Recovery, relapses and preventing relapses.
Recovery does not mean everything is over – it is an ongoing process.
Accepting help and going on the journey to help oneself, to recover, is only just the beginning. The emotions and experiences do not just end by accepting that there is a problem, although it is a big positive step in the right direction.
As those in recovery know, a relapse is never out of the realm of possibility, no matter how long it has been. As such, it is vital to have a plan for how to avoid relapse and what to do if it does happen. It is important to remember that relapse is a process, not a spur of the moment event, and does not automatically make someone a failure.
In order to understand relapse prevention, we have to understand the stages of relapse. Relapse can start weeks or even months before the event of significant relapsing. Gorski & Miller (1986) first described the stages of relapse. Typically, it is a three-part process, including:
- Emotional relapse – Relapse prevention at this stage means recognising that you are changing your behaviour, isolating yourself and reminding yourself to ask for help. Recognise that you are anxious and practice relaxation techniques. Recognise that habits are slipping and practice self-care e.g. healthy eating, exercising, mindfulness, managing time effectively and praying on time.
Not changing our behaviour at this stage and living too long in the stage of emotional relapse makes a person exhausted, and when you are exhausted, you will want to escape, which will move you into mental relapse.
- Mental relapse – In mental relapse there is a war going on in your mind. Part of you wants to regress, but part of you does not. In the early phase of mental relapse, you are just idly thinking about going back to how it was before recovery. However, in the later phase, you are definitely thinking and it gets harder to make the right choices as the pull of addiction/negative thoughts/unhealthy coping mechanisms gets stronger.
Remind yourself of the negative consequences you have already suffered, and the potential consequences that lie around the corner if you relapse again.
- Physical relapse – Once you start thinking about relapse, if you do not use some of the self-care / self-monitoring techniques, it does not take long to go from there to physical relapse.
A relapse prevention plan is a vital tool for anyone in recovery. Having a plan helps us to recognise our own personal behaviours that may point to relapse in the future. It also outlines ways to combat those behaviours and get back on track.
Relapse plans can be verbalised but most often, a relapse prevention plan is a written document (in order to have a clearer outline of what steps to take should a relapse seem to be a possibility) a person creates with their treatment team and shares with their support system. The more detailed the plan is, the more likely it will be to get back on track quickly. The plan offers a course of action for responding to triggers and cravings.
With a relapse prevention plan, it is possible to acknowledge and act upon certain feelings and events, in turn avoiding a physical relapse (which is the stage when someone returns to the behaviour (e.g. self-harming, substance use).
Regardless, it is important to consider the following items when creating a relapse prevention plan.
- Assess Your History
A few questions to ask when creating a relapse prevention plan include:
Was there a certain time you were more prone to indulging in unhealthy behaviours?
Did specific people factor into those times?
What thought patterns make you more likely to behave that way?
Why did you relapse before?
Determining what caused a prior relapse is vital in avoiding them in the future.
- Determine Any Signs That Could Lead to Relapse
Try to brainstorm a list of scenarios that could lead to potential relapse and list the warning signs of relapse.
Some people begin to feel, think or behave differently when a relapse is brewing.
Creating a list of warning signs can give a person more insight into their relapse. Sharing the list with the treatment team can provide them with needed information to prevent relapse in the patient.
- Establish an Action Plan
Create a relapse prevention action plan for what to do instead of turning to unhealthy behaviours.
For example, going through a breakup could lead to a relapse, think of other outlets for your pain and frustration. Instead of drinking or using or self-harming, plan to attend a support meeting, visit to health services or call a family member/close friend right away.
The more specific the action plan is, the better, as this means you will be less likely to come within close reach of a relapse.
Every day of our lives can be a step in the right direction, another opportunity to be better. It is important to reflect and start processing the emotions that led to relapse so that it does not happen again. Learning how to make a relapse prevention plan and going through the process of creating a relapse prevention plan could be the difference between longer periods of ‘recovery’ and repeated relapse.
May Allah grant shifaa (healing) for every ailment, our distress less hard to cope with and recovery become easier, Ameen.