Relapse In 12-Step
What the difference between 'slip' and 'relapse' in 12 step?
Let's say that you're a gambling addict and you've sworn off all forms of gambling and someone gives you a couple of quick pick cards. Now, Id' say if you were truly committed to not gambling you would give those away or just say "I'm not interested," but you might say, "I'm just going to scratch off a couple just to see if I win." If that throws you back into your whole gambling addiction, then I would say that was relapse. But if you're able to say, "Okay, I see where this is going. I've got to stop, I've got to regroup, I've got to refocus," then it was a slip. So it's just a matter of degree.
What is the 12 step understanding of how relapse happens?
Relapse initially starts in the mind. It's all of those triggers, all of those behavioral states, and all of the options that we give ourselves in dealing with those emotional states. Triggers are what set us up for relapse. Usually, some people see relapse as when you have finally either used the drug or engaged in your addictive behavior. I would say relapse is much more subtle and starts earlier. It's about when you start to lose balance in your life again and you start to believe some of the old lies, and you start to fall into familiar patterns. In AA, they say that one of the important things in early recovery is HALT: don't let yourself get too hungry, angry, lonely or tired because if you do, you're going to be vulnerable. When you're vulnerable and you're not taking care of yourself is when you become vulnerable to relapse, or to those frames of mind where it's okay to do this. Even if you say, "Just this once."
What are high risk situations 12 step recommends avoiding?
That's where you need to identify what are the triggers that are most important to you, and they would be different for every person. How can you minimize or eliminate exposure to those triggers? And how can you have an alternative plan to either work through, if you are exposed to those triggers, or some kind of support that will allow you to not have to interact with that external trigger. Internally, to be able to know yourself and to come up with other alternatives of how to deal with stress, anxiety, whatever it is that tends to be your trigger.
How does 12 step help avoid relapse?
Staying honest. Being able to observe yourself, being able to work a recovery program. I hear that terminology, but it's very important because it's a way to keep reminding yourself of what's important, of what your vulnerabilities are, and what you need to do to be able to maintain your present state, your present non-addicted state. If you relapse, whether that's a slip or whether that's a real relapse, to realize that you can still change, you can pick up again, and you can recover at any point in your life until you're dead. I truly believe that you can recover at any point during your life, as long as you are truly willing and honest.
Will everyone have a relapse as they recover under the 12 step program?
Depending on how you define relapse, I can't say that everyone will. I will say that relapse is common in this disease, because we we're talking about the brain chemistry and the emotional states that we go through. There's no way that we can avoid having emotional ups and downs. There is a place where we can become much more okay with the ups and downs. But that's going to be a learned behavior over time, or an experience over time. And I would say that avoiding relapse is not so much the issue as maintaining your integrity, maintaining your honesty. If you relapse, don't beat yourself up. It's about your life. It's about the quality of your life. And it's about the precious moments of your life that you have. Ultimately, you're going to make the decision of what's going to be the level of quality in your life. Whether you decide to go back to being an addict again, or whether you decide that because of all of the other consequences, you truly want to commit yourself to a life of recovery. It's ultimately going to be up to you. It's up to the individual.
How do I recover from a relapse under the 12 step model?
The key there is to stop the relapse before it goes on so far. It is going to be very difficult to retain balance again, whether you're going to have to go through detox again, if it's a substance. Even if it's a behavior, you're going to have to go through all those uncomfortable feelings again. You're going to have to make up for all of the negative consequences that you have experienced and you're going to have to do things differently again. Sometimes, I would say, people in the process of recovery, they may have a slip or two because there is still that part of us inside wanting to play the game and is still wanting to fall back into that addictive behavior. All of those dialogues or those internal messages of "just one won't hurt" or "I need to reward myself" or "I wasn't really that bad", those are the things that set us up and those are the things that can take us down the road where we are going to have even more problems later on.
Under the 12 step program, how can you tell if you need some extra help?
Each person in a relationship needs to be very clear with what their commitment is and what their level of tolerance is. It's a very difficult time in early recovery. A person is going to need a lot of support. Sometimes the family can be a wonderful support. Sometimes the family is one of the primary persons or group of people that the individual needs to make amends to. And they may have a lot of resentment, a lot of anger. I've seen both. The thing is that you have to identify the support system. Do not try to do this on your own.
What is the 12 step understanding of 'codependency'?
Codependency is a term that was coined a number of years ago, initially to identify the kind of relationships that those involved with alcoholics or addicts get into in trying to maintain a sense of balance in that kind of environment. Someone who, when they're in the midst of their disease, is very unpredictable, is going through a lot of changes, who is very self destructive, can be very difficult to be around, and the codependent was originally the co-alcoholic and referred to the spouse, or the person that basically was not only living with them. But in some level was enabling them to maintain their addiction by maybe calling the boss at work and saying, "No, my husband's sick today", or going out and running errands or going and buying alcohol or whatever when the person wouldn't go out, or bailing them out of jail. Basically, all of those things that would prevent them from suffering the natural consequences that they would. Over time, it's become a terminology dealing with the way a person interacts with others in their life, and it is usually characterized by, on the surface maybe appearing very self efacing, very loving, very giving, very concerned about other people, but on the surface being not only very resentful if people do not respond to them in a certain way, but also has a lot to do with control. This is because one of the things that the spouse of the addict was trying to do is maintain a sense of control in their life, and so she or he, it could be either one, would create a structure in their life where they could maintain the illusion of stability, and that involves a lot of control, in some cases a lot of deception, a lot of manipulation, and at the same time codependents may appear as martyrs, but it's much more about the payoff. Codependents on some level are trying to show how they want to be treated, but they're going about it the wrong way. They also tend to have poor boundaries and their well being is to hide into the well being of others. Their good feelings about themselves are tied into other people having good feelings about them. They're very externally directed and it's almost like their sense of well being is tied to the person or persons or group that they are codependent with, and that becomes more important than their direct experience of life.
Can a recovering 12 step member have a relationship with someone who is still using?
That's where a lot of the difficulties are in, during early recovery. The system that evolved around the unpredictable addict and around which the codependent developed her identity - and I mean he or she, I'm just using 'her' as an example - that all gets disrupted. Not only is the addict changing their life, but the person who's identity was tied up into living with the addict, their life is totally changing too. Their identity is being called into question, and also that's usually a time when a lot of the underlying control issues come to the forefront and that's why they developed groups such as Allenon for spouses of alcoholics and Co-dependents Anonymous for those that are dealing with codependency.
How can a 12 step member handle the difficulties of life and relationships?
When you walk back into that system, there's only so much you can do. You can make a man, you can try to change your life but you're not responsible for other people's reactions. You are not responsible for other people's feelings. I'd say one of the things that implies a co-dependency is like you make me feel a certain way. It's like, no you're making yourself feel that way. When I respond in a certain way the way you want, you give yourself a very positive feeling. When I don't respond the way you want, you give yourself very negative feelings and it could be anything from fear and anger to rage. The behavioral addict needs to focus on themselves. The co-dependent needs to focus on themselves and their issues because they have their own issues. Not only do they relate to the addict, but as they relate to their own life and to their own identity.
