A Journey Within and Beyond Relapse

Most of us who work in addiction treatment have had the deeply unsettling experience of looking into the eyes of someone who is completely, totally certain that they will never drink or use again – only to hear within less than a year that this person has been overtaken by their disease again. Those of us with addiction in our families know it in an even more intimate way – the curious, exasperating, and crushing way that the disease returns to claim someone we love, even after hard work, copious tears, and sincere intentions have been committed by all. Those of us with addictions and compulsions know it in the most direct way of all – having a solid relapse prevention plan is key to long-lasting sobriety.

We have witnessed our own deeply unexplainable enslavement to destructive, irrational cycles. Deceptively, we may have had intermittent periods of sanity – just enough, perhaps, to convince us that the problem does not really exist. In moments of insight, however, those lucky enough to awaken to our enslavement can see that overall, we have traversed a limited, redundant path. In times of clarity the witnessing parts of us may shine through to our consciousness with the realization that our destinies have been controlled by something which is not really us. Something in us sees that our will has not been our own.

In our weekly relapse prevention plan program, we start by asking clients how THEY would explain the relapse phenomenon. How can it happen that a person, who, sitting in the safe confines of rehab, is completely sure that they are done forever, could have a change of state? Why the return to irrationality so soon after treatment? One tautological answer is that relapse is a symptom of the disease. A pattern of return to deterioration after periods of abstinence is one of the typical signals of addiction in the first place.

But no matter how close neuroscientists and geneticists get to the etiology of addiction, their approach is asymptotic. Psychology is no better – despite myriad attempts, a satisfying explanation for the origin of this heartbreaking condition remains at large. So, we are left just with the observable facts: for whatever reason, by the time a person is symptomatic, presenting the hallmark signs of addiction, she cannot guarantee her own consistency of will or choice. A person with addiction can no more guarantee how she will behave in two days, than she can guarantee how she will be in 20 years.

This is because, through the process of addiction, our minds became open portals to thoughts that do not belong to us, but rather are generated by our disease. Our emotions were replaced by passions and torments originating in the unquenchable quality of physiological craving. Our body signals, designed to tell us what we need in every moment for optimal physical well-being, were hijacked by addiction, and can no longer be trusted to give accurate information about what we need. The frightening thing is that, however obvious our addiction may have been to others, it was not that obvious to us.

Like frogs in the proverbial pot of slowly warming water, we didn’t notice what was happening to us or think to jump out of the water in time, until one day we found that the person we always thought of as “me” had been replaced by an addict. Mercifully, there is an antidote. In recovery, we learn to regain sanity through the support of others, in 12-Steps and other recovery meetings, and through the personality change, via spiritual awakening, that happens when we work the 12-Steps. That personality change and spiritual awakening make it possible to have a daily relationship with a power greater than ourselves, who can now be in charge of our lives, since “me”, along with its usual thoughts, feelings and physical sensations, is in the clasp of addiction.

Over time, we experience more and more release from the bondage of the disease, and regain our thoughts, feelings, and bodies, but this is contingent upon sticking close in a daily way to that life-saving, personality-altering benevolent force. A few weeks into residential treatment, when we’ve had a chance to rise above the fogbank of our poisonous addictive desires, we see what actually needs to happen for us to make it out of the hell realms our addiction brought us to. We must make a strong relapse prevention plan while we have that clarity.

While surrounded by loving sane people, we need to set things up for ourselves in a way that we are likely stick to, no matter what. We should not expect our willpowers to work very well, but rather rely on habit and the simplicity of following a repeatable structure. We put one foot in front of the other for a good long while before we evaluate or make changes. We give our brains a respite from having to grapple with choice, so that our neural pathways can cement in the direction we really intend them to. In our relapse prevention plan program, we make a kind of wilderness survival plan for what happens after treatment.

Where we will live, and with whom. What type of contact we will have with friends, loved ones, and work colleagues. What our days will be like. We plan for “taking the medicine” for our disease: attending 12-Steps or other recovery community meetings and continuing to work at clearing out the disease. We build a plan around our outpatient treatment schedule. We also develop a personal protocol for handling triggers. We pre-plan which tools we will use in the moment of being activated. We lay down track to follow automatically, that will help us act in time to protect ourselves.

Mindfulness-Based Relapse Prevention Plan and Program for Women

At Villa Kali Ma, we help each woman assemble a comprehensive, livable plan that can be the blueprint for life after treatment, using the power of:

On her final day, each graduating member shares her plan with her peers and staff – for the extra sanity check, loving challenge and validating recognition of her true intentions. Please know you are warmly welcomed here at Villa Kali Ma, to come make plans for your freedom from addiction. Know that you can design your life plan from a place of true self-love, with support and wisdom from women recovering all around you.

What is a relapse?

Relapse refers to a period of deterioration in health that takes place after a phase of improvement. In the context of healing from trauma and mental illness, relapse can be understood as reappearance of a disease pattern after a stage of getting better. When speaking about addiction specifically, relapse means a return to using substances after a period of sobriety. 

Relapse is a common part of many mental health conditions and addiction in particular. Relapses can be dangerous most especially in the case of addiction, because of the risk of overdose. When a person returns to substance use after a time of non-use, it is difficult to calculate the change in tolerance introduced by sobriety. The amount of a substance needed to experience effects will have changed.

Relapse is can feel quite heartbreaking, and it is tempting to interpret it from a negative lens. But in reality relapse should not be taken as a sign of personal failure. For many people, relapse may be part of learning to more deeply understand the dangers and power of their addiction. 

Care should be taken to avoid relapse, because of their destructive potential. But if a relapse does take place it’s important not to go into judgment or excessive demoralization. Those responses will only prolong a relapse. 

It can be helpful to understand recovery from any form of illness as a lifelong learning process. Recovery and wellness come to us in stages, including periods of time when it may seem as though we are regressing. As the saying goes, three steps forward, two steps back. The brain and body need chances to rewire and reset to positive patterning. We may need to learn to take a longer view and look at the bigger picture to see the progress we are making, as well as remember how it is that humans learn. We learn the most through doing things wrong, and then trying again and again until we get it right.

Recovery from any form of imbalance is an ongoing process that is best approached one day at a time, with respect and acknowledgement of the complexity involved with building and maintaining health and happiness after illness. 

Compassion, kindness, and self-acceptance are daily necessities on the path, as recreating a life from the ground up after drug or alcohol addiction especially is a big job that will be completed one step at a time, slowly and steadily. 

Relapse warning signs and how to avoid them

It is wise to develop a savvy understanding of relapse, comprehending what it is as well as how and why it happens. 

It is preferable where possible to stop a relapse early on than to be caught by surprise. If we are caught by surprise, then it’s best to immediately forgive ourselves and dig our way out again by returning back to basics to rebuild our health. Once feeling better again, we should reflect on what signals we may have missed, so that we are wiser next time around. 

At the surface level, relapse is seemingly triggered by external events. When difficult life experiences arise, either as outer events or as inner ones, we may be a risk for relapsing into a previous way of coping with life.

In the face of emotionally overwhelming situations, people with addiction may find themselves automatically resorting to old behaviors, which lead to the same results they experienced in the past (using substances excessively and losing command of one’s life). 

People with destructive mental-emotional or traumatic patterning may find themselves helplessly revisiting old terrain they thought they had moved past. For that reason, an important part of relapse prevention is a thorough inventory of one’s triggers, so that at the surface level of our lives, we protect ourselves from any unnecessary weakening of our intentions to be healthy and happy. 

As the saying goes, where there’s a will, there’s a way. If we truly prioritize our well-being above all else, that will show in our behavior in terms of what we choose to move towards and what we stay away from. We will naturally avoid any people, places and things that are clearly linked to our negative patterning, anywhere we have proven to ourselves to be unable to stay involved without it being bad for us. 

Every person should make their own list of personal triggers and maintain regular awareness of them. Common triggers for relapse include stress, grief, changes in a relationship, status, or life circumstances, and trauma surfacing for healing. Positive life events may also be triggering, such as success in work or relationship life, in which we feel vulnerable and afraid of losing happiness. Alternatively, we may become complacent, thinking that our troubles are fully behind us and that we do not need to be as present, focused and mindful of the possibility of disease returning. 

In addition to such larger life trigger-zones, there are daily bugaboos to keep awareness on. For example, becoming too hungry, angry, lonely, or tired (the AA acronym H.A.L.T.) can be reason enough to suddenly resort to a previous coping strategy. Generally, it is important to understand that prioritizing well-being has to come first, and needs to be done every day.  

There are also known relapse warning signs that can be noticed earlier on and corrected before they turn into relapse. Early signals include letting go of self-care, becoming too isolated, skipping meetings or therapy, lying, becoming secretive, and avoiding people who will hold us accountable for our recovery.  

Similarly, certain types of thinking imply a relapse is on its way: nostalgia for people places and things associated with drug use, thinking about or contacting friends from our past using years, romanticizing or glamorizing past drug use, and thinking we should try again because we’ve certainly recovered enough and maybe we can handle it now are all red flags for a relapse.  

Why do people relapse?

What we think of as a relapse actually begins long before we take the negative course of behavior, and there are early warning signs that we may be back on a self-destructive path. 

For example, if we are returning to codependent behaviors, feeling excessively victimized and indulging our tendencies towards negativity rather than responsibly maintaining a clean, positive thoughtspace, that is a sign that we may have “decided” on some level that we want to return to our previous coping strategy, even if it means self-destruction. 

When we look closely at such a (usually unconscious or semi-conscious) choice, we always find shame at the root of it, that on some level we have reached a limit in our ability to love and allow ourselves to thrive, for some reason or another. 

When spooked by life and the possibility of being hurt as we were hurt in the past, we may find ourselves unconsciously returning to self-destruction as an “easier” path than working through the shame and recovering our lovability and basic worthiness of having a good life. 

One way to help prevent relapse, therefore, is to regularly take note of fear, anger, and shame, making a conscious effort to reduce the presence and intensity of these destructive emotions. Taking the time to find out “what’s really going on” is key. 

One of the reasons that it’s so very very helpful to stay connected to other recovering people is that recovering communities talk regularly about the underlying struggles, feelings, and temptations of life in recovery. Airing secret thoughts out in the open, telling on our disease, receiving emotional support and understanding for what it feels like to do the work of recovering from addiction or mental health problems, and listening to the experiences of others all support relapse prevention. 

The benefits of relapse prevention during addiction recovery

There are significant protections afforded to us when we proactively take care to prevent relapse. Relapse prevention is an active practice that requires effort and regular maintenance, rather than a one time thing.

Relapse prevention centers around having a solid, road-tested plan for living life without substances. A good relapse prevention plan includes a structure for daily living that recognizes the many different kinds of situations we find ourselves in during ordinary life; contingency plans for special situations like weddings, funerals and family gatherings; and a robust toolkit of many coping strategies and options for when we need help on the spot.

A relapse prevention plan should include the names and numbers of people we can call who we can rely upon to talk us out of bad decisions when facing temptation to use. These are people who will non-judgmentally witness us with love and kindness paired with a keen understanding of the wily ways of our addiction (who can help us see the disease’s attempts to pull us back in). 

A relapse prevention plan will also include a list of one’s personal triggers, to be regularly reviewed and kept top of mind. We might also like to add our reasons for wanting to be sober, including the names of people we love who will be hurt if we return to using, any life goals, and values we have about how we want to show up in the world. 

It is extremely important to practice relapse prevention every single day, most especially in the first 90 days of sobriety. During such a window of time, it is best to attend AA meetings every single day, rain or shine, and to maintain daily contact with the work of recovery through working the steps with a sponsor. 

Relapse prevention options

Villa Kali Ma places a big emphasis on relapse prevention and planning as a part of supporting women to succeed in their deepest goals. Should you choose to enter treatment with us or to engage in any of our many healing programs, we will support you to create a personalized plan that covers all of your bases, so that you leave our doors with the highest chance of success. We will include options for aftercare and follow ups that help you stay connected to your best self and the people who are rooting for you to succeed in your recovery.

In addition to having a relapse prevention plan, it is vital to stay connected in many ways to people who are committed to a positive path of recovery. This can mean staying in contact with a therapist who helped you recover, completing all aftercare recommendations, staying involved with groups where people with many years of recovery can be found, and working proactively to heal your underlying issues, which typically take some time to heal. 

Most important is to keep the fact of having an addiction front and center, to counteract the aspect of the disease which causes us to forget about it, and therefore be caught unawares. This requires a daily commitment and structure, and it is very helpful to place oneself in the company of those who practice positive, healthy, spiritually full lives as a way of keeping centered on the path that sobriety requires of us. 

There are many lifestyle-based supports for relapse prevention, including diet, exercise, spiritual practices, creative hobbies, as well. Villa Kali Ma’s programs offer a huge variety of options for comprehensively engaging with your recovery through many channels of mind, body and soul. 

I don't believe it to be an exaggeration to say that Villa Kali Ma saved my life.
I couldn't have asked for a better environment to heal and redirect onto a path towards true living.

KRISTEN B.

This place completely changed my life. I needed a drastic change from the typical recovery environment in order to stay sober long-term. I can honestly say that I love who I am today and I am forever grateful for Villa Kali Ma!

CYNTHIA B.

I am so grateful I found Villa Kali Ma, it has truly changed my life. Kay is awesome and the entire team who works there is absolutely amazing. If you need treatment, I highly recommend making this the start to your recovery.

SUZIE H.

Villa Kali Ma is an in-network provider with Anthem BCBS, Multiplan, First Health, and an authorized
out-of-network provider with TRICARE accepting most PPO plans or out-of-network benefits.
Call (760) 350-3131 for information on cost and payment options.