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Recovery Plus 56 Feb 2016 The seven warning signs of relapse In the recovery movement, there is an adage: “Relapse may be part of my story, but it doesn’t need to be part of my recovery”. It sounds great: there are many men and women who get clean and sober and stay so without ever suffering a relapse. I do not believe for a moment that relapse needs to be part of the disease! Relapse is a process. What we examine here are the warning signs that become apparent as this process develops. This article cannot be written without mention of the work of Terry Gorski, a pioneer known for his research and contributions to this topic. In my own case as a man in long-term recovery, I am happy to report that I have never succumbed to a return to substances. Having said that, one could imagine that life has been a breeze. The reality is different. I am reminded of the Alcoholics Anonymous adage that we have been given a daily reprieve contingent on the maintenance of our spiritual condition. What has that meant to me over the years? It means that, subtly, “stinking thinking” reappears as I become disconnected. Stinking thinking means that I revert to my old ways of thinking. I revert to a state of introspection and ego protection. The people closest to me notice that something is changing, that something is going on and yet when challenged all they get back from me is the fact that “I am fine”. I learned over the years that, when this state is entered and not addressed, it becomes a matter of time before a return to use is guaranteed. If this were to happen, I would have been guilty of thinking my way out of recovery and back into active addiction. So as clinicians if we are not able to notice these subtle shifts in attitude in our client we will miss the subtle changes which left unchallenged will nearly always result in relapse. Let me tell you about a very recent case where I missed the telltale signs completely. I had been lulled into a false sense of confidence. The person was a former male intervention client who had done very well in four years of recovery. I had worked with other family members and he was the motivator in recovery coming to other family members. He attended his 12-step fellowship meetings assiduously, worked with a sponsor and sponsored other young men. So to all appearances, the man was thriving. But he relapsed. What could have gone wrong? The man was nursing a potential for untreated sex addiction which was always bubbling beneath the surface. Over spring break, with all his family away and by turning his back on his 12-step support system, he smoked a little marijuana which he had confiscated from his son some time earlier. We might ask why he had not thrown it away. Soon he was using other substances again. In hindsight, this was a classic stinking thinking act... the client was secretly keeping the weed for a rainy day, it was his secret and he was not going to share this information with anyone. The good news is that he has responded well and is back on track. How would Gorski describe what happened? “So here we are, moving along in recovery. We tip over one small domino. No big deal. But that domino hits the next, then the next. A chain reaction starts. The first dominoes are so small


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