The End of the World...and Other Things Relapse Is Not

Recovery Tools from Asana Recovery August 9, 2023

We come to treatment to “get sober” or “get clean,” and we celebrate each day that we’re able to live without mind-altering substances. In AA and other 12-Step groups we have “birthday” or “milestone” celebrations for periods of sobriety. Many of us treasure the coins or keychains or applause we get at our home group meeting for 30 Days, 60 Days, 90 Days, One Year of sobriety…

Clean time, or continuous sobriety, is the priority of most - if not all - addiction treatment programs. But let’s talk about the elephant in the living room, the monster under the bed. Relapse. Staying sober is such a priority for us and the prospect of returning to the shackles of addiction is so scary that most of us cringe just hearing the word. However, we know from our recovery work that our fears only become bigger and more dangerous if we don’t acknowledge them.

Dialectical Abstinence: ‘Abstinence’ Plus ‘Harm Reduction’

If you participated in Dialectical Behavior Therapy (DBT) as part of your recovery efforts, you might remember the concept of ‘dialectical abstinence.’ When dealing with addiction, there are two common approaches, each with pros and cons:

1. Abstinence. This is swearing off an addictive substance completely. According to DBT, the positive aspect of this approach is that people who commit to abstinence stay off longer. The drawback is that it can take longer for people to “get back on the wagon” if they fall off.

2. Harm reduction. This approach acknowledges that there will be slips and aims to minimize the damage of a slip, but does not demand perfection. On the plus side, if a slip does happen, people can get back “on the wagon” faster. But the down side is that people who commit to harm reduction relapse quicker.

The DBT approach is a synthesis of these two philosophies called ‘dialectical abstinence.’ “The goal is not to engage in addictive behavior again— in other words, to achieve complete abstinence. However, if there is a slip, the goal is to minimize harm and get back to abstinence as soon as possible.”

While there is no limit to the number of times someone can try to get sober in AA or other 12-Step programs, when the primary goal is consecutive days of sobriety, a relapse can feel like a failure. Given that we’re already prone to cognitive distortions like “all-or-nothing” thinking, this is often counterproductive to recovery efforts, especially if it leads us to hopelessness and self-recrimination. It can be more helpful to approach relapse with more balanced view like dialectical abstinence. Recovery is not a competition. We neither “win” nor “lose” at it. We are human beings facing a challenging illness, and we deserve our own grace and forgiveness.

If you’re interested, read more about dialectical abstinence and DBT.

What Relapse Is Not

While it’s natural and very easy to let yourself be consumed by shame, blame, hopelessness and other negative emotions following a relapse, it’s not helpful. In fact, it’s dangerous. So, here is a reminder of some of the things that relapse is not:

• Relapse is not the end of the world. You can

• Relapse is not evidence that you are ….doomed, hopeless, a failure, never going to succeed (fill in the blank with whatever harmful description is running through your thoughts). The DBT harm reduction plan suggests: “Stay away from extreme thinking. Don’t let one slip turn into a disaster.”

• Relapse is not a vacation. You’re always either abstinent or working to get back to abstinence.

• Relapse is not inevitable, unavoidable or necessary. It’s actually easier to prevent relapse than to deal with the aftermath.

• Relapse does not mean that all your recovery work is lost or not working. It is not a good reason to give up on trying to stay sober.

For people with Substance Use Disorder who have made a commitment to recovery, it’s obvious that using alcohol and drugs can no longer be a part of our lives. Therefore, we cannot view relapse as an acceptable or inevitable part of our recovery journey. In fact, some of us engage in such dangerous activities as part of our addiction that we might not even survive a relapse. However, relapse can be an opportunity to grow if we’re willing to learn from your experience and recommit to your recovery.

“A bend in the road is not the end of the road…Unless you fail to make the turn.”

―Helen Keller

Questions? Comments? Personal experiences? Tell us in the ‘comments.’