The Stages of Relapse

The key to relapse prevention is understanding that relapses are not an event but rather a process. They happen gradually, and the process begins days, weeks, or even months before a person returns to substance use. The goal of treatment is to help people identify their personal warning signs and develop coping skills to prevent relapse early in the process.

Everyone will have their own personal warning signs, but essentially most people return to old ways of thinking and behaviors that aren’t healthy. This eventually leads to a domino effect of unhelpful behaviors that are a precursor to relapse.

The process involves three stages an individual progresses through, usually subconsciously.

An emotional relapse is a state of ignorance, complacency, or overconfidence. People pull away from their support and neglect their self-care/recovery rituals. This leads to a mental relapse, characterized by the need for excitement, due to unmet needs. Finally, a physical relapse is the act of returning to substance use.

Emotional Relapse

During an emotional relapse, people do not consider the fact they are making themselves increasingly vulnerable. In fact, many people feel great! The pink cloud syndrome refers to the euphoria one feels when breaking free from addiction. In this time, many believe they will never return to their old lifestyle. It’s all in the past. To believe that the problem is all in the past removes any need to continue recovery work.

When we hear someone has relapsed, we typically wonder what went wrong. Did they experience conflict with their partner, stress at work or did something upset them? However, many men struggle with positive emotions before relapsing.

This feeling of euphoria causes complacency. They feel so great, they are confident they’ll never return to the way things used to be.

During an emotional relapse, people pull away emotionally or even physically from programming. They may miss meetings or attend meetings and not share. Others may attend but only focus on other people’s problems. This allows someone to continue their program without emotional commitment.

Other people may become compulsive with their recovery and neglect other areas of their life. For example, to cut out all negative influences but fail to establish new healthy connections.

Focusing only on sobriety and not making other changes never works in the long run. Just like a diet aims to change your lifestyle, it isn’t enough to just cut out certain foods, you also need to exercise.

The common denominator in an emotional relapse is a person’s needs not being met. Their recovery rituals and self-care fall to the side because they fail to see a need to maintain them. In their minds, they have everything under control.

A newly sober person is usually open to feedback and quite invested in learning new skills. When someone has emotionally relapsed, the opposite happens.

This sense of complacency removes any need to plan constructively for the future. Individuals may speak of very vague goals such as “I’d like to get a job”, which is based on wishful thinking rather than actionable steps.

After a relapse, many can retrace their steps, identifying exactly where their recovery went off track. The chain of events typically starts with a seemingly irrelevant decision. This decision, at the time, appeared unimportant, so it wasn’t given much thought. Looking back, we can see the impact it had on pushing us in the wrong direction. These seemingly irrelevant decisions can include not following through with setting boundaries, neglecting self-care, or assuming relapses will never happen. 

Ultimately, decisions like these lead to high-risk situations. One must be self-aware and assess every situation that requires a decision carefully. Think about the possible outcomes and always select the option that puts you at the lowest risk.

Mental Relapse

During a mental relapse, part of them is beginning to want to use or drink, but a part of them doesn’t. Due to unmet needs, they experience more cravings and thoughts of ways to better control their use. They may start to make deals with themselves and even look for opportunities to relapse.

Reflection Question:   What are some ways people make deals with themselves before a relapse?

During a mental relapse, there is a focus on avoidance. People avoid conflict and responsibility at all costs and allow important things to slide. They stop answering their phone and pull back from the world.

A clue that someone has mentally relapsed could be seen in how they start their day. Mornings become challenging due to a lack of motivation. The person has become bored and places blame externally rather than looking inside themselves.

Some pursue money or new relationships, hoping it will calm the inner tension. Ultimately, this is a common way for people to subconsciously sabotage their sobriety because it is not what they actually need, healthy connection and support.

Those who are mentally relapsing are also especially vulnerable to sudden triggers, the ones that appear to come out of nowhere. This could mean a direct opportunity to relapse presents itself or the person experiences a very triggering circumstance, whether it’s a person, place or thing.

At this point, the individual has already been tolerating negative emotions for quite some time. The mind’s focus is on instant gratification.

Some revert to old behaviors: attention seeking, risk-taking, and cross addictions, which never really provide satisfaction. The domino effect continues until the person picks up their substance of choice and physically relapses.

Reflection Question:   What are common examples of impulsive behaviors?

Physical Relapse

Finally, physical relapse is when a person starts using again.

When people don’t understand relapse prevention, they think it involves saying no just before they are about to use. But that is the final and most difficult stage to stop, which is why people relapse. If an individual remains in mental relapse long enough without the necessary coping skills, clinical experience has shown they are more likely to turn to drugs or alcohol just to escape their turmoil.

To register for individual or group counselling, please call 204 232 7505.