Question: why do addicts relapse?
It’s a question that’s been asked countless times by everyone who has experienced or been around addiction. Most reputable studies have put the relapse rate for substance use disorders at between 40-60%. While the number may seem high, particularly to those entering treatment and the people close to them, they are actually comparable to rates of relapse for virtually any chronic disease, from asthma to hypertension. But addiction is different, because it is a problem which insidiously attacks both the body and the mind, and the factors driving relapse are often psychological, rather than physiological.
Let’s take a quick survey of the information and theories available on why addicts relapse…
The Myth Of Willpower
Willpower was often cited in the past as the reason why alcoholics and addicts suffered. They simply lacked the self-control to manage their use of substances, and all they needed was a nice big serving of cold turkey. But as our understanding of addiction and the mechanisms behind it became more sophisticated, we learned that this is largely untrue.
Thousands of sufferers who are highly intelligent and well-disciplined in other areas of their lives have flushed stashes down the toilet, made solemn vows to the people they love, and navigated withdrawal symptoms only to fall right back down after a period of days, weeks, or months. It’s a fundamental tenet of 12 Step programs that addicts are powerless over addiction, and need help from both a Higher Power and their peers in order to overcome it.
One study from the University of Illinois found an intriguing paradox which lets us know why willpower isn’t the answer. Researchers used a variety of puzzles and commitments (solving anagrams, starting exercise programs, etc.) and made one group begin with setting the intention “I will [accomplish the task]”, while the other started with the question “Will I [accomplish the task]?”
The results showed that the group who began with the question were more “goal-directed”, motivated, and successful than those who declared their intention. In the experiment where subjects undertook to exercise regularly, those primed with the question stated motivations like “Because I wanted to take more responsibility for my own health.” People primed with a declaration had responses like “Because I would feel guilty or ashamed of myself if I did not.”
The researchers have concluded that “Put in terms of addiction recovery and self-improvement in general, those who were asserting their willpower were in effect closing their minds and narrowing their view of their future. Those who were questioning and wondering were open-minded—and therefore willing to see new possibilities.”
The Problem Of Pain
It has long been speculated that the difference between casual substance use and addiction is the presence or absence of emotional or physical pain. The prevalence of dual diagnosis issues and trauma among the addicted certainly seems to validate this theory. If alcohol or drugs alleviate severe symptoms of psychic or physical distress, dependence on substances is far more likely.
Dr. Gabor Mate, one of our favourite thinkers addressing addiction, notes that he focuses not on the substance of abuse, or length of addiction, but begins by asking the addicted what their addictive focus offers them. As he writes: “universally the answers are: ‘It helped me escape emotional pain… it helped me deal with stress… gave me peace of mind… a sense of connection with others… a sense of control.’”
These responses led him to the theory that addiction is a natural human response to pain, whether in the form of anxiety, trauma, depression, or shame. He also notes that the parts of the brain which trigger and respond to addictive stimuli are the same regardless of whether the addictive focus is drug use, alcohol, shopping, gambling, or television. And the emotional responses, self-deceits, and loss of control are the same across all forms of addiction.
If you accept Mate’s reasoning, relapse is so prevalent because of a mistaken focus in treatment. The addiction is simply a symptom of the pain, and dealing with substance abuse while neglecting its underlying cause leads to a cycle of suffering which blames the patient for the failure of inadequate treatment. According to him, not all traumatized people are addicts, but all addicts are the victims of trauma, and until the trauma is addressed, healing isn’t possible.
The Dangers Of Relapse And How To Break Free
Relapse can be more dangerous than garden variety drug abuse, because users often go back to the dose they had been using at the height of their addiction. But as their bodies have adapted to sober life, their tolerance is dramatically lower and their nervous systems are under a greater strain. Furthermore, a relapse following an extended period of sobriety can lead the addicted into a greater sense of shame and hopelessness, which can compound addictive and self-destructive behaviour.
One of the best ways to prevent relapse is to explore your triggers and learn how to cope with them. People, places, stressors, and moods are the most common triggers, and by acknowledging them, avoiding them, and developing strategies for dealing with them when they’re unavoidable is highly recommended.
Another key is creating and following through on an aftercare program which meets your needs. Peer-support, therapy, nutrition, exercise, and activities that promote mindfulness (think yoga, meditation, and journaling) are all powerful tools which can help you heal both body and mind as you begin your sober life. If you’ve struggled with relapse after undergoing traditional addiction rehabilitation, it might be time to explore alternatives like Naikan therapy, ibogaine treatment, or ayahuasca, which have proven beneficial for many who have found that their addictions were resistant to treatment. If you need help, get in touch with Tabula Rasa Retreat today for a free one-on-one counseling session!
For further information visit www.tabularasaretreat.com or call PT +351 965 751 649 UK +44 7961 355 530