By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.
Is relapse a necessary part of recovery?
You will hear this a lot if you hang around treatment facilities, even self-help groups. I suppose it comes from seeing people relapse and feeling helpless to prevent those relapses. But is relapse really a necessary part of recovery?
Mostly this is applied to substance abuse, drugs, and alcohol, but more and more we are seeing that other emotional, mental, and behavioral challenges can follow the same processes. People get unhealthy; they may get sick and then they recover.
Do symptoms have to get worse before they get better?
Every time one of my colleagues says that relapse is a part of recovery I cringe. It feels like saying that heart attacks are a part of treating heart disease. I do not believe that good treatment should accept any negative outcome as a part of the recovery process.
Relapse is common, but it is not universal. Some people, more than you might think, recover, and never relapse. A surprisingly large number of people report that they were able to quit drugs, get over their depression and anxiety, and stay quit and recovered.
So how do they do recover without relapse?
We need to talk about several things. What is recovery, what is relapse, and how do people go about changing?
Emotional challenges and substance use problems are a lot like chronic physical disorders. If you have had a stroke there has been some damage done. If you have been diagnosed with diabetes you will never be “cured.” Some changes will always remain as a result of your experience.
While you will never be “cured” you can, and most people do, recover from that disorder. The same thing happens to those people who have had an emotional or substance use disorder. They can and do recover but they are never fully cured. There is a risk that if they are not careful they may slip back into an active stage of their problem but if they are vigilant about their recovery they do not need to keep getting sick again and returning to their provider to, again and again, be treated and recover over and over.
These ideas about substance use problems and mental health problems are both included in the The Big Book of Alcoholics Anonymous. Bill W. wrote about the issues that those with Bipolar Disorder will face that may make their recovery more difficult than that experienced by people who do not have an underlying mental health disorder.
Bill W also wrote that in the early days of those who came to the program and stuck (meaning actually continued to attend and participate in the program) 50% quit drinking forever. That does not sound to me like he believed that relapse needed to be a part of recovery.
He went on to report that of the remaining half about 25 % had to quit a few times to get it right but those people did eventuality stop for good.
What about that last 25%? The big book reports that while some people never did manage to stay stopped those people, while attending A.A. were much improved. I take that to mean that while the treatment for a mental or emotional problem may not fully effect a cure, reducing your symptoms is a way to reduce the harm that a mental, emotional, or substance use problem creates.
These days we are applying the stages of change model to both mental health and substance use disorders. Take a look at some of the books on how people change such as Changing for good.
I have written posts in the past on this model and how it can help you change and stay changed.
In this model, we see that people need to recognize they have a problem, gather information, get ready to change, and then go through the process of making real meaningful changes in their lives. In this model, we see that maintenance, those things you need to do to stay changed once you have made a change, those maintenance steps are the key to preventing relapses.
Relapse is a failure to maintain recovery.
Relapse is not a part of recovery, but the result of failing to continue doing the things that helped you get better in the first place. Whatever you did to get your emotional problem or substance use issue in remission in the first place, those actions need to continue to be a part of your life if you want to insure yourself against relapse.
If you do relapse, do not beat yourself up. Get back into recovery and practice the things you need to stay well. Just know that repeated relapses do not need to be a part of recovery if you practice your maintenance program.
Staying connected with David Joel Miller
Seven David Joel Miller Books are available now!
My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.
Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.
Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.
As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.
Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.
Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.
Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.
Planned Accidents The second Arthur Mitchell and Plutus mystery.
Letters from the Dead: The third in the Arthur Mitchell mystery series.
What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?
Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.
For these and my upcoming books; please visit my Author Page – David Joel Miller
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