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Addict in Wonderland: A Tale of Relapse Prevention
Drug Treatment
QCS & KCTS
How many addicts or alcoholics have been walking the path toward recovery, feeling like life was going well, only to stop to look at a rabbit hole and, like "Alice in Wonderland", fall in seemingly without the ability to catch our fall?
Since the discovery of the progression of the disease of addiction, pre-dating E.M. Jellinek's "Progression Curve" in the early 1950's, the prospect of developmental recovery has been contemplated. In 1985 Dr. Stephanie Brown wrote the book, "Working with the Alcoholic: A Developmental Model of Recovery", and Terrence Gorski took that work and developed the CENAPS Model for relapse prevention. The notion that relapse was a part of recovery came from a new perspective that recovery was a dynamic process, not a static point at which to arrive.
The concept asserts that one is already in relapse long before one actually uses again. There are thoughts and feelings that lead to behaviors that indicate that one is already accessing a relapse pattern. To be able to identify those warning signs allows us to intervene before we accelerate to fast down the hole. Not being able to identify those warning signs leaves us extremely vulnerable to that slide.
There is something attractive about the rabbit hole, something that peaks our curiosity. We look in, then all of a sudden, we are sliding in faster and faster, into another reality, one we knew before we entered the pathway toward recovery. At some point, like Alice, we seem to be in a free fall, no way out. At that point we will likely see some damage before we find our way out, and it might take a while.
It is that slippery slide that we want to avoid. Often the attraction to the rabbit hole is a return to a place where there was strong emotional attachment. Sure, it represented some good times, but it also represented loss, grief, resentment, guilt, a whole spectrum of negative, powerful emotions associated with the cost, the toll addiction extracts upon us to serve it.
Those strong emotions are the rabbit holes we often cannot afford to look into, especially not alone. The act of looking alone means that, before we can stop it, we are sliding, accelerating without a foothold, toward a flashback to another reality or memory that we often cannot handle.
When we experience traumatic events we often associate sensory perception surrounding those events with the intense emotion that we feel at the time. This creates a compulsive programming in the brain, a neuropathway, that forms a "trigger". Once the trigger is flipped, we experience all sorts of sensory perceptions and memories all over again, sometimes so vividly that it seems like we are back there again.
Avoiding triggers or developing trigger management strategies are the subject of relapse prevention planning. Triggers flip you into a compulsive mode by triggering neuropathways that lead you into an alternate reality, like PTSD victims experience on a more vivid scale in flashbacks. If it were as vivid, perhaps we could see it and take evasive action. But these compulsions are invisible, except for the "warning signs" that we can identify from past relapses. Before we realize we are too near the rabbit hole, we have slid into it and are falling.
Avoiding the rabbit hole altogether is the preferred strategy, but some triggers we cannot avoid. Exposure therapy is used when treating triggered responses for certain PTSD symptoms, panic attacks and various phobias like agoraphobia. It allows a person to experience incremental amounts of triggers with therapeutic support, well thought out and planned, so that the victim is armed with a management strategy.
Learning to manage triggers is risky business. Having immediate support is one method. Another is accountability, a call in. You know you will be in a high risk situation, so you call ahead of time, strategize with a sponsor or therapist, and arrange a time-specific post-event processing session.
Predetermined self-talk is yet another method, along with breathing and other relaxation exercises. These can be done in conjunction with the other methods.
If you have fallen into one too many rabbit holes, maybe you need some help with relapse prevention planning. Check out a list of warning signs to help your stop the slide.
For information regarding relapse prevention planning go to:
http://qcs-okc.com
http://quapawcounselingservices.com
http://kctxs.com
Article submitted Monday, September 22, 2008
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