Cory Monteith's overdose has generated many assumptions, misconceptions and misinformed ideas about relapse throughout the Internet. Monteith had voluntarily admitted himself into rehab for substance abuse earlier this year. It is now clear from news reports that he had struggled to overcome the disease since his late teens. (Recent news from castmates). In the aftermath of this tragic lose, perhaps we can start a new conversation about relapse, and ask an expert rather than rush to judgment about what relapse is and what it is not. Hmmm, so why not ask an expert? Okay, let's.
When thinking about understanding relapse and relapse prevention, the name Terence T. Gorski is sure to come up. Gorski is a cognitive behavioral therapist who is internationally recognized for his contributions to Relapse Prevention Therapy. He has written several books on the subject, helped to popularize Post Acute Withdrawal Syndrome, or PAWS, and is the founder of CENAPS, an organization dedicated to providing advanced clinical skills training for the addiction and behavioral health fields, with a focus on relapse prevention. You can read more about him here.
MYTH: RELAPSE IS SELF-INFLICTED. False: Relapse-prone patients experience a gradual progression of symptoms that create so much pain that they become unable to function in sobriety...more on myths here
“Relapse is often misused and is defined as an act of drinking – or returning to a abhorrent behavior,” said Terence T. Gorski. “Relapse also describes a process of building and moving to the steps of altering behavior.” That’s the big lie involving relapse—relapse moves a patient forward--it is not a shame-based willful step down. Relapse is very dangerous and people die from it. However, relapse can also further identify a patient’s unique needs for long-term remission or sobriety.
Gorski began understanding relapse by studying the histories of one hundred and seventeen people in recovery in the late 1970s. His research showed consistent warning signs that formed a critical path to relapse. That discovery has lead to many other discoveries, books and a personal dedication to addiction sciences with a focus on Relapse Prevention Therapy.
“The brain is a habit forming computer—a trigger goes off and activates automatic responses. When a habit is established it never goes away,” explained Gorski. “In recovery, we work to reprogram and create other habits that act to overcome the original habit.” There is a big difference, Gorski cautioned, between someone who has a relapse and someone who is experiencing an interruption in their disease—that person has not yet experienced the changes necessary to begin to challenge the old ideas or the disease and learn to use recovery behaviors in the place of addictive habits, whereas, a relapser has done that but needs to readjust their approach.
MYTH: RELAPSE IS AN INDICATION OF TREATMENT FAILURE. False: For many patients recovery involves a series of relapse episodes as they learn overcome their illness.
In order to avoid relapse, Gorski explained that it is imperative that patients, or the newly sober, initially avoid cues that may generate addictive behaviors like going to bars or being around people or places that trigger using thoughts. However, in time most can take the cues on and desensitize or think of the triggering cues in new and safe ways. This gets practiced over and over and the patients evolve in their ability to create new habits and thought patterns. “Essentially it’s about reprogramming the brain in order to develop new behaviors that effectively turn off the addictive behaviors.”
ONCE RELAPSE OCCURS THE PATIENT WILL NOT RECOVER. False: Once patients learn effective strategies for identifying and managing relapse warning signs they can and do experience remission from alcoholism and addiction.
People suffer from other fatal and chronic illnesses and work hard to lead healthy full lives in spite of their disease, and just like them millions successfully work hard to recover from alcoholism and addiction every day. They survive and thrive in their remission and value life as much as anyone else who survives attacks on their psyche and body from a vicious disease. No one is guaranteed recovery from any disease--many do continue to try to overcome it anyway; relapse or no relapse.