SECTION XXXII: RELAPSE PRONENESS Therapists Overview

EARLY WARNING SIGNS OF RELAPSE

GOALS OF THE EXERCISE

1. 2. 3. Develop coping skills to use when experiencing high-risk situations and/or cravings. Increase awareness of personal early warning signs of relapse. Learn that relapse is a process and how a person can prevent that process from continuing to its completion in his/her life.

ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE USEFUL

Eating Disorders Gambling Nicotine Dependence Opioid Dependence Substance Abuse/Dependence Treatment Resistance

SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH CLIENT

The Early Warning Signs of Relapse activity is intended to help clients in early recovery learn about cognitive, emotional, and behavioral changes often seen in the early stages of relapse (before an actual return to active addiction) and plan strategies to counter these changes if and when they see them. This exercise is also useful to prepare for the Relapse Prevention Planning activity. Follow-up can include sharing the information gathered with a program sponsor and keeping a journal to track and record red flag symptoms.

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EARLY WARNING SIGNS OF RELAPSE

In addition to external pressures to use, our attitudes, thoughts, and behavior play a key role in relapse. Learning about early warning signs can help you avoid going back to drinking, using, or other addictive patterns. This exercise will help you identify your personal warning signs, stop the relapse process, and turn it around before you pick up a drink or drug or return to another addictive behavior. When a person picks up a drink or drug, walks into a casino, or otherwise returns to an addiction, thats the completion of the relapse process, not its beginning. Before that happens, there are many warning signs. Knowing the warning signs can help you cut the process short and stay in recovery. 1. Relapse-related changes in thinking may include persuading yourself that some new method of controlled drinking, drug use, gambling, etc. will work; remembering the good times and overlooking the problems; thinking of addictive actions as a reward for success or a way to celebrate; or believing that one cannot succeed in recovery. Please list specific examples of how your thinking changed before your last relapse, or similar changes youve seen in others.

2.

Emotions and attitudes also change as a person drifts toward relapse. Determination, optimism, teamwork, and motivation may be replaced by forms of negativity such as apathy, selfishness, and a feeling that being unable to drink, use, gamble, or so on is an undeserved punishment. Please list specific examples of how your attitudes changed before your last relapse, or similar changes youve seen in others.

3.

Another area where there are clear differences between an actively addicted persons lifestyle and that of a recovering person is in how he/she relates to others. Before returning to active addiction, our behavior slips back into patterns such as

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self-isolation, manipulation, dishonesty, secretiveness, and being demanding and resentful. Please list specific examples of how your ways of relating to other people changed before your last relapse, or similar changes youve seen in others.

4.

You have probably also seen common behavior patterns in yourself and others who were abusing alcohol or other drugs or practicing other addictions, and seen very different patterns in recovering people. When a person is sliding back toward addiction, his/her behaviors start looking more and more like they did before recovery. Some typical addictive behavior patterns include irregular eating and sleep habits, neglect of health, irresponsibility, recklessness, procrastination, impulsivity, and other patterns showing a loss of self-control and the growth of chaos in ones life. Please list specific examples of how your behavior changed before your last relapse, or similar changes youve seen in others.

5.

Together with the other changes described above, the feelings and moods of actively addicted people tend to be different from those they experience in recovery. Common addictive patterns of feelings and mood include irritability, anxiety, depression, hopelessness, indifference, self-pity, anger, and self-centeredness. Please list specific examples of how your feelings and moods changed before your last relapse, or similar changes youve seen in others.

6.

Now think back, check with others if possible, and identify whatever warning signs from all the areas above that you or others saw in you before your last relapse. If youve never tried to quit before and have no experience of relapse, list the main patterns that were normal for you when you were drinking or using. Either way, please write these red flags down in the order in which they happened.

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Once youve completed this exercise, youve gathered the information you need to complete another exercise, Relapse Prevention Planning. Be sure to bring this handout back to your next therapy session, and be prepared to talk about your thoughts and feelings about the exercise.