This week’s guest blog is written by Sean Leadem, MSW, CSAT, CMAT, Leadem Counseling Services, Toms River, NJ
Shawn is a Licensed Clinical Social Worker in New Jersey and Virginia with a Master’s Degree in Social Work from Radford University. Through his specialized training by Dr. Patrick Carnes, Shawn has received his certification as a Sexual Addiction Therapist and a Multiple Addictions Therapist by the International Institute for Trauma & Addiction Professionals. Shawn is a contributing author to the publication An Ounce of Prevention: A Course in Relapse Prevention and Co-Director of the Relapse Prevention Intensive. His lifelong exposure to the “recovery culture” and his personal recovery experience has left him with a deep personal empathy for the social and emotional suffering endured by others and a strong faith in a person’s ability to change.
This article is the first in a series focusing on relapse prevention tools. More relapse prevention tools will be featured in an upcoming publication entitled: Ounce of Prevention: A Relapse Prevention Guide. The publication’s approach to identifying and intervening on personal relapse triggers or self-defeating behaviors will help you develop a plan for preventing relapse and enhancing the quality of your recovery. The publication challenges the traditional notion that relapse is an event, and advocates relapse is a process and clearly highlights the roadside warnings that can caution you about the slippery slope you may be on.
Relapse is identified by the phases we experience prior to sliding down the slippery slope into the murky pond with a deep dark bottom. One of the many strategies for intervening on the phases of relapse is learning to identify the first phase in the relapse process : Emotional Discomfort.
To introduce this phase called Emotional Discomfort, I begin by referring to an old 12 Step saying. It goes something like this,
“If you want to know what ‘the drug’ will do to you, keep ‘using it’ and you will find out. If you want to know what it is doing for you, you need to stop ‘using it’.”
The first part of the saying is self-explanatory; it isreferring to the consequences one will pay because of their unbridled addiction. The second part of the saying makes reference to the fact that one’s “drug of choice” will be used to numb some emotional pain that will resurface when abstinence is secured. It is the wisdom of this saying that helps to show the reason for using mood-altering drugs is to, alter one’s mood.
Some form of emotional discomfort is in every recovering addict; however, emotional discomfort appears differently in different people. One of the ways in which emotional discomfort can be identified is in “negative self-talk”. Negative self-talk is negative internal dialogue we use to view the world, explain situations and communicate to ourselves that focuses our attention on what we believe to be wrong with us or wrong with our life. Negative self-talk is a challenge for many of us.
Whether you are new to recovery or have struggled with relapse, it is likely that you have experienced “negative self talk” and consider it a challenge or defect of character. If you have indulged in negative self-talk, you undoubtedly understand the power it has to diminish hope, evaporate self-esteem, and threaten your resolve to remain sober. Negative self-talk can be quite seductive. When we begin embracing statements such as “I have nothing to offer in this relationship” or “people will always disappoint you”, the seductive power of this negative dialogue takes over. Where does it come from? Negative self-talk comes from the comfort or the “familiarity” it brings to you and from the illusion of “protection” this talk may offer you (e.g. to protect you from hurt or abandonment). While most will agree negative self-talk lacks logic or reason, we find ourselves self-degrading before others get a chance to do so, as if it is going to be a protective shield! Does negative self-talk insulate us from criticism or rejection? So why, if it makes no sense, if it does not protect us from rejection, or does not feel good, why do we use it?
Clinical experience suggests that much of the data for negative self-talk is acquired during our youth when we are the most impressionable and egocentric. Egocentrism, defined as regarding one’s self as being at the center of all things, is a normal part of childhood development. It is normal for a child to view the world and the adults as somehow being related to them. A child is likely to internalize the pain or chaos that is happening around them and would think – “what is wrong with me?” or “what did I do wrong?”
If being impressionable and egocentric are parts of a child’s development why do the messages still hold such power in a recovering adult’s life today? When one becomes dependent on mood altering drugs or experiences, they stunt their development and rob themselves of the opportunity to address the original messages they received and resolve these messages as an adult. Additionally, the older the messages are, the more power they tend to have and as a result, they are more difficult to change. Therefore, it is important to act quickly when the negative self-talk begins or risk succumbing to the seduction it has to offer.
This tool, What’s Your Proof?, is designed to address the seductive elements of negative self-talk. This tool will help you recognize that the people who might have contributed to your library of negative self-talk, were hurt people and that you were a victim of their pain, you suffered from collateral damage from their dysfunction – you were not the cause of it.This tool is broken down into five sections.
1. In the first section, you are asked to identify one negative self-talk phrase or perception that is currently causing you injury.
2. Second, identify the “author” (e.g. caretaker, sibling, neighbor) you learned this perception from and/or who in your life would likely have agreed with the perception (e.g. caretaker, siblings, co-workers).
3. In the third section, you are asked to come up with the proof to support the “author’s” perception.
4. In the fourth and final section, you are asked to examine the author’s story and look into their lives and discover what would have hurt them so badly as to cause them to project onto you, this negative attribute.
5. Lastly, ask, “What’s your proof that ___________?
If you are having difficulty completing this exercise or find that is bringing up great emotional pain, please seek out professional help and allow them to guide you through it. Once you have completed this exercise we encourage you to bring it to your support group, including your sponsor for feedback and encouragement.
Written by:
Sean Leadem, MSW, CSAT, CMAT
Leadem Counseling & Consulting Services, PC
http://www.leademcounseling.com/
Corporate Headquarters
668 Commons Way, Bldg. I –
Toms River, NJ 08755
732-797-1444 | Email: leadom@comcast.net
And
Leadem Counseling & Consulting Services
NCADD of Middlesex County, Inc.
152 Tices Lane
East Brunswick, NJ 08816
Phone Number: 732-307-7387
Email: lccs@leademcounseling.com
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Listen to Melissa's 
Negative self talk is such a bad and fruitless habit. Fruitless for the healthy part of myself – fruitFUL for the addict lurking in the dark corners of my mind- hoping to trip me and trap me. From discussions with other people in recovery it is not a disability of mine alone – many of my friends suffer from this. Finding the source of the voices(s) is one thing, but developing new ways of framing self talk and self discovery are also important. I have learned to talk to myself kindly and also to kindly talk myself through difficulties. I try to be my friend. Compassion works better for me.
Thank you for your comment, as you said and I agree, negative self talk is not disability of addicts alone – when those ‘old tapes’ start running in our heads…watch out! The slippery slope is on the horizon….I see you do yoga. What do you tell your clients to do to ‘rid’ themselves of the negative talk?
Kyczy Hawk, thanks for the comment. I agree that compassion works and I find when it is joined by serenity and humility the combination can be quite powerful and healing. However, my experience has shown me that individuals who are beginning down the road towards relapse and have begun to re-experience negative self-talk already do not seem to be able to sustainably hold onto the compassion necessary to relieve the obsession. The above exercise is geared towards retarding the growing momentum towards relapse by specifically targeting negative self-talk and encouraging the addicted individual to “take the unhealthy thinking to court”. This will hopefully create a window big enough for the compassion to come in as the addict again commits to turning his/her will over to a caring higher power.
Shawn:
I am glad you are on line in these comments. Your post has brought up some really good thoughts and a lively discussion. I have attached one post from Shimon Frankel, which I have posted below. Please feel free to reply to Shimon directly. I too have the same question as Shimon:, when will you have the next post on “Relapse Prevention?”
Shimon Frankel
linkedin.com/in/shimonfrankel
shimonfrankel@gmail.com
71.250.194.240
Submitted on 2012/05/29 at 12:29 pm
Melissa and Shawn:
Thanks for this informative and helpful blog. I have heard it asked: If addiction was an answer, then what was the question? What a great opening question, I think, when working with relapse prevention.
Every therapeutic model I have been exposed to attempts to discover and discard the negative self messages and replace it with a positive one. Beck mite call it a “core beliefs”, Freud mite call it “Ego”, and Rogers or Maslow mite call it “self-esteem” but it all boils down to how we experience our own identity and how we respond to it. Obviously, merely knowing that relapse is no longer a viable option in response to the emotional discomfort is not enough to keep the addict from going back to the drug.
The author alludes to a more complete understanding of the relapse process. He writes “This article is the first in a series focusing on relapse prevention tools.” I would be very interested in knowing what those other tools and stages of relapse mite be. Relapse is the one roadblock for any addiction counselor which can leave both client and therapist feeling discouraged. Therefore, a working model for prevention is so so important.
I look forward to reading more about relapse prevention on this site in the future!
Thanks for this informative and helpful blog. I have heard it asked: If addiction was an answer, then what was the question? What a great opening question, I think, when working with relapse prevention.
Every therapeutic model I have been exposed to attempts to discover and discard the negative self messages and replace it with a positive one. Beck mite call it a “core beliefs”, Freud mite call it “Ego”, and Rogers or Maslow mite call it “self-esteem” but it all boils down to how we experience our own identity and how we respond to it. Obviously, merely knowing that relapse is no longer a viable option in response to the emotional discomfort is not enough to keep the addict from going back to the drug.
The author alludes to a more complete understanding of the relapse process. He writes “This article is the first in a series focusing on relapse prevention tools.” I would be very interested in knowing what those other tools and stages of relapse mite be. Relapse is the one roadblock for any addiction counselor which can leave both client and therapist feeling discouraged. Therefore, a working model for prevention is so so important.
I look forward to reading more about relapse prevention on this site in the future!
Shimon,
Very good points, especially, merely knowing that relapse is no longer a viable option in response to the emotional discomfort is not enough to keep the addict from going back to the drug. What can a therapist or coach do? I am forwarding your message to Shawn Leadem so he may give some input to your thoughts.
I am also looking forward to publishing more on Shawn ‘relapse prevention ‘eries soon!
-Melissa Killeen
First, the readings reifonrced for me that relapse is an expected part of the process. According to the Witkiewitz article there is a learning curve involved in the recovery process. Learning, as described on a curve, rather than a straight line indicates there is going to be mistakes in the process. I would approach this client with compassion. A relapse of some sort is not unexpected. I would be concerned because her behaviors are life threatening. In session, I would want to back up to the part of the story where she started thinking about using again and attempt to identify any triggers. I would look for both situational and emotional triggers. After exploring triggers, I would work on a plan to return to abstinence. The plan would include effective ways to address any identified triggers that came up. Next, the plan would evaluate the resources and strengths she has immediately available. What kind of social, spiritual, financial, and occupational support does she have? In particular I would focus on clean and sober social supports encouraging her to actively connect with safe people. Before she left I would also check in about the possibility of involving a medical doctor if necessary. It’s possible that she may have medical concerns from her usage, and she may need the support of medications in her recovery.
There are mistakes in the process. This is accurate! On page 60 of the book Alcoholics Anonymous it states:
“No one among us has been able to maintain anything like perfect adherence to these principles. We are not saints. The point is, that we are willing to grow along spiritual lines. The principles we have set down are guides to progress. We claim spiritual progress rather than spiritual perfection.”
There are ups and downs in recovery, for sure, but abstinence from the drug of choice should not be one of these. I have seen this time and again. If a recovering addict is remaining completely abstinent then they will have success at navigating the ups and the downs. They will make mistakes in the process and they will recover from those mistakes because all the while they are remaining sober from their bottom line addiction. If however, there is relapse back into “active addiction” the entire process must begin all over again. Thus, actual relapse to one’s drug of choice is really NOT an expected part of the recovery process, it is the opposite of it.
Shim:
Yes, relapse is the opposite of recovery, however, what do you say to the hundreds of researchers that have come to the conclusion (from studies done on relapse prevention), that relapse or a slip is an expected part of the recovery process? Shouldn’t coaches/therapists/counselors anticpate relapse and be prepared in their plan for the clients recovery?
Yes, the process begins all over again, but I think therapists have to be prepared for thier client’s slips. “the principles we have set down are guides to progress. We claim spiritual progress rather than spiritual perfection.”
Fabulous discussion, Mellisa. You make fantastic points. Thank you.
Agreed, as a clinician I unfortunately see relapse, and I see it often. I call it unfortunate however, because I do not believe it needs to happen. So yes, I expect to see it in my office. No, I do not think any specific client should expect to personally relapse. I believe personal progress and change occur when sobriety is maintained absolutely.