Why Does Relapse Occur? Marlatt and Gordon (1985), conducted several studies on why relapse occurs, they found that there is a process that leads up to relapse that often begins long before the first drink is taken.
They describe the process as an apparently irrelevant decision that leads to a high-risk situation, this situation leads to a response in which you feel unable to cope which in turn leads to a feeling of helplessness and low self-control.
This feeling of a lack of self-control leads to an expectancy that the drink or drugs will make you feel better, this leads to the initial drink.
As you can see from this it is the initial decision that leads up to the first drink.
This may be something as minor as getting off at a different bus stop, which means you end up walking past a pub or inviting friends round for a meal only to find they bring a bottle with them.
These situations are ones you are likely to face all the time in your day to day life and therefore it is important that you are prepared to face them and have ways to deal with them before they occur.
It is the lack of preparation for these situations that will lead to the next stage of feeling unable to cope.
Lapse becoming Relapse However, taking one drink wouldn't be such a problem, it's when that first drink becomes a full-blown relapse.
Marlatt describes four stages that lead from that first drink to a relapse.
He describes the first step as a feeling of stress because that first drink has been taken and therefore they have broken the rule of 'no drink', this leads to a feeling of self-blame and a tendency to believe that you drunk because of some internal weakness which leads to drinking to reduce the blame and stress.
This leads to the positive effects of the drink reinforcing continued drinking.
Common sense states that just one drink is just one drink.
However, due to the strong belief in society that alcoholism is a disease and therefore one drink is a relapse as opposed to just one drink and therefore ruins months (or sometimes even years) of abstinence and therefore they may as well continue drinking.
Research reinforces this suggestion; recent studies have shown that whether or not that first drink leads to a full blown relapse is closely linked to the beliefs they hold.
The more people believe that just one drink is a loss of control, the more that drink will lead to a relapse.
Preventing and Dealing With Relapse There are two kinds of relapse: the first occurs very quickly during early intervention; the second occurs some way down the path of change sometimes even years later.
The first type is because you have tried to move, or have been pushed, into the action too quickly.
You can only change when you are ready to change and if you relapse early there is more work to be done on your feelings of ambivalence and motivation.
The second type of relapse is very different.
Here we have clients who have really dealt with their ambivalence, who feel ready to take action, but who do not manage to carry out their intentions.
This comes down to needing more work in anticipating problems you may face in your life and how to tackle with them when they do arise.
Anticipating Problems and their Solutions It is not the short-term abstinence or control over your drinking that is the main aim, it is the long-term aim of the being problem-free in the years to come.
In order to do this you need to brainstorm exactly what situations you will face that may lead to relapse and what both you and those around you can do to prevent relapsing in the future.
A useful activity to help with this is to think of a situation where you have exerted control - why did that happen? What did you do to enable you to keep control? Now think of a time when you relapsed - why did this happen? What led to you drinking in that situation and how could it have been prevented? The main aim throughout relapse management is not to ignore any possibility of relapse or to see the first drink as a loss of control but instead to see it as a learning process and a step on the road to recovery.
It's a situation you can use to learn from and develop strategies to support you in the future.