Leading Causes of Relapse: Four Steps to Real and Lasting Recovery 

Why do people relapse?

First, it’s important to realize that relapse is not uncommon. Many people who are striving to overcome addictive behaviors have set-backs and relapses as they move toward healthier attachments and relationships. Do not allow relapse to cause you to give up.

Second, the causes of the relapse offer valuable insights into the healing process. So, it’s important to carefully examine why people relapse.

Intimacy and relationships are the most critical, contributing reason someone relapses into addictive behavior. When we ask, “What are you afraid will happen if you let go of your addiction?” The most common response is about loneliness, “I’m afraid I’ll be alone.”  What we know to be true is that the addiction is actually providing solace and comfort — a solace that offsets the fear of loneliness. The addiction itself becomes a trusted companion, and its chosen over the companionship of people and the formation of nurturing relationships.

Addictive behaviors isolate the individual as it pushes others away, and inadvertently, creates a pseudo-relationship with itself that substitutes for true connections with others. With the addiction as a companion, the addiction sufferer forgets, or never learns how, to create real relationships with friends or lovers. The bottom line for recovery is this: Successful recovery is dependent on learning how to connect authentically with one’s self and connect more deeply with others.

The first step in connecting is by helping the client uncover their “real-self,” instead of their pseudo connection with their “false self” — the one they have been showing to the world as a result of learning to hide themselves. The false self is an adaptation, a mask that’s been created — like an actor on a stage, because the client’s childhood experiences never taught them how to “authentically be,” let alone be effective in the world. The client often tells us that they feel like an impostor, imitating others in order to try and avoid rejection. For the person’s real self to unfold and emerge, they need to re-own the parts of themselves they had inadvertently discarded, parts that had been shamed or rejected early on by caregivers — such as the expression of certain emotions or particular needs the caregivers couldn’t/wouldn’t meet (for one reason or another). It’s critical that we guide our clients to integrate the biographical experiences from early development with their current, adult self, reconnecting them with the parts of self they may have abandoned (without even knowing it) in order to adapt to or cope with the demands of caregivers, adaptations that may have been utterly overwhelming when tiny.

The second step in connecting is to establish “earned secure attachment” with self and with others. When we are afraid or overwhelmed, the natural response is to turn to others for help. If those others are rejecting or punitive, we learn early on to protect ourselves from this danger. Which means, we’ll learn instead to shut down, we won’t be able to trust, and we’ll erect so-called walls around our hearts that inevitably form the structure of the “false self.”

Learning how to connect means a client must learn how to trust again and must learn how to choose people deserving of their trust. They’ll need to actually practice being open, vulnerable, and reciprocal, allowing emotional attachment without retreating. This is not easy at first as its counter-intuitive to childhood-formed adaptations. The client must also accept that others will not always be available and may not always meet their needs constantly and consistently. This is not a trust breakdown, but the reality of human nature and human relating. When this happens, the client builds their capacity to not retreat safely into old familiar habits and addictions, but to work through the perceived rejection(s) and still continue on to build the attachment.

The third step in connecting is strengthening the client’s feelings of self-acceptance, self-efficacy, and  to treating one’s self with kindness and respect. Persons struggling with addiction often had parents whose love was conditional; they expected perfectionism and modeled obsessive recrimination for mistakes and shortcomings. In these cases, the child grows into an adult filled with shame, self-hatred, and various forms of self-punishment. It is hard to accept care from others when the person despises themselves, deep down. Therefore, challenging and reversing the client’s constant barrage of negative self-statements and underlying beliefs is critical to fostering healthy connections to both self and others.

The fourth step is emotional regulation. Individuals who are impulsive or compulsive need to identify their underlying (perhaps unwanted) emotions and then learn to tolerate them without catastrophizing, reacting, suppressing or repressing. Strong emotions are considered clues to the unfinished business needed to be worked on in therapy.

All of these steps as shared above are what move our clients toward intimacy. Establishing true intimacy is the most critical process to undertake in order to to move a client out of addictive behavior and into true and sustaining recovery. Therapists are able to best facilitate this journey once the client is practicing these steps on a daily basis.

The road to recovery is one most often driven through relapse, but, there is a bright light that emerges on the other side, one that will be full of greater insights, capacities, and skills. Recovery is the road to a far healthier future and far healthier, more loving and supportive relationships.  

by Mark F. Schwartz, Sc.D
Harmony Place Monterey, Monterey, CA