Unfortunately, many people who leave treatment end up relapsing, but this is not necessarily the end of the world.
Obviously we do not want to see anyone relapse, and this is never the intended result from treatment. But this does not change the fact that relapse can be a part of the learning process, and sometimes it is a necessary part of it for certain addicts and alcoholics.
The journey to “permanent” sobriety is a learning process
The idea of “permanent” sobriety is put in quotation marks because we all know there is really no such thing as an alcoholism or addiction cure. Anyone in recovery, no matter how long they have been clean and sober, is still just one drink or drug away from a terrible relapse. Addiction is never cured fully but is only put into remission.
But we still say “permanent” because there is still a point in recovery where the addict or alcoholic achieves what we might call “maximum stability.” They are clean and sober and they have pushed themselves very hard in their recovery program, they have learned a great deal about themselves and they have taken significant steps to achieve their sobriety. Such people have several years clean and sober, probably at least five to ten years.
Now, could such a person still relapse? Sure. Anyone can. Their sobriety is not really “permanent,” any more than the newcomer’s sobriety is permanent. But from the perspective of the learning process in recovery, their sobriety is more stable. In a comparative sense, because they have done the work and done the learning, their sobriety is “as permanent as you can get” in recovery, even though the threat of relapse is always going to be there.
The point here is that getting to this level of stability is a learning process, and it generally takes at least a few attempts at recovery in order to achieve it. Most people on the outside of addiction who are looking in probably underestimate this learning process, thinking that it is fairly straightforward or easy. I mean, how hard can it really be to figure out that abstinence is the best strategy for your life? But obviously, we know that addicts and alcoholics struggle a great deal, and some of them never really achieve a life of recovery and abstinence at all.
This learning process that I am speaking of here is not like going to school and learning how to spell words. Instead, I am talking about learning about acceptance and surrender. This is a different sort of learning process and it can take years or even decades for some addicts to figure this out. This does not mean that the person is stupid or that they are a slow learner, it may just mean that they are stubborn and resilient and hard headed.
Obviously one of the big keys to this learning process is to pause after each failure in your life and try to learn something from it. If you just crash through life and experience relapse after relapse and you never pause to see the bigger picture or the bigger pattern then you are missing out on valuable lessons. They have a saying in recovery programs that gets thrown around so much it is not even funny any more: “Insanity is doing the same thing over and over again and expecting different results.”
People who say that are generally referring to the idea that we tried to overcome our addiction on our own and learn to control our own drug or alcohol intake, but kept losing control and creating chaos in our lives. We basically were not changing anything at all (we kept using our drug of choice) and we were expecting things to turn out differently. The only way to overcome this insanity, they argued, is to try something different (such as abstinence, a recovery program, etc.).
But the journey to “semi permanent” sobriety (if I can call it that) can also resemble this cycle of insanity. Many people keep trying to get clean and sober using the same techniques only to keep failing over and over again. Some of them use rehab as a revolving door, going back to treatment dozens of times over the course of their life in an attempt to “dry out.”
Such people need a wake up call that they are just not getting. They need to realize that in trying to find a solution for their addiction, they are stuck in this cycle of insanity. They have already been to detox or rehab several times, and it has never worked out for them. What are the missing? What is the missing piece of the puzzle that would allow them to stay clean and sober if they finally found it?
In my opinion that missing piece is surrender. Ask yourself: “This time it is going to be different because……why?”
The correct answer is “This time it is going to be different because I have nothing left to fight with, I am completely destroyed, I have no more will to go on living in addiction, I am at rock bottom and cannot sink any lower. I do not care what happens next, I do not care if they send me to treatment, prison, or wherever.”
Now that might be just a touch extreme but you are getting the idea now. The addict has to be completely surrendered, completely defeated, if they are going to be able to go to rehab and have a different outcome than in the past.
And this is the part of the learning process that people may not be getting.
It is NOT that the addict or alcoholic has to learn some secret method of staying sober.
It is not that the addict has to learn a new attitude.
The secret is that the addict must fully learn and experience their own bottom, their own hopelessness, they have to be utterly defeated by their addiction. This is the lesson that will eventually produce success in the struggling addict.
Can they learn this by reading a book or by talking to someone? Probably not. More likely, they must learn this lesson through experience.
They have to learn surrender through taking action.
So let’s take a look at some typical strategies for a post-treatment relapse.
Worst option: say “screw it” and let your shame drive you further into addiction
The absolute worst thing that you can do if you relapse after leaving rehab is to say “screw it” and simply go back to your old lifestyle of active addiction.
Think for a moment about what this sort of decision really entails.
You actually have to lower your consciousness in order to do this. You have to say to yourself:
“I know full well that there is a healthier path that I could be on, a healthier way to live my life, and yet I am going to ignore this healthier and happier path so that I can stay stuck in the comfort and misery of active addiction. I would prefer this easier path even though it is killing me slowly and is much more miserable and chaotic.”
This is the conscious decision that you are making if you decide to “just run with your relapse” and let it take its own course.
Denial is the mechanism by which the addict can do this. Denial is the mental gymnastics that the addict will use in order to justify their relapse and allow themselves to continue to use.
It is just easier for the addict to self medicate all the time without really thinking about it. It is easier for the addict to slip back into their old patterns of behavior where they are constantly self medicating with their drug of choice. This is the easy path, the mindless path, the easy way out for the struggling addict.
Recovery takes obvious effort. You have to make positive decisions, follow it up with positive action, and you have to maintain some sort of positive attitude most of the time in order to make it work.
Active addiction takes effort as well….you have to hustle to get more of your drug of choice, you have to use tons of mental energy in order to plan out your next high in advance, you have to work hard to maintain any sort of normal life while you continue to self medicate every day.
Either path requires hard work, hustle, and mental commitment. The recovery path is not necessarily harder or easier than living in active addiction. The two are actually pretty comparable in most regards.
The difference is that active addiction is familiar. It is comfortable. Does this mean it is easier, healthier, happier, more fulfilling? Not necessarily. But the addict knows what to expect and they know how they will feel and what each day will bring. They have been living that lifestyle for years and it is comfortable to them, so the lure of relapse is quite strong.
Recovery is not necessarily more difficult than active addiction but it is foreign and scary at first. The decision, therefore, is to give recovery a chance, even though it feels scary and foreign to the newly recovering addict. This is the main hurdle that must be overcome in early recovery, even after that initial surrender is made. Can they face the fear of the unknown, can they face the discomfort of having their emotions be all over the place, without the ability to medicate them at will, like they did in active addiction? Early recovery is scary and can feel like baring your soul to the world.
When you leave treatment and you are trying to stay clean and sober, you either have support systems in place along with the right attitude or you do not. If you do not, then life is pretty much guaranteed to start piling up challenges on you until you are pushed to the point of relapse.
Getting to this point of relapse will be full of drama for the addict. It is not like they will just instantly grab their drug of choice with absolutely no forethought at all and start using it again like a maniac gone wild. No, the act of relapse after treatment is very deliberate and methodical. To the casual outsider who is not addicted, we may think that the addict is completely out of control and is running around like a crazy person, just dying to relapse and use their drug of choice again. The truth is that the addict or alcoholic will likely have a very intense internal battle going on long before they pick up the drink or the drug again. They do not do it mindlessly.
Instead, they talk themselves into it. They justify it first, with lots and lots of what we call “mental gymnastics.” It requires these mental gymnastics because the addict must first rationalize their relapse before they actually pick up their drug of choice again. They have to give themselves permission to relapse first, mentally. So there is this process that is going on internally before they actually relapse.
The two major factors after this relapse are guilt and shame. The addict will feel these both, in part, because they worked so hard using mental justification in order to rationalize their relapse. They know that they manipulated themselves into making the relapse OK. And they will feel guilty for it.
So the shame and the guilt can threaten to keep the addict stuck, to keep them using, to prevent them from “climbing back on the horse.”
They have left treatment and they talked themselves into a relapse and now they feel shame and guilt over it.
The worst possible thing that they can do at this point is to do what they have always done in the past: try to cover up that shame and guilt with more using. This is the worst thing that they can do.
If they decide to self medicate their guilt and their shame, they will quickly be back to their regular routine of active addiction, where they medicate every single day, regardless of any guilt or shame. Not good.
Common middle option that typically fails: patch it up, suck it up, move on with your life
This happens all the time, and is probably the most common reaction to the post-rehab relapse.
The addict treatment and at some point within the first month or two they relapse. It is a big deal, highly unexpected, and potentially devastating to both the addict and their family.
But instead of making a big deal of it, the addict attempts to brush it off. They had not really been following through with their aftercare of course (or they probably would not have relapsed to begin with), so they try to make good and start participating in their aftercare recommendations. They may hit a few 12 step meetings or go to a counseling appointment or whatever.
Deep down this may all just be more manipulation on the part of the addict, even if they do not necessarily realize it themselves.
They are trying to “make good” by putting forth at least SOME effort in their recovery, and since they suddenly relapsed, they know they had better step it up for moment and make it look like they are really trying. Denial can be so tricky that the addict may really believe that they are making an honest effort at recovery at this point. They might really believe that they are trying to remain clean and sober. So they “make good” and put up this effort in order to keep the other people in their lives happy.
Well at this point you can guess what is really going on. People do not casually relapse in recovery. It is all or nothing with addiction. The person who is trying to make good and show some sort of effort at recovery is just buying time, simply going through the motions, their addiction and recovery is in a state of standstill for the moment.
There are really only two ways that the switch can be flipped when it comes to real addiction and real alcoholism. Recovery is either on or off. Addiction is either on or off. There is no in between. When we see a state of in between like the one described here, we know that it is a mask for either one or the other. And if someone just left rehab and they casually relapsed and they are going to try to pull it back together without taking any sort of drastic action….well, that person is likely headed right back into full blown addiction.
Relapse is insidious in that a little taste might hold someone over for a few days, a week, even a month or two. But once they have relapsed, the seed of addiction has been “replanted.” The only thing that will really prevent a full blown relapse at this point is “massive action.” What kind of action?
Commitment to recovery, taking positive action every day, full immersion in support groups, and things like that. These are the kinds of actions that the newcomer in recovery needs to pursue if they want to stay clean and sober. They need to cling to recovery solutions with “the desperation of a drowning man.” Those who just casually say “oh, yeah, I relapsed….I guess I better go back to those meetings or something” are not going to make it. They are not getting it. They do not understand the magnitude of what is required in overcoming an addiction. They are playing with fire and do not even know it.
Best option: scramble for support and stability and intensive treatment options
The best option for a post-rehab relapse is to “scramble” to take positive action in getting more treatment. Ideally, the relapse should act as a wake up call that the treatment you just received was not intensive enough.
For me, this means that if you leave residential rehab after staying there for 2 weeks, and you suddenly relapse, the only way that you are going to make recovery work for you is if you dive back into your recovery, dive back into a treatment program, and possibly even go find a more intensive treatment solution than the one you just experienced.
For example, I was in a residential treatment center at one time and the therapists there were recommending that I go to long term treatment. At the time, I ignored these recommendations (because I had not yet fully surrendered to my disease) and I left the rehab center and quickly relapsed.
What happened next was that I took the wrong path, I choose the worst option, which was to run away from recovery, from responsibility, and to keep self medicating. I did that for about a year until I had enough chaos and misery, and then I got lucky enough to be able to choose the right path, which was long term treatment of course. It was what I needed in order to overcome my addiction, given my current situation, I was just too stubborn to see it for many years. When I finally surrendered to my disease I was able to accept that as my solution.
If you relapse after leaving treatment then this is a wake up call. You are in seriously rough shape and you are definitely on a path headed for nothing but chaos and misery unless you correct course.
The obvious answer is to correct course, quickly. Get back into treatment, get back into recovery, find a more intensive treatment option, and take positive action as quickly as possible.
Sometimes a relapse is exactly the wake up call that a person needs in order to finally “get” recovery.
Don’t let a relapse become an excuse. Instead, turn it into an opportunity, a wake up call, a reason to seek more help.