Preventing Relapse: High Risk Situations and Healthy Thinking


For counselors who work in the chemical dependency field, few things are as demoralizing and discouraging as learning of a patient who has relapsed back into active addiction. For this reason, much work has been done to develop methods to prevent such a relapse. We hope to expose what makes us vulnerable to such a devastating reversion, and to make the appropriate adjustments in our approach to sobriety that will help us forestall this painful event.

Fortunately, we can take advantage of a relapse to learn of a weakness in our sobriety that we had overlooked. For example, some people seem to expect that treatment for an alcohol or drug addiction will magically make them sober. All they have to do is attend treatment sessions and it will automatically happen. If only it were so easy, but treatment requires much more than attendance. Unless the suggestions for getting sober are implemented, they will be worthless.

Other people come for treatment and want to get sober and still get high at the same time. They want to learn how to minimize the negative consequences of their using while continuing to use. They do not realize that getting sober and getting high are incompatible. For this reason, they really are not prepared for treatment.

We will review some of the most common approaches to preventing relapses, which do work for those of us who employ them diligently. We also want to address the difficulties we may have about spirituality, because deficiencies in this area often affect our ability to stay sober despite temptations. We want to learn how to benefit from our inclinations to get high, so that we can convert this energy and use it constructively. And if we are successful, then we may be able to pass what we have learned on to others who want it.

Reconstructing The Sequence

After a relapse, we can only learn how it happened by going back through it to uncover the weak link in our sobriety. We may have been caught off guard, and we will need to develop a new approach to the problems that used to trigger our use. In other words, getting high to avoid discomfort is no longer a viable option because it gets us in more trouble than it’s worth. Sobriety entails a radical readjustment to our whole personality.

Relapses tend to occur when we have an intense emotional experience, we engage in defective reasoning about it, and then we act impulsively. In other words, we are blindsided by a very strong feeling, either positive or negative, then we rationalize or justify it, and since the feeling overwhelms us, we revert to getting high in order to soothe our disturbance.

List of High Risk Situations

Here is a list of situations which sometimes lead to relapse. Consider each situation in terms of its likelihood to trigger a strong urge to get high. Note the ones that could apply to you.

When you are criticized

After an argument or fight with a spouse, lover, boss, etc.

Losing or winning a competition, being envious

When jealous in a love affair

After losing a job or having a financial setback

Right after being hired for a job or promoted

After a rejection

If someone were to offer or urge you to drink or use a drug

When everyone around you is drinking or using, such as at a dance, party, concert, ballgame, etc.

After getting great news and wanting to celebrate

If you unexpectedly found a bottle or stash you forgot you had hid or left in the house

If you began hanging out in a bar or other place in which you used to drink or use

After getting news that a friend or relative had just died

When on vacation

On payday

To deal with physical pain or injury

When feeling lonely, depressed or bored

When feeling anxious, tense or nervous

When wanting to feel more self-confident

When feeling discouraged or frustrated

Some of us remain vulnerable to getting high because we have not yet planned how we will deal with situations that are very risky for us. In this case, we can rehearse how to deal with them in advance, so that we are not caught by surprise and we are confident in our ability to cope with them.

Dealing With Intense Emotions

Very strong feelings may precipitate a relapse. We need to find better ways to cope with them than to get high. These tools will include learning how to adapt these feelings for our benefit and improving our thought processes so that we can interpret these feelings in a healthy way.

Some of the most common intense emotions that we may experience in recovery are resentments, falling in love, envy, jealousy, anger, boredom, and elation. These are all natural feelings that could occur to anyone. Those of us who are healthy can use such emotions to guide our behavior in a constructive manner.

Those of us, however, who are inclined toward addictions will prefer to exploit intense feelings as a reason or justification for getting high. It is as if our thinking gets hijacked to support our addictive tendencies. Fortunately, our inner Addict is not the only side of our personality that seeks to influence us. In recovery, we have awakened the Healthy Self in us, who shows us a constructive way to interpret our feelings and the stinkin’ thinkin’ that our emotions may stimulate.

Stinkin' Thinkin' VS. Healthy Thoughts

Everybody does it!

In fact the vast majority of people do not get high, only most of the people we associate with do it.

It's harmless!

In fact it leads to big trouble.

You'll feel much better!

Actually it's not such a great experience anymore. And when it wears off, we feel dreadful.

Just take one!

One doesn't satisfy, we always want more.

You need it!

We really need something better than getting high, we need inner harmony, deep intimacy with other people, and a sense of contact with our spiritual Source.

You deserve it!

We do deserve something, but it's not getting high. We deserve to respect ourselves and to be respected.

You can handle it!

We can use our hands to take the drink or drug, but we can't handle the consequences.

Who will know?

Living a double life takes tremendous effort and it divides us from our own true desires.

Even though the inner Addict doesn't give a damn about the aftereffects, we can still choose to listen to the healing and positive message of the Healthy Self in us.

Next week: Emergency Kit For Sobriety

Richard G. Hartnett, MA, MS, LCADC is a former Jesuit priest who now lives with his wife, Kathy, by a lake in northwestern New Jersey. He has served as the chaplain at Hazelden New York, pastoral counselor at the Chemical Dependency Department of the International Center for the Disabled in NYC, and continuing care counselor at the outpatient Chemical Dependency Program of High Focus Centers in New Jersey. Currently he maintains a private practice in New Jersey. He is the author of The Presence at the Center, Renewing Your Fourth Step, The Three Inner Voices: Uncovering the Spiritual Roots of Addiction and Recovery, and Sobriety and Inspiration: Entrusting Ourselves to the Source of Our Healing and Creativity.

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