Relapse Prevention for Dual Disorders

Relapse Prevention for Dual Disorders

• 1.
  Relapse Prevention PartI Dr. Dawn-Elise Snipes PhD, LMHC, LPC, NCC
• 2.
  Objectives  Define Relapse Identify Relapse Warning Signs  Identify Strengths  Learn about how your issue developed
• 3.
  Relapse Definition  Relapseis the return to something that has been previously stopped  Relapse is multidimensional  Emotional  Mental  Physical  Social  Review your Distress vs. Happiness worksheet.  A relapse is when you start returning to any of these people, places, things, behaviors or feeling states.
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  Emotional Relapse  Inemotional relapse, your emotions and behaviors become negative and unpleasant.  You start finding it difficult to experience pleasure  What triggers your negative emotions (Anger/resentment/jealousy/guilt; anxiety/fear/stress; depression)  Things/Media  People  Places  Events
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  Emotional Relapse  Negativeemotions make us uncomfortable Identify the emotion, explore why you are feeling that way and take steps to fix the problem You can become stuck in the emotion, sometimes  Nurturing and blowing it out of proportion  Compounding it with other emotions like anger and guilt  Personalizing it  Trying to escape from it Remember that emotions are just cues like a stoplight. You feel how you feel in the moment You can choose to change or improve the next moment
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  Preventing Emotional Relapse Practice mindfulness  Increase positive experiences (real and guided imagery)  Keep a gratitude journal  Avoid personalizing something that may not be about you  Remember that…  Negative emotions are the mind’s way of telling us to get off our butts and do something—Like our car’s idiot light or hunger pangs  Dwelling on, nurturing, avoiding or hiding from negative emotions never makes anything better  You can *choose* to feel and fix, or relapse and repeat
• 7.
  Activity  List 10things that you chose to get anxious or angry about over the last week  Why did you get upset? (What was your mind telling you needed to be fixed)  Did holding on to the upsetness do any good?  What was your initial reaction, and was it helpful?  What could you do differently next time to either  Change/fix the situation (Improve the next moment)  Change how you feel about the situation (Walk the middle path)  Let it go (Radical Acceptance)
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  Mental Relapse  Inmental relapse there's a war going on in your mind.  Part of you wants to stay positive, but part of you is struggling with tolerating the distress.  The signs of mental relapse are:  Focusing on the negative  Having a pessimistic/helpless/hopeless attitude  If you had an addiction, you may also be:  Thinking about people, places, and things you used with  Glamorizing your past use  Lying to yourself and others  Justifying your behaviors  Minimizing the impact of one (drink/hit/bet etc.)  “Screw It” attitude
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  Mental Relapse  Whattypes of things trigger negative thoughts?  Things/Media  People  Places  Events  What thoughts do you have that make you feel  Angry/irritated/resentful  Guilty  Envious  Scared/Anxious/Worried/Stressed
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  Identifying Unpleasant Thoughts Lossof Control/ The Unknown Failure Isolation/ Rejection Death Angry/ Irritated /Resentful Guilty Envious/ Jealous Scared/ Anxious/ Worried/ Stressed Identify and address the thoughts that trigger the emotions related to each fear/threat
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  Preventing Mental Relapse KISS: Keep It Simple Stupid  Trying to change too many things at once can lead to failure  Often some of simplest things can have the greatest impact  Prevent and address vulnerabilities that can make you focus on negative or have a strong, negative emotional reaction  Good Orderly Direction  Your life is a road map  The destination is recovery and happiness  Before you act, think whether that keeps you on the right road, or is an unplanned detour  Maintain Head-Heart-Gut Honesty (Rational, Emotional, Wise Mind)
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  Social Relapse  Symptoms You have returned to the old people and places who co-sign on your b.s.  You have withdrawn from your social supports  You have become self-centered  You have withdrawn  What triggers your social relapse  People  Places  Things  Events
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  Preventing Social Relapse Contact your social support(s) on a daily basis for the first 3 months  Keep a business card in your wallet with the names and numbers of 3 social supports  Change your phone number (if possible) and destroy contact information for people who might trigger a relapse  Find at least one prosocial activity to do each week --- volunteer, church, go to the gym
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  Physical Relapse  Physicalrelapse is characterized by:  Fatigue  Increased anxiety  Difficulty sleeping  Neglecting physical health (sleep, exercise, nutrition, medication)  If there was also addiction… Cravings Dreams about the drug
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  Preventing Physical Relapse HALT  Hungry Nourish your body with proper nutrition Nourish your mind with activities and things that increase “happy chemicals”  Angry/Anxious Reduce chronic stress  Lonely Nurture social supports to buffer stress Be willing to ask for help  Tired Get sufficient quality sleep Address issues such as sickness and pain that prevent quality sleep
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  Review Strengths  Whatis life like when you are happy?  What is different?  What is the same?  List three ways you cope with stress.  What activities do you like to do?  What are your positive qualities and strengths?
• 17.
  Review Prior Relapses What was happening before the relapse?  What triggered the relapse?  Relapses occur when old behaviors are more rewarding or stronger than new ones.  What became more rewarding than your recovery program?  Before you relapse, what changes in  Your emotions  Your thoughts  Your behaviors  Your interactions with others?  What have you learned?
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  Relapse Prevention Planning Include time in the morning and at night to use mindfulness skills to “get grounded”  Identify and prevent or mitigate vulnerabilities each day  Avoid alone, idol time if your mind tends to wander to dark places  Incorporate positive experiences each day  Set realistic daily goals  Give yourself credit for positive accomplishments
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  Summary  Relapse triggerscan be emotional, mental, physical or social  For each trigger you identified, describe at least 1 way you can deal with it  Practice mindfulness each day can help you become aware of your personal, daily vulnerabilities for relapse  For each general category, identify 3 things you can do to continue on your journey toward happiness