Relapse


Slide1
(Re)lapse: people are human (obviously) and this means that most will have to try several times before they succeed. It is not reasonable to expect people to change an engrained behaviour without making mistakes. If this is true for people trying to cut back on chocolate biscuits – then how much more for people trying to change how they use cocaine
Traditional views of relapse focused on how internal cravings would trigger the use of the substance leading to an inevitable loss of control – the person would have to go the whole way; ‘one drink one drunk’ If any of the substance was taken the person would be in remission and have failed Marlatt, the pioneer of relapse prevention questioned this and drew a distinction between
  • A lapse is a blip. A simple one off.
  • The relapse is the full return to the old behaviour and may even lead to higher levels of usage than before.

Breaking the tabu

The more energy invested in not doing things coupled with the belief that that a full return to the horrors of what went before will inevitably follow on from any use can create a self fulfilling policy. This is compounded by emotions like grief, despair, pain and self disgust. ‘I have wasted all that time and energy – what’s the point? – what they all said was right – I am a hopeless addict’ etc. etc.’
Dimeff and Marlatt *list four will power factors that impact on this. These are
  • degree of commitment to the goal,
  • effort exerted toward the goal,
  • the length of time maintaining the goal, and
  • the degree of value associated with progress made to maintain the goal.
    Relapse as growth

*Preventing Relapse and Maintaining Change in Addictive Behaviors Linda A. Dimeff, G. Alan Marlatt, Clinical Psychology: Science and Practice 1998 5:4 513