Relapse: What Now?

Joel walked into my office looking tense and uncomfortable. He was there  for his weekly therapy session where we have been addressing his amphetamine use and depression. His eyes avoided mine, clearly he was upset about something. 

Joel is just now dealing with his amphetamine use and coming into the realization that he may have an amphetamine dependency. This is a huge transition for anybody who begins to realize that “Maybe  I CAN’T control this”.

“What’s happened Joel”, I asked, suspecting the answer would relate to his drug use. “Well, I made a phone call to a Mexican pharmacy. They sent me my order (a stimulant used to treat ADD) and I used them over the weekend. This feels like such a dead-end”.  

Joel had relapsed, but had been able to tell me. Relapse and shame tend to go together, as they have for Joel. “I’m glad you told me. Let’s talk about what happened. Does your partner know you used?” Joel and I used the rest of the session to deal with what he shared, and what next steps he might consider.

 It turns out that Joel did tell his partner. While I am not working with the couple, I offer ideas to Joel about considering relationship issues in the context of his recovery.  Relapse translates to the need to reevaluate the current program and strengthen it somehow.

How can couples manage relapse? One of the strategies I talk about with couples is to have a relapse strategy in place. Once somebody has committed to sobriety/recovery, the couple can talk about what they would do and what would need should the partner relapse. For example, one couple I worked with came up with a plan that should there be a relapse, the addict partner would take the next steps in increasing a recovery plan to include an evening treatment program. His partner said she would need to be able to tell her family, so she could get support. She also talked about her need to be in a couples support group or 12 step program like Recovering Couples Anonymous (RCA). Both partners said they were committed to the relationship and would want to work in ways to manage recovery for the both of them individually and as a couple.

Couples who can talk about relapse – the thing they hope will never happen – are better equiped to deal and manage with relapse if they are prepared. Hopefully relapse fears can freely be talked about, and built into an ongoing dialogue.

Having said that, we still take it one day at a time. 


Want A Relationship Boost? Try This

Jeff spoke about the deep roots that alcoholism has had in his family. He is an adult child of two active alcoholic parents and his brother is in recovery from addiction.  It turns out that in his family, despite his parent’s active alcoholism, not all family gatherings are so bad. I asked how Father’s Day went, he replied that it actually went OK. Jeff went on to say that is sister had a great idea that he really liked.

It worked this way. Jeff’s sister asked Jeff and their brother to write out 30 separate positive things about their father – these had to be real appreciations and expressing gratitude for what each person genuinely felt. Jeff’s sister took the lists and cut out each affirmation and put them a nicely decorated jar. The gift they gave their father was a nicely decorated jar that every day, for 90 days, he could pull from the jar one of the affirmations that one of them wrote.

Jeff was quite taken with this idea stating, “I wish somebody would do that for me”. This exercise in positivity stands in great contrast to the negativity often experienced in alcoholic families. The challenge is in the ability to find the positive, and to feel one could honestly express gratitude and appreciation to the family member or partner.

It certainly would have been OK for Jeff to pass on this idea if he didn’t feel comfortable participating.When I asked Jeff about how he felt about writing these positive things about his father, he replied that it helped him to remember some of the positive things his father did, “He did do some things right.  He was there at my sports events in high school, and has tried to support me through some of my recent challenges”.  For Jeff this worked, much like a gratitude list works in AA. Jeff gained something for himself  in the exercise.

Denial is usually thought of in the context of denying addiction. I suppose one could argue denial could also be related to not acknowledging positivity as well. There is compelling research that when we are feeling negative about a relationship, awareness of anything positive about the relationship isn’t noticeable or on the radar at all. Neutral and even positive interactions are viewed as negative.

Think about whether this could work in your relationships that could benefit from a boost and whether you would want to discuss this idea with your partner and/or family members. Good luck.