By now the term “relapse” is both widely used and engrained into the minds of most all of who are lucky enough to enter some form of treatment in the US for chemical dependency. The “treated” person is informed that with chemical dependency, relapse can occur at any time and that from moment to moment one must be alerted to the “triggers” that may cause this regrettable fall, back to the clutches of addiction. “One day at a time” and, “you are only an arms length away from your next drink” are the clichés which echo through most AA halls and treatment offices. Although well intentioned, the concept of relapse is associated with the idea that chemical dependency or addiction is a disease. Those unfortunate enough to have this biological/chemical abnormality will forever have to be conscious of their struggle to maintain sobriety. There is no escape. The disease of chemical dependency never leaves, and in fact it is waiting in the background for its chance to reclaim its victim. Relapse is viewed as something outside the realm of the person’s control. Sure, no one forces them to pick up a drink, but if they succumb to the temptation, it is blamed on the disease. It is not until the addict surrenders his will and admits complete defeat that any hope of abstinence from chemical dependency can be obtained. Or so we hope, remember the disease is powerful and no one is off the hook, ever!
I feel the above is unfortunate and that our current outlook and use of the term “relapse” needs a more honest investigation.
First of all, there is no study or medical literature that proves or has found there to be any biological disease with chemical dependency or addiction. There is none! Believe it or not, the disease idea is used purely because no one has a clue why someone would continue to destroy his or her lives through an addiction. If we believe people would not consciously choose chemical dependency or addiction as a way of life, we conclude it must be a disease.
With no scientific literature to support this, the concept of relapse is absurd. We cannot relapse if there is no disease.
Telling people addiction is a disease, and relapse is part of that disease, (when both are false) is setting them up for failure. The disease concept does not encourage the addict to choose and control what he can to improve his life. The disease concept strips the addict of free will and puts them under the control of an imaginary disease. Again, no one and nothing can force them to pick up a drink. But if they do take the drink, it is the disease, not the man. Try this; think of someone you know who doesn’t drink. Now think of them as an alcoholic. What did you just add to them? You got it, a disease. By labeling them an alcoholic, in your mind, you have just separated them as being “different” from the normal person because of some internal biological craving. They are not different. They are just choosing a form of behavior you would not.
Secondly, 80% of those who admit they once had a problem with an addiction no longer have the addiction. They “recovered” on their own. The importance here is that these people are not struggling with a day-to-day battle of the wills to abstain from drug or alcohol use. They did not need 90 meetings in 90 days, or intensive outpatient therapy with relapse plans. They simply quit. They can do this because there is no disease. Their values and focus changed and they decided drugs and alcohol no longer held the power and significance it once had. People normally change when they realize they have something to lose if they don’t change. Pain and consequences are important here for when one gets disturbed enough they will be more motivated to change. Those who continue to use alcohol or drugs have not yet been convinced that life would be better lived if they quit. Some would then ask if those who continue to use alcohol or drugs need to “hit bottom” in order to change. The answer to that is simple. No.
The addict will continue to use until he or she is convinced that they can successfully live life without the use of alcohol or drugs.
This can come at any time and for some, it is never. There is no “bottom”. It is relative, and has more to do with why people think they can’t quit than why people continue to drink or use drugs. In other words, I am not going to quit until I think I can.
So knowing that addiction is not a disease, relapse cannot exist. And, knowing that the majority of people quit on their own, personal perception and choice is important. Why?
Because it is human nature to choose what we perceive will give us the most happiness at any given moment
But what does happiness have to do with drinking or using drugs? Anyone can tell that the addict isn’t happy. That’s right, those who drink or drug aren’t happy but that doesn’t mean they can’t perceive it to bring happiness. Addicts are full of fear, like many people who live life. The only difference is that the addict consistently chooses not to productively deal with that fear. The addict hides, and with this hiding comes the illusion of control. They numb themselves to have a moment of peace, happiness. Now are they actually experiencing peace and happiness? Of course not, but if you have a splinter in your foot and you knock yourself on the head with a baseball bat, you wont be thinking about the foot!
But this still does not answer the question of why some can’t seem to quit even though they portray a real desire to do so?
The obvious answer would be because they are told they cannot.
The same people who want to help them are at the same time telling them they can never escape their addiction completely.
This is not acceptable to me. Let’s look at the process. Someone struggling with an addiction goes to counseling or AA. They are given all the above and more standard information. They buy into “One day at a time” and the disease concept and get “sober”. They are excited about this and jump into the “recovery” process full force. But something starts to happen when they are told “recovery” is a life long process and they can never escape their disease. They find only two choices; remain in AA(treatment), or fail. They remain in AA and periodic counseling for a while. But shortly they start realizing that the mistakes they have made are coming back to haunt them. Their finances are in trouble, friends are hesitant to call, family distrusts them, they still are not happy, etc. Things are a mess. What happens? Well when you take away the addiction, the person becomes like everyone else (probably with a bit more mess to clean up though). There is no more hiding or excuses and the person is hit with the realization that the position he is now in is from his own past choices. He knows he can refrain from drinking or drugging, because he is doing it now. But, he feels alone and has difficulty understanding and controlling his feelings. For the first time in a while he feels fear. What does he do?
He holds on to his “recovery”. It is his saving grace. It becomes his identity and image.
His self-esteem seems to hinder on his progress of the 12 steps and how other members view him. But this wears thin and he soon finds out that people don’t care. The world goes on. His progress in the steps do not land him a job or get his family back. His image falls. He remembers his disease. At least he has that fight. It becomes harder to deny the usefulness his old addiction could give him now. It’s a disease remember. He feels out of control and needs to regain it. He uses and the cycle starts again. Until he realizes that addiction is a choice, he cannot regain control and ownership of his life.
He must come to realize that his individual worth is not because he is “sober” but because he is alive.
If he does “relapse” it is not because he has a disease, but because he chose to deal with his fear by avoidance.
So why can’t people quit drugs or alcohol when everything they say indicates they want to? Simply, they feel they cannot live life without it. They have made the wrong choices for so long and depended on their addictions as a crutch. To stop drinking or using drugs would strip them of the only constant they know:
The ability to control their fear and helplessness in a way they perceive as most effective for their particular situation.
This is relapse, addiction. So what can we do? Lets keep this simple.
The Ebook – A Practical Guide To Quit Addiction!
– We must empower the individual struggling with alcohol or drugs. We do this by taking away all excuses they may have to why they cannot stop drinking or druging. They will have many of these excuses. But the bottom line is that they don’t believe they have the necessary personal resourses to overcome it. Find their talents and help them emphasize them. I do not believe they are weak willed or spiritually deprived. Their will’s have taken them to a place where no one else would want to go. If they wanted to drink or drug, they found a way to do it. Use this strength to re-focus them. Their spirituality is normally quite strong. They are searching for something, a meaning. Help them find this meaning. Victor Frankl wrote that if you give a person purpose and meaning, they will find a way through anything. No matter how hopeless it seems. Even atheists believe in something. Even if it is life itself.
– There is no biological or chemical disease.
If they use, it’s their choice. Relapse is a choice. Tell them this.
– For every choice to use alcohol or drugs, there is an alternative choice also available.
They may have forgotten this part. The alternative choice will most likely impact the problem more directly to resolve it and not further its existence. Fear may enter here. They have avoided responsibility like the plague. But when they finally realize that their control comes from responsible choices they are more willing to attempt it. The key is when they can see how choosing the responsible choice will positively impact their life situation. When life situations can’t be seen as improving, change will be hard fought.
– No one truely enjoys their addictive behavior.
They don’t drink or drug because they “like it”. Think back to the first few times you used. The taste was awful and it most likely made you sick. No one I have ever encountered formed their desire to use after the first drink or hit. It took some work.
– Make sure goals are clear and achievable.
The addict must develop a clear vision and plan of what they want and who they want to be. This is most important, for through their use of alcohol or drugs most have lost sight of the dreams and goals they once had. Remind them. Most healthy people look at the world as their playground. The addict looks at the world as their prison. Help them find the key.
– Avoid cleaning up their mess.
Don’t get involved with the blame game. Addicts are real good at this. They can twist any situation to support their misery. Let choices and consequences be theirs. This way there is no one to blame but themselves.
– Let them know that it is ok to feel.
Most addicts don’t know how to do this. Teach them. To them, feelings are the enemy and have to be avoided. Feelings come and go and feelings will not kill you. It’s how you respond to them that matters.
– Fear is at the root of all addictions
Get them to takle one of these fears head on and they gain some ground. Build on these small successes so they can start to see their innate abilities to change.
– Get them out of their heads!
There is no destructive force in the world greater than an addicts self centered thinking. Mental illness has been defined as perceiving without testing. We perceive according to the stories we tell ourselves in our heads. It does not matter the reality of these stories. They are how we see the world. The addict has such a selfish view (story) that if they are left in their own heads there is little chance of positive change. What works well here is to have the addict help out others. If they are thinking of someone else, they will not be thinking of themselves. There is no greater fullfillment in the world than one who truly gives to another and expects nothing in return. Teach them to give.
– Perhaps the most dangerous idea in the treatment field is the phrase “You have to do it for yourself”.
Who do you think the addict has been serving all this time? His family and friends? Get them out of their heads! Teach them to help others.
– Motives drive an addiction.
Teach them to examine the motives behind their behavior. Most of their motives will be fear based. Remember their addiction is their attempt to control an internal feeling of fear and helplessness. A good rule of thumb in checking motives to a behavior is to ask, “will this hurt or harm myself or others?” If the answer is yes, then difficulties lie ahead. Behaviors with fear as their motive will only result in self protecting behavior. They will not focus on a solution to a problem and will not satisfy.
– Fear and guilt do little to help the addict abstain from alcohol or drugs!
Most professionals focus on the negative consequences as a reason to abstain from alcohol or drugs. This is the wrong approach. The addict already knows, or has experienced the negative consequences associated with using. This has not hindered their use. They may cut down for a while after experiencing a negative consequence only to resume normal use as time goes on. This is because people do not like to live in fear. They want to escape it. Guilt is the same thing. People want to avoid it. Fear and guilt focus on the problem not the solution. Teach them to focus on the solution. Help them see that change occurs when they focus their life on something other than drinking or drugging. Don’t define them as “in recovery” or by “sober time”. This is a focus on the problem. When they realize they can handle stress in life, not because the are “sober” or “in recovery” but because they are alive and equipped with the ability to do so, drugs and alcohol will be irrelevant.
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