Stressors That Trigger Relapse
Relapse often occurs to those in recovery, but it is not automatic – and it is preventable. In fact, relapse prevention training is generally included in the final phase of active treatment before the client is released from the program. But, just because you may have had relapse prevention modules doesn’t mean that you have absorbed all you need to in order to ward off relapse. Just as each addict has a unique set of circumstances leading to his or her addiction, and treatment is tailored to best match the individual’s wants and needs, each person in recovery will face numerous stressors, pressures, cravings and cues, that may trigger relapse.
Some stressors, while they may be experienced to a different degree, are somewhat universal. To the extent that the recovering addict falls prey to the stressors and slips into relapse very much depends on how well prepared he or she is to handle the challenges and obstacles that occur – especially in early recovery.
What are some of the most common stressors and, beyond merely identifying them, what can be done about them? Read on.
Once an addict completes treatment and attempts to resume a normal life, one of the first stressors likely to be encountered is job-related. If the individual goes from treatment directly to a sober living home or halfway house, there may be assistance available to help the person transition from active treatment phase to resumption of normal living. A strong component of the transition phase is training in communication skills, how to present oneself for an employment interview, filling out a job application, writing a resume, and, possibly training to open up new employment opportunities.
Some recovering addicts do not go to a halfway house but return directly home. They attempt to pick up where they left off in their job, if they still have one. For some, their job is no longer there, or they were fired or quit as a result of their addiction. Being unemployed is a huge blow to the recovering addict, who now has to face the prospect of finding new employment while trying to negotiate a mountain of accumulated past-due bills, medical expenses, family obligations, and the like.
Add to the pressure the fact that the person may have been the family’s sole provider, and unemployment may become a primary trigger that results in relapse.
If you are a recovering addict and have no job, seek help in getting back into the work world. Use the resources available to you in your 12-step groups such as job fairs, job training, communications training, and financial aid to go back to school, and the like. Your 12-step sponsor and other group members may also be able to recommend programs in the local community that can help. Many alumni members have strong ties to such programs and are more than willing to help out fellow members get back on their feet.
Ask for help – and be willing to accept it. After all, your support system is going to be bedrock of your ongoing recovery. And everyone needs to have gainful employment in order to secure a satisfying and rewarding future.
The Enablers: Family, Friends and Co-Workers
If the family members have not also participated in treatment – such as family treatment programs – the individual in recovery is returning to the same environment he or she left prior to treatment. Family members may become enablers to the person in recovery. They help the addict avoid the consequences of his or her addiction, or they make it easier for the recovering addict to pick up their addictive behaviors that they thought they had left behind.
The same enabling stressors can occur with close friends and co-workers, people with whom the recovering addict spent time engaged in unhealthy and addictive behaviors.
Not everyone in the family will have the same reaction to attending family treatment – if they even went. They may mean well – enablers usually do – but they inadvertently spark or trigger stress that results in the recovering addict’s resumption of the addiction.
How can you help prevent the enabling of family, friends and co-workers? Start by listing ways to avoid relapsing that may be triggered by the actions of these people. You can’t prepare a coping strategy if you don’t have options available to you. Again, don’t try to figure this out on your own. Talk it over with your 12-step sponsor, fellow group members, your therapist or counselor in continuing care or aftercare (if these are part of your overall treatment plan), or an independent therapist trained in recovery strategies.
Economic Downturn and Financial Problems
When money is tight, everything becomes a potential stressor that may trigger relapse. Economic downturns make the recovering addict’s personal situation worse in that there is less perceived help available – either financial, job-related, skills training, and continuing counseling or support.
Foreclosures, bankruptcy, maxed-out credit cards, depleted checking and savings accounts, unpaid bills and past-due notices, collection demands, lawsuits, fines, legal fees and so on can mount up to the point where the individual in recovery sees no way out. Why not resort to the bottle or downing pills or injecting, inhaling, gambling, etc. as a means to cope with the economic calamity? While that’s certainly one way to look at it – escape – as always, the escape is only temporary. The economic problems of the recovering addict, mirroring the downturn in the economy, will still be there. They may even become worse. Thus, the escape is not only a delay tactic of facing the inevitable – it is also worthless as a solution. It simply doesn’t work.
You can’t ignore the economic downturn or your own personal financial situation. So, how can you deal with a worsening economic situation without resorting to relapse?
• First, don’t allow things to pile up or get to the point where you feel you don’t have any hope of coming out from under. Seek the help of a financial advisor – perhaps one of the resources available to you in your 12-step group or a program you can be referred to in the community.
• Work with your creditors to arrange a graduated payment plan, reduced payments, loan modification program, or the like. Creditors want their money, but some money negotiated in advance is better than no money at all. Generally speaking, they will be willing to work with you to create a repayment plan or schedule. You need to at least give this option a try. It will go a long way toward helping reduce the economic stressor that could otherwise do you in.
• Recognize that the economy goes through regular upturns and downturns. The cyclical nature of the economy is such that one usually follows the other. While this may not be comforting when you’re drowning in debt, it at least lets you acknowledge that you will probably be able to overcome your financial and economic difficulties at some point in the future.
• Take a tip from financial planners and organize, pare, and prioritize. Sort bills according to due dates, amount due, and prioritize according to most important. These include your mortgage or monthly rent, car and insurance payments, utilities, food, and recurring medical expenses. Eliminate all but essential expenses – at least until you’re back on solid financial ground. When you get back to work, set up an automatic deduction for the high-priority obligations (mortgage payment, car payment, etc.) from your checking account. This will ensure that there are no late payments and you won’t be tempted to spend the money instead of taking care of those bills. Just be sure that you deduct that amount from your check register so that you don’t overdraw your account – and incur overdraft fees.
Loss of a Loved One
Your biggest support will come from your loved ones – your spouse or partner, your immediate family. When you lose a loved one, however, your entire world is thrown into turmoil. You are at great jeopardy of relapse, as the loss of a loved one is one of life’s traumatic stressors that do the most damage. This is true of nearly every human being, but even more so in the case of those in recovery whose emotional state and ability to overcome cravings and urges is so fragile.
Where you once had the constant presence, love, encouragement and support of your loved one is now a gaping hole. You feel the pain as if it were a physical wound. Nothing cuts the pain – except going back to your addictive ways. This is a common trap that recovering addicts often fall into. They feel that there is no way out except to go back to a coping mechanism they’re familiar with – their addiction.
How do you survive the loss of a loved one without having it trigger relapse? This is a tough situation. There’s no getting around that fact. Platitudes about time healing all wounds will bounce right off you – as they do to most persons in the first stages of bereavement. People utter those words because they don’t know what else to say, and it is also true that time will help ease the pain. But, right now, that probably won’t do you any good.
What you can do to keep yourself on the straight and narrow road to recovery is to surround yourself with others who understand your situation, your addiction, the tremendous desire to escape your pain by succumbing to your addiction. Step up your participation in 12-step meetings. Go every day or several times a day if that will help. Ask for a referral to a grief counselor or participate in online grief counseling meetings, blogs or chat rooms. Ask your doctor for assistance in finding some help for you to cope with your grief.
Other tips to help you in your time of bereavement include:
• Spend time with friends. – Don’t sit at home alone and allow yourself to wallow in self-pity or remorse.
• Stay active. – Get involved in physical activity, exercise, sports, recreational activity, intellectual pursuits, going out to entertainment venues.
• Find solace in spiritual comfort. – Whatever your religious background or spiritual inclination, many persons in recovery find comfort in seeking the assistance of a higher power to help them weather this very emotionally-draining time. Prayer may work for you, or meditation, or going to church or contemplating the power of the universe. Listening to motivational and inspirational tapes may be helpful, or reading books on overcoming grief, especially those that are available through addiction recovery websites.
• Take it one day at a time. – This often-repeated mantra really does work. You can’t expect that you’ll have all the answers for all the days ahead, but you can do everything you can to engage in positive behaviors today. Be sure that you take care of yourself, including eating properly, getting enough sleep, and tending to your physical and emotional needs. Cut yourself some slack as well. You don’t have to be perfect, and there’s no timetable that you need to adhere to in terms of when you’ll start to heal from the loss of your loved one.
Going back home after treatment often means the recovering addict is subjected to the same daily routine they encountered prior to rehab. In fact, addiction may have become part of the daily routine, something the addict automatically did at certain times. It could have been a certain time of day, such as after work, after eating, before and during smoking a cigarette, on pay day.
Identify what these daily routine stressors are that most likely will trigger relapse and then design ways to modify your behavior so that you don’t fall victim to them.
A big trigger to relapse involves stress in relationships. When the recovering addict returns home following treatment, the loved ones are the first people he interacts with. At first, there may be underlying tension, apprehension, even fear, as family members tiptoe around the returning addict. Things may be left unsaid, or, on the opposite spectrum, too much may be said. Arguments may occur, becoming heated. The threat of physical violence may loom as tensions escalate.
Anticipating the kinds of relationships that may be stressful, or the types of situations that may provoke stress in the relationship also means that you need to develop ways to overcome the stress. Individual and group counseling can assist in defusing the tension, help ameliorate the stress, and put you back on track toward repairing the family relationships.
There are times when you may need to take a break from the family – or vice versa. Things may have become so frayed, the relationship so tenuous, that a temporary split is advisable. Don’t take this as an indictment of your recovery. It is what it is. Everybody may need time to learn how to deal with these new circumstances – your recovery – and to learn how they play a part in helping your recovery along (or not).
If your family relationships are a contributing part of your addiction, either they get counseling and change – or you need to remove yourself from the surroundings. Each situation is different, and each solution needs to be worked out with the best interests of all concerned. Don’t attempt to figure it out on your own. Talk with your continuing care counselor, your 12-step sponsor and fellow group members. Encourage your family members to participate in Al-Anon or Nar-Anon or the family portion of whatever 12-step group you attend. Almost every 12-step group has a family component – and there are many resources available to you and your family members through such groups. Make use of them.
Testing Yourself by Trying to Meet Old Challenges
Just because a person has gone through treatment for addiction, learned a few coping strategies, listened to a few lectures on relapse prevention, doesn’t mean he or she is well-equipped to waltz back into their old life and resume the kind of lifestyle that previously contributed to addiction. Some persons in recovery seek to test their ability to withstand the urge to use by hanging out with old drinking buddies or going to bars, clubs, or hangouts. This often leads to relapse – and is an unnecessary and totally preventable risk.
Don’t put yourself in that position. Recognize that you cannot hang out with former drinking or using friends. There is no such thing as just stopping by to say hello or drinking coffee or soft drinks while your pals down shots and beer. It won’t last. Before your mind even recognizes that you are going to do it, the chemicals in your brain will have been activated by the sights and sounds and smells (the triggers) – and you will pick up a drink. No, you won’t want to, and you will do it despite your best intentions not to. The only way to avoid this is to stay away from the people, places and things that will prompt those urges.
Monitoring your emotions is a good way to help avoid the stressors that may trigger relapse. Think about how your body feels when you experience cravings and urges. When you do experience them, what kinds of emotions do you encounter?
Common stressor feelings include:
• Suicidal thoughts
• Other feelings
How do you deal with these emotional stressors that may trigger relapse? Talk over what you can do with your 12-step sponsor, your counselor, and your loved ones. Work out a strategy that encompasses each of them. Make a list of concrete things you can do to get your mind off the negative emotion before you find yourself giving into the cravings and urges to use.
Preventing Relapse is Up to You
Preventing relapse requires knowledge and awareness of triggers and cues. Once you’ve identified the risky situations, toxic emotions, worked out all the potential stressors that could catapult you into relapse, the rest is up to you. Ask yourself the following two questions:
Am I willing to do something about it?
What am I willing to do?
Then, do it – making sure that you avail yourself of all the resources and help that are available to you. Will it be easy? No, it probably won’t be. Some days will be more difficult than others. But, over time, you will become stronger, more self-confident, and more capable of addressing the stressors that come your way – without triggering a relapse.