Conversations about relapse:

From a forum discussion:

“Yesterday I made another mistake….

I’ve stopped drinking inumerable times over the course of the past four years...have not gotten beyond three to four months….

When I don’t drink things eventually do seem to improve to some degree… after several weeks I felt great, confident, even happy at times, certain that I had it licked....not so.

I have a problem with honesty, with developing the fortitude that it takes. I do try. I do want to be a sober person.

I figured that I have not only a cellular addiction to alcohol, but other things going on. Presumably we all have.

I am posting this for no other reason than I need to. For me it’s a matter of life and death. For others it may be a jump start, for me I have no where else to go.”

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Lapses usually relate to our commitment to abstinence, our success at making lifestyle changes, and/or how (or whether!) we plan for urges. Rebounding from them can be complicated by our secondary upset at having lapsed and by our feelings of helplessness.

A strong desire to stop drinking is not necessarily a commitment. Lifestyle changes can be as simple as shopping elsewhere or even changing the direction by which you travel. But usually we have to make specific changes, sometimes pretty drastic, to break the patterns we’ve established. Planning for urges may be something we do daily—by talking with others, by role playing, by reading how others have done it.

Some folks describe drinking behavior as if it is coming out of nowhere, almost beyond control. Identifying what sparks a binge—the starting point, the trigger, the urge which you acted on—is important. There’s usually a pattern or a specific event, and somewhere in that process we gave ourselves permission to start drinking. CBT Tool: the ABC!

Focus on that first drink, because it was the ‘rational’ decision. You may have lapsed before, so you know the pattern. The important thing to remember is that you’ve also QUIT successfully before.

Getting started.

The quitting part is pretty easy. It’s the staying quit that can be tricky. That’s where it will help if you can identify what benefit you feel drinking provides. CBT Tool: the CBA... Why do you drink? What are you trying to achieve? If you can answer that question, perhaps you can think of other ways to achieve the same results without the drug. If the answer is too simple (‘because I like the buzz’), get more specific: what do you like about the buzz?

Sometimes just getting started is the obstacle. When we get very down and discouraged we start adding up all the things that have gone wrong in our life. (In CBT that’s called “awfulizing”.) I’m not diminishing the facts: things may be very distressing; life sometimes sucks! But it isn’t useful to dwell on how bad things are: look for some balance. The fact that things are discouraging can lead us to filter out the positive things that are going on in our lives. Any sober time is an accomplishment, and it isn’t undone by a lapse. Nobody here judges you by the frequency or duration of your lapses. Lapses are normal, though undesirable, and they can be learning experiences.

Try to avoid over-analyzing your SELF when you’ve lapsed. If you’re going to be ruthlessly introspective, I’d suggest that every time you think or write something negative about your character, that you consciously balance it with something positive. Better yet, consider whether your self-analysis is really self-downing. It might be useful to find some ways to divert yourself when you start blaming, castigating, or otherwise flagellating your SELF. Best of all: don’t rate your self. Rate your behavior instead. CBT principle: USA!

‘Secondary upset’ is the term for being upset about being upset. It’s not secondary, though, in how we deal with it! It is the first thing to get out of the way in planning to dispute the next urge. Our self-esteem may be shot, and it’s not uncommon to hear people describe themselves negatively—when it is the behavior that is unhealthy.

An accurate description of what you did and what happened can be important. Don’t sugarcoat it, but describe it neutrally. ‘I chose to drink, and now I feel sick this morning. I am, and others are, disappointed by my behavior.’

Part of long-term sobriety may be daily reinforcement. Forums, meetings, and setting aside time for daily reflection are all techniques folks have mentioned. I find it useful to review the concepts underlying my sobriety, and I think that doing that casually and daily is better than doing it intermittently. Others find it helpful when you post here based on your own experiences. It can become a habit to replace your older, unhealthier one! And it’s good to know that there’s an online community here that cares about you.

Fill the time. Developing an active interest in something you are (or used to be) interested in can be incredibly useful. Drinking fills up a lot of time. An evening spent on the forum board, or reading a good book, or doing digital photography is an evening spent NOT drinking.

It’s surprising how often people mention drinking to avoid boredom! Or how much of a focus of our leisure time is spent actively pursuing intoxication. Part of planning for urges involves having something else in place, especially for those times of day that you know are usually drinking times. CBT Tool: your VCAI!

What it takes….Commitment is really the key, and there’s a difference between commitment to sobriety versus desire to stop drinking. It’s not strength. It might involve willpower. I know that desire can vary in intensity, but that success at sobriety is not related to that intensity.

Commitment is less emotional and more matter-of-fact. It’s really just a firm behavior based on some firm beliefs, repeated and reinforced daily:

·      That drinking at all is simply NOT SOMETHING YOU DO.

·      That I might hypothetically be able to drink moderately, but it wasn’t the case in the past, so abstinence is a better choice for me.

·      That there is no benefit to me from even a small amount of alcohol. That there is no benefit which outweighs the many negatives—and you know what those negatives are.

·      That I would no more consider buying alcohol than I would consider buying cigarettes or heroin.

 

Commitment means alcohol just doesn’t pass your lips. It’s not a daily negotiation, or something that applies on weekdays but not on weekends. You may have difficulty explaining the commitment to others (so don’t bother!). You just DON’T DO IT.

It’s a lot of things you don’t do. You don’t buy it, you don’t go places where drinking is the primary pastime (bars), you don’t accept it if offered. You do plan for how you’ll do social events without drinking. You avoid situations or places where you are likely to give yourself permission to drink, and you take away the means of drinking at home.

When my son had behavior problems at school, we worked with his counselors to establish a system he would use when he realized he had failed to control an undesirable impulse.He was to go to a designated, trusted person and say, “I have made a mistake.”

We all do. Don’t beat yourself up. Get your system in place, and review it daily.

It’s just behavior, and behavior CAN be changed.