Relapse is a Behavior
Relapse is a behavior. What I mean by behavior, is a cycle of thinking, feeling, and action. It is not an event, it is a process. As in all processes, as long as you are in the process, you have not validated the self-defeating perspectives of, “I can’t,” “It is, ” “I’ll never,” - you are in the process of change.
I often explain to my clients’, “Since change is a process and relapse is an outcome to a behavior, as long as you are in the process you have not relapsed. As long as you are in the process, as long as you do not validate self-defeating thoughts, allow yourself to feel threaten, and then remove yourself from the process, you are indeed changing.”
WHERE THE MIND GOES THE BODY FOLLOWS
No one can count to ten in their mind and at the exact same time verbalize the ABCs. What you think you feel, what you think and feel, you act. Action is the outward, objective display of what is thought and felt. I have never seen a bottle, jump off a shelf, pour itself down a throat. What I have seen is people validate the thoughts of wanting, need of a drink or drug, choose to reach out and consume a drug of choice.
It is indeed impossible to validate two cognitive processes at the same time. Just as we select our feelings, we select our thoughts. For example, as you sit, you are in the behavior of sitting, as a result of your validated thoughts. While sitting, it is impossible to stand at the exact same time. In order to stand, you have to shift your thoughts, shift your validation, feeling, and take action. The point is, we all validate, pay attention to what we think. There is a skill involved here.
Recently I had a client who was addicted to the narcotics to the pain medication he was prescribed through a Pain Management Center. In the course of helping this person with his emotional competence and social skills, I discovered he was not only snorting his pain medication, he was also smoking it. In the course of helping this individual, my goal for him was to separate his addiction mind-set from his pain. His pain, or rather his expression of his pain served a compensatory nature, for as long as he presented in physical distress, his drug was prescribed. For this individual, relapse prevention was an issue.
A DRUG IS A DRUG, IS A DRUG
How do you discover the skills necessary to live well, when in pain? With this in mind, the answer was obvious. When addicted to narcotics, you cannot consume narcotics for pain. When you take a drug to get well, that is one mind-set, but when you take a drug to get high, that is another mind-set, the addiction mind-set. In the end, this client learned the skills not to validate his pain as a debilitating event, rather to validate his pain as a trigger to his mind-set that something was wrong, and work with that wrong and not be a victim to it. In other words, this person learned to use his pain as a sign that he was surrendering control to his mind-set. No one like to be control, and as such he worked hard to be in control rather than controlled. Such a mind-set is necessary for relapse prevention and lasting change.
ABSTINENCE VIOLATION EFFECT
As a behavior, relapse occurs on two levels. The first level is what Alan Marlatt out of the University of Washington called the Abstinence Violation Effect (Marlatt, G.A., Gilford Press, 1985). In effect, abstinence is the behavior that results in the consequence of not doing something. When it comes to abstaining from alcohol and drug abuse, domestic abuse it’s abusive power AND control, and loss of anger (so to speak), each of these behaviors is susceptible to the Abstinence Violation Effect. Incrementally and within this effect, the involved loses his or her power OF control over their impressions, frustration, and impulse’s and, in effect, surrenders to: “F*$K it; I am a loser anyway, so I might as well do what I know,” drug, hence relapse.
When a person is in the throws of his or her abusive behavior, when he or she lacks the self-efficacy, the ability to cope with conflict and its stress, what happens is the person actually surrenders control. This is a big problem in the world of addictions, for the simple reason no one feels comfort when experiencing lost control and so desperately seeks control (the insidiousness of addictedness). In such a case, anchored, or what I refer to as “validated” perspectives of self-defeat (e.g., I can’t, It is, I’ll never), the involved is motivated to abuse not use through his or her irrational perspective of establishing control. More now so than ever, as instigated by his or her fictional mysticisms of guilt and same, he or she is motivated for greater abuse.
SEEMING UNIMPORTANT DECISIONS THAT LEAD TO ERROR
The second level of relapse also comes from Dr. Marlatt. This level is referred to as Seeming Unimportant Decisions that Lead to Error. For the individual involved in abstinence, one can always find the proverbial straw that breaks the abstainers back.