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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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