Learning from the Relapse – Psych Congress Network
Posted: October 10, 2019 at 7:45 pm
My goal is to meet my patient where hes at. If he isnt ready to try abstinence, we work from that positionembracing harm reduction techniques and keeping an eye on the benefits and consequences of being a social drinker. This article, however, assumes the patient has been abstinent, has relapsed, and wishes to return to abstinence.
How was it?
Usually, a return to my office suggests the relapse did not end well. But I need the patient to articulate that, so I ask: How was the relapse? Did you have fun? Why are you here with me? When he shares that It didnt get any better out there, we can explore what led to the decision to use.
Usually my client is confused, uncertain about what made using seem like a good idea. I did it again! How did that happen? This is why a relapse reconstruction can serve as a major foundation as we build a defense against the next drink/drug.
Was it a moment of simply not caring? Was it a belief that the relapse would not be discovered and no harm would come? Did romance cause distraction? Did a resentment cause an angry relapse? Did euphoric recall blur judgment?
What were you doing?
When I ask what happened, many addicts are unable to identify a precise cause and effect. The response is usually something like, I dont know, it just seemed like a good idea at the time, or I missed the good times.
I start with the moments immediately leading up to the use:
The answers to these questions can reveal quite a bit. If my client was with unsafe people or in a dangerous place, these are things she can avoid in the future. Note: Even if the unsafe people are family, there are ways to avoid them, in order to create a new family of stable individuals. This is, after all, a deadly disease. Saying goodbye to family members, although difficult, may have to be done.
Very often, there are signals that a relapse is imminent, but those signals can be subtle and difficult to recognize, and can be present weeks and months before the actual relapse. Its important to explore:
Gambling (buying scratch tickets is big with the population we serve).
Changes in eating habits.
Mood swings (depressive or manic episodes).
Elevated anxiety.
Aggressive behavior.
Adrenalin-inducing activities (stealing, skydiving, etc.).
Buying things not really needed.
Changes in sexual habits.
Spending time with online gaming or watching porn.
Spending too many hours at work or the gym.
Many addicts innocently fall into these habits, failing to recognize them as manifestations of the disease. At least Im not drinking is a common response when someone mentions these behaviors to the addict. In reality, the behaviorsswitched addictionsare an attempt to fill the void once filled by the drug use.
What werent you doing?
This is the area of greatest opportunity for the addiction professional, because there are myriad ways to fortify ones sobriety, but they do require action. I try to maintain silence when my patient tries to enumerate things he could have been doing differently. Patients need time to frame their thinking and to identify what wasnt happening.
I believe the most common and important variable is the lack of safe, sober people in the addicts life. Creating a network of stable people can take time and effort, and many addicts in early recovery are uncomfortable in social situations. But there are ways to meet and bond with stable people, such as night school, church, self-help groups, volunteering, etc.
AA, NA and SMART Recovery meetings offer a wonderful opportunity to meet like-minded individuals who have learned how to stay sober and to have fun. Without seeming to promote AA, I work with patients to help them make the best use of that fellowship. In that regard, theres much to be examined:
Do you have a home group?
Do you have a job (like coffee maker) in that group?
Do you have a sponsor?
Do you attend enough (three? five?) meetings each week?
Do you sit up front at these meetings?
Do you show up early to participate in the meeting-before-the-meeting?
Do you have any friends in recovery?
Do you stick your hand out to the newcomer?
Obviously, a negative response to any of these questions creates an opportunity for behavioral change. Ill try to get my patient to agree to one or more of these activities in the immediate future.
Exercise and nutrition also are topics that present opportunities for the newly recovering. Encouraging patients to practice basic self-care habits is certainly appropriate for any addiction professional.
Finally, medication compliance must be examinednot only meds to treat substance use and other mental disorders, but also those to treat physical ailments. Ideally, the addiction professional will have an ongoing dialogue with the prescribers.
Let us not forget that were dealing with a brain disease. Logic and willpower are not likely to yield long-term success. In my experience, learning from a relapse is a golden opportunity to create new behaviors that support a recovery lifestyle. Relapse is not part of recoveryits part of the disease. Lets learn from it.
Brian Duffy, LMHC, LADC-I, is a mental health counselor at SMOC Behavioral Healthcare in Framingham, Mass. His email address is bduffy@smoc.org.
Continued here:
Learning from the Relapse - Psych Congress Network
- Cocke and Fink: Community organizations work best - Roanoke Times - January 3rd, 2021
- 10 Books To Help You Reach Your Potential In The New Year - Patch.com - January 3rd, 2021
- Hoarding workshop - there is HELP available | Missoula, MT - Patch.com - January 3rd, 2021
- Names and faces - Arkansas Online - January 3rd, 2021
- The Boston Heralds Top 20 stories of 2020 - Boston Herald - January 3rd, 2021
- Opinion: There's power in the spoken word, even if no one else hears - BethesdaMagazine.com - January 3rd, 2021
- Remdesivir and baricitinib shortened recovery time from COVID-19 - Medical News Today - January 3rd, 2021
- Finding time for creativity will give you respite from worries - The Guardian - January 3rd, 2021
- New Year 2021: The resolution we all need to make for mental health - The Indian Express - January 3rd, 2021
- Life coach and movie mentor Dawud Gurevitch prescribes patients with films to boost their happiness - The Irish Sun - January 3rd, 2021
- Book Club: 3 books we read to close out 2020 | KSL.com - KSL.com - January 3rd, 2021
- 10 great local foodie products to help soothe Clevelands cold January bluster - cleveland.com - January 3rd, 2021
- 5 Ways to Take Care of Yourself in the Year Ahead - Rewire.org - January 3rd, 2021
- Three ways to help refugees and each other create a healthy path - Buffalo News - January 3rd, 2021
- Healthcare workers have 7 times the risk of severe COVID-19 - Medical News Today - January 3rd, 2021
- What Taunton's leaders have learned from 2020 that they'll carry into 2021 - Taunton Daily Gazette - January 3rd, 2021
- COVID-19 Decision Fatigue: What It Is and How to Deal With It - Healthline - January 3rd, 2021
- Solon author hopes poetry book will inspire others to love themselves - cleveland.com - January 3rd, 2021
- Sac Self-Help Housing Invites the Community to Donate Items to Housewarming for the Unhoused Drive-Thru - The Sacramento Press - November 24th, 2020
- Bluffton Self Helps gives 400 families a Thanksgiving dinner thanks to generous community donations - WJCL News - November 24th, 2020
- Your Mental Health Can Affect How You Save Money - Daily Journal Online - November 24th, 2020
- Fairway's New Self-Checkout Kiosks are the Buzz of the Neighborhood; Some Approve While Others are 'Flummoxed' - westsiderag.com - November 24th, 2020
- Fight the Power: Squash your beef this holiday season - Charleston Post Courier - November 24th, 2020
- Answer Man: How bad is the rent crisis? How can I help? - Citizen Times - November 24th, 2020
- Whats happening Monday in the north valley - Chico Enterprise-Record - November 24th, 2020
- Driving their way to self-reliance - The New Indian Express - November 24th, 2020
- This Constructed Self of Mine: On the Narrative Possibilities of Racial Melancholia - lareviewofbooks - November 24th, 2020
- 10 Habits Of Resilient Employees And How Company Leaders Can Support Them - Forbes - November 24th, 2020
- At Home Learning, Covid-19, and Working from Home: Managing Stress of 2020 and Beyond - Local Profile - November 24th, 2020
- Credit union moves to DeLand | Business | beacononlinenews.com - The West Volusia Beacon - November 24th, 2020
- HarborOne Bank breaks ground at new West Grove Street location - SouthCoastToday.com - November 24th, 2020
- 10 Tips To Find Balance And Thrive In Your Career During The Holidays - Forbes - November 24th, 2020
- What Is Bigorexia? Definition, Symptoms, Coping & More - Healthline - November 24th, 2020
- Why Self-Help and Development Is Crucial for CEO Success - Yahoo Finance - November 24th, 2020
- What to Know About Dating Someone with Depression - Healthline - November 24th, 2020
- COVID holidays inspire behaviors, expectations for life in new year - Williamsport Sun-Gazette - November 24th, 2020
- In a Time of Darkness, This Student Is Helping His Peers Find Their Authentic Selves - UVA Today - November 24th, 2020
- New Line Up of Virtual Classes Aim to Help Parents and Teachers Through the Holidays and Beyond - Signals AZ - November 24th, 2020
- Trial launched to test app that promises digital self-help for youngsters - Yahoo Finance UK - November 5th, 2020
- Off the Shelves November 5 - Greenfield Daily Reporter - November 5th, 2020
- Op-ed: Health care workers literally lose sleep over pandemic. That's bad for patients. - IndyStar - November 5th, 2020
- Global Airport Self-service Markets, 2019-2020 & Forecast to 2025: COVID-19 Impact - Market is Expected to Expand at a CAGR of 0.3% -... - November 5th, 2020
- Self-care is critical this election season - Famuan - November 5th, 2020
- Teaching: Helping Students Make Sense of the Election - The Chronicle of Higher Education - November 5th, 2020
- Feeling stressed? 3 ways to cope with election results - KCRA Sacramento - November 5th, 2020
- Student initiative helps bring attention to food insecurity - OSU - The Lantern - November 5th, 2020
- Digital Transformation Initiatives Post Pandemic to Drive Marginal Growth in the Global Airport Self-service Market, 2025 - GlobeNewswire - November 5th, 2020
- Election Day is now 'Election Week.' Here are 50 ways to get through it - CNN - November 5th, 2020
- Which Purchases Are Worth the Splurge? - Kiplinger's Personal Finance - November 5th, 2020
- 5 things you can do to stay calm, collected and happy this election season - Citizen Times - November 5th, 2020
- New research documents how COVID-19 multiplies stress and trauma for people with disabilities - Vanderbilt University News - November 5th, 2020
- 17 Breathing Videos That Will Help You Relax and Unwind - Self - November 5th, 2020
- Give more help to caregivers who often ignore self-care: Experts - The Straits Times - November 5th, 2020
- Neocase, leader in cloud-based HR Service Management solutions, has been named a Core Challenger in the EMEA market by Fosway. - GlobeNewswire - November 5th, 2020
- UPs Mirzapur goes global, handicrafts made by citys self-help groups to be exhibited in Japan - Newsroompost - November 5th, 2020
- IIT Bombay launches a self- help website to enhance emotional wellbeing of its students The website is supported by the alumni of Class of 1992 -... - November 5th, 2020
- Clinical trial to assess rehabilitation treatment for infants and toddlers after stroke - Newswise - September 29th, 2020
- Exercise plays a key role in addiction recovery, stresses of pandemic - Las Vegas Sun - September 29th, 2020
- Romance Meets The Real World In 'Real Men Knit' - NPR - September 29th, 2020
- Meet the team of Arcadia, the salon bringing style + color to Avondale - Bham Now - September 29th, 2020
- Great British Baking Show is back on Netflix and coming for Nailed It - Polygon - September 29th, 2020
- In support of student media handoffs and the power of personal essays - Poynter - September 29th, 2020
- The different selves of self help - The Michigan Daily - September 19th, 2020
- Ken Norton, The Former US Marine Who Used A Self-Help Book To Beat Ali - The Sportsman - September 19th, 2020
- How to identify and address feelings of anxiety and depression - IU Newsroom - September 19th, 2020
- VDH COVID-19 Update: Spigot turned to help hospitality industry - Vermont Biz - September 19th, 2020
- Perks and Benefits Remote Workers Actually Want - Built In Chicago - September 19th, 2020
- Keep your coffee and other advice from people who paid off thousands in debt - CNBC - September 19th, 2020
- Suicide Prevention Month - Catholic University of America The Tower - September 19th, 2020
- Diabetes self-management telephone class to begin Oct. 7 - The Tribune - Ironton Tribune - September 19th, 2020
- Jay Shetty: How to "Think Like a Monk" | Amanpour and Company - pbssocal.org - September 19th, 2020
- WebMetrix Group On The 21 Podcasts to Expand Your Mind in 2021 - GlobeNewswire - September 19th, 2020
- This Veteran is Helping Fellow Vets Transition to Civilian Life Through Video Gaming - Good News Network - September 19th, 2020
- Coping and Hoping: Mental Health Tips for Trying Times | University of Michigan - Michigan Medicine - September 19th, 2020
- Sound baths | A holistic approach to relaxation and healing | Your Best Life - KCENTV.com - September 19th, 2020
- You Be the CP: Case Studies of Complex MIH Patients - EMSWorld - September 19th, 2020
- First Things First Adapts to COVID-19 Regulations for Class of 2024 - Wesleyan Argus - September 19th, 2020
- Dallas Therapists Share Their Pandemic Advice for Patients - Dallas Observer - September 19th, 2020
- Citizens Financial's Discount Is Shrinking, But It's Still Too Wide Relative To The Opportunity - Seeking Alpha - September 19th, 2020
- Learning In The Age of COVID: From Chaos Comes Opportunity to Build Community - Sacramento Observer - September 19th, 2020