Misconceptions about recovery and relapse

Misconceptions about what it means to be in recovery can lead to unreasonable expectations, and erroneous beliefs about relapse can be a self-fulfilling prophecy.

When we view an erroneous concept as truth, we will act as if this belief is true, and when the resulting behavior leads to a cycle of relapse, there is the danger that this mistaken belief becomes real.

The errors and myths that prevent someone who is prone to relapse from recovering can be categorized into four areas:

  1. Erroneous beliefs about the role of alcohol and drug use in recovery and relapse.
  2. Erroneous beliefs about the warning signs of relapse.
  3. Erroneous beliefs about the role of motivation in recovery.
  4. Erroneous beliefs about the effectiveness of treatment.

Many people define recovery as abstinence from alcohol and drug use, and relapse as the use of alcohol or drugs. At first glance, this might sound reasonable, but it leads to a belief that we are recovery any time we refrain from drinking or using drugs, and that we are in relapse whenever we drink an alcoholic beverage or take part in drug use. As a consequence, using alcohol or drugs becomes the primary task in recovery.

In reality, abstinence is a prerequisite for recovery; it cannot, in itself, be defined as recovery. An effective process of recovery involves the completion of a series of daily tasks that facilitate the management of acute and post-acute withdrawal, early on, as well as the correction of biological, sociological, and psychological damage
abstinence
cause by the addiction.

In short, recovery is more than simple abstinence. If we define recovery as not using, we will not be prepared for the dysfunction caused by withdrawal and other sobriety-based symptoms of addiction. Worse, these mistaken beliefs will prevent us from finding a way to deal with these symptoms.

Another harmful result of the mistaken belief that abstinence alone will lead us to recovery is that often come to believe that as long as we don't drink or use, we will be in control of ourselves and our behaviors, or that we are always in control when we are sober.

The obvious conclusion to such erroneous thinking is that the only way that we can use control is to use alcohol or drugs, and that relapse is a conscious choice that we make.

The reality is that not drinking alcohol or using drugs does not guarantee that we will always be in control of our behaviors.

It is true that not using alcohol or drugs will help to break the cycle of addiction, and help to prevent the losses of control that are caused by intoxication, but when the alcohol/drug-based symptoms are interrupted by abstinence, they are generally replaced by sobriety-based symptoms that can cause us to make bad decisions or exhibit poor judgment.

It is not unusual for someone who is practicing abstinence to become so dysfunctional in recovery that they view a return to drug or alcohol use as a positive option.

Please don't misunderstand. Abstinence from alcohol and drug use may, and probably will be necessary for recovery, but this should not be the only goal. Learning to lead a productive and meaningful life without using is the primary goal in recovery.

Another common erroneous belief is that relapse occurs spontaneously and without warning. When we accept this idea as truth, we can only view ourselves as helpless and wholly without power in the matter. This belief leads us to view relapse as something mysterious over which we are powerless. All we can do is to hope and pray that it doesn't happen to us.

In reality, there are warning signs, and if we recognize them we can exert control over the relapse process, preventing it from getting started. However, if we view relapse solely as alcohol or drug use, we will be blind to all but a few of the warning signs.

If we define relapse as alcohol or drug use, then the only warning signs we will be aware of are those that related to drinking or using drugs.

Thinking about alcohol and drug use, feeling a compulsion to use, allowing ourselves to be in situations of alcohol and drug use, and stopping recovery activities are indeed serious warning signs of impending relapse, but these signs occur late in the relapse process. By the time we become aware of these signs, there is a very real danger that we are already out of control, and may no longer be in a position to interrupt the process.

Most people in recovery are aware that relapses are common. Alcoholics Anonymous, the largest and perhaps the oldest recovery group, cites long-term recovery statistics that range from three to ten percent.

Knowing that relapse is common, people in recovery devise a number of explanations for this sad fact.

However, if we have accepted some of the preceding erroneous beliefs, we may come to believe that relapse occurs from a lack of motivation, and that effective motivation comes only after we have harmed ourselves enough to want to recover. This idea is exhibited in the often-repeated concept that we cannot recover until we have reached rock bottom. The obvious conclusion is that people who are prone to relapse need to hurt more in order to interrupt the patterns of relapse.

Of course, while it is true that many people are not sufficiently motivated to recover until they have reached rock bottom, one danger in this thinking is that permanent damage may have been done by that point. Another is that if we know that we want to do better, but are unable to do so, this belief causes us to question our sanity and leads to shame, guilt, and feelings of worthlessness.

Hitting rock bottom can be a motivating factor in people who have not yet accepted that they are addicted, and this is often because they haven't experienced consequences severe enough to be persuasive. This pattern of relapse occurs in people who are in the pre-treatment phase of recovery, and should not apply to those who are aware that they are addicted, and that they cannot safely use alcohol or drugs.

Feelings of guilt, shame, and worthlessness are not positive motivating factors, as pain simply increases the risk of relapse.

People in recovery are those who understand that they are addicted to either drugs or alcohol, and many of them work very hard at their recovery. This may include counseling, group therapy, and attendance at 12-step meetings or other self-help group activities.

Yet, we may fail to recover. Repeated relapses may lead to the erroneous belief that no form of treatment or self-help groups can work for us. This is patently false, as many relapse-prone people have eventually recovered after going back and reapplying themselves to the same recovery programs that did not seem to work for them before. Others may benefit from another program or treatment plan.

Indeed, for most, relapse is a part of recovery. Of course, it doesn't have to be that way, but it often is.

Another dangerous and erroneous belief is on the other end of the scale, which is the belief that a recovery program is one hundred percent effective for anyone who truly wants to recover, and that the major cause of relapse is the decision to cease participation in the program. When we accept this belief and consequently relapse, we are likely to assume that there is something wrong with us that make it impossible for us to recover. The conclusion, then, is that if we relapse it is because we are incapable of recovery, and that there is no point in continuing along the path that may lead to recovery.

In reality, some programs may be better than others, but there are also treatments and programs that may be quite effective for some, but not for others.

We may relapse because we have not yet attained the skills necessary to stay sober, but that doesn't mean that we are incapable of recovery. A history of relapse is not a sign that we are incapable of successful recovery. It simply means that we need to get back to work and on the path to recovery.

For some, the path itself may be defined as recovery, while others may reach a point where they no longer feel the need to attend the meetings that assisted them on their road to recovery, understanding that this may change, for them, at some point.

Don't let statistics get you down, because the statistics may include people who aren't working as hard at recovery as you are, and some who may hardly be working at all. The chances are very good that if you continue along the path to recovery, you will reach a point where you will no longer stray from it. But if you do, this doesn't mean that recovery is out of your grasp. Get back on the path.

Note: For this article, I borrowed concepts from the book, Staying Sober: A Guide for Relapse Prevention, by Terence T. Gorski and Merlene Miller.