Helpful article about relapse
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Join Date: Jul 2013
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Helpful article about relapse
I found this linked to a thread here is SR last week and I think its helpful in terms of thinking of relapse. I used to be so scared of it, and the article tackles something Ive seen mentioned a lot. "Relapse means a person doesnt want recovery enough". very bad mindset for family members I think, often untrue. My husbands doctors directed it more from the perspective shown here, one of learning, and developing skills. Its also what we learn in CRAFT. How lapse or relapse can be used productively to educate should it happen.
The Karma of Behaving Badly by William Dubin, Phd.
People generally seek the clinical services I offer when they have relapsed – gone back to drinking, regained the weight they lost, etc.During the first session, I almost always ask the obvious questions: “What led up to the first lapse?” Generally, they cannot remember the details of the sequence of events that led to the critical first violation of their rules. This is in striking contrast to the detail I receive when the same client describes some political conflict at work.
This surprising observation provides a clue as to why escaping such a problem is so difficult. Note that in order to recall information, that information must have been originally encoded into long-term memory–a process that requires attention. When my client, the clever attorney H, can only give me a superficial analysis of the sequence of events that led to his relapse, that suggests that his consciousness was not fully engaged at the critical time; he was on autopilot following the path of least resistance.
Relapse is hard to prevent, because: “It is the enemy whom you do not recognize who is the most dangerous” – Fernando Rojas. During his recent relapse, Hasselbring observed himself following a path he had previously recognized as harmful and vowed to never follow again. He reports that he remembered the vow of abstinence, yet he simply did not exert the effort required to perform mindfully, and passively followed the familiar sequence to self injury and demoralization.
Put yourself in my position, every week I am spectator to different versions of the same theme: The client appears sincere and highly motivated when vowing to follow the intended path no matter what the circumstance, but when actually faced with a crisis he or she tends to invest surprisingly little energy to perform as intended.
One explanation is: Hasselbring is fooling himself and me, and doesn’t really want to quit drinking. While this is indeed true for some, although probably the minority, of my clients, I honestly do not think Hasselbring is trying to con me. Nevertheless, it cannot be denied that he voluntarily follows a sequence of actions that he, and everyone else, knows will lead to failure and demoralization. The explanation of this absent minded relapse contains an important key to escape the addictive trap.
Performance becomes easier with practice. In fact, with enough practice performance can become so effortless that it requires no conscious attention at all; the behavioral sequence has become autonomous. Consider activities such as driving or using a computer or musical keyboard. When first attempted, performance is slow, hesitant, and filled with error, but with practice speed increases, variability decreases, and execution becomes increasingly effortless. What once demanded considerable attention can now be performed rapidly and accurately with little or no awareness of the component actions.
Conscious attention is not required to initiate an autonomous sequence. Mere exposure to the triggering stimulus is sufficient, and once initiated the action has a ballistic quality – tending to run on to completion all by itself.
For example, when driving, a red light is sufficient to elicit a sequence of events that I control, but the control is outside of my awareness. Cognitive resources are not required of me to begin and then guide the complex sequence of behaviors that brings the vehicle safely and smoothly to a stop.
Rapid, accurate, effortless performance that makes no demands on valuable conscious resources has obvious advantages. The problem occurs when you want to change a behavior that has become autonomous. For example, an experienced driver would take longer to learn to reliably stop at a green light than he originally took to learn to stop at a red light. Until the new habit is acquired, the driver must pay attention in order to over-ride the well practiced behavior of driving through a green light.
Stephen Tiffany1, whose views have been paraphrased in the preceding paragraphs, suggests that after considerable practice, addictive behavior becomes autonomous. Autonomous behavior can be over-ridden, but it requires conscious attention to do so.The karma of repeatedly following the path to substance use is that this path becomes autonomous. As a result, whenever conscious resources are occupied by a demanding social situation, powerful emotional state, or diminished due to fatigue or intoxication, one tends to follow this default path.
An absent-minded relapse occurs when mindful processing, which is necessary to interrupt the autonomous sequence, is not invoked when needed. This may occur when a person was simply not conscious of the original commitment until the relapse sequence was already well under way. Less dramatic, but quite common, the person was more or less aware of the unfolding of the sequence of events leading to the lapse, and was also fully aware of the previous intention to remain abstinent, yet simply failed to dedicate the conscious effort required to interrupt the autonomous behavior chain.
The decision to quit using the rewarding substance sets up a conflict. On one side there is the autonomous behavior that leads to immediate gratification. Against this is pitted the person’s rational decision to move in a different direction – one that the rational mind concludes is more advantageous for the self. The conflict plays out in real time, and resolves in either success or failure [success is better].
The purpose of these pages is to promote success in escaping the addictive trap by providing a summary of biological, psychological and social factors that pertain to addiction and its resolution. Bear in mind that addiction is such a potent and deceptive foe that intellectual appreciation is not sufficient. The procedural knowledge required to intentionally guide your actions during real time crises cannot be acquired by reading alone. Each person must develop this competence through personal experience.
The Karma of Behaving Badly by William Dubin, Phd.
People generally seek the clinical services I offer when they have relapsed – gone back to drinking, regained the weight they lost, etc.During the first session, I almost always ask the obvious questions: “What led up to the first lapse?” Generally, they cannot remember the details of the sequence of events that led to the critical first violation of their rules. This is in striking contrast to the detail I receive when the same client describes some political conflict at work.
This surprising observation provides a clue as to why escaping such a problem is so difficult. Note that in order to recall information, that information must have been originally encoded into long-term memory–a process that requires attention. When my client, the clever attorney H, can only give me a superficial analysis of the sequence of events that led to his relapse, that suggests that his consciousness was not fully engaged at the critical time; he was on autopilot following the path of least resistance.
Relapse is hard to prevent, because: “It is the enemy whom you do not recognize who is the most dangerous” – Fernando Rojas. During his recent relapse, Hasselbring observed himself following a path he had previously recognized as harmful and vowed to never follow again. He reports that he remembered the vow of abstinence, yet he simply did not exert the effort required to perform mindfully, and passively followed the familiar sequence to self injury and demoralization.
Put yourself in my position, every week I am spectator to different versions of the same theme: The client appears sincere and highly motivated when vowing to follow the intended path no matter what the circumstance, but when actually faced with a crisis he or she tends to invest surprisingly little energy to perform as intended.
One explanation is: Hasselbring is fooling himself and me, and doesn’t really want to quit drinking. While this is indeed true for some, although probably the minority, of my clients, I honestly do not think Hasselbring is trying to con me. Nevertheless, it cannot be denied that he voluntarily follows a sequence of actions that he, and everyone else, knows will lead to failure and demoralization. The explanation of this absent minded relapse contains an important key to escape the addictive trap.
Performance becomes easier with practice. In fact, with enough practice performance can become so effortless that it requires no conscious attention at all; the behavioral sequence has become autonomous. Consider activities such as driving or using a computer or musical keyboard. When first attempted, performance is slow, hesitant, and filled with error, but with practice speed increases, variability decreases, and execution becomes increasingly effortless. What once demanded considerable attention can now be performed rapidly and accurately with little or no awareness of the component actions.
Conscious attention is not required to initiate an autonomous sequence. Mere exposure to the triggering stimulus is sufficient, and once initiated the action has a ballistic quality – tending to run on to completion all by itself.
For example, when driving, a red light is sufficient to elicit a sequence of events that I control, but the control is outside of my awareness. Cognitive resources are not required of me to begin and then guide the complex sequence of behaviors that brings the vehicle safely and smoothly to a stop.
Rapid, accurate, effortless performance that makes no demands on valuable conscious resources has obvious advantages. The problem occurs when you want to change a behavior that has become autonomous. For example, an experienced driver would take longer to learn to reliably stop at a green light than he originally took to learn to stop at a red light. Until the new habit is acquired, the driver must pay attention in order to over-ride the well practiced behavior of driving through a green light.
Stephen Tiffany1, whose views have been paraphrased in the preceding paragraphs, suggests that after considerable practice, addictive behavior becomes autonomous. Autonomous behavior can be over-ridden, but it requires conscious attention to do so.The karma of repeatedly following the path to substance use is that this path becomes autonomous. As a result, whenever conscious resources are occupied by a demanding social situation, powerful emotional state, or diminished due to fatigue or intoxication, one tends to follow this default path.
An absent-minded relapse occurs when mindful processing, which is necessary to interrupt the autonomous sequence, is not invoked when needed. This may occur when a person was simply not conscious of the original commitment until the relapse sequence was already well under way. Less dramatic, but quite common, the person was more or less aware of the unfolding of the sequence of events leading to the lapse, and was also fully aware of the previous intention to remain abstinent, yet simply failed to dedicate the conscious effort required to interrupt the autonomous behavior chain.
The decision to quit using the rewarding substance sets up a conflict. On one side there is the autonomous behavior that leads to immediate gratification. Against this is pitted the person’s rational decision to move in a different direction – one that the rational mind concludes is more advantageous for the self. The conflict plays out in real time, and resolves in either success or failure [success is better].
The purpose of these pages is to promote success in escaping the addictive trap by providing a summary of biological, psychological and social factors that pertain to addiction and its resolution. Bear in mind that addiction is such a potent and deceptive foe that intellectual appreciation is not sufficient. The procedural knowledge required to intentionally guide your actions during real time crises cannot be acquired by reading alone. Each person must develop this competence through personal experience.
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Wow, this brought me back to when H relapsed only days out of detox. He said he didn't even remember finding the bottle and twisting off the cap was simply habit. He had no idea why he did it or why he brought the cup full of rum to bed with him that night.
In DD's dance, they call it muscle memory, when you dance without hearing the music anymore, your body just knows what it should be doing when. I think that first relapse is addict memory.
So it also stands to reason that not using will become the new muscle memory, which makes complete sense to me, even though at the beginning it is a very conscious thing.
In DD's dance, they call it muscle memory, when you dance without hearing the music anymore, your body just knows what it should be doing when. I think that first relapse is addict memory.
So it also stands to reason that not using will become the new muscle memory, which makes complete sense to me, even though at the beginning it is a very conscious thing.
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Its also helpful in terms of our own behavior, like trying to let our walls down, communicate differently. Its like muscle memory, good one! I think my FIL also uses the term plasticity of the brain? I will have to think if Ive got that straight, but we can learn and change. It takes time and effort but most of us can do it.
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Blue thank you for this very helpful article. Wow it certainly explains a lot! I can recall in my own experience this strange phenomenon. How it felt like I was on autopilot just a few weeks ago when I relapsed on cigarettes. I think this explains a lot of the relapses that occur very early in recovery. Interesting how there are even terms for this...."muscle memory, plasticity of the brain".
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