To work with lapse from the perspective of the “resonance factor”
(based on a service user’s experience)
A woman has been drinking alcohol for 25 years which has become problematic in the last 15 years.
She has been to detox for 2 weeks to withdraw from the physical alcohol dependence followed by attending an abstinent day programme, where she could learn the tools to maintain an abstinent lifestyle.
She completed 12 weeks of the day programme, and lapsed just at the point when she had been informed that she had received extra funding to attend the aftercare programme. She was accepted back onto the programme after being excluded for 2 weeks. 10 weeks later she lapsed again.
After the first lapse, she came into the group room and was chirpy, humorous and engaging. This was totally out of character. She was breathalyzed and tested positive. The second occasion she was randomly tested and she tested positive. At first she denied the result of the test, but with persistent questioning she eventually owned it. The following is a summary of the group that followed the positive test.
She was adamant that she felt total remorse regarding the lapse and was angry that she drank 3 quarter bottles. She said she hated every minute of the lapse. She said she didn’t understand because she didn’t get anything out of it.
Client (C) I hated the lapse. I don’t know why I did it. I have ruined everything.
Worker (W) So you got nothing out of the binge aside from misery?
W) You said earlier on that you hated every minute of it?
C) Yes I did.
W) Can you tell me what you hated about it?
C) The remorse, the guilt, the deceitfulness and the hangover.
W) I’m not sure if I’m hearing you correctly, but everything that you’ve just stated seems to pertain to the aftermath of the drinking.
C) I’m not sure what your saying.
W) At what point did you realize that you hated the drinking. Was it after the first bottle?
C) No. After the first glass
W) How many glasses in the bottle?
W) Did you buy 3 bottles in one go?
C) No. I went back to the shop twice.
W) On the way back to the shop, did you inform yourself of how much you hated that first bottle?
W) Ok. Can you ask me how you felt when the first glass started to take effect, excluding hating it?
C) I felt free. I was on the phone to my children and friends. I felt a part of things again.
W) Correct me if I’m wrong, but what it sounds like your saying is that when the alcohol took affect, it changed the way you viewed the world.
C) Yes it did.
W) The latter view seems a lot more enjoyable than the initial view.
C) It was. I find it difficult to communicate like that when I’m sober. I felt happy, carefree and connected.
W) If that’s the case then why did you start of talking about all that you hated about the binge, but chose not to talk about the incentive of your action, which was the enjoyment you received from the binge.
C) I didn’t want to glorify it and talking like that makes me feel that’s what I’m doing.
W) I didn’t hear you glorifying it, but what I did hear from you is a greater awareness of the whole picture. The incentive, which is the enjoyment, and how it changes the way you feel, but also the other side of your drinking that rips apart your wellbeing. It’s important that if you want to get a greater understanding of yourself, then you cannot be selective with your awareness. If you look at the whole picture, it will allow you to make informed choices that will remove denial and justifications from the conversation.
The client begins to see that stating that they hated the binge and relating only to this repeatedly, they are faced with questioning what they have always done and finding that: This doesn’t make sense! They have disregarded the pleasure that motivates the drinking (or using) and therefore failed to see what they are truly pursuing.
Janus Solutions The Resonance Factor