Lapse and Relapse

It is not difficult to find examples in our own lives of people making commitments to change and not being able to sustain them.

For example, “I must stop shopping for clothes, I just cannot afford it”, may be followed some days or weeks later by unnecessary purchases, with a rationalisation such as “It was on a sale!”

Someone who is confronted for lateness at work may then make a concerted effort to attend on time. After a couple of weeks, they will revert to being a few minutes late, with that time increasing every day.

Parents who struggle to find a good work/life balance may promise their partner and children that they will spend more time at home, usually after something has happened to highlight their absence. A notable may take place immediately, but begin to waver after a week or so and drift back to the previous pattern with a couple of weeks.

These examples are not intended to trivialise the process of lapse or relapse but merely to illustrate that these concepts apply to many areas of human behaviour, particularly when they are well established. The conclusions drawn from the behaviours listed above will rarely label the person an incurable shopaholic or workaholic, but may be approached in terms of the benefits or pleasure derived from the activity.

From this perspective a lapse or relapse into drug use can be viewed similarly: the return to something that is enjoyed.

Why would someone want to return to using after having:

• Had a significant amount of time of abstinence from substances?
• Begun to forge stronger relationships with significant others?
• Had his or her children returned to their care?
• Returned to education?
• Returned to work?

And why would someone who has just completed a six-month rehabilitation programme decide to return to using the very same day?Traditional approaches to lapse and relapse state that the drug user is an ‘addict’ and will therefore always be prone to relapse, as the addiction is a life-long condition. Other approaches might suggest that individuals struggle to cope with the overwhelming feelings arising from historical traumas and will opt to find an escape from these feelings in a substance that will do just that. Others still might say that a lack of personal and situational awareness leads to lapse and then relapse.

Perhaps the underlying reason that drug and alcohol users lapse is because they enjoyed the feelings that using brings on and they miss those feelings. Perhaps also it is convenient to believe that when they have indulged once, they may as well continue, as the drug- or alcohol-free period of time is now broken. Once under the influence of their drug of choice, the decision to abstain is also impacted. A colleague once said “once you get the taste…” The memory of that taste might therefore be the thing to manage!

Working with our Resonance Factor approach, Janus views lapse and relapse as episodes on the way to recovery. By understanding the reasons for a lapse or relapse, the client can reduce the chances of a recurrence and reaffirm their decision to abstain. In doing so, they reassert control over their own lives and become stronger for it.

How do you work with lapse and relapse? We’d like to hear from you