Someone recently asked me, “Do you get frustrated with patients that relapse over and over again and then try to re-enter treatment?”
My initial thought was that the patients who use treatment as a tool for to either appease a loved one (and/or the courts) or as a way to lower their tolerance levels do in fact piss me off. But really, those patients are in the minority. In my experience, most people who relapse do have intentions of one day becoming sober. However, their circumstances don’t really change enough for them to develop needed coping/refusal skills. It takes a psycho-emotional, social, and spiritual revolution for someone to find his or her way back to health and most of the time, an addict doesn’t have either the internal or external resources for the needed revolution to occur.
Because of the lack of resources, both treatment providers and families must use relapses as learning opportunities. Setbacks will happen. But it’s the response to setbacks where learning can happen. For example, when an addict relapses, we tend to get pissed off and yell and issue ultimatums. I’ve learned, over the years, ultimatums simply don’t work with addicts. When an addict is “in cycle,” he or she doesn’t care about anything other than using. Because nothing else matters, an addict isn’t going to care about the ultimatum, so issuing them is nothing but a waste of time. In reality, if an addict has never really wanted sobriety, treatment isn’t really an option.
However, if an addict does want to get clean and then sober, I recommend that: 1) We develop a plan to address the next steps after a relapse. This plan may involve re-entering a treatment facility; 2) We talk with the addict about the relapse in an effort to learn what happened from trigger to using;and 3) After learning about the relapse, we decide whether or not to execute the relapse plan.
These steps sound super-simple, but I can guarantee that implementing them will be challenging. Whe someone is new to recovery, they tend to be gung-ho and make tons of promises. But we need to be realistic: An addict will relapse a whole bunch of times until he or she finds a path towards sobriety. Anger and frustration don’t really do much good. Believe me, I’m a master at getting angry at setbacks…
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