Relapse Prevention


"I thank You, oh God, for giving me strength to pass one more one clean day."

Whose prayer is this? What clean day he is talking about?

This is the typical prayer of an addict who was entrapped in drugs for many years. Now, having come out of it, he thanks God for just one more drugless day; because he knows he is walking on a thin tight rope; he can fall any moment, at the slightest flutter.

How he began, what ordeals he passed through, how he exerted and strained himself to come clean, and the last and the most strenuous, how he strives to stay clean and sober day by day - all this is a horror story plot. Millions of young and old are going through this story at one stage or the other. As a friend said to me, "To quit using is easy but to keep on not using, ain't!"

Here are an articles from written by the esteem Dr. Stanley J. Gross, Ed.D. I hope by reading this article and the like will make my journey to recovery smooth going. So will you too.

Relapse Prevention

by Stanley J. Gross, Ed.D.

Once you have made a change, how do you maintain it? What is the difference between a lapse and a relapse? How can I recognize when a relapse is likely?

A lifestyle change is not easy to make or maintain. Lapses (a one-time return to addictive behavior) and relapses (a return to an addictive lifestyle) do occur. Some people relapse several times before new behavior becomes a regular part of their lives. Thus, it is important to learn about and use relapse prevention techniques. Before discussing prevention, it is useful to understand the nature of relapse.

Relapse Process

The relapse process occurs in a series of steps and in the direction of a return to addictive or other self-destructive behavior. Along the way, there are opportunities to use new ways of thinking and acting to reverse the process. To understand relapse process and prevention in the following example, imagine you are making one of these lifestyle changes: stopping smoking, attending 12-step group meetings, or beginning an exercise program.

Sometime after making a change, the demands of maintaining it seem to outweigh the benefits of the change.
We don’t remember that this is normal. Change involves resistance. Reaching out to a supportive person can help clarify our thinking.

We feel disappointed.
We forget -- disappointment is a normal part of living.

We feel deprived, victimized, resentful, and blame ourselves.
These are "red flags" for a lapse. Talk with a supportive person to clarify the situation.

It occurs to us that our old behavior (smoking, isolation, inactivity) would help us to feel better.
If we would consider why we made the change in the first place, we would remember how the old behavior made us feel worse. Talking to a supportive person, distraction, or relaxation can help relieve the pressure.

Cravings for the old behavior begin, undermining our desire to continue to care for ourselves in the new way.
Cravings are a "red flag" for relapse. We need a plan to divert our attention.

A cigarette ad attracts us, or someone in a group puts us down, or we strain ourselves by overdoing exercise.
More "red flags!" Acknowledge that it is difficult to make a change. Talk to a supportive person or distract yourself.

We say, "I told you so. This new stuff will never work." The cravings increase.
This shows our immediate need to develop a diversion plan to deal with cravings.

We then take a risky action. We go to a smoke-filled bar, or hang out with support group cynics, or phone a friend who berates anyone who exercises.
These are "dangerous situations" that put us on a slippery slope toward relapse. Put diversion plan into effect.

We ignore our "slippery slope," focused as we are on the old behavior.
Now is the time to put our plan into action or we increase the risk of a lapse.

The cravings keep increasing.
"Red flags" are waving. With our limited coping skills, failure to employ an alternative plan, and unwillingness to talk to anyone, we increase the risk of going back to our old behavior.

When we begin to think the old behavior will reduce the cravings, a lapse in maintaining the new behavior is likely to occur. We smoke a cigarette, avoid support group meeting, or miss our regular exercise appointment.
If we understand that the lapse is a natural result of our resistance to change and using the plan, we will be able to go back to our new behavior with minimal guilt. It is also helpful to talk to a supportive person to clarify the situation. We also understand that there is no magic. The cravings will not go away until we find ways of coping with them while maintaining the new behavior. To help contain and reduce cravings, start: (1) a program of new activities, ways of thinking, and acting; (2) self-help groups and psychotherapy; and (3) diet and exercise.

If our guilt is intense and in the absence of a plan, we will likely relapse until our next effort to change.

Relapse Prevention

Preventing relapse requires that we develop a plan tailored to maintaining new behavior. The plan involves integrating into our behavior diversion activities, coping skills, and emotional support. Our decision to cope with cravings is aided by knowing: (1) there is a difference between a lapse and a relapse; and (2) continued coping with the craving while maintaining the new behavior will eventually reduce the craving. These coping skills can make the difference when cravings are intense:

Ask for help from an experienced peer and use relaxation skills to reduce the intensity of the anxiety associated with cravings.

Develop alternative activities, recognize "red flags," avoid situations of known danger to maintaining new behavior, find alternative ways of dealing with negative emotional states, rehearse responses to predictably difficult events, and use stress management techniques to create options when the pressure is intense.

Reward yourself in a way that does not undermine your self-caring efforts.

Pay attention to diet and exercise to improve mood, reduce mood swings, and provide added strength to deal with stressful circumstances and secondary stress symptoms, including loss of sleep, eating/elimination problems, sexual difficulties, and breathing irregularities.

-This article was adapted from Growing Ourselves Up: A Guide to Recovery and Self-Esteem, by the author, Stanley J. Gross, Ed.D.


Stanley J. Gross, Ed.D.


Stanley J. Gross, Ed.D. is licensed as a psychologist in Massachusetts and Indiana, and is co-owner of Access for Change, L.L.C., a firm offering behavioral health services in Quincy, Massachusetts. He is Professor Emeritus of Counseling Psychology at Indiana State University. Dr. Gross trained in systems work with family therapy pioneer Virginia Satir, and at the Boston Family Institute. He is a Certified Addictions Specialist (of the American Academy of Health Care Providers). Dr. Gross regularly offers workshops on self-esteem for the public at the Boston Center for Adult Education and for professionals at the Massachusetts School of Professional Psychology. He has published numerous articles (and a book) on mental health related issues. Dr. Gross’ doctoral degree is from Columbia University, and he has done post-doctoral work at the University of Illinois Medical School and at the Center for Addictions Study at Harvard Medical School.

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2 Comments thus far...


Wonderful post as always.


Sent you a link to HNT.

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