A big part of relapse prevention is studying setbacks, learning about triggers, and planning how to either avoid the triggers and/or respond differently to them in the future.
People who relapse from their drug decisions feel discouraged and can benefit enormously from support. Unfortunately, well-meaning loved ones and counselors often make matters worse by focusing on the negative consequences, as in this situation:
After two months of abstinence, Anthony was embarrassed and in despair about a one-night binge at a party over the weekend. Trying to help him get back on track, his friends focused on the harm. They hoped he would recognize the consequences of his relapse and avoid these setbacks in the future.
- “Look what you’ve done.”
- “Don’t you see the trouble this means.”
- “Now you’ve got to start all over again.”
His “helpers” meant well with their negative messaging. They were following the harm-based theory of change, built on the premise that people will overcome drug problems when they see the totality of the harm from their drug use. Carried to an extreme, this means people have to “hit rock bottom” before they will really change. When harm ultimately brings them to their knees, then they will finally take action. Therefore, helpers believe that they should accentuate the negative by focusing on the harm. This awfulizing should motivate loved ones to do better in the future.
The harm-based theory makes intuitive sense because recognition of harm is what initially gets people thinking that maybe they need to make some changes in their lives. However, to move from contemplation of change to effective action, they also need (1) a vision of a better life and (2) confidence that they can succeed in bringing about the desired change. After a relapse, they usually don’t need to be reminded about harm that is self-evident. In fact, they may be drowning in their regret. They feel discouraged and their self-confidence has been shaken. What people usually need after a setback is support in bolstering confidence that they could succeed.
This doesn’t mean ignoring setbacks. Anthony didn’t need well-meaning helpers to say: “Just forget about it, move on.” In fact, it’s important to figure out what caused the slip so that it can be prevented from recurring. A big part of relapse prevention is studying setbacks, learning about triggers, and planning how to either avoid the triggers and/or respond differently to them in the future.
PRINCIPLE 1: EMBRACE WITH COMPASSION
Family and friends are most helpful when they embrace a person who has suffered a setback with understanding and compassion. A barebones example would be:
“I’m so sorry that this has happened. I know you wanted to make a change, and this has been a setback.”
A compassionate statement can be embellished with genuine affection, such as “I really care about you” or “I love you so much.”
PRINCIPLE 2: ENCOURAGE CONFIDENCE
Next, people who relapse can benefit from encouragement from others who have confidence in their ability to succeed.
“I want you to know I believe in you. I know that people are capable of overcoming drug problems and I know that you can do it.”
This, too, can be embellished by commenting about previous demonstrations of strength and determination.
PRINCIPLE 3: ASK ABOUT NEEDS
Too often, friends and family members guess and make assumptions about what people need after a relapse. Helpers may even try to impose solutions. Instead, they could start by simply asking respectful questions.
Is there something I could do or something you need from me?
This not only shows respect, but also a real interest in providing support.
PRINCIPLE 4: OFFER A REMINDER
When setbacks occur, friends and family member can remind people about how the change process works – that relapses are to be expected and that setbacks offer the possibility of a learning opportunity. People who relapse can figure out what happened and learn from these difficult and often painful experiences. Friends and family members can offer a kind and simple reminder.
“You know, you can think about what happened and determine what triggered this setback, learn from it, and get back on your agenda. Don’t give up. You can figure this out.”
PRINCIPLE 5: PROMOTE PERSONAL RESPONSIBILITY
Friends and family may or may not be able to help someone figure out their triggers and develop new ways to cope. That problem rests on the shoulders of the individual with the drug problem. There is work to be done. Be careful to avoid the common pitfall of trying to take over and be the fixer. It only diminishes the self-confidence of those who are disheartened by a relapse. Here’s a sample statement.
“If you want to succeed in your decision and avoid the consequences of more setbacks, you will definitely need to face up to this problem. You can do this on your own or get help. If I can be helpful, I will.”
Although Anthony’s friends didn’t help him figure out what triggered his relapse, his counselor took a supportive approach:
“I’m glad you’re here today. I’m so sorry you suffered this setback. You know, relapses aren’t uncommon when you try to break bad habits or overcome addictions. What do you think happened? Let’s see what you can learn from this experience that can help you get back on your feet again.”
Together they discovered that Anthony’s relapse occurred after an argument that led to intense anger toward his spouse. He left home angry and that triggered his use. Rather than dwelling on negative consequences, he and his counselor focused on the possibility of future success. Anthony began to work on marriage issues as well as new ways to manage his anger. He renewed his commitment to abstinence and then moved forward with pride and increased self-confidence. After the relapse, he benefited from compassion, respect, encouragement and guidance.