Sunday, February 16, 2014

Why does someone choose to pick up again?

Perhaps a more illuminating question would be- why did they choose to neglect 'avoidance of' certain situations, thoughts, chemicals that will inevitably lead to picking up?

It's important to reiterate that people vary significantly in their willingness and ability to recovery. People's disease processes vary greatly.  And, that people present in different stages of their disease.  I speak in generalities from my personal and professional experiences.  Much of what I know comes from studying the research, literature and over 25 years of work within clinical healthcare settings. and, quite literally- practicing).  There are always exceptions to these generalities.  I try to speak to the hump in the bell curve, as it were.  There are very fascinating outliers.  But the meat is in the hump.

Most relapses are days, maybe weeks in the making.  That is to say, there are various changes in the brain, manifested in thoughts, feelings, moods. Small decisions.  Shifts in behaviors.  Conversations with oneself.  These are occurring, like a volcano gurgling away, building up pressure. And then, the physical and behavioral manifestation of the disease shows itself.  And then an individual ingests an intoxicant.  

Addiction is a brain disease.  No way to argue this point.  An award winning 61 minute educational discussion film (dvd)  "Pleasure Unwoven" explains this better than anything, or anyone, I have ever encountered.  It's about $25.00, clips available on tube (Kevin McCauley).  If behavioral health is your profession or interest, or you are in recovery- or reflecting what might be going on with your own use, I encourage you to watch this dvd.  And, lest I forget, if you are wondering about the substance use of someone you love, I'd encourage you to watch the video.

Most of us are oblivious to all the chatter in our head. We are commenting and making meaning, interpreting, categorizing information faster than my little macbook pro.  Some of us are more aware of these than others. We can learn to make these mental meanderings more conscious- bringing them more into our awareness.  Mindfulness and meditation are just two of the better known practices.

Anger is a common trigger emotion. Anger unresolved, and instead cultivated, kneaded and regurgitated turns into a favorite resentment.  One withdraws, broods, replays the insult/assault.  Cherishes it.  All sorts of interesting thoughts go through one's mind.  Two weeks later they relapse.  Upsetting emotions happens to be the most common trigger for folks w alcohol use disorder.  'Anger is the privilege of the common man'.  No the folks w a substance use disorder.  Ask a self identified alcoholic- they'll tell you that nothing leads to the drink faster than a resentment.

There is no way to avoid upsetting emotion. But there are MANY ways to manage them that will avoid the process and path to relapses.  And yes, upsetting emotions trigger a cascade of chemicals, hence feelings, thoughts, moods.  Thoughts of alcohol, cravings (which often manifest as thoughts, i.e.-  the obsession); Leading to decisions and eventually picking up.  In "normies", people without an alcohol use disorder, this process does not occur.

AA and the twelve steps can teach people the solutions to this process.

Different intoxicants have different triggers. That is, people dependent on heroin have different triggers than folks dependent on alcohol.  More on that another day.

So, do people choose to relapse? Sure, sometimes, but the process is generally more complex than that, hence the solution is very different than 'Just Say No'.

To avoid a relapse, or slip- one must be armed with important information about themselves, and a PLAN.

How did you make a relapse avoidance plan,  and what have you found to be the most important aspects and actions from it?