Breaking away from maladaptive behaviors can be difficult. There is usually at some initial discomfort followed by a period of adjustment. The extent of negative symptoms during the adjustment period will vary in intensity depending on the nature of the maladaptive behavior. In the case of alcohol or drug addiction the process can be a significant challenge. Those people who find that their current behavior is causing them pain become willing to break away from them. They decide that the discomfort of making changes in their life will be worth it because of the rewards of doing so. This is how people do manage to break away from bad habits. It is all too common though, for the individual to make a significant effort to change their life only to return to the maladaptive behavior later on – this is referred to as recidivism.
Recidivism can be defined a tendency to relapse into a previous condition or mode of behavior. It usually refers to a return to maladaptive behaviors following a period of abstinence from such behaviors. This word is often used when referring to criminal activity where it can mean repeated relapse into criminal or delinquent behavior. It can also be used to refer to those individuals who return to alcohol or drug abuse after a period of sobriety.
There are many potential causes of recidivism following rehab including:
* The individual was not serious about changing their life. They may have entered rehab in order to please other people or get themselves out of trouble.
* The person was not adequately prepared for the transition from rehab to home. The move from a protected environment to familiar temptations can be overwhelming if the individual is not ready for it.
* Some people leave rehab with the idea that their work is done, and that their success is now guaranteed. Their failure to appreciate that the real work only begins after rehab means that they do not make it through early recovery.
* If people continue to have contact with their drinking or drug using peers they can be tempted back into substance abuse.
* Those individuals who do not have adequate support following rehab are most at risk of relapse. The level of support required does vary from person to person, but most people will need at least some type of support network.
* When people become sober they will suddenly have a great deal of free time on their hands. Boredom is a common relapse trigger and this will arise unless people find meaningful ways to make use of their free time.
* A significant number of substance abusers have a dual diagnosis – this means that they are dealing with another mental health problem alongside their addiction. Until this other issue is dealt with the individual will be unable to find comfort in recovery and so their risk of relapse will be high.
* Those people who do not make use of any type of aftercare following rehab are the most likely to return to substance abuse.
* Those individuals who have unrealistically high expectations for early recovery are likely to become disappointed, and this may give them a justification to return to substance abuse. This is because it takes time and effort to build a successful recovery.
* The early months of recovery are full of changes and challenges. The individual has to be willing to face these if they are to succeed.
* If people in recovery engage in new maladaptive behaviors it will increase their risk of relapse. Those who become caught up in workaholism or exercise addiction are trying to avoid dealing with their real issues, and this approach will later backfire on them.
Relapse following rehab is far more than just a wasted opportunity. The dangers of a return to addiction include:
* Some people only manage one shot at rehab, and they never again become willing to try recovery. If they lose this opportunity they might not have another one.
* The individual who relapses following rehab may try to push the blame onto the program rather than their own actions (or lack of action). The addict can then use their negative experience as justification for never making another attempt at recovery.
* Cravings can continue to occur even years after the person has stopped the substance abuse. If the person is not prepared to deal with these occasional temptations they may be undone by them.
* The misery of addiction can feel much worse after a period of sobriety. Once the individual has tasted mental freedom it can be hard for them to adjust to the limitations of chronic substance abuse.
* The return to addiction will usually be a disappointment for family and friends. They may lose all trust in the addict because of it.
* The addict themselves will often feel full of regret and disappointment. They may try to console themselves by using increasing amounts of alcohol or drugs.
* A relapse can have the effect of lowering self efficacy – this is the individual’s believe in their ability to do something. If the person has a reduced self efficacy in relation to recovery it will be harder for them to stop next time.
* A return to addiction will often damage the person’s self esteem. They may begin to think that they are a hopeless case or that they deserve the life of the addict.
* In order to enter recovery the individual will have needed to see beyond their denial. It is harder to get any relief out of alcohol and drugs once the person is aware of their predicament.
* For some people a return to alcohol or drug use will be a death sentence.
The dangers associated with recidivism following rehab are real and need to be avoided. The individual can eliminate the risk of relapse by:
* The person needs to be 100% willing to do whatever it takes to stay sober. If they possess such willingness their success is guaranteed – it is always the person’s choice to stay sober or relapse.
* The most dangerous time is the transition from rehab to home. It is vital that people are fully prepared for this transition, and they should begin preparing for it almost from day one in rehab.
* It is a fantastic achievement to make it through rehab, but the individual should not view this as their graduation day. They need to fully understand that recovery is a process and not an event.
* If people have some type of aftercare following rehab it will greatly increase their chances of staying sober. This can come in the form of recovery fellowships], therapy sessions, or just sober friends.
* In order to stay motivated the individual needs to make use of recovery resources. This has been made easier in recent years because of the internet and the availability of online recovery communities.
* It is recommended that people learn all about the relapse process and the common relapse triggers. They should also have devised a relapse prevention plan – this is often done in rehab.
* The cravings to drink or use drugs again can appear suddenly and at any time. The individual needs to be prepared for this and have contact numbers for people who will support them – these craving do not last long but they can keep returning in the early months of recovery.
* Those people who are in early recovery need to be cautious around extremes of mood because it can interfere with their ability to think rationally. Feeling too happy (pink cloud syndrome) can be almost as dangerous as feeling low.
* Boredom is a common relapse trigger and needs to be avoided when at all possible. In early recovery the individual needs to experiment with different activities to find out what they enjoy.
* Another potential danger is loneliness, and this occurs because the person will have needed to break away from their drug using or drinking friends. One of the advantages of joining a recovery fellowship is that it offers a new opportunity to build friends.
* Techniques such as mindfulness meditation can help people deal better with addiction cravings and other types of negative thinking. In order to get the most from this type of practice the individual will need to practice regularly but over time they will learn how to stop being a prisoner to their own thoughts.
* Success in recovery means staying away from all mind altering substances. When one drug of choice is removed a new one can quickly take its place – even if this was a drug that the individual never had any problems with previously.
* The individual needs to be careful of falling into new maladaptive behaviors such as exercise, internet, sex, or work addiction.
* The better the life the person makes for themselves in recovery the less they are likely to relapse. The individual owes it to themselves to build the best life they can.
* The person has to be prepared to face bad days in recovery. These are part of being alive and nobody gets a free ride in life.
* A beginner’s mind is a great asset in sobriety. It means that the person is able to continuously learn and experience new things.
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