Sober Synthesis

Relapse Prevention and the Five Rules of Recovery

Yale Journal of Biology and Medicine

Steven M. Melemis, Sep 2015

https://pmc.ncbi.nlm.nih.gov/articles/PMC4553654/

Relapse Prevention:

• Relapse is gradual and has distinct stages
• Cognitive therapy and mind-body relaxation
• Five rules of recovery

Stages of Relapse

Emotional Relapse

• Bottling up emotions
• Isolating
• Not going to meetings
• Going to meetings but not sharing
• Focusing on other people
• Poor self-care (eating, sleeping, exercising, etc.), HALT

Mental Relapse

• Craving alcohol/drugs
• Thinking about people, places and things associated with past use
• Minimizing consequences/glamorizing
• Bargaining
• Lying
• Schemes to control using
• Seeking opportunities
• Planning

Physical Relapse

• Lapse (first drink)/Relapse (uncontrolled)
• Most are due to opportunity

Cognitive Therapy – Overcoming negative thinking

• Fear – Failure, Judgement, Shame, etc.
• Redefining fun – glamorizing, forgetting consequences
• Learning from Setbacks
• Distress Tolerance – comfortable with being uncomfortable

Stages of Recovery

1. Abstinence – dealing with cravings & not using, 1-2 years, Post-acute Withdrawal Syndrom (PAWS
2. Repair – relationships, finances, legal, health, self-esteem, 2-3 years
3. Growth – More forward, self-knowledge and awareness, 3 years+

Five Rules of Recovery

1. Change Your Life – Negative thinking; Avoid people, places, and things
2. Complete Honest
3. Ask for Help
4. Self-Care – physical, emotional, mental, spiritual
5. Don’t Bend the Rules!

QUESTIONS:

How do you protect your emotional sobriety?

Thinking about your last relapse, were there any emotional or physical signs?

What did you learn from it that you plan to do differently?

If you avoided a relapse, what did you do?

How have you (or plan to) changed your life to support your recovery?

If you have a Relapse Prevention or Safety Plan, what does it include?