Someone who has been through treatment but continues to relapse

Someone who has been through treatment but continues to relapseIn a perfect world, everyone would do the right thing, follow the rules and help each other and live happily ever after. However, life is often challenging and people rarely do things the way you think they should. Though relapse is not a given, it happens so often that it should be addressed. You’ve given your loved one all the help and support you can think of, but he still continues to drink (or use drugs – I refer to both with the term “using” here) and you’re at your wits end. You don’t want to send Johnny packing (although that is an option…) because you could never live with yourself if he died on the street, but it seems obvious to you the treatment route’s gone bust. You’ve invested what seems like years of your time and it’s made no difference whatsoever. If this doesn’t end somewhere,  you’re the one who’s going to commit suicide!  What do you do with someone who has been through treatment but continues to relapse?

Hang in There

Try not to give up. That’s easy for someone else to say, but you know it’s pretty hard to do. When your home life is constantly disrupted – even when Johnny is living somewhere else – dealing with his dysfunction has sapped both your energy and empathy. But continued relapses don’t have to be game over. If you can understand how it is for your sister battling diabetes, than perhaps you can open your mind to remember that Johnny is battling a disease that may be even more debilitating – and fatal if left untreated. Somewhere underneath all that denial and rationalization, beneath the lies and meltdowns, is a really sick individual. Plus, most people don’t even recognize addiction as a bona fide illness! Frustration is inevitable, so if giving up isn’t the answer, what is?Read more:

First thing to recognize is that when there is an alcoholic (or addict) in your life, by nature, the whole family gets drawn into the craziness. Therefore, if normalcy or peace is to be achieved, the family needs treatment, too. Just like for the alcoholic, there are options to explore for yourself. These run the gamut from inpatient and outpatient treatments to outside groups like Al-Anon or Codependent’s Anonymous, or even some church outreach groups. Knowledge is power.

Since everyone gets sucked into the addiction vortex, learning how to duck the wind and stay out of it is key to your happiness, and that might be the added help it takes to convince Johnny that his future is pretty much nil unless he can do more than skirt the surface of his recovery. Enabling masks itself as ‘helping.’ Your intent may be honorable, but allowing Johnny to keep doing what he has been and still survive – albeit with the disapproval he continually shrugs off – why would he try to do thing’s differently? I mention enabling first because it can be a great obstacle to your loved one’s continued sobriety. Addicts never change until the consequences they experience become worse than the fears and work it takes to recover.


The Real Issue

So with that out of the way, let’s look at some of the other issues at play. The first thing to look at is whether Johnny really wants to be sober. He could be doing the minimal that’s required to get whomever off his back for awhile so he can go on his merry way. He could be planning his first binge during the last days of his treatment, while saying all the right things to you and his counselor. If there are no consequences attached to his lifestyle,why would he give up his safety blanket? And the substance of choice for the addict is his do-all end-all resource.

Johnny’s been in the bubble of his high for so long that his problem solving, work and social skills are no longer of any importance. Using is his answer to everything. He’s lost sight of the values most of us hold. He’s emotionally a perpetual child. He may even feel there’s no hope for himself and instead fluctuates from wallowing in self pity to congratulating himself for being so non-conformingly cool. Everyone else may know that Johnny has a problem, but does he? Maybe he’s just going through the motions because he knows what everyone wants him to do. If you do identify a willingness problem, you may want to start to think of raising his consequences and holding him more accountable. When he’s released from his rehab, set some rules and insist he be responsible for his own recovery.

Tell him what the deal breakers are and hold your bottom line. He’s used to what he considers the easier, softer way. Make him do for himself and resist the urge to do for him. If you inform yourself, then you will know what he should be doing. You may also learn what symptoms to look for if relapse is coming and be able to head it off before it happens. Some common relapse symptoms include:
  • Lying, making excuses, or being vague about things
  • Blaming others for whatever it is
  • Becoming irresponsible and breaking rules
  • Isolating and becoming lax about responsibilities, appearance, or attending meetings
  • Romancing the “good old days” of his addiction, maybe renewing old, unhealthy relationships
  • Entertaining the notion he is ‘fine’ and doesn’t need to maintain his recovery
  • Going back to his old haunts and attitudes
  • Living in denial about his addiction, making excuses or even choosing another substance to soothe the ‘rough’ spots
If you recognize any or all of these behaviors, your antennae should go up. Relapse is pending if it hasn’t already happened. Remind him of the consequences you have set in place, what you know about addiction, and encourage him to step it up. If he doesn’t have a sober mentor or sponsor, remind him he needs one. Ask others in your own support group what they have done when faced with a loved one’s relapse. Make your bottom line concrete. Don’t let anything soften your resolve. Throw out those rose colored glasses and look honestly at what’s before you. Johnny may be so darn clever and engaging that you want to see it his way, but his way may ultimately kill him! You want to believe he’s his old self again, before this huge battle, but just as a pickle will never again be a cucumber, Johnny will never be who he was before his addiction. Resist the urge to harangue or berate – you’ve been that route before and it’s been of little value.

It’s hard to remember one is sick when he’s on your last nerve, but venting your anger will only give him that added “reason” he needs to crawl back into his misery. Besides, enticing works much better than trying to force, unless that’s your last option. Detachment is the key for you, action is key for him. Be understanding, but be firm. Old, entrenched coping mechanisms take years to change, both his and yours. Find out what works and scrap all that wishful thinking.

Don’t Give Up

Frustration may lead you to believe that it’s just hopeless, but it really isn’t. It may take many, many treatments and relapses before the light bulb goes off. Or before the addict is just too tired to fight the inevitable. There’s no magic formula or time line to sobriety. The disease of alcoholism (or addiction) is progressive. Maybe the eighth treatment center didn’t do the trick, but now that Johnny’s getting the shakes every morning or he’s facing that third D.W.I. it’s become a whole new ballgame.

Maybe going on blind faith that where Mabel sent her daughter for her crack addiction should work for Johnny was an unfortunate misconception. Finding the right type of treatment can be crucial. Johnny may have completely different issues than Mabel’s daughter. Consult a professional – there may be something important that hasn’t been addressed before Johnny can gain the upper hand or break his denial. Sometimes depression or another type of undiagnosed mental health issue may be the stumbling block. If identifying obstacles or getting clean were easy, no one would even need treatment centers!

If you’re in a position to, watch for relapse triggers. Generally relapse occurs in those early months of abstinence, but the addict is at risk anytime, so why take chances? Has Johnny grown negative or has he unrealistic expectations? Sometimes people feel so good in the very beginning of sobriety that they want to make up for all that lost time and fix everything at once. Realistically, that would be tough for anyone since that mountain of dysfunction can only be dismantled a bit at a time. Going to work, to the gym, to meetings and to his sponsor’s once a week, while quitting smoking, learning to eat more healthily and repainting the whole house is obviously a lot to chew on at once, even if our brain chemicals weren’t misfiring and adjusting!

If you see this happening, you may want to remind your addict to concentrate on creating a good foundation for his continued sobriety. Think of the flight attendant explaining the oxygen mask – if you don’t put it on yourself first, then you and your child will both perish. The addict’s program is his ‘oxygen mask.’ If he doesn’t care for himself first, everything will go by the wayside. Encourage him to take ‘baby steps’ rather than tackling everything at once. Maybe you can help with the diet or caution Johnny when you see he’s going off in six different directions. Remind him he can paint the house in the spring. If it’s a choice between the gym and his recovery, encourage the latter. It’s often suggested that the addict should not make any major changes or start a new relationship in that first year of so. He may feel like he’s ready to conquer the world at two months, than at four feel so mired under his responsibilities that he can’t think straight. That would certainly not be the best time to get divorced or quit a job.

And encourage the new, healthy behaviors while helping him stay positive. Congratulate him on new milestones. Find out what his program is about and be part of new, sober social activities. Don’t keep that bottle in the pantry that he says is reinforcing how strong he has become. When his mind remembers all the fun he had, remind him of the times he was feeling distraught and hopeless so he may also remember that his addiction was not so fun after all.

Realize neither you nor he has all the answers, so reinforce his probable instructions to recognize when he needs help and then ask for it. If a relapse should happen, stress how important it is to get right back to his sober routine. Remember that though you may love him, you’re not the recovery professional, so this is something you can’t fix. Leave that for those in the know then offer your support instead. Above all, don’t give up and don’t give in. His life may depend on it!

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