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Dr. Dawn-Elise Snipes PhD, LMHC, LPC
~ Define Relapse
~ Identify Relapse Warning Signs
~ Identify Strengths
~ Learn about how your issue developed
~ Relapse is the return to something that has been previously stopped
~ Relapse is multidimensional
~ A relapse is when you start returning to any of these people, places, things, behaviors or feeling states.
Activity: Distress vs. Happiness Worksheet
In your Unhappiness
When you are Happy
~ Triggers are stimuli that set off an event.
~ Triggers can prompt positive or negative event as
~ Triggers can be
~ Temporal (Time or location)
~ In emotional relapse, your emotions and behaviors become negative and unpleasant.
~ You start finding it difficult to experience pleasure
~ What triggers your negative emotions (Anger/resentment/jealousy/guilt; anxiety/fear/stress; depression)
~ Negative emotions make us uncomfortable
~ Identify the emotion, explore why you are feeling that way and take steps to fix the problem
~ You can become stuck in the emotion, sometimes
~ Nurturing and blowing it out of proportion
~ Compounding it with other emotions like anger and guilt
~ Personalizing it
~ Trying to escape from it
~ Remember that emotions are just cues like a stoplight.
~ You feel how you feel in the moment
~ You can choose to change or improve the next moment
Preventing Emotional Relapse
~ Practice mindfulness
~ Increase positive experiences (real and guided imagery)
~ Keep a gratitude journal
~ Avoid personalizing something that may not be about you
~ Remember that…
~ Negative emotions are the mind’s way of telling us to get off our butts and do something—Like our car’s idiot light or hunger pangs
~ Dwelling on, nurturing, avoiding or hiding from negative emotions never makes anything better
~ You can *choose* to feel and fix, or relapse and repeat
~ Identify and put in place triggers for positive emotions
~ List 10 things that you chose to get anxious or angry about over the last week
~ Why did you get upset? (What was your mind telling you needed to be fixed)
~ Did holding on to the upsetness do any good?
~ What was your initial reaction, and was it helpful?
~ What could you do differently next time to either
~ Change/fix the situation (Improve the next moment)
~ Change how you feel about the situation (Walk the middle path)
~ Let it go (Radical Acceptance)
~ In mental relapse there's a war going on in your mind.
~ Part of you wants to stay positive, but part of you is struggling with tolerating the distress.
~ The signs of mental relapse are:
~ Focusing on the negative
~ Having a pessimistic/helpless/hopeless attitude
~ If you had an addiction, you may also be:
~ Thinking about people, places, and things you used with
~ Glamorizing your past use
~ Lying to yourself and others
~ Justifying your behaviors
~ Minimizing the impact of one (drink/hit/bet etc.)
~ “Screw It” attitude
~ What types of things trigger negative thoughts?
~ What thoughts do you have that make you feel
Identifying Unpleasant Thoughts
Preventing Mental Relapse
~ KISS: Keep It Simple Stupid
~ Trying to change too many things at once can lead to failure
~ Often some of simplest things can have the greatest impact
~ Prevent and address vulnerabilities that can make you focus on negative or have a strong, negative emotional reaction
~ Good Orderly Direction
~ Your life is a road map
~ The destination is recovery and happiness
~ Before you act, think whether that keeps you on the right road, or is an unplanned detour
~ Maintain Head-Heart-Gut Honesty (Rational, Emotional, Wise Mind)
Identifying Pleasant Thoughts
~ You have returned to the old people and places who co-sign on your b.s.
~ You have withdrawn from your social supports
~ You have become self-centered
~ You have withdrawn
~ What triggers your social relapse
Preventing Social Relapse
~ Contact your social support(s) on a daily basis for the first 3 months
~ Keep a business card in your wallet with the names and numbers of 3 social supports
~ Change your phone number (if possible) and destroy contact information for people who might trigger a relapse
~ Find at least one prosocial activity to do each week —volunteer, church, go to the gym
~ What triggers can you put in your environment to remind you to use these tools?
~ Physical relapse is characterized by:
~ Increased anxiety
~ Difficulty sleeping
~ Neglecting physical health (sleep, exercise, nutrition, medication)
~ If there was also addiction…
~ Dreams about the drug
Preventing Physical Relapse
~ Nourish your body with proper nutrition
~ Nourish your mind with activities and things that increase “happy chemicals”
~ Reduce chronic stress
~ Nurture social supports to buffer stress
~ Be willing to ask for help
~ Get sufficient quality sleep
~ Address issues such as sickness and pain that prevent quality sleep
~ What is life like when you are happy?
~ What is different?
~ What is the same?
~ List three ways you cope with stress.
~ What activities do you like to do?
~ What are your positive qualities and strengths?
Review Prior Relapses
~ What was happening before the relapse?
~ What triggered the relapse?
~ Relapses occur when old behaviors are more rewarding or stronger than new ones.
~ What became more rewarding than your recovery program?
~ Before you relapse, what changes in
~ Your emotions
~ Your thoughts
~ Your behaviors
~ Your interactions with others?
~ What have you learned?
Creating the Plan
~ Why do you want to change
~ What are the most common pitfalls for your relapse
~ What you can do to prevent that from happening again
~ What has worked in the past
~ Create a schedule including
~ Recovery activities
~ Reflection time
~ Positive health behaviors including nutrition, exercise, sleep
~ Nurturing positive relationships
The Forgotten Parts
~ Two main things people forget when they try to make a change plan
~ We do what we do for a reason, and any substitution MUST fulfill the same function to the same degree
~ You would not go on a diet and replace chocolate with celery
~ It is as more about living a healthier lifestyle, guided by purposeful action, than “removing” any one behavior
~ If you remove the behavior without an adequate replacement you will relapse
~ If you remove the behavior, but are still around the same PPTs, you may relapse
~ If you are immersed in positive activities, you will have less time to make the wrong choices
Tips for Increasing Motivation
~ Decisional Balance Exercises
~ Increase/Strengthen these
~ The benefits of the new behavior
~ The drawbacks to the old behavior
~ Decrease/Mitigate these
~ The benefits of the old behavior
~ The drawbacks to the new Behavior
~ Find meaning in everything…After you do any activity or read any literature, ask yourself…
~ What was in it for me?
~ What is one thing I can take away from this (even if it only that you were reminded how much you do not want to use again)
~ In our unhappiness we often forget what makes us happy, or neglect things we love.
~ All work and no play puts you at risk, even if a lot of the work is on your recovery.
~ Make a list of …
~ Things you enjoy doing (Scrabble, gardening, exercise, baking…)
~ Things you would like to do or try (hiking, cooking class, playing in a band, reading…)
~ Is there anyone you knowwith similar interests? If not, where would you find them?
~ Do at least 5 per week
Relapse Prevention Planning Highlights
~ Include time in the morning and at night to use mindfulness skills to “get grounded”
~ Identify and prevent or mitigate vulnerabilities each day
~ Avoid alone, idol time if your mind tends to wander to dark places
~ Incorporate positive experiences each day
~ Set realistic daily goals
~ Give yourself credit for positive accomplishments
~ Relapse triggers can be emotional, mental, physical or social
~ For each trigger you identified, describe at least 1 way you can deal with it
~ Practice mindfulness each day can help you become aware of your personal, daily vulnerabilities for relapse
~ For each general category, identify 3 things you can do to continue on your journey toward happiness