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Relapse is a process, not a single event

Often times I hear the phrase, “I had a relapse”. What does that mean? I think within the

context of substance abuse treatment we associate relapse with the active use of chemicals or

addictive behavior (eating, gambling, sex, etc.) in 2018, I had the opportunity to go to Atlanta to

be trained in Relapse Prevention Counseling (RPC) which is a form of counseling that combines

12-step ideology, Cognitive Behavioral Therapy (CBT), and Motivational Interviewing (MI).

Terrence Gorski, referred to as the “Godfather of relapse”, created this method of counseling in

the 1980s when working with chemically dependent clients. What I learned changed the way I

view the term “relapse”. Relapse is a process, not a single event. The addictive behavior comes

at the end of the relapse process. This process can take anywhere from days, weeks, months,

and even years. What is interesting about this process is that it starts as soon as we make the

commitment to get well! Consciously or subconsciously, we subscribe to the belief that “we are

cured” and stop our personal growth. We think, “I’ve been in recovery now for X amount of

days/months/years and feel great” and cease really starting the work we need to do on

ourselves. Gorski defines early recovery loosely as “building a track record (30, 60, 90 days),

doing the necessary footwork, and fully admitting and accepting you have a problem”.

I think the one of these I see clients struggle with the most is the FULLY admitting and accepting

we have a problem part. It is easy to admit to others, especially if we are entering treatment for

them, that we have a problem. Accepting that we have a problem or a disordered pattern of

behavior is really the hard part. This is where the mistaken belief that we are “cured” comes

in—we can’t work on changing anything if we haven’t fully accepted that change needs to occur

in the first place! I really enjoy doing this type of work with clients because we really get to

explore the timeline leading up to the relapse. It gives clients clarity on where their thought

process was and the behaviors that led to the high-risk situation where they used chemicals or

engaged in the problematic behavior. It can help put the pieces of the puzzle together that

helps us to better understand ourselves and create a healthy future picture of recovery. One of

my favorite sayings in the recovery community is, “we cannot think our way into different

actions, we have to act our way into different thinking.” Once we know our relapse patterns

and history, we can take action to intervene by repeating past patterns.

If you are interested in learning more about Relapse Prevention Counseling or to want to

explore this work, please feel free to reach out!

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