Relapse prevention

Recovery WellnessRecovery WellnessMeans for SuccessMeans for Success

Relapse PreventionRelapse Prevention

By James D. Amburn CDP, REV.By James D. Amburn CDP, REV.

Addiction and RecoveryAddiction and Recovery• Over the years I have heard many Over the years I have heard many

different speakers state that different speakers state that “Spirituality is the absence of fear”.“Spirituality is the absence of fear”.

• I personally believe that “Spirituality is I personally believe that “Spirituality is the healthy management of fear”.the healthy management of fear”.

• When even in fear you can manage the When even in fear you can manage the courage to do the right thing then you courage to do the right thing then you have become ok with you and your have become ok with you and your place in the universe. “A True place in the universe. “A True Spiritual Being” Spiritual Being”

What is RelapseWhat is Relapse(How did we get here?)(How did we get here?)

Relapse is a holistic change that occurs in a Relapse is a holistic change that occurs in a person; before they return to active person; before they return to active addiction (using).addiction (using).

Relapse is a return to old survival skills: Relapse is a return to old survival skills: Thinking; feeling (poor feeling Thinking; feeling (poor feeling management); and behaviors that create management); and behaviors that create urges, and if not stopped a return to active urges, and if not stopped a return to active addiction or death.addiction or death.

Like addiction, relapse is progressiveLike addiction, relapse is progressive

Event

Thoughts Feelings Behaviors Urges

EventsEvents• External events cause a chemical External events cause a chemical

response in the brain: response in the brain: • Even though a person may not be Even though a person may not be

cognitively aware; memories are cognitively aware; memories are being recalled, memories retained in being recalled, memories retained in nerve cells called dendrites.nerve cells called dendrites.

• The more extreme the event, the The more extreme the event, the longer we stay in the memories; the longer we stay in the memories; the greater the urges are.greater the urges are.

Events Events (samples)(samples)

• Fall in Love (Lust); Fall out of LoveFall in Love (Lust); Fall out of Love• Get a job; Lose a jobGet a job; Lose a job• Have money; don’t have moneyHave money; don’t have money• Music; smells; old friends; old placesMusic; smells; old friends; old places• Legal issuesLegal issues• Have a car (broke down, running); don’t Have a car (broke down, running); don’t

have a carhave a car• Have my children; don’t have my childrenHave my children; don’t have my children• Ex-wife/husband; present wife/husbandEx-wife/husband; present wife/husband

EventsEvents

Identify events and high riskIdentify events and high risksituations:___________________________________________________________situations:___________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Identify means to avoid or minimize events or high riskIdentify means to avoid or minimize events or high risksituations:____________________________________________________situations:____________________________________________________

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

EventsEvents• Identify who can help you in times of need manage high Identify who can help you in times of need manage high

risk situation or events:risk situation or events:

Name Phone #Name Phone #_______________ ______________________________ ______________________________ ______________________________ ______________________________ _______________ _______________ _______________ _______________ ______________________________ ______________________________ ______________________________ ______________________________ ______________________________ ______________________________ ______________________________ ______________________________ ______________________________ _______________• ““I will allow them to help me if I call”.I will allow them to help me if I call”.

ThoughtsThoughts• Thought is actually pictures and as Thought is actually pictures and as

our mind see the pictures we our mind see the pictures we translate them into languagetranslate them into language

• The first thought process in relapse The first thought process in relapse is a return to denial.is a return to denial.

• Then to self-abusive thinkingThen to self-abusive thinking• Finally our thinking goes to Finally our thinking goes to

Automatic Negative Thinking.Automatic Negative Thinking.

Thoughts Thoughts (examples)(examples)

• Self- abusive thinking:Self- abusive thinking:• Putting one-selves down Putting one-selves down • Cussing one-selfCussing one-self• Calling one-selves names (stupid, Calling one-selves names (stupid,

crazy, retarded, or dumb, comparing crazy, retarded, or dumb, comparing one self to another.one self to another.


• The language of denial that stops forward progress:The language of denial that stops forward progress:• If only, I don’t, should have, could haveIf only, I don’t, should have, could have• Denial is also the thinking that minimizes, rationalizes, Denial is also the thinking that minimizes, rationalizes,

intellectualizes, justifies, and personalizesintellectualizes, justifies, and personalizes• If only my PO would stopIf only my PO would stop• If only my ex would let meIf only my ex would let me• I should have been able if onlyI should have been able if only• I could have if onlyI could have if only• I can have one hit no one will knowI can have one hit no one will know• No one really stops usingNo one really stops using• Everyone does itEveryone does it• They’re out to get meThey’re out to get me


• Automatic Negative ThinkingAutomatic Negative ThinkingConcrete thinking (My way or No way, right or Concrete thinking (My way or No way, right or

wrong)wrong)• Victim stance thinking; Victim stance thinking; It wasn’t my fault, blamingIt wasn’t my fault, blaming• Vindictive Thinking; Vindictive Thinking; I’ll show themI’ll show them• CriminalityCriminality

• For every negative thought towards self it takes For every negative thought towards self it takes two-hundred positive thought to counter act.two-hundred positive thought to counter act.

ThoughtsThoughts• Identify denial Identify denial

thinking:___________________________________________________thinking:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

• Identify self-abusive Identify self-abusive thinking:___________________________________________________thinking:_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

• Identify my Identify my ANT:_______________________________________________________ANT:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

FeelingsFeelings• Feelings are neither good nor bad; they Feelings are neither good nor bad; they

are just feelings.are just feelings.• In addiction, extremes and intensity are In addiction, extremes and intensity are

the norm. However in reality extremes the norm. However in reality extremes and intensity are infrequent.and intensity are infrequent.

• In relapse a person will attempt to regain In relapse a person will attempt to regain the addictive norm. Thoughts create the addictive norm. Thoughts create feelings. So negative thinking creates feelings. So negative thinking creates feelings such as anger, resentment, feelings such as anger, resentment, depression and loneliness. depression and loneliness.

FeelingsFeelings• In recovery it is learned that healthy In recovery it is learned that healthy

feeling management is needed. The feeling management is needed. The formula E/I is used for addiction formula E/I is used for addiction Emotion over Intellect. When Emotion over Intellect. When entering into recovery the formula entering into recovery the formula changes to I/E, Intellect over changes to I/E, Intellect over Emotions. When entering into Emotions. When entering into relapse the formula again changes relapse the formula again changes back to E/Iback to E/I

FeelingsFeelings• Identify feeling I have when in Identify feeling I have when in

relapse:__________________________________________relapse:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

• Identify means to be ok with my Identify means to be ok with my feelings:_________________________________________feelings:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

FeelingsFeelings• Identify who can help you to express and manage feeling Identify who can help you to express and manage feeling

in a healthy wayin a healthy way

• Name Phone #Name Phone #• _______________ ______________________________ _______________• _______________ ______________________________ _______________• _______________ _______________ _______________ _______________ • _______________ ______________________________ _______________• _______________ ______________________________ _______________• _______________ ______________________________ _______________• _______________ ______________________________ _______________• _______________ ______________________________ _______________• ““I will allow them to help me if I call”.I will allow them to help me if I call”.

Behaviors Behaviors • From the “Sanskrit”; “All that we From the “Sanskrit”; “All that we

project on the outside is but an inner project on the outside is but an inner reflection”.reflection”.

• Behavior is where most people start Behavior is where most people start to realize that they are in relapse. to realize that they are in relapse. Unlike thoughts or feelings; behavior Unlike thoughts or feelings; behavior is easily identified as appropriate or is easily identified as appropriate or inappropriate.inappropriate.

Behaviors Behaviors (examples)(examples) • Language: Comparing one-self to Language: Comparing one-self to

others;others;Victim speech; they have all the luck, if I Victim speech; they have all the luck, if I

only had the breaks they have, they only had the breaks they have, they aren’t really clean.aren’t really clean.

Cursing self or others, systems, threats Cursing self or others, systems, threats towards people or places.towards people or places.

Disorganized speech; idea’s going in Disorganized speech; idea’s going in every direction, fantasizing.every direction, fantasizing.

Behaviors Behaviors (examples)(examples)

• External actions:External actions:Pacing, isolating, aggressive actions, Pacing, isolating, aggressive actions,

slamming doors, throwing things, slamming doors, throwing things, self-harm, higher pitched voice; self-harm, higher pitched voice; short choppy speech, clenched fist, short choppy speech, clenched fist, jaw, fast tense movement, or jaw, fast tense movement, or inability to sleep.inability to sleep.

BehaviorsBehaviors• Identify behaviors I have when in Identify behaviors I have when in

relapse:__________________________________________relapse:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

• Identify means to change my Identify means to change my behaviors:_______________________________________behaviors:___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

BehaviorsBehaviors• Identify who can help me manage my behaviors in a Identify who can help me manage my behaviors in a

healthy wayhealthy way

• Name Phone #Name Phone #• _______________ ______________________________ _______________• _______________ ______________________________ _______________• _______________ _______________ _______________ _______________ • _______________ ______________________________ _______________• _______________ ______________________________ _______________• _______________ ______________________________ _______________• _______________ ______________________________ _______________• _______________ ______________________________ _______________• ““I will allow them to help me if I call”.I will allow them to help me if I call”.

Activities to Help Break the Activities to Help Break the Cycle of RelapseCycle of Relapse

• Working out with a friendWorking out with a friend• Go to a meetingGo to a meeting• Call a friend, sponsor, mentor, elderCall a friend, sponsor, mentor, elder• Volunteer Oxford presentations, H & Volunteer Oxford presentations, H &

I (12 step ) presentationI (12 step ) presentation• Help someone who is having Help someone who is having

problems with their own recoveryproblems with their own recovery

Personal Activities that Personal Activities that Promote Recovery Promote Recovery

• To help me change my thinking and To help me change my thinking and behaviors I can;behaviors I can;

____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Relapse Prevention Relapse Prevention ContractContract

• As a Recovering person I;_______________________. As a Recovering person I;_______________________. I will allow others in recovery to help me manage I will allow others in recovery to help me manage my thinking, feelings, and behaviors in a healthy my thinking, feelings, and behaviors in a healthy manner. manner.

My main purpose is to develop a health life style My main purpose is to develop a health life style

that will let me remain in recovery.that will let me remain in recovery. I no longer want to live in my past, allowing my I no longer want to live in my past, allowing my

addiction to jeopardize my; life, freedom, friends, addiction to jeopardize my; life, freedom, friends, family, income, or spiritual growth. family, income, or spiritual growth.

To achieve this goal I will allow;To achieve this goal I will allow;

• Name Phone #Name Phone #• _______________ ______________________________ _______________• _______________ ______________________________ _______________• _______________ _______________ _______________ _______________ • _______________ ______________________________ _______________

• ““I will allow them to help me even if I do not I will allow them to help me even if I do not believe I need help”.believe I need help”.

• Signature of Sponsor ___________________.Signature of Sponsor ___________________.

• Signature of Recovery Friend ___________________.Signature of Recovery Friend ___________________.

Resources'Resources'• Terence T. Gorski:Terence T. Gorski:• Staying Sober; Relapse Prevention Staying Sober; Relapse Prevention

Counseling Workbook; Relapse Counseling Workbook; Relapse Prevention Therapy with Chemically Prevention Therapy with Chemically Dependent Criminal OffendersDependent Criminal Offenders

• Dr. Darryl Inaba:Dr. Darryl Inaba:• The Evolving Science of Relapse and The Evolving Science of Relapse and

RecoveryRecovery

Resources'Resources'• Dennis C. Daley:Dennis C. Daley:• Relapse Prevention WorkbookRelapse Prevention Workbook• Ernie Larson;Ernie Larson;• Stage Two RecoveryStage Two Recovery

• My mind is not my friend. When I am My mind is not my friend. When I am alone with my thinking I’m in the alone with my thinking I’m in the wrong neighborhood and hanging wrong neighborhood and hanging with the wrong person.with the wrong person.

Relapse prevention

Education

Relapse prevention