance of panning our recovery, moving through its various stages, and recognizing when we become stuck and taking corrective action. Reactively, relapse prevention teaches us to recognize the warning signs that show us we are backsliding into previous stages of recovery. We can then take action to manage those warning signs before we return to alcohol and drug use.
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There is a relationship between spirituality and relapse.
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See also: