Understanding Substance Use: Relapse Patterns and History

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”.

Most often, I see clients struggle with FULLY admitting and accepting the "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 contact us for a free 15 minute consultation.

Authorship: This blog was written by Joe Woodbridge, LCSW. He has experience using EMDR therapy and IFS-informed EMDR therapy to work with adults, young adults, teens, and neurodivergent men who have experienced relational trauma such as attachment ruptures and family related trauma. Joe also has significant experience working with individuals in recovery from substance use from addictive behaviors.

Disclaimer: The information in this blog is provided for educational and informational purposes only. It is not intended to be a substitute for mental health care nor a recommendation or endorsement for any particular treatment plan, organization, provider, professional service, or product. The information may change without notice. No claims, promises, or guarantees are made about the completeness, accuracy, currency, content or quality of information linked. You assume all responsibility and risk for any use of the information.

The Willow Space for Trauma Treatment is an outpatient, trauma-focused therapy group founded by Joe Woodbridge and Erin Ziegelmeyer. Located on the Main Line of Pennsylvania in Paoli, we specialize in helping adolescents & adults struggling with traumatic responses and disorders of all kinds, including post traumatic stress disorder (PTSD) and complex post traumatic stress disorder (C-PTSD), attachment wounding, and relational trauma. We provide EMDR therapy to address symptoms such as anxiety and phobias, depression, low self-esteem, grief, panic, and dissociation. We offer ongoing support as well as EMDR intensives; both of which are informed by IFS, EMDR, DNMS, DBT, CBT, Polyvagal Theory, attachment theories, and developmental theories, among other therapeutic principles.