Is picking up the first drink or drug of relapse a “conscious decision?” Those who resist the idea of being “powerless” often seem to argue this point. But a decision can only be as valid as the information on which it is based. In “wishful thinking,” the alcoholic/addict has forgotten his or her own suffering, the reason for quitting in the first place. Not only that, the person seems consistently unable to perceive the real consequences of the act. Add to this a blindness to the internal pain for which the pain killer may be sought, and an equal unawareness of just how strong a desire is clamoring for “just one.”  What you have is a decision being made in the absence of all of the most critical information!  The generally more emotional “expletive” relapse seems to lack a sufficient grasp of two things. The infinite number of alternative ways to deal with almost any upset. And the specific values that are ultimately more important to the person than the immediate frustration, things which will cause far more suffering when they are lost due to the relapse. Conscious, I don’t think so.

Exciting news!  I have been added to the program at the United Kingdom and Europe Symposium on Addictive Disorders – UKESAD –  in London, May 11.  The conference theme is on “a strong and stable recovery”  and my workshop will be on motivation for maintenance, an almost perfect fit.  I will try to develop the same eight “motivational discrepancies” that are the basis for the workbook.  My understanding of a motivational discrepancy is a moment of “getting it,” the realization that I cannot have some particular cake and eat it too.  Recently saw the movie “Ray” again, saw multiple people try to motivate him, trying to develop discrepancies  every single time.  At the end, his wife and imaginary mother were effective, with an assist from the FBI.

Have received some initial feedback on the workbook, very positive. It comes from people who know me and know my work with the two kinds of relapse thinking. One said,” there isn’t anything comparable out there that I have seen that personalizes relapse syndrome as this does.” However, this same person thought the workbook might require “a clientele that can engage in a little abstract thinking.” And a counselor who tried the workbook in a Suboxone support group reports that they rejected it out of hand, because they weren’t “college students.” Working with this version in individual sessions, I have seen clients struggle with the wording. At this point, I am striving to make it more and more user-friendly. I am actually more interested in the criticisms them the compliments, for that reason. One of my thoughts is to begin directly with the client’s personal experience of the moment of relapse. Another is to include illustrations from the book which give a visual depiction of what the client may be struggling to “get.” A facilitator’s guide, possibly posted on my website, might also help. At the same time, I have attended a workshop on self-publishing. I am very excited about the ability to have a first version out there, on a pay for printing basis, in the next few months.

An overlap between resentment and trauma: a fictionalized
client experienced restlessness and boredom and sometimes drank when her
boyfriend left her for the evening to do almost anything fun. Tennis. Poker
night. Bowling. The frequency of this was not great and she was sober most of
the time. When we explored the experience, we made a direct connection to her
being left alone as a child while her single mother drank at the local tavern.
Because of the helplessness involved, I treated this as a trauma and utilized
the “thera-tapper .”  Not only did the process not reduce the emotion we had activated, she became more and more aware of how much resentment she had. This, of course, could be dealt with by other means. The lightbulb that went on for me, as a clinician, was that trauma and
resentment have one major element in common. Reliving the earlier experience.  And both trigger their fair share of craving and relapse.

httpv://www.youtube.com/watch?v=XzbzqDLWv28

We start by acknowledging the importance of the process of relapse. However, it is clear from observation and experience that many people in recovery go in and out of the process of relapse without ever actually taking that first physical drink or drug. What is the difference? Those who relapse make a decision to actually pick up the first drink or drug, and do so. Universally, this decision is voiced in their own minds by two kinds of thinking, “wishful” and “expletive.” It is the thinking that reveals what has gone so terribly wrong. Whether by individual exploration or group exercise, we can help victims of this thinking to see what has happened to them and what to do about it. And that is why the moment of relapse is so important.