Hello everyone, I was talking to a fellow poster from MWO over the phone about the relapse process and what I learned from my last therapist in detox, things I've never heard in my numerous past therapy and psychiatry sessions and detoxes and rehabs. I am posting a synopsis of what I learned here in the hopes that it can be helpful to others.
The relapse process goes through four distinct stages that can happen over weeks, days or just milliseconds (as was the case that started my last binge). Those are:
Trigger --> thoughts --> craving --> use, in that order.
To use my last binge as an example, it started when someone had inadvertently left some wine in the back of my car after a camping trip. I was the guinea pig in the group therapy session and we dissected the process in detail. I argued that I did not have the time to have gone through this process; that it was a snap decision. But in fact, I had gone through these four stages:
1. I saw the wine (trigger).
2. I may have thought things like, "What a nice surprise," or "I can't let this go to waste," (thoughts).
3. Craving
4. I drank the wine (use).
Just because it happened in milliseconds doesn't mean that I did not go through each of these four stages. What is critical though, is that the thoughts are stopped before "phenomenon of craving," as it's called in AA's Big Book, kicks in. Because "thoughts" are still psychological. But if those thoughts are allowed to continue, they will eventually trigger the phenomenon of craving, which is no longer psychological, but rather biological. You "need" to drink, just like you need eat a meal when you are hungry. Once (in our case, alcohol), hits the brain, the brain starts releasing dopamine, reinforcing the reward pathway in the brain and we feel a sense of satisfaction in much the same as we do after eating a satisfying meal or having satisfying sexual intercourse, just to use two examples.
What is critical then, is employing thought-stopping techniques before biological craving has a chance to kick in. Some ones I have used with success are (these are taken in handouts from the therapist):
1. Visualization - picturing a lever or switch in your mind and imagining yourself moving it from on to off to stop the alcohol thoughts. Have another mental picture ready to think about in place of those thoughts. You may need to change what you are doing to make this switch.
2. Snapping (I use this a lot) - wear a rubber band loosely on the wrist. Each time you become aware of alcohol thoughts, snap the band and force yourself to think about another subject. Have a subject that is meaningful and interesting to you.
3. Relaxation/grounding - inhale deeply and exhale slowly three times. Clear your mind and do your best to be present in the moment. Feel and experience the surface you are sitting on, the smells around you. If you do this with your eyes open, take in your surroundings in detail. Be completely objective and do not let judgment creep into these thoughts. Instead of thinking, "that chair over there is dirty," just think, "there's a chair over there." Mentally describe an everyday activity in great detail like preparing a meal. Say a soothing phrase to yourself (the AA Serenity prayer works for me). The possibilities are endless.
4. Talking (this is the best and most effective for me) - CALL SOMEONE! There is a reason they pass around a piece of paper for phone lists whenever there is a newcomer at an AA meeting. Or better yet, actually GO to a meeting. And as they say, come early and stay late. Talk to people. Make friends. I would probably be dead if it weren't for these people and I'm not exaggerating.
The relapse process goes through four distinct stages that can happen over weeks, days or just milliseconds (as was the case that started my last binge). Those are:
Trigger --> thoughts --> craving --> use, in that order.
To use my last binge as an example, it started when someone had inadvertently left some wine in the back of my car after a camping trip. I was the guinea pig in the group therapy session and we dissected the process in detail. I argued that I did not have the time to have gone through this process; that it was a snap decision. But in fact, I had gone through these four stages:
1. I saw the wine (trigger).
2. I may have thought things like, "What a nice surprise," or "I can't let this go to waste," (thoughts).
3. Craving
4. I drank the wine (use).
Just because it happened in milliseconds doesn't mean that I did not go through each of these four stages. What is critical though, is that the thoughts are stopped before "phenomenon of craving," as it's called in AA's Big Book, kicks in. Because "thoughts" are still psychological. But if those thoughts are allowed to continue, they will eventually trigger the phenomenon of craving, which is no longer psychological, but rather biological. You "need" to drink, just like you need eat a meal when you are hungry. Once (in our case, alcohol), hits the brain, the brain starts releasing dopamine, reinforcing the reward pathway in the brain and we feel a sense of satisfaction in much the same as we do after eating a satisfying meal or having satisfying sexual intercourse, just to use two examples.
What is critical then, is employing thought-stopping techniques before biological craving has a chance to kick in. Some ones I have used with success are (these are taken in handouts from the therapist):
1. Visualization - picturing a lever or switch in your mind and imagining yourself moving it from on to off to stop the alcohol thoughts. Have another mental picture ready to think about in place of those thoughts. You may need to change what you are doing to make this switch.
2. Snapping (I use this a lot) - wear a rubber band loosely on the wrist. Each time you become aware of alcohol thoughts, snap the band and force yourself to think about another subject. Have a subject that is meaningful and interesting to you.
3. Relaxation/grounding - inhale deeply and exhale slowly three times. Clear your mind and do your best to be present in the moment. Feel and experience the surface you are sitting on, the smells around you. If you do this with your eyes open, take in your surroundings in detail. Be completely objective and do not let judgment creep into these thoughts. Instead of thinking, "that chair over there is dirty," just think, "there's a chair over there." Mentally describe an everyday activity in great detail like preparing a meal. Say a soothing phrase to yourself (the AA Serenity prayer works for me). The possibilities are endless.
4. Talking (this is the best and most effective for me) - CALL SOMEONE! There is a reason they pass around a piece of paper for phone lists whenever there is a newcomer at an AA meeting. Or better yet, actually GO to a meeting. And as they say, come early and stay late. Talk to people. Make friends. I would probably be dead if it weren't for these people and I'm not exaggerating.
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