The Relapse Episode

Announcer: Welcome to Addiction and the Family, “Episode 8: The Relapse Episode.”

Casey Arrillaga: How has addiction affected your family?

Female Speaker: It robbed me of my father.

Female Speaker: Addiction's affected my family in absolutely every way.

Male Speaker: It has caused a lot of turmoil.

Female Speaker: It goes back to what I understand is at least three generations.

Female Speaker: It robbed my daughter of her mother. It robbed my mother of her daughter.

Female Speaker: Addiction has made our family quite challenging.

Male Speaker: Addiction has affected my family tremendously.

Male Speaker: It's affected my relationship with my sister where I wouldn't – I'd go for months without talking to her. It's a very difficult thing for everybody involved. It doesn't just affect the one individual. It's a disease that affects the whole family.

Male Speaker: Addiction is spread not only genetically through some of my relatives and I assume ancestors.

Female Speaker: It's generational.

Female Speaker: I think of him every day.

Casey Arrillaga: Welcome to Addiction in the Family, a podcast by and for family members of anyone with an addiction. My name is Casey Arrillaga, and I'm a social worker and addiction counselor at both Windmill Wellness Ranch and InMindOut Emotional Wellness Centers in Texas. I've led hundreds of family workshops, but I've also lived the experience of being family to addiction as both a child and adult. My wife, Kira, and I were in our addictions together for over a decade and now have been in recovery together for almost 20 years. Join us as we offer experience, strength, and realistic hope about how you and your family can find recovery together.

Kira Arrillaga: Hi, this is Kira. In this episode, Casey and I will be discussing relapse, not just the addict’s relapse but the family members’ relapse as well. We’ll talk about what relapse is, how it happens, and what you as a family member can and cannot do about it, including how to prepare for it. As always, we’ll get some experience, strength, and hope from the perspective of people with addiction and also some family members who have dealt with relapse. All this and more after a quick word from one of our sponsors.

[Commercial]

In the previous episode, we talked about the stages of change, pre-contemplation, contemplation, preparation or planning, action, and maintenance. This episode is devoted entirely to the sixth stage of change, which is relapse. We refer to relapse as the optional stage because it isn’t universal. Some people get to the maintenance stage and never go back. Relapse is the return to a state of lesser health after a period of higher functioning. It happens so often around addiction that some consider it a normal part of the recovery process. Others say this is defeatist thinking that gives people an excuse to use again. However you view it, relapse is a possibility that everyone must face. Relapse rates for addiction are about the same as other chronic health conditions, such as diabetes or asthma, but addiction relapse is often judged as a moral failure rather than a medical issue.

Casey Arrillaga: It is too often seen as a betrayal rather than as an unfortunate event that requires additional care. When I struggled to maintain sobriety early in my journey, the people around me sometimes reacted with tears or shook their heads. More often, they showed compassion but I judged my own relapse as harshly, disappointed in myself and fearful that I would never achieve lasting sobriety. As a result, I sometimes looked down on others who relapsed. I bought into the idea that they didn’t want it enough. It took a while for me to realize that they, like me, are on a long journey of recovery with an uncertain destination. It took even longer to see that we were all suffering from a brain condition we would never have chosen that many said conditions involved relapse. I don’t know if I would have relapsed more, less, or the same number of times with a more compassionate attitude, but I feel certain that there would have been less anguish and distress for everyone involved if we had had a better understanding of addiction and relapse.

To help move towards that kind of understanding, let’s hear the voices of some people with addiction and some family members about what relapse has been like for them. What is your experience around relapse, in yourself or other people you know?

Male Speaker: I’ve been fortunate enough to maybe get close to it when I’ve stopped doing what works for me but when I actually do my recovery plan, whether it’s 12 steps or whatever I’m working on, I haven’t had a relapse yet. When I actively do the stuff, it works. I don’t understand it. It doesn’t make any sense logically to me, and I’m a logical person, but it works. I’ve gone through some crazy things in recovery that I don’t know if I didn’t have what I have today would have been able to get through those things, breakups, hardships, people passing away, people relapsing, job changes, housing changes, all that stuff.

Female Speaker: It’s sad for the families, for yourself. You feel worthless. You feel defeated, hopeless. I have people that are addicts in my family.

Casey Arrillaga: How do you get through it if somebody else that you know is struggling with that?

Female Speaker: That’s hard because you have to let them hit rock bottom. You start to try to help them before, you’re enabling them instead of helping them. That’s from experience. I had to hit rock bottom before I would accept help.

Female Speaker: I have found that I do really well when I have a purpose, and when things go quiet for me or I don’t have a career or things of that nature, I tend to relapse.

Casey Arrillaga: Have you had any experience with other people that you know relapsing?

Female Speaker: Quite a few, I feel the same thing, not having a purpose. I think that really helps people out. People tend to relapse over relationships, job, and all those things are going to become a part of our lives, it’s just [06:58].

Male Speaker: I would say relapse is an excellent tool in the hands of someone that has been educated about the true nature of his condition, which is that he has a disease and it’s not to beat himself up but to propel himself to move forward as a learning experience. As opposed to someone who does not know who he is and relapses, they will be doomed to a continuous cycle of relapses not knowing the problem of why they relapsed in the first place. Me, myself, I come from a 12-step background. I was educated in 12 steps. I understood 12 steps academically. I understood the physical allergy. Once I started drinking, it was down the river. I understood the mental obsession that I didn’t have the power to stop it. I understood the spiritual malady. There are underlying issues that cause me to drink in the first place. Did I really believe it? I understood the 12-step work. I stopped doing the work. I found myself in the middle of a relapse trying to figure out how I got there. Being a drug addict, I relapsed on Smirnoff Ice. It tumbled quickly into crack cocaine within a matter of hours. My plan was just to drink some Smirnoff Ice. Being educated in the program and knowing things about myself and trusting the people around me, I called and told on myself and the [08:25] AA actually came and scooped me up. We like to say the same people who were there for my graduation, the same people who were there for my accomplishments were the exact same people who were there for my worst moments, my relapse.

Male Speaker: I have relapsed many times. Basically, I got sober with the steps. I guess my main obstacle was always step one. After two, three months, I forgot how unmanageable my life was. I forgot the DWUIs. I forgot the passing out. I forgot the wreckage that it caused my family. Over 20 years of drinking, I’ve had periods of sobriety, but for some reason, after five months, six months, I always relapsed. It’s, again, because I forgot the damage that drinking did to me.

Male Speaker: As far as close friends of mine, relapse, it’s one of those things where, at first, I wanted to save everybody. I realized very soon in this whole deal that I can’t save everybody and that all I can be is supportive and walk on the backend. I love this quote that I heard, we don’t shoot our wounded. If a sponsee relapses or if a friend relapses or anyone that’s close to me relapses, all I can really do is just be there for them when they’re ready to come back in. I’ve tried enforcing my will and my suggestions and my techniques on others and it never works out very well. In fact, that has built resentment because my expectations are never met. I’m one of those hands-off guys where you’re either going to do what works for you or you’re not and it’s not up to me whether you do it or not. It’s up to you and it’s up to the bigger plan, your higher power, God, whatever.

Female Speaker: Personally, I’ve been affected by relapse through a family member experiencing that and how it affected our family and just seeing the emotional toll that it takes on oneself and others around them with not managing finances properly and stealing and things of that nature that affected the family household. It was very frustrating. I felt a sense of betrayal and a sense of frustration of why they just couldn’t get it together for the sake of the family and for himself. Now that I reflect back on it, I realize the effects of addiction. When I was a teenager, I just didn’t realize what was going on completely. I just saw the effects of the consequences of addiction around me. Now I have a greater sense of the disease of the addiction.

Female Speaker: I’ve always had a really deep admiration for the addict or alcoholic who does relapse or is a chronic relapser and comes back into these rooms time and time again because the strength that it took to come in once not knowing anything, it felt so intense and it felt like I didn’t have it. I didn’t realize how strong I was until after the fact and did some reflecting. I can’t imagine the strength that it would take and knowing how I carry shame and guilt and how I’m afraid of judgment, even though I’ve been on the other side. I’ve seen people come back in and I have nothing for respect and love for them. I’ve always just imagined that it would take a lot to bring me back into these rooms. I don’t know what that means exactly. I don’t know if it means that it would take a lot of misery because I think our kind can handle a lot of misery and pain. I don’t know if it means that it would take a lot of prayer to come back in.

As far as relapse goes, I’m thankful that it’s not a part of my direct story, at least as far as it’s been written, but that the chronic relapser is somebody who just they keep trying. They’re a chronic relapser because they keep trying and that’s what I try and focus on when I come into contact with somebody who gets a couple months or even a couple years at a time and then goes back out. One of my best friends has been a chronic relapse for quite a while. I hear the misery in his voice right before he comes back in and then you hear the hope that he has and just keeps trying. I met him four years ago. He just got 60 days a couple weeks ago. It’s definitely not his first 60 days but I don’t plan on ever losing the hope. I don’t know what it’s like to be directly related to somebody who has been doing this for my whole life and this is all I’ve seen and I hear the empty promises, but I’m hopeful when I hear the hope in his voice. I don’t know. To all the chronic relapsers, if you’re ashamed or if you’re disappointed or if you’re embarrassed or down on yourself, I’ll be on your side.

Casey Arrillaga: When we come back, we’re going to see what it looks like when family members relapse into their old behavior and what you can and cannot do if you think your loved one is heading for a relapse in their addiction. All that and more after a quick break to hear from one of our sponsors.

[Commercial]

Welcome back. We’re going to look now at how relapse is something that doesn’t just happen for the person with the addiction but can also happen for the family members around them.

Kira Arrillaga: Those who love someone with an addiction must be aware of the possibility of relapse in themselves as well. In other words, family members are just as prone to a return to less functional behaviors as the person with addiction, even if they’ve been doing well for some time. Let’s take a moment to consider what a relapse in your attitudes and behaviors would look like.

Casey Arrillaga: We know it may be different to think about relapse as something that happens to a family member and not just something that occurs in people with addictions. Perhaps it’ll be helpful to take a field trip. Ready? We’re going to go visit the County Pharmacy. Welcome to County Pharmacy. What can I help you with today?

Kira Arrillaga: I’m looking for a magic pill for my husband. He won’t admit it but I think he has relapse.

Casey Arrillaga: Relapse, huh? Have you tried rescuing him from the natural consequences of his actions?

Kira Arrillaga: Yes.

Casey Arrillaga: Have you tried setting boundaries and then let yourself get talked out of them?

Kira Arrillaga: Yes.

Casey Arrillaga: How about forcing solutions?

Kira Arrillaga: Yes.

Casey Arrillaga: Have you given up your own selfcare for him even though he doesn’t want you to?

Kira Arrillaga: Yes, I’ve tried everything.

Casey Arrillaga: Ma’am, I’m sorry to have to tell you this but I think you may have caught relapse from your husband.

Kira Arrillaga: What? I didn’t realize it was contagious.

Casey Arrillaga: It can be. In fact, sometimes a family member can get relapse just by thinking their loved one has it, even if it turns out they’re fine.

Kira Arrillaga: What can I do? How do I find out for sure if he has it?

Casey Arrillaga: Let’s take care of you first. You can’t help anyone else if you aren’t well. Have you tried going to an Al Anon meeting?

Kira Arrillaga: No.

Casey Arrillaga: A Families Anonymous meeting?

Kira Arrillaga: No.

Casey Arrillaga: A Codependents Anonymous meeting?

Kira Arrillaga: No.

Casey Arrillaga: How about SMART Recovery family and friends?

Kira Arrillaga: What? No, I haven’t gone to any meetings. I’m too busy trying to make sure everyone else is okay.

Casey Arrillaga: Have you been on an airplane?

Kira Arrillaga: Yes, but I don’t see how that’s relevant.

Casey Arrillaga: What do they say to do if the air pressure starts to drop?

Together: You put on your oxygen mask first.

Kira Arrillaga: Thanks, this was much more helpful than I could have imagined.

Casey Arrillaga: In AA, it’s been said that drinking is the last thing that happens in a person’s relapse pattern. This means that there’s often a period in which other emotions added to then behavior start to show up in a progression that leads to the relapse. As a family member, this applies just as much to you and your own relapse behaviors.

Kira Arrillaga: Let’s look at an example. As a family member, my relapse behavior might be to lose my temper and say things I regret. Before I get to this point, I will likely feel, think, and do things that lead me to angry acting out behaviors. It could all start with me feeling fear when my loved one goes out without telling me where they will be. At first, I decide that I’ll try to be supportive by burying the fear and pretending that I have all the faith in the world in my loved one. I don’t see that I’m being dishonest by pretending to feel better than I really do and I start to feel grumpy that nobody notices that I’m not doing well. I tell myself that if my loved one would behave properly then I wouldn’t have to feel this way. I start asking them leading questions to find reassurance they’re working on their recovery. They tell me that they’re doing fine but I don’t believe them. I get more agitated. I try even harder to get them to do or say what I want, telling myself it’s for their own good. This starts to grate on them, and pretty soon, they do or say something that reminds me too much of how they acted in active addiction.

Finally, I blow up, which is my own relapse behavior. It feels like my anger came out of nowhere and I’m confused afterwards at how things turned bad so quickly. How to avoid all that? In fact, there are several points at which I can interrupt my process and avoid relapse in the future. When I feel the initial fear, I can acknowledge that this is a natural reaction and then journal about it talk to someone in my recovery fellowship or pray about it. I could remember that I can’t control my loved one’s reactions so it’s okay to kindly tell them that I’m having trouble trusting them. I might remind myself that other people can’t read my mind so if I want acknowledgment of something, I have to speak up about it. If I choose to do this, I can remember that they may not give me the reaction I want. I don’t have to be upset about this because they are no more responsible for my feelings than I am for theirs. If I don’t like what I’m hearing, I can work on my own acceptance rather than pushing harder to get what I want out of them. When I start to tell myself it’s for their own good, I might do better to remember that I am not their higher power and I don’t always know what is best for them. If I still blow up after all my best efforts, I can go back and examine what I missed in my own thinking and behavior so that I can learn and grow from the experience. You may notice that none of these things requires my loved one to change their behavior. My relapse is not really about them. Getting them to change is not the solution.

Casey Arrillaga: If you see yourself in this example, or if you can think of what your own relapse might look like, it may help you have compassion and patience for yourself and your loved one. This is especially helpful if they struggle to stay sober. Feeling fear and upset when someone close to you stumbles is understandable. I want to encourage you to seek extra support and double down on your own recovery if this happens. It may help to understand that if your loved one relapses, it doesn’t mean they never wanted sobriety in the first place or that they will never get it. In fact, many people do not get sober on the first try. I certainly didn’t. I had to go back and touch the stove a few more times to see if it was still hot.

Kira Arrillaga: Was it?

Casey Arrillaga: It was, every time, and I’m sure it still is. Each time, I learned something. If nothing else, I saw that I’m not as self-sufficient as I thought. This was initially scary because I had taken on a belief as a toddler that I had to look out for myself and that even the most loving and well-intentioned people in my life couldn’t be trusted to keep me safe. Therefore, the idea of accepting help was scary and I tempted to try and do everything on my own. Even though I was showing up at recovery fellowship meeting every week, I didn’t do all the things I was told to do and I certainly didn’t look for the mentorship that was suggested. I thought I would be a shiny example of recovery by doing it my way. Instead, I became a shiny example of how not to stay continuously sober.

With each relapse, I became more willing until I was so willing that I did everything suggested in my program of recovery and I’ve been sober ever since. I learned some valuable lessons through relapse. Each time I got back up from scraping my knees, I learned that I never have to give up on my recovery. I learned greater compassion for others who are struggling. I learned that my life long stubbornness and perseverance, which kept my addiction going for a long time, could also be applied to my recovery. I learned that others will not automatically abandon me if I admit my struggles. I learned that surrendering to the recovery process does not mean giving up. Perhaps the most important lesson that I learned is that accepting help and following direction can be safe. Without my relapses, I might have never seen these things and thus would have missed out on seeing myself as I do today.

Next, we’ll tackle the questions family members most often ask me about relapse. What can I do if I see my loved one heading for relapse? What can I do if I suspect or even know it’s already happened? If you believe you see your loved one heading for relapse, you’re well advised to look at what kind of groundwork, if any, has been set out ahead of time. If you and your addicted loved one have agreed on boundaries around relapse and what your place in this is, then it’s time to put these plans into action. For instance, if you’ve all decided that you are to keep your loved one accountable and point out any signs of potential relapse, then now is the time to let your voice be heard. This can be done diplomatically and kindly. I like to think that any truth can be spoken with love and compassion but it must be done. If you find you’re not greeted with the thankful reception you had hoped for, well, it may be time to reexamine the boundaries or your comfort level with your role.

Perhaps, on the other hand, you and your loved one have agreed that only some signs are to be pointed out and others can be ignored, then you might want to make sure that what you see is something upon which you all agreed to speak about. If you’re like most families, though, nothing was discussed and agreed upon ahead of time. This means that your options are more limited. At best, you can ask if they are open to your observations and then respect whatever answer they give. You can offer to give them help, such as counseling, but once the offer is made, you have done what you can. Reminding them of the offer over and over becomes an attempt to control them and stands a better chance of driving a wedge between you than it does of helping them. Keep in mind that it is never your responsibility to make sure that they stay sober, even if you want it to be. While this may seem frustrating or scary, you have no power to make or break someone else’s recovery. You can, however, set clear boundaries regarding what happens if they relapse.

If you’re sure that they’re headed for disaster and they don’t seem to want your input or help, then there are still a few things you can do. First and foremost, you can prepare yourself as best you can in the same way that people prepare themselves when they get warning that a hurricane is heading their way. Lock down items that may be lost or damaged, both literally and metaphorically. Know where you will turn for support and start reaching out before things get bad. Work on your recovery with all the energy you want to see your loved one devote to theirs. Double down on any parts of your life that may help you relieve anxiety. Note that relieving anxiety is not the same thing as masking it or just distracting yourself from it. For instance, working 60+ hours a week is likely only distracting whereas engaging in selfcare and counseling are more likely to actually reduce the anxiety. All of these suggestions apply as much or more if they actually relapse. Once again, you can offer help. In this case depending on the severity of the relapse, you can offer to get them treatment. If you think this is something you’re willing to do, then it’s a good idea to familiarize yourself with different options. Armed with this knowledge, you might see what’s available in your area and even some places that are farther away that might be a better fit.

As you can imagine, these decisions are harder to make in the middle of a crisis so doing some exploration before your loved one relapses can pay dividend if they slip in the recovery. Think of this like taking out an insurance policy. You hope you never need it, but if you do, you’re sure glad you made the investment. Whether or not you decide to get involved in their treatment, if they relapse, then it is time to keep boundaries. If you didn’t set any before the relapse, it’s vital to formulate them now, make them clear, and stick to them. This can be done lovingly but firmly. No matter how they are expressed, they can make a big difference in how well your relationship to your loved one and the rest of the family will weather the relapse.

Even if they struggle more because of the boundaries or get angry because you’re keeping them, you’re setting a foundation upon which the relationship can grow later. At the very least, if you keep your boundaries during the relapse, you’ll be keeping yourself and the people closest to you safe during the storm. This is also the time to invest even more heavily in selfcare. Rather than put all the focus on your loved one and the ups and down of their relapse, take some of that energy and put it into making sure you are as good as you can be in difficult circumstances. Your loved one may not want your help or they may not want the type of help you’re willing to offer. There is one person, however, that you can get to safety and who you can help grow, you. Not only will this contribute to your wellbeing, it will help the rest of the family since family functioning can be improved as any family member is doing better. Additionally, it may model selfcare for other family members.

Finally, it may signal to the person struggling with relapse that their addiction does not run in the family dynamic. This can help them reduce guilt and shame which gives them better odds of pulling back out and it can take away any power or attention that they might be trying to grab if they have a penchant for being self-destructive to skew the family dynamic. If you are able to take some of these suggestions and implement them in your life, then relapse can be transformed from a seeming disaster into opportunity and inspiration for growth and change in your life and perhaps that of the people you love who are struggling with addiction.

One of the other concerns I hear around relapse has to do with the expression relapse is a part of recovery. Is this true? Does it have to be? Let’s hear from people in recovery from addiction as well as family members about what they think. Some people say relapse is a part of recovery. What’s your reflection on that?

Male Speaker: I mean, personally, is relapse a part of recovery? No, it doesn’t have to be, but it can be a part of your journey. It can be instrumental. It’s twisted. I get happy when people relapse, not in seeing their life crumbled but in knowing that on the other side of that relapse could be an even better recovery.

Female Speaker: I would hope that it doesn’t have to be, but I guess in a sense, I personally have not met anybody who has not tried to quit on their own. Now that I work at 12-step program, I haven’t met anybody who was also in the 12-step program that didn’t give it a good college try beforehand, so if that constitutes relapse, then I guess so. Other than that, in the traditional sense, I don’t think relapse always has to be a part of the story.

Female Speaker: I think it doesn’t need to be part of recovery. Yes, it happens but there’s also people that went to treatment and they’ve been clean and sober for 15 years. If you think about other things that people can relapse on, maybe not their drug of choice, maybe it’s sex and love, maybe there’s more relapses than we probably know about because we always concentrate on just what their drug of no choice is, you know what I mean?

Male Speaker: What SMART says is relapse does not have to be part of recovery but SMART Recovery says relapse will happen with some people. What SMART Recovery does is it gives the tools to get right back into sobriety. Yeah, it’s a setback, but SMART Recovery doesn’t view it as the end of the world. It views it as a little bump in the road. The SMART Recovery student has to get right back on their way again and gives the tools to do that but I want to stress it doesn’t promote relapse. It just says it might happen and here are the tools to deal with it.

Female Speaker: Personally, I don’t think so but then I haven’t relapsed so I don’t know. I know I have a sister that has relapsed a lot. She believes that because relapse is part of recovery. I guess until I experience it, I don’t know.

Casey Arrillaga: Sometimes people say relapse is part of recovery. I wonder if you have any reflection on that idea.

Female Speaker: I would agree with that. It’s not a linear process of recovery and relapse could be a factor in that recovery process.

Casey Arrillaga: Is there anything you want to say to other family members around that idea?

Female Speaker: To be patient, continue to be loving, and just be kind to yourself as well during that process.

Male Speaker: People always say a lot of times that relapse is a part of recovery but I don’t necessarily believe that to be totally true either. I don’t think relapse has to be a part of recovery. I think if you really put your recovery first and make it your priority and realize how progressive this disease is, that means your recovery needs to be progressive as well. That’s how I look at my recovery today. I need to keep growing. I can’t have what I had yesterday. I need to keep working on it. My sponsor wants to say it’s three simple things you have to do, trust God, clean [31:17] others.

Casey Arrillaga: As you can hear, relapse is clearly a real possibility that everyone acknowledges but few want to claim as part of the process. This is understandable since there is concern that someone in recovery might take this as their excuse to touch that stove again. Instead, it seems wisest to know it is possible and be ready if it happens but always keep your eyes on the prize of recovery, whether you’re someone with addiction or someone who loves them.

With that, we move towards closing another episode of Addiction and the Family. In this episode, we learned about relapse, what it is and what it isn’t, how to be aware of relapse as a family member of someone with addiction, and what you can and can’t do if faced with it in someone you love. Thanks for joining us.

Thanks for being with us through another episode of Addiction and the Family. As they say in many recovery meetings, take what you liked and leave the rest. Go out and explore the possibilities for recovery in your life and give your loved ones the space and dignity to make their own choices.

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