Recovery Workshop: Lesson Sixty

Preventing Slips/Relapse

There are two common, sincere strategies that people adopt when dealing with relapse prevention. The first is a passive, “I can do this...” approach — relying on their existing knowledge, experience and desire to manage future urges in an effective, healthy way.

Strategy #1: "I can do this..."

Usually, those who adopt this strategy have, somewhere in the back of their minds, continued to hold on to the false belief that recovery is an event — with a distinct beginning and an end. Intellectually, they may understand the concept of transitions and processes, but have not yet learned to apply these concepts to their own life in a functional way. This may get confusing, so do your best to follow. Often, even though these individuals may believe that they have adopted a 'recovery as a process' approach — and thus, believe that they are taking the most efficient path to health — in reality, they have adopted a series of beginning and endings along that path. A series of milestones. Of time measurements. Of black-and-white/good-or-bad behavior. Successes/failures. And while this pattern is not the 'all-or-nothing' extreme experienced in a raging addiction, it is also not the most effective approach to long-term change or to relapse prevention.

"Why then, do so many adopt this pattern?"

There are three answers to this question. The first is that, quite simply, adopting the "I can do this..." approach is the most natural. The approach itself is rooted in the positive emotions generated from the powerful feelings that come from the sincere belief that the individual will never again engage in such destructive behavior. And because they "feel' as if they won't engage in such behavior, they then translate that feeling into the belief that they won't. Which is unrealistic and often leads to the most devastating of all relapse triggers: complacency.

Experiencing the confidence and strength from such a positive affirmation as "I can do this...", while valuable at the time, becomes wholly irrelevant when the emotional variable of the urge is added to the decision-making equation. With the intensity of the urge factored in, the "I can do this..." is reduced to "I want to do this." Then, "I wish I could do this." Then, "I wish I would have done that." Then finally, "I will do it the next time." Why? Because it is still the emotions that are taking the primary role in decision-making. Overcoming this natural pattern will be an issue addressed later in this lesson.

The second reason that so many adapt the passive approach to transitioning their life is that it is all they know. Life management is a skill that does not get mastered until after addiction has been removed, and so, the passive, confident approach is an easy one to manage once the compulsive behavior has stabilized. By continuing to attend meetings, read recovery books, take medication, go to counseling sessions and whatever other strategies they used to stabilize their addiction, they continue on with that approach — with the logical assumption that the continuation of those strategies will be an effective way to keep those behaviors from returning.

Unfortunately, such logic does not translate into an efficient platform for relapse prevention. Why? Because at the core, it is fear that is motivating the behavior: the fear of relapse. And because it is the fear of relapse that motivates behavior, the motivation to continue relapse prevention remains only for as long as that fear continues. Once complacency arrives — and it always does — it will require only a return to the compulsive behavior to re-engage the fear motivator — and thus, re-engage the 'recovery' effort. Many individuals convince themselves into believing that addiction is permanent, and so they must fear potential relapse every day for the rest of their lives. How effective of a strategy is this? Well, for some it works. Of course, it is impossible to measure the effects of such an approach on that person's quality of life, but from an abstinence standpoint, it works. But for very few individuals. The great majority instead fall victim to reality (e.g. it is impossible to remain so intensely focused on recovery/relapse every single day) and complacency.

The third reason for the passive approach is that human beings, as a species, don't like change. And so, when faced with an opportunity to continue with something that is comfortable and stable or move to something that is new and for which they are inexperienced — the majority of people will choose the former. In relapse prevention, the behavior in question is their current, stable recovery routine. From the moment they made the commitment to change, recovery became a developing value in their life — capable of producing healthy emotional intensity. The more experienced they became at managing their recovery, the more balance they were capable of achieving. Eventually, they were able to manage their recovery based on their existing value system. But managing recovery and managing a healthy life are two completely separate tasks. One (recovery) is a fraction of the other (life). And so, while the essence of recovery can be achieved with a relatively small number of values/skills...living a stable, fulfilling lifestyle requires a foundation of values — not just one or two.

And so, while the efforts people made in recovery have been an important value in regaining stability, these efforts are not sufficient to maintain that stability in a healthy life. Why? Because life is not stable; it is fluid. And because this is so, a continued reliance on 'recovery' to manage life will fall way short in redeveloping a healthy, fulfilling life. New values must be developed. New skills must be mastered. Otherwise, people will be trapped in a life management strategy that is focused on avoiding the past, and will be incapable of adapting to new, healthy challenges in the future.

Taking a reactionary approach to 'life after addiction' leaves people at the mercy of their current emotional state. When that emotional state is stable, life is good. And complacency sets in. But when that emotional state becomes disrupted — due to stress, trauma, the consequences of complacency, etc. — life becomes vulnerable.

Strategy #2: "I am doing this..."

In a passive, reactionary approach, the main deficiency is that when you react to a stimuli, your decisions will be affected by the intensity of the emotions experienced as a result of your perception to that stimuli. In simple terms, your emotions will influence your decisions. And for someone attempting to end compulsive behaviour, the influence of emotions should be limited — and preferably eliminated.

The second group takes an active approach to relapse prevention. Much like early recovery required the active development of an initial foundation of values, boundaries, emotions, decision-making, prioritization, goal setting and more…an active approach to relapse prevention requires that specific actions be taken to master/ingrain these areas of life management. When you act, you place yourself in a position to develop the most efficient strategy for dealing with triggering stimuli and urges—a strategy that is based in the stability of your values/boundaries versus the instability of your emotions.

The question then becomes, should you choose to take an active approach to relapse prevention—and thus, an active role in transitioning your life to health—WHEN SHOULD YOU ACT?

There are five specific times that you must act if you are to ingrain the skills that you have been developing in the earlier part of the workshop. These five times are:

• Prior to an Expected Trigger
• Prior to a Spontaneous Trigger
• On the Experience of an Urge
• On the Discovery of Being “Off-Track”
• On Schedule

Five Required Actions in Effective Relapse Prevention

1. Prior to a Expected Triggering Event

With your development of a functional self-awareness having begun, and a policy of absolute honesty with yourself already in place (and if it is not, it had better be or you're wasting your time), you now have the opportunity to use these skills to help you prepare for emotional crisis that could lead to unhealthy decisions/destructive consequences. The first action that must be taken in relapse prevention is to develop action plans that will address all known triggers that you will be exposed to (or likely exposed to) prior to the event. This does not, however, mean that you must develop these action plans now. In fact, they will be most effective when they are created in the time immediately preceding a known triggering event.

Throughout your life, you have been exposed to certain stimuli that has ingrained a ritualistic type of emotional response — usually ending with the decision to engage in the behavior. Some of these potential triggers will be obvious:

• You are leaving for an out-of-town business trip
• A new secretary has been hired that you find yourself attracted to
• A long-time neighbor is having trouble in their marriage and seeks comfort
• You have just broken up with your romantic partner
• You are going to be at an event where you will be drinking
• Significant time of year/anniversary is approaching
• Major life event occurs (e.g. fired, promoted, divorced, married, death, etc)
• Family reunion
• You befriend someone with a spouse that you are attracted to
• Your romantic partner will be out of the country for an extended period of time (e.g. military, international business)
• An old romantic friend contacts you after years to say that he will be passing by and would like to see you

One thing that all of these events have in common, is that they are all known events — you know that they are going to happen. And because you are engaging in absolute honesty with yourself — you also know what your most likely emotional responses will be when you are in this situation. You may not know the decisions that you will eventually make at the time of the experience, but you will certainly know the temptations that will be present. This provides you with an opportunity to take effective action to help prevent your emotions from influencing your decision-making process. In other words, relapse prevention includes the need — no, the requirement — to prepare for known triggering events.

Action to take:

I. Upon the discovery that you will be facing a situation that has caused you to make destructive choices in the past, your first step is to err on the side of caution. Rather than taking an "I'm doing so much better...I can handle this." approach to the event, allow yourself to believe that you are not yet prepared to handle it. That your emotions, your decision-making skills, your prioritization skills are not yet mature enough to allow you to manage the situation on your own.

The truth of the matter is that you may very well be able to manage the event flawlessly, but that is not the point. Whether you can or can't manage the event at this particular time in your life is irrelevant to the much more important task of learning how to prevent relapse. And so, you must take the emotional pressure off yourself by allowing yourself to be the student. By seeing these events as opportunities to further your own development, you are constructing the best possible foundation for preventing life-altering episodes of addiction relapse.

II. As a student, the second step is to construct an action plan that you will engage in — should the expected temptations/urges appear. As with all action plans, the goals/actions/decisions should be based on your existing values/boundaries. Creating this action plan prior to the actual event ensures that the emotional aspects of your behavior are mechanically removed from the equation. Or more accurately, they are processed with an appropriate amount of influence — as opposed to the unrealistic expectation that they are not to be taken into consideration at all.

III.(Optional, but recommended) With an action plan that you feel comfortable with in place, validate this plan with someone you care about/respect. Ask them to review it for realistic expectations and achievable actions.

IV. Role-play this scenario in your mind again and again and again...in the days/weeks leading up to the event. Allow yourself to envision different ways that the temptations may come across. Allow yourself to imagine the emotions that you will most likely experience at the time of these temptations/urges. And then, always, imagine yourself following through with your action plan. Always. Every single time. Allow yourself to envision the successful implementation of the action plan in your role-play. Allow yourself to evaluate the positive consequences of those actions.

And while such actions may desensitize you to the emotional intensity of the event, it will not stop you from making destructive choices — it will merely place you in the best possible position for making whatever choices that you want to make.

2. Prior to a Spontaneous Triggering Event

Of all the actions to take in relapse prevention, this one is the most effective for staving off complacency and for ingraining the life skills that you have introduced into your life.

If you approached your recovery content to wait until compulsive urges appear before taking action, then the tools that you were exposed to in early recovery will never become fully developed. Just as an athlete must spend thousands of hours in practice to excel on the field; so too must you practice life management skills to the point of mastery — ideally, long before you have the need to use them. Obviously, you don't want to set up actual compulsive situations with which to test yourself on — that is both naive and gamely. But you do want to set up opportunities to continue gaining confidence and experience in utilizing these tools so that, when it comes time to confront an actual compulsive event, your response will be automatic.

Action to take:

I. Begin fantasizing on a regular basis — accept that the purpose of your fantasy is to learn, rather than to be stimulated. You will need to visualize compulsive triggers/events and your healthy responses to them. The important part of visualization is that you actually commit yourself to using it on a regular basis...and that the focus is on you seeing yourself actively engaged in the triggering event and making the decisions/actions that you know to be healthy.

II. Fantasize often. Several times a day is not too much, as each can be accomplished in a matter of minutes and can be completely undetected by those around you. But always fantasize about a healthy conclusion to the urge.

III. Begin with the most common triggers that you have experienced, and as you feel more and more comfortable in mastering a healthy reaction to those triggers, begin to branch out to other behaviors that are closely related to the original. One visualization to an event will not ingrain a response. Twenty visualizations to that same event over the course of several months will.

IV. For any events/triggers that you cannot clearly visualize in a healthy way, develop an action plan.

To best understand visualization in recovery, I will share a summary of my own experiences:

After spending the first year or so in a "trial and error" mode of recovery, I began collecting more and more experience in managing my urges. I had adopted the attitude that, 'I may get thrown off track by an event/trigger that I was unprepared for, but I will never fall into the same trap twice.' And this approach worked fairly well, except for the fact that there are an endless amount of triggers out there. You simply cannot prepare for them all and you certainly can't continue a strategy of personal development where your sole source of learning comes from the destructive consequences of your actions.

And so, I began to apply the visualization technique to my own recovery process and my recovery took off in a way that I could not have imagined. Suddenly, my recovery focus wasn't based in the fear of experiencing negative consequences/destructive actions, it was based in the enthusiasm that I could actively work on building a more healthy lifestyle on a day-by-day basis. No more waiting for urges. No more flirting with compulsive situations. I could actually learn from the experiences that were generated inside my own head — without the temptation and potential destructive consequences. What's more, once these experiences became ingrained, their transition to reality was almost effortless.

Just as I had played in my head so many times before, when I actually came across a porn magazine in a dumpster, it was easy to leave it there. And as I walked away, I was filled with the pride and intense emotional stimulation that comes from the positive consequences of making healthy choices. It was just the way that I had envisioned it. When a client I had bonded with asked to see me 'as friends' after she was discharged, it was easy to say no. It was just as I had envisioned it. When I would come across a woman in the community that struck me as being special, it was easy to see her not as an object of beauty, but as a mom, a daughter, a person. Because this is how I envisioned her in my own role-playing.

Over the years, I got to the point where every realistic trigger of mine had been mastered. And with this development, a new consequence evolved: I no longer feared triggers. It didn't matter what they were or when they occurred. I was prepared to handle all compulsive triggers in a way that would further my existing values/goals. With such a realistic confidence in place, I then learned the most important fact that, to this day, remains the most significant insight into relapse prevention that I have ever experienced: triggers have no power. They are not capable of producing action. They are not capable of producing emotions. It is how we perceive those triggers that will determine our responses, not the triggers themselves. And so, to this day I have yet to experience a single 'trigger' where I felt fear and anxiety. When I see porn now, it is with no real emotional intensity — a reality I couldn't have imagined fifteen years ago. When I am propositioned now, there is only an association of what I have to gain and what I have to lose. The emotional intensity is absent.

All of this was ingrained due to ongoing visualization/role-playing — as opposed to waiting to experience such things in reality.

3. On the Experience of an Urge

While visualization will be the easiest and most effective action to take in preventing relapse, this will be the most difficult and will take the longest to master. Ironically, this is also the area of recovery that many people try to tackle first...and experience discouragement when they are unsuccessful. And make no mistake, most are unsuccessful. It is only when you have pulled all of the pieces to the compulsive puzzle together in your mind...when you have learned to master each of the individual pieces...that the tools involved with Urge Control become effective. And so, relying on pure desire and sincerity is an insufficient approach in urge control.

Action to take: (Action Plan)

When dealing with an existing urge, most of what is required was discussed in the Urge Control lessons. Please review these as necessary until you have a solid understanding of the urge control process. What follows is a brief summary only:

I. The time to act is immediately following the recognition of the urge. Once the compulsive trance has been established, you will only be playing mind games with yourself.

II. Isolate your emotions. Separate them from your core identity (values/boundaries). Acknowledge their limits in terms of pain/uncomfortableness. Recognize their temporary nature.

III. Engage in your Action Plan for this trigger. If you do not have one, then take the time to mechanically create one. Ensure that your decision-making skills were implemented with the emotions isolated. Ensure that absolute honesty was engaged in determining options/consequences.

IV. Accept the consequences for whatever actions you decided to take. If you acted in a healthy way, embrace the success. If you acted in a destructive way, embrace the responsibility.

4. On the Discovery of Being “Off-Track”

Most everyone, even the sincerest of individuals, will occasionally open their eyes to the realization of "What in the hell am I doing?!" To their best intentions for health, they have found themselves returning to destructive behavior for temporary emotional relief. Most often, this return will include behavior from previously ingrained patterns, but it can also be seen in the development of new compulsive behaviors that can have similarly devastating consequences.

When you have found yourself to be 'off track', there are certain actions that you must take to prevent a full relapse from completely destroying your life. These actions are not intended to shield you from taking responsibility for what you have done, only to ensure that you get back on the right track as soon as possible. The destructive consequences will remain for you alone to take responsibility for.

Action to take: (Action Plan)

I. Regain Stability — this means emotional and behavioral stability. It is imperative that the first goal is to regain balance in your life. Without it, you will remain vulnerable to continued acting out. For most, this means a recommitment to recovery...which as we know, provides a temporary balance only.

II. Evaluate/Update Your Values — another means for regaining stability, updating your values will begin to provide the initial clues as to where you struggled in relation to life management.

III. Update/Refine Your Goals — yet another means for regaining stability, updating your goals will provide the most obvious clues as to where you struggled in relation to life management. Most often, those who relapse will have completely lost control of the goals that they are working on — and thus, completely lost control of their ability to manage their life. The most important aspect of goal management in relapse is to REDUCE the number of goals that are being attempted; and to SIMPLIFY the goals that will continue to be worked on. This means that, while a goal may have originally had a month time frame for completion, it should be broken down into more immediate, specific tasks that can be accomplished in a matter of days. Set yourself up for success, not failure.

IV. Develop a Three-Day Time Management Schedule — set-up a time management schedule for the upcoming three days and follow-it. This does not have to be a minute-to-minute, inflexible time management schedule, but it should be a clear, stable map of what you will be doing with your time over the next several days. There are numerous reasons for such a schedule, but the most important is to regain stability and control. To remove the emotional aspects of decision-making form your life management tools for a few days.

V. Map Out the Progression of the Relapse — once your life has stabilized, map out the progression of the events that led to the unhealthy behavior. Many of these events will become clearly associated with a poor use of values, decisions, time management, etc. And that is okay. This is why you must give yourself time to recover and time to develop these skills. They are not easy ones to develop — especially to a compulsive mind that tends to expect perfection and is prone to getting overwhelmed by multiple stimuli.

VI. Analyze the Relapse — once you have mapped out the process of how you lost your way, look for known triggers and times where existing tools could have been used to help you. Develop action plans for the known triggers and visualize your effective use of these tools in avoiding this relapse. Document the process of this relapse for future study.

VII. Assess the Signs of Relapse — once you are stable, take inventory of the secondary signs of your relapse (signs beyond destructive behavior). When appropriate, ask family and friends to give an honest account of any behavioral/emotional changes in you of late. Document these changes and use them in your fifth relapse prevention action: Scheduled Self-Assessments.

5. On Schedule

While most people committed to the recovery process do find themselves "off track" in the first year or two of their transition, many discover this fact only when their destructive actions are discovered by another. In most cases, the culprit to this relapse will be complacency; which means that in most cases, the relapse could have been avoided.

When all is going well, the individual too quickly jumps to the conclusion that, Because their life is currently stable, they have achieved an effective 'recovery'. Of course, we know by now that recovery is a process, not an event...and so this false belief that current success can be translated into skill mastery is naive. To believe that mastery has been achieved when the skills themselves have not yet been ingrained is to open the door for the same self-deception that is experienced in addiction. The person convinces themselves that, Because they are doing so well, it is now safe to return to a life of 'temporary secrecy'. As in, they will only engage in this compulsive behavior to help them get past this current emotional state, but after that, they will return to their commitment to change.

Because this behavior does occur under the veil of secrecy, it often goes undetected for significant amounts of time. The longer it goes undetected, the more ingrained the return to such destructive behaviors become, the more damage the relapse will wrought. Your goal then, is to ensure that these patterns never go undetected. And you accomplish this critical task by scheduling regular self-assessments.

A second common pattern of relapse occurs when the individual is not engaging in secrecy, but in a complete lack of awareness of their behavior. This is much more frequent in love addiction, than it is in sexual addiction — as the behaviors associated with sexual addiction are much more concrete. Thankfully, scheduling regular self-assessments will prove to be just as efficient for both in preventing relapse.

Action to take: (Action Plan)

I. Create an ongoing list of signs/symptoms of when you are struggling to manage your life. Note that you are not asked for the times you act out...but instead, a more general approach is necessary.

II. Create an ongoing list of major life events/triggers that would likely create a significant emotional imbalance in your life.

III. Create an action plan for what you will do should you determine that you are currently struggling to mange your life/emotions.

III. For the first six months, review your life/this list weekly, adding to it as appropriate. Ensure that you engage in an honest, objective review

IV. For the following six months, review your life/this list on a monthly basis.

V. Continue to adjust the time between your reviews accordingly, but always schedule a review at least once a quarter. Why? I have the perfect example of why: it has been fifteen years since I last acted on any sexual addiction urges. And because I continue to assess my own life on a quarterly basis, I was able to recognize a developing unhealthy pattern on the love addiction side just a few short years ago. What gave it away? The symptoms/traits listed on my self-awareness sheet fit my current behaviors to a tee. And yet, I was totally clueless at the time. Such scheduled self-assessments are a critical aspect of relapse prevention.

Lesson 60 Exercise:

1. Develop a Plan

Engaging in these five actions will ensure that you maintain the most efficient skills for preventing relapse. Develop a plan that is unique to you. Post this plan on your Recovery Thread.

2. Motivators

A fundamental of early recovery is to establish a list of positive motivators that can be used to sustain one's focus and energy throughout the transition to health. Go back and examine your own motivators (Lesson One) — note those that continue to motivate you today and those that have lost their intensity. You will almost universally conclude that it is the positive motivators that have survived the crisis. Those based on negativity and fear (e.g. I don't want to lose my marriage; I hate who I have become) tend to lose their ability to motivate as the initial crisis wanes.