One of the primary goals of recovery is to obtain and maintain sobriety.
People who have never entered recovery often assume a relapse starts when the drug of choice enters a person’s body after a period of abstinence. However, relapse can actually begin days or even weeks before a person breaks their abstinence from alcohol or other substances. The time before a person starts to use again is often marked by negative thought processes, which further increase their odds of returning to substance abuse.
According to Steven M. Melemis, in his article for the Yale Journal of Biology and Medicine, Relapse Prevention and the Five Rules of Recovery, “The negative thinking that underlies addiction is usually all-or-nothing thinking, disqualifying the positives, catastrophizing, and negatively self-labeling. These thoughts can lead to anxiety, resentments, stress, and depression, all of which can lead to relapse.”
Common Negative Thoughts
Melemis shared a list of negative thoughts which frequently sabotage sobriety:
- My problem is because of other people.
- I don’t think I can handle life without using.
- Maybe I can just use occasionally.
- Life won’t be fun without using.
- I won’t be fun without using.
- I’m worried I will turn into someone I don’t like.
- I can’t make all the necessary changes.
- I don’t want to abandon my family.
- Recovery is too much work.
- My cravings will be overwhelming; I won’t be able to resist them.
- If I stop, I’ll only start up again; I have never finished anything.
- No one has to know if I relapse.
- I’m worried I have been so damaged by my addiction that I won’t be able to recover.
These negative thoughts, especially when allowed to repeat unchecked, can convince a person that they will not succeed in maintaining sobriety or that sobriety isn’t really important enough for them to put in the hard work to maintain.
Stages of Relapse
Melemis also identified three stages of relapse in his article:
- Emotional: Individuals are not thinking about using, but their emotions and behaviors are setting them up for relapse.
- Mental: After prolonged, poor self-care, the person is starting to think more and more about using and how to justify it if they do use.
- Physical: The person uses alcohol or another drug.
Emotional Relapse
During emotional relapse, people may bottle up their emotions, isolate themselves from others, focus on another person’s issues, and have poor self-care.
A simple reminder of poor self-care is the acronym HALT: hungry, angry, lonely, and tired. A person who is ignoring their own basic needs and feelings is setting themselves up to make poor choices that could lead to returning to their drug of choice.
Mental Relapse
When individuals exhibit poor self-care and live in emotional relapse long enough, they begin to feel restless, irritable, and discontented. They start to think about using just to escape, but it is still easier to reverse a relapse at this point, than after a person actually partakes of their drug of choice.
If a person stays in this stage for too long, without healthy coping skills to get themselves out of it, then they are far more likely to move into the physical relapse stage. As a result, it can be especially helpful for a person in this stage to talk to their sponsor and attend recovery meetings, therapy, and/or substance abuse counseling.
Physical Relapse
This is when a person actually returns to using the substance they have been trying to avoid. Because people in addiction are not generally able to stop after a single indulgence, it is more difficult to regain sobriety after this point. According to Melemis, this return to using also leads to a return to obsessive, uncontrolled thoughts of using—a pattern which is difficult to break and makes it harder to re-enter recovery.
Breaking the Cycle of Negative Thoughts
Cognitive therapy and mind-body relaxation help break old habits and retrain the brain to create new, healthier ways of thinking, according to Melemis. These strategies can help individuals to address their relapse during the stages when it is easiest to reverse and before they use.
One of the ways therapy helps people to get out of negative thought patterns is to challenge the reality behind their negative thoughts and help them to recognize that barriers they are facing may not be as insurmountable as they might have imagined. PsychPoint.com has a Steps to Challenge Automatic Negative Thoughts Worksheet, which people can complete on their own when they feel that they are allowing negative emotions to get the better of them.
In her article for Social Work Today, Mindfulness-Based Relapse Prevention — Paying Attention to Recovery, Kate Jackson promotes mindfulness as a key strategy people in recovery can use to prevent relapse. Her article outlines how mindfulness has been combined with 12-Step programs and various therapeutic interventions to support substance abuse recovery.
Prevention.com also outlines steps for combating specific negative thought patterns in their article, How To Quit Your Negative Thinking For Good:
- Focus on resiliency by reminding oneself that whatever happens, it will be possible to cope.
- Meditate. There are many free videos online, if you need help getting started.
- When a situation isn’t ideal, make a list of things that are still good about it.
- Remember that an occasional mistake is not a pattern of failure.
- Remember that much can be learned from things not working out as planned, if faced with an open mind.
Safe Harbor Recovery Center has professionals on staff who can help you or your loved one battle the negative thoughts that are hindering long-term recovery from substance abuse.
